bluuebunny/crossref_metadata_2025 huggingface dataset:
Protocol for process evaluation of a randomised controlled trial of family-led rehabilitation post stroke (ATTEND) in India
Authors: Liu Hueiming , Lindley Richard , Alim Mohammed , Felix Cynthia , Gandhi Dorcas B C , Verma Shweta J , Tugnawat Deepak Kumar , Syrigapu Anuradha , Ramamurthy Ramaprabhu Krishnappa , Pandian Jeyaraj D , Walker Marion , Forster Anne , Anderson Craig S , Langhorne Peter , Murthy Gudlavalleti Venkata Satyanarayana , Shamanna Bindiganavale Ramaswamy , Hackett Maree L , Maulik Pallab K , Harvey Lisa A , Jan Stephen
Published: September 2016

Introduction

We are undertaking a randomised controlled trial (fAmily led rehabiliTaTion aftEr stroke in INDia, ATTEND) evaluating training a family carer to enable maximal rehabilitation of patients with stroke-related disability; as a potentially affordable, culturally acceptable and effective intervention for use in India. A process evaluation is needed to understand how and why this complex intervention may be effective, and to capture important barriers and facilitators to its implementation. We describe the protocol for our process evaluation to encourage the development of in-process evaluation methodology and transparency in reporting.

Methods and analysis

The realist and RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) frameworks informed the design. Mixed methods include semistructured interviews with health providers, patients and their carers, analysis of quantitative process data describing fidelity and dose of intervention, observations of trial set up and implementation, and the analysis of the cost data from the patients and their families perspective and programme budgets. These qualitative and quantitative data will be analysed iteratively prior to knowing the quantitative outcomes of the trial, and then triangulated with the results from the primary outcome evaluation.

Ethics and dissemination

The process evaluation has received ethical approval for all sites in India. In low-income and middle-income countries, the available human capital can form an approach to reducing the evidence practice gap, compared with the high cost alternatives available in established market economies. This process evaluation will provide insights into how such a programme can be implemented in practice and brought to scale. Through local stakeholder engagement and dissemination of findings globally we hope to build on patient-centred, cost-effective and sustainable models of stroke rehabilitation.

Trial registration number

CTRI/2013/04/003557.
Establishing cross-discipline consensus on contraception, pregnancy and breast feeding-related educational messages and clinical practices to support women with rheumatoid arthritis: an Australian Delphi study
Authors: Briggs Andrew M , Jordan Joanne E , Ackerman Ilana N , Van Doornum Sharon
Published: September 2016

Objective

Recognising the need for a best-practice and consistent approach in providing care to women with rheumatoid arthritis (RA) in relation to (1) general health, (2) contraception, (3) conception and pregnancy, (4) breast feeding and (5) early parenting, we sought to achieve cross-discipline, clinical consensus on key messages and clinical practice behaviours in these 5 areas.

Design

3-round eDelphi study. In round 1, panellists provided free-text responses to open-ended questions about care for women with RA across the 5 areas. Subsequently, panellists refined and scored the synthesised responses, presented as metathemes, themes and detailed elements. Where ≥5% of panellists did not support a theme in a given round, it was removed.

Setting

Panel of practicing Australian rheumatologists (n=22), obstetricians/obstetric medicine physicians (n=9) and pharmacists (n=5).

Results

34 (94.4%) panellists participated in all 3 rounds. The panel supported 18 themes across the 5 areas (support/strongly support: 88.2–100%) underpinned by 5 metathemes. Metathemes focused on coordination in information delivery, the mode and timing of information delivery, evidence underpinning information, engagement of the right health professionals at the right time and a non-judgemental approach to infant feeding. Themes included practices for primary prevention of chronic disease and their sequelae, the importance of contraception and planning pregnancy and breast feeding, close monitoring of medications, supporting mental well-being, managing disease activity and providing practical support for early parenting.

Conclusions

A cross-disciplinary clinical panel highly supported key information and clinical practices in the care for women with RA across the continuum of contraception to early parenting within a whole-person, chronic disease management approach.
Epidemiology of lower respiratory infection and pneumonia in South Africa (1997–2015): a systematic review protocol
Authors: Roomaney Rifqah A , Pillay-van Wyk Victoria , Awotiwon Oluwatoyin F , Dhansay Ali , Groenewald Pam , Joubert Jané D , Nglazi Mweete D , Nicol Edward , Bradshaw Debbie
Published: September 2016

Introduction

Lower respiratory infections (LRIs) and pneumonia are among the leading causes of death worldwide, especially in children aged under 5 years, and these patterns are reflected in the South African population. Local epidemiological data for LRIs and pneumonia are required to inform the Second National Burden of Disease Study underway in South Africa. The aim of this systematic review is to identify published studies reporting the prevalence, incidence, case fatality, duration or severity of LRI and pneumonia in adults and children in South Africa.

Methods and analysis

Electronic database searches will be conducted to obtain studies reporting on the prevalence, incidence, case fatality, duration and severity of LRI and pneumonia in South Africa between January 1997 and December 2015. Studies that are assessed to have moderate or low risk of bias will be included in a meta-analysis, if appropriate. Where meta-analysis is not possible, the articles will be described narratively. Subgroup analysis (eg, age groups) will also be conducted where enough information is available.

Ethics and dissemination

This systematic review will only include published data with no linked patient-level information; thus, no ethics approval is required. The findings will be used to calculate the burden of disease attributed to LRI and pneumonia in South Africa and will highlight the type of epidemiological data available in the country. The article will be disseminated in a peer-reviewed publication.

PROSPERO registration number

CRD42016036520.
Exploring effects of presurgical weight loss among women with stage 0–II breast cancer: protocol for a randomised controlled feasibility trial
Authors: Tsuruta Yuko , Rogers Laura Q , Krontiras Helen , Grizzle William E , Frugé Andrew D , Oster Robert A , Umphrey Heidi R , Jones Lee W , Azrad Maria , Demark-Wahnefried Wendy
Published: September 2016

Introduction

Obesity is a known risk factor for postmenopausal breast cancer and is associated with poorer prognosis for premenopausal and postmenopausal patients; however, the aetiological mechanisms are unknown. Preclinical studies support weight loss via caloric restriction and increased physical activity as a possible cancer control strategy, though few clinical studies have been conducted. We undertook a feasibility trial among women recently diagnosed with stage 0–II breast cancer hypothesising that presurgical weight loss would be feasible, safe and result in favourable changes in tumour markers and circulating biomarkers.

Methods and analysis

A two-arm randomised controlled trial among 40 overweight or obese women, newly diagnosed with stage 0–II breast cancer and scheduled for surgery was planned. The attention control arm received upper body progressive resistance training and diet counselling to correct deficiencies in nutrient intake; the experimental arm received the same plus counselling on caloric restriction and aerobic exercise to achieve a weight loss of 0.68–0.919 kg/week. In addition to achieving feasibility benchmarks (accruing and retaining at least 80% of participants, and observing no serious adverse effects attributable to the intervention), we will explore the potential impact of an acute state of negative energy balance on tumour proliferation rates (Ki-67), as well as other tumour markers, serum biomarkers, gene expression, microbiome profiles and other clinical outcomes (eg, quality of life). Outcomes for the 2 study arms are compared using mixed models repeated-measures analyses.

Ethics and dissemination

Ethics approval was received from the University of Alabama at Birmingham Institutional Review Board (Protocol number F130325009). Study findings will be disseminated through peer-reviewed publications. Given that this is one of the first studies to investigate the impact of negative energy balance directly on tumour biology in humans, larger trials will be pursued if results are favourable.

Trial registration number

NCT02224807; Pre-results.
Subarachnoid haemorrhage guidelines and clinical practice: a cross-sectional study of emergency department consultants' and neurospecialists' views and risk tolerances
Authors: Lansley J , Selai C , Krishnan A S , Lobotesis K , Jäger H R
Published: September 2016

Objectives

To establish if emergency medicine and neuroscience specialist consultants have different risk tolerances for investigation of suspected spontaneous subarachnoid haemorrhage (SAH), and to establish if their risk–benefit appraisals concur with current guidelines.

Setting

4 major neuroscience centres in London.

Participants

58 consultants in emergency medicine and neuroscience specialities (neurology, neurosurgery and neuroradiology) participated in an anonymous survey.

Primary and secondary outcome measures

The primary outcome measure was the highest stated acceptable risk of missing SAH in the neurologically intact patient presenting with sudden onset headache. Secondary outcome measures included agreement with guideline recommendations, risk/benefit appraisal and required performance of diagnostic tests, including lumbar puncture.

Results

Emergency department clinicians accepted almost 3 times the risk of a missed SAH diagnosis compared with the neuroscience specialists (2.8% vs 1.1%; p=0.02), were more likely to accept a higher risk of missed diagnosis for the benefit of a non-invasive test (p=0.04) and were more likely to disagree with current published guidelines stipulating the need for LP in all CT-negative cases (p=0.001).

Conclusions

Divergence from recognised procedures for SAH investigation is often criticised and attributed to a lack of knowledge of guidelines. This study indicates that divergence from guidelines may be explained by alternative risk–benefit appraisals made by doctors with their patients. Guideline recommendations may gain wider acceptance if they accommodate the requirements of the doctors and patients using them. Further study of clinical risk tolerance may help explain patterns of diagnostic test use and other variations in healthcare delivery.
Determinants and trends in health facility-based deliveries and caesarean sections among married adolescent girls in Bangladesh
Authors: Shahabuddin A S M , Delvaux Thérèse , Utz Bettina , Bardají Azucena , De Brouwere Vincent
Published: September 2016

Objective

To identify the determinants and measure the trends in health facility-based deliveries and caesarean sections among married adolescent girls in Bangladesh.

Methods

In order to measure the trends in health facility-based deliveries and caesarean sections, Bangladesh Demographic Health Survey (BDHS) data sets were analysed (BDHS; 1993–1994, 1996–1997, 1999–2000, 2004, 2007, 2011). The BDHS 2011 data sets were analysed to identify the determinants of health facility-based deliveries and caesarean sections. A total of 2813 adolescent girls (aged 10–19 years) were included for analysis. Bivariate and multivariate analyses were performed.

Results

Health facility-based deliveries have continuously increased among adolescents in Bangladesh over the past two decades from 3% in 1993–1994 to 24.5% in 2011. Rates of population-based and facility-based caesarean sections have increased linearly among all age groups of women including adolescents. Although the country's overall (population-based) caesarean section rate among adolescents was within acceptable range (11.6%), a rate of nearly 50% health facility level caesarean sections among adolescent girls is alarming. Among adolescent girls, use of antenatal care (ANC) appeared to be the most important predictor of health facility-based delivery (OR: 4.04; 95% CI 2.73 to 5.99), whereas the wealth index appeared as the most important predictor of caesarean sections (OR: 5.7; 95% CI 2.74 to 12.1).

Conclusions

Maternal health-related interventions should be more targeted towards adolescent girls in order to encourage them to access ANC and promote health facility-based delivery. Rising trends of caesarean sections require further investigation on indication and provider–client-related determinants of these interventions among adolescent girls in Bangladesh.
Do GPs know their patients with cancer? Assessing the quality of cancer registration in Dutch primary care: a cross-sectional validation study
Authors: Sollie Annet , Roskam Jessika , Sijmons Rolf H , Numans Mattijs E , Helsper Charles W
Published: September 2016

Objectives

To assess the quality of cancer registry in primary care.

Design and setting

A cross-sectional validation study using linked data from primary care electronic health records (EHRs) and the Netherlands Cancer Registry (NCR).

Population

290 000 patients, registered with 120 general practitioners (GPs), from 50 practice centres in the Utrecht area, the Netherlands, in January 2013.

Intervention

Linking the EHRs of all patients in the Julius General Practitioners’ Network database at an individual patient level to the full NCR (∼1.7 million tumours between 1989 and 2011), to determine the proportion of matching cancer diagnoses. Full-text EHR extraction and manual analysis for non-matching diagnoses.

Main outcome measures

Proportions of matching and non-matching breast, lung, colorectal and prostate cancer diagnoses between 2007 and 2011, stratified by age category, cancer type and EHR system. Differences in year of diagnosis between the EHR and the NCR. Reasons for non-matching diagnoses.

Results

In the Primary Care EHR, 60.6% of cancer cases were registered and coded in accordance with the NCR. Of the EHR diagnoses, 48.9% were potentially false positive (not registered in the NCR). Results differed between EHR systems but not between age categories or cancer types. The year of diagnosis corresponded in 80.6% of matching coded diagnoses. Adding full-text EHR analysis improved results substantially. A national disease registry (the NCR) proved incomplete.

Conclusions

Even though GPs do know their patients with cancer, only 60.6% are coded in concordance with the NCR. Reusers of coded EHR data should be aware that 40% of cases can be missed, and almost half can be false positive. The type of EHR system influences registration quality. If full-text manual EHR analysis is used, only 10% of cases will be missed and 20% of cases found will be wrong. EHR data should only be reused with care.
Comparing group-based acceptance and commitment therapy (ACT) with enhanced usual care for adolescents with functional somatic syndromes: a study protocol for a randomised trial
Authors: Kallesøe Karen Hansen , Schröder Andreas , Wicksell Rikard K , Fink Per , Ørnbøl Eva , Rask Charlotte Ulrikka
Published: September 2016

Introduction

Functional somatic syndromes (FSS) are common in adolescents, characterised by severe disability and reduced quality of life. Behavioural treatments such as acceptance and commitment therapy (ACT) has shown promising results in children and adolescents with FSS, but has focused on specific syndromes such as functional pain. The current study will compare the efficacy of group-based ACT with that of enhanced usual care (EUC) in adolescents with a range of FSS operationalised by the unifying construct of multiorgan bodily distress syndrome (BDS).

Methods and analysis

A total of 120 adolescents aged 15–19 and diagnosed with multiorgan BDS, of at least 12 months duration, will be assessed and randomised to either: (1) EUC: a manualised consultation with a child and adolescent psychiatrist and individualised treatment plan or (2) manualised ACT-based group therapy plus EUC. The ACT programme consists of 9 modules (ie, 27 hours) and 1 follow-up meeting (3 hours). The primary outcome is physical health, assessed by an Short Form Health Survey (SF-36) aggregate score 12 months after randomisation. Secondary outcomes include self-reported symptom severity, symptom interference, depression and anxiety, illness worry, perceived stress and global improvement; as well as objective physical activity and bodily stress response measured by heart rate variability, hair cortisol and inflammatory biomarkers. Process measures are illness perception, illness-related behaviour and psychological flexibility.

Ethics and dissemination

The study is conducted in accordance with Helsinki Declaration II. Approval has been obtained from the Science Ethics Committee of the Central Denmark Region and the Danish Data Protection. The results will be sought to be published according to the CONSORT statement in peer-reviewed journals.

Discussion

This is one of the first larger randomised clinical trials evaluating the effect of a group-based intervention for adolescents with a range of severe FSS.

Trial registration number

NCT02346071; Pre-results.
Bioethics training programmes for Africa: evaluating professional and bioethics-related achievements of African trainees after a decade of Fogarty NIH investment
Authors: Kass Nancy E , Ali Joseph , Hallez Kristina , Hyder Adnan A
Published: September 2016

Objectives

Our primary aim was to evaluate the impact of US National Institutes of Health (NIH)-funded bioethics training programmes (Fogarty bioethics training programmes, FBTPs) that trained individuals from Africa over the programme's first 10 years to examine changes between pretraining and post-training in individual achievement and to document any associations between individual, training programme and post-training accomplishments.

Design

We surveyed trainees from the 10 bioethics programmes funded by NIH Fogarty International Center from 2000 to 2011 that included African trainees. McNemar's and Wilcoxon signed rank-sum tests were used to analyse pre–post levels of general and bioethics-related professional achievement. Likelihood of specific post-training achievement outcomes was measured using logistic regression including demographic, pretraining and intratraining variables.

Setting

10 different FBTPs that trained individuals from Africa from 2000 to 2011.

Participants

Of 253 eligible respondents, 171 completed the survey (response rate 67.6%).

Primary outcome measures

Pre–post comparisons of professional achievement indicators (eg, serving in leadership roles, teaching, publishing manuscripts); likelihood of specific post-training achievement outcomes.

Results

Post-training, respondents were significantly more likely to report serving in a leadership role, being an investigator on a research grant, serving on international committees, serving as a mentor, and publishing manuscripts than at pretraining. Post-training, significantly greater numbers of respondents reported bioethics-related achievements including being a bioethics instructor, serving on an Institutional Review Board (IRB), being an investigator on a bioethics grant and publishing bioethics-related manuscripts than pretraining. Controlling for other factors, there were no significant differences by gender in the post-training success of these participants in terms of leadership roles, being instructors, investigators on grants and holding IRB roles.

Conclusions

African trainees who participated in FBTPs reported significantly higher levels of professional achievement after training. There was no single factor—either demographic, related to a trainee's professional background, or in programme design—that consistently predicted greater levels of post-training achievement.
Rates and drivers of progression to pre-diabetes and diabetes mellitus among HIV-infected adults on antiretroviral therapy: a global systematic review and meta-analysis protocol
Authors: Nansseu Jobert Richie N , Bigna Jean Joel R , Kaze Arnaud D , Noubiap Jean Jacques N
Published: September 2016

Introduction

With the new ‘test and treat’ policy of the WHO, it is obvious that the number of HIV-infected patients taking antiretroviral therapy (ART) will grow exponentially, with consequential increase in the burden of diabetes mellitus (DM). Our aim is to summarise existing data on the incidence of pre-diabetes and DM, and associated risk factors among HIV-infected adults.

Methods and analysis

This systematic review will include cohort studies reporting the incidence of pre-diabetes and/or DM, and associated risk factors among HIV-infected adults on ART, with these patients being free of any impaired glucose metabolism at study baseline. We will perform electronic searches in PubMed, Excerpta Medica Database (EMBASE), Web of Science and WHO Global Health Library, supplemented with manual searches. Articles published from 1 January 2000 to 31 July 2016, in English or French languages, and without any geographical restriction will be eligible for inclusion. 3 authors will independently screen, select studies, extract data and assess the risk of bias with discrepancies resolved by consensus. We will assess clinical heterogeneity by examining the study design and setting, criteria and cut-offs used to define pre-diabetes or DM, process of calculation of incidence and outcomes in each study. We will also assess statistical heterogeneity using the χ2test of homogeneity and quantify it using the I2statistic. A random effects meta-analysis will be used to estimate the overall cumulative incidence of pre-diabetes/DM and risk factors.

Ethics and dissemination

This systematic review will use data from published studies and does not require ethics approval. Its results are expected to help putting in place action plans and preventive measures to curb the growing burden of DM in the HIV population on ART. Findings will be published in a peer-reviewed journal and presented at scientific conferences.

PROSPERO registration number

CRD42016039651.
An assessment of the accuracy of a novel weight estimation device for children
Authors: Jung Jae Yun , Kwak Young Ho , Kim Do Kyun , Suh Dongbum , Chang Ikwan , Yoon Chiyul , Lee Jung Chan , Kim Hee Chan , Choi Jae Yeon , Ahn HeeJeong
Published: September 2016

Background

We sought to validate the accuracy and assess the efficacy of a newly developed electronic weight estimation device (ie, the rolling tape) for paediatric weight estimation.

Methods

We enrolled a convenience sample of children aged <17 years presenting to our emergency department who volunteered to participate in the study. The children's heights and weights were measured, and three researchers estimated these values using the rolling tape and Broselow tape at 5 min intervals. The weight estimates of researcher 1, researcher 2 and the Broselow tape were compared with measured values, and mean percentage error (MPE), root mean square error (RMSE) and percentage of estimates within 10% of the actual measured values were calculated. For 30 randomly selected subjects, we compared the time interval from the start of the measurement to the time that orders for epinephrine, defibrillation dose and instrument size could be given in a simulated arrest scenario.

Results

We enrolled 906 children (median age 4.0 years). For researcher 1, researcher 2 and the Broselow tape, MPE values were 0.11% (RMSE 2.61 kg), 1.41% (RMSE, 2.61 kg) and 1.72% (RMSE 5.41 kg), respectively, and the percentages of children with predictions within 10% of their actual weight were 75.1%, 75.7% and 60.6%, respectively. In the 30 simulated cases, the mean time for measurement to ordering was significantly shorter (25.8 s vs 35.5 s, p<0.001) for the rolling tape compared with the Broselow tape method.

Conclusions

The rolling tape is a good weight estimation tool for children compared with other methods. The rolling tape method significantly decreased the time from weight estimation to orders for essential drug dose, instrument size and defibrillation dose for resuscitation.
The effect of timing of antibiotic delivery on infection rates related to open limb fractures: a systematic review
Authors: Whitehouse Michael R , McDaid Catriona , Kelly Michael B , Moran Christopher G , Costa Matthew L
Published: September 2016

Objective

To examine whether the timing of delivery of intravenous antibiotics following open limb fractures has an effect on deep infection rates and other outcomes.

Design

We published an a priori study protocol in PROSPERO. Our search strategy combined terms for antibiotics, timing of administration and fractures. Two independent reviewers screened, selected, assessed quality and extracted data from identified studies.

Data sources

We searched five electronic databases with no limits and performed grey literature searches.

Eligibility criteria for selecting studies

Randomised and non-randomised controlled studies, prospective and retrospective observational studies in which the effect of the timing of delivery of antibiotics on the outcome of deep infection in open fractures was considered were included.

Results

Eight studies were included according to the above criteria. There were no randomised or non-randomised controlled trials. None of the included studies provided data on patient reported or health-related quality of life. The overall deep infection rate ranged from 5% to 17.5%. All of the studies were at substantial risk of bias. One study reported a reduced infection rate with the delivery of antibiotics within 66 min of injury and seven studies reporting no effect.

Conclusions

Sufficiently robust evidence is not available currently to determine whether the timing of delivery of intravenous antibiotics has an effect on the risk of deep infection or other outcomes following open limb fractures. There is therefore a need for a randomised controlled trial in this area before policy changes should be instigated.

Trial registration number

PROSPERO (CRD42015016729).
Executive Functioning in Children with Congenital Adrenal Hyperplasia
Authors: Agoston A Monica , Gonzalez-Bolanos Maria Teresa , Semrud-Clikeman Margaret , Vanderburg Nancy , Sarafoglou Kyriakie
Published: September 2016

Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency is a disorder characterized by impaired cortisol synthesis leading to excessive production of adrenal androgens. Prenatal and postnatal exposure to excess androgens may increase neural vulnerability to insult and affect cognitive functions, particularly dopamine-dependent neural circuits responsible for executive functioning (EF). Our study aimed to investigate relationship between more pronounced androgen exposure and EF-related behaviors in children with CAH, as well as sex differences in these associations. Parents of patients with CAH (n=41, boys=17, girls=24; age: M=8.41, SD=4.43) completed the Behavior Rating Inventory of Executive Function (BRIEF), a measure assessing behavioral manifestations of EF. Assessments of bone age advancement, a proxy of cumulative androgen exposure, were analyzed. Advanced bone age predicted more inhibition difficulties in boys but not in girls, and more difficulties in all other BRIEF domains in the total sample. Excessive androgen production affected EF such that more advanced bone age led to more EF-related difficulties. Sex differences in inhibition may result from estrogen exposure moderating the impact of androgens in girls but not in boys. Future interventions may include targeting EF in patients with CAH to enhance quality of life and reduce cognitive consequences associated with this disease.
Association between Serum Cotinine Level and Prevalence of Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Study from the Third National Health and Nutrition Examination Survey
Authors: Shen Huafeng , Peng Jennifer L , Tayarachakul Sucharat , Liangpunsakul Suthat
Published: September 2016

The data on the effect of smoking on non-alcoholic fatty liver disease (NAFLD) has been controversial. The aim of this study was to investigate if an association exists between serum cotinine level (a tobacco biomarker) and NAFLD prevalence in the general US population. We conducted a cross-sectional analysis of data from the Third National Health and Nutrition Examination Survey (NHANES III). We included 11,003 adults aged 20–74 years who underwent ultrasonography. Of those, 4036 were identified as having NAFLD and 6967 were recognized as controls. The percentage of current smokers was significantly lower in subjects with NAFLD compared with those in controls (21.5% vs 26.0%, p<0.01). After adjustment for potential confounders, there was no association between current or former smokers with NAFLD. Additionally, no associations were observed between the levels of serum cotinine and NAFLD. No association between serum cotinine levels at each quartile level and NAFLD was observed regardless of smoking status. In this large US population-based study, we did not find an association between NAFLD and self-reported smoking status or measured serum cotinine level.
Proposal of a Dukes-Mac-Like Staging System for Gastric Cancer
Authors: Gurzu Simona , Sugimura Haruhiko , Orlowska Janina , Szederjesi Janos , Szentirmay Zoltan , Bara Tivadar , Bara Tivadar , Fetyko Ananmaria , Jung Ioan
Published: September 2016

The aim of this study was to present an epidemiological update regarding the classical prognostic parameters of gastric cancer (GC) in 3 countries from Eastern Europe and to suggest a modification of the pTNM staging system. In 333 consecutive cases which were diagnosed between 2003 and 2012 in 3 departments of pathology from Romania, Hungary, and Poland, the following parameters were analyzed: age and gender of patients, tumor localization, macroscopic and microscopic aspects including the degree of discohesivity, depth of tumor infiltration, and pTNM stage. From all of the studied parameters, the following proved to have independent prognostic value, indicating a lower survival rate: presence of distant metastases (p=0.001), lymph node positivity (p=0.0009), depth of tumor infiltration (p=0.04), age over 50 (p=0.02), proximally located tumors (p=0.03), and ulceroinfiltrative or diffusely infiltrative macroscopic aspect (p=0.0002). The pT2N1-3 staged cases showed a worse prognosis compared with the pT3N0 ones (p=0.02). Regardless of depth of invasion, the lymph node status remains the strongest indicator of the survival rate in GC. The pTN staging system should be adapted and a Dukes-MAC-like staging system should include the following groups: stage A1—T1N0, stage A2—T1N1-3, stage B1—T2N0, stage B2—T2N1-3, stage C1—T3N0, stage C2—T3N1-3, and stage D—T4N0-3. The grade of discohesivity/budding is not a prognostic factor in GC.
Comparison of venous sinus manometry gradients obtained while awake and under general anesthesia before venous sinus stenting
Authors: Fargen Kyle M , Spiotta Alejandro M , Hyer Madison , Lena Jonathan , Turner Raymond D , Turk Aquilla S , Chaudry Imran
Published: September 2016

Introduction

Venous sinus stenting is a popular treatment strategy for patients with high venous sinus pressure gradients across a site of outflow obstruction. Little is known about the effect of anesthesia on venous sinus pressure measurements.

Objective

To compare venous manometry performed in patients under general anesthesia and while awake.

Methods

A prospective database was accessed to retrospectively identify patients who had undergone venous sinus stenting. Pressure gradients were compared between those patients who underwent manometry while awake and before stenting under general anesthesia.

Results

Thirty patients with both general anesthesia and awake pressure recordings were identified. Pressure measurements were highly variable but overall were higher under general anesthesia by an average of 5.8 mm Hg (1.7; p=0.002). A significant difference between awake and general anesthesia pressure measurements was detected in the sigmoid sinus (5.8 mm Hg (2.0); p=0.005) and the jugular vein (8.1 mm Hg (3.9); p=0.040). Only 11/30 (36.7%) pressure gradients remained within 5 mm Hg of the original awake gradient when repeated under general anesthesia; 9/30 (30%) patients had gradients that were at least 10 mm Hg different across procedures.

Conclusions

Calculated pressure gradients were markedly affected by anesthesia. These findings suggest that candidacy for stenting should be determined with venous manometry while patients are awake owing to the unpredictable and highly variable effect of general anesthesia on pressure measurements and an apparent tendency to underestimate the degree of venous outflow obstruction.
Acupuncture as an aid to treatment of Chiari‐like malformation (CM)/syringomyelia (SM) in a Cavalier King Charles spaniel (CKCS)
Authors: O'Leary Donal Joseph
Published: September 2016

Syringomyelia associated with Chiari‐like malformation is a common inherited condition in the Cavalier King Charles spaniel (CKCS) and often leads to debilitating clinical signs. Both conventional surgical and medical intervention in veterinary medicine tries to address the pain associated with the condition. The most common symptoms associated with Chiari‐like malformation in human beings are neck pain and suboccipital headaches. The patient exhibited signs which suggested it was suffering from similar clinical signs and acupuncture was used successfully as an aid to control these clinical signs along with conventional medical treatment.
Is there a link between treatments with exogenous corticosteroids and dog behaviour problems?
Authors: Notari L. , Burman O. , Mills D. S.
Published: September 2016

Possible side effects of exogenous corticosteroids have been described in both humans and laboratory animals, with recent studies highlighting this issue in dogs. In this paper the behaviour of 345 dogs drawn from the caseload of a behaviour clinic based in the north of Italy between February 2012 and November 2014 were analysed. Possible relationships between dogs that received treatment with corticosteroids versus dogs that received treatment with drugs other than corticosteroids and positive or negative affective states, aggression towards people, other behaviour problems apart from aggression, occurrence of severe bites, and prescription of psychoactive drugs were initially assessed using a Pearson's chi‐squared test. Regression analysis was then performed in order to evaluate the best predictors of the investigated items. The goal of this retrospective survey was to investigate possible relationships between the affective states associated with the behavioural complaint of dogs and their previous history of treatment with corticosteroids. Results showed that a history of corticosteroid treatment was a significant predictor of a range of behaviour problems associated with negative affective state, but this result may be confounded by age‐related effects.
A new species ofAthrotaxites(Athrotaxoideae, Cupressaceae) from the Upper Cretaceous Raritan Formation, New Jersey, USA
Authors: Escapa Ignacio H. , Gandolfo Maria A. , Crepet William L. , Nixon Kevin C.
Published: September 2016

A new species of anatomically preserved Cupressaceae is described from the Upper Cretaceous Raritan Formation (New Jersey, USA). The fossils are charcolified isolated ovuliferous complexes that were studied by means of a combination of SEM images and micro-computed tomography (micro-CT), allowing the observation of morphological and anatomical characters. Each ovuliferous complex bears 3–4 anatropous winged seeds, disposed in one row on a thin medial part of the adaxial side of the ovuliferous complex. Based on the combination of characters such as ovuliferous complex morphology, arrangement of vascular tissues and resin canals, seed number and their morphology, orientation and disposition, these fossils are placed within a new species of the fossil genus Athrotaxites. The developmental stage of the specimens is analyzed base on comparisons with living representatives of the subfamily Athrotaxoideae (i.e., Athrotaxis spp.), which supports a post-pollination stage for these fossils. In addition, the new species is compared with other extant and extinct representatives of basal cupressaceous subfamilies. This new record from the Upper Cretaceous sediments of New Jersey further supports a wider distribution of the subfamily Athrotaxoideae during the middle part of the Mesozoic, as it has been also noted for other basal representatives of the family Cupressaceae.
A mass-deformed BLG theory in Gribov–Zwanziger framework
Authors: Upadhyay Sudhaker
Published: September 2016

In this paper, we extend the Gribov–Zwanziger framework accounting for the existence of Gribov copies to the mass deformed Bagger–Lambert–Gustavsson (BLG) theory in [Formula: see text] superspace. The restriction of the domain of integration in the Euclidean functional integral to the first Gribov horizon is implemented, by adding a nonlocal horizon term to the effective action. Furthermore, the soft breaking of the BRST symmetry due to horizon term is restored with the help of external sources. We compute the various Ward identities for this theory relying on the Lie 3-algebras.
The subpower membership problem for semigroups
Authors: Bulatov Andrei , Kozik Marcin , Mayr Peter , Steindl Markus
Published: September 2016

Fix a finite semigroup [Formula: see text] and let [Formula: see text] be tuples in a direct power [Formula: see text]. The subpower membership problem (SMP) asks whether [Formula: see text] can be generated by [Formula: see text]. If [Formula: see text] is a finite group, then there is a folklore algorithm that decides this problem in time polynomial in [Formula: see text]. For semigroups this problem always lies in PSPACE. We show that the [Formula: see text] for a full transformation semigroup on [Formula: see text] or more letters is actually PSPACE-complete, while on [Formula: see text] letters it is in P. For commutative semigroups, we provide a dichotomy result: if a commutative semigroup [Formula: see text] embeds into a direct product of a Clifford semigroup and a nilpotent semigroup, then [Formula: see text] is in P; otherwise it is NP-complete.
Numerical approximation of statistical solutions of planar, incompressible flows
Authors: Leonardi Filippo , Mishra Siddhartha , Schwab Christoph
Published: September 2016

We present a finite difference-(multi-level) Monte Carlo algorithm to efficiently compute statistical solutions of the two-dimensional incompressible Navier–Stokes equations (NSE), with periodic boundary conditions and for arbitrary high Reynolds number. We propose a reformulation of statistical solutions in the sense of Foiaş and Prodi in the vorticity-stream function form. The vorticity-stream function formulation of the NSE in two-space dimensions is discretized with a finite difference scheme. We obtain a convergence rate error estimate for this approximation which is explicit in the viscosity parameter [Formula: see text], under realistic assumptions on the solution regularity. We also prove convergence and complexity estimates, for the (multi-level) Monte Carlo finite difference algorithm to compute statistical solutions. Numerical experiments illustrating the validity of our estimates are presented. They show that the multi-level Monte Carlo algorithm can significantly accelerate the computation of statistical solutions in the sense of Foiaş and Prodi, even for very high Reynolds numbers.
Resistance-Geodesic Distance and Its Use in Image Segmentation
Authors: Gaura Jan , Sojka Eduard
Published: September 2016

Measuring the distance is an important task in many clustering and image-segmentation algorithms. The value of the distance decides whether two image points belong to a single or, respectively, to two different image segments. The Euclidean distance is used quite often. In more complicated cases, measuring the distances along the surface that is defined by the image function may be more appropriate. The geodesic distance, i.e. the shortest path in the corresponding graph, has become popular in this context. The problem is that it is determined on the basis of only one path that can be viewed as infinitely thin and that can arise accidentally as a result of imperfections in the image. Considering the k shortest paths can be regarded as an effort towards the measurement of the distance that is more reliable. The drawback remains that measuring the distance along several paths is burdened with the same problems as the original geodesic distance. Therefore, it does not guarantee significantly better results. In addition to this, the approach is computationally demanding. This paper introduces the resistance-geodesic distance with the goal to reduce the possibility of using a false accidental path for measurement. The approach can be briefly characterised in such a way that the path of a certain chosen width is sought for, which is in contrast to the geodesic distance. Firstly, the effective conductance is computed for each pair of the neighbouring nodes to determine the local width of the path that could possibly run through the arc connecting them. The width computed in this way is then used for determining the costs of arcs; the arcs whose use would lead to a small width of the final path are penalised. The usual methods for computing the shortest path in a graph are then used to compute the final distances. The corresponding theory and the experimental results are presented in this paper.
Vision-Based Vehicle and Pedestrian Tracking of Intersection Videos
Authors: Shirazi Mohammad Shokrolah , Morris Brendan Tran
Published: September 2016

Vehicle and pedestrian tracking is a key component for vision-based safety analysis which can use motion and appearance cues of road users. Since appearance-based detectors generate false alarms and provide lower speed, motion-based detectors are preferred but they work poorly when pedestrians or vehicles stop due to traffic signals. In this paper, a tracking system is proposed to track waiting and moving road users by fusion of motion and appearance cues at detection level. The enhanced optical flow tracker handles the partial occlusion problem, and it cooperates with the detection module to provide long-term tracks of vehicles and pedestrians. The system evaluation shows 13% and 43% improvement in tracking of vehicles and pedestrians respectively, and finally heat-maps show benefits of using the proposed system through the visual depiction of intersection usage.
Resolving critical degrees of entanglement in Olympic ring systems
Authors: Igram Spencer , Millett Kenneth C. , Panagiotou Eleni
Published: September 2016

Olympic systems are collections of small ring polymers whose aggregate properties are largely characterized by the extent (or absence) of topological linking in contrast with the topological entanglement arising from physical movement constraints associated with excluded volume contacts or arising from chemical bonds. First, discussed by de Gennes, they have been of interest ever since due to their particular properties and their occurrence in natural organisms, for example, as intermediates in the replication of circular DNA in the mitochondria of malignant cells or in the kinetoplast DNA networks of trypanosomes. Here, we study systems that have an intrinsic one, two, or three-dimensional character and consist of large collections of ring polymers modeled using periodic boundary conditions. We identify and discuss the evolution of the dimensional character of the large scale topological linking as a function of density. We identify the critical densities at which infinite linked subsystems, the onset of percolation, arise in the periodic boundary condition systems. These provide insight into the nature of entanglement occurring in such course grained models. This entanglement is measured using Gauss linking number, a measure well adapted to such models. We show that, with increasing density, the topological entanglement of these systems increases in complexity, dimension, and probability.
On a relation between conway polynomials of (m,n)- and (n,m)-Turk’s head links
Authors: Takemura Atsushi
Published: September 2016

The [Formula: see text]-Turk’s head link is presented by the alternating diagram which is obtained from the standard diagram of the [Formula: see text]-torus link by crossing changes. In this paper, we show that for any integers [Formula: see text] and [Formula: see text], the coefficients of [Formula: see text] in the Conway polynomials of the [Formula: see text]- and [Formula: see text]-Turk’s head links coincide for [Formula: see text] and differ by sign for [Formula: see text]. We conjecture that this property holds for any [Formula: see text].
Dynamics of modified Chaplygin gas inflation on the Brane with bulk viscous pressure
Authors: Jawad Abdul , Ilyas Amara , Rani Shamaila
Published: September 2016

We investigate the role of bulk viscous pressure on the warm inflationary modified Chaplygin gas (MCG) in braneworld framework in the presence of standard scalar field. We assume the intermediate inflationary scenario in strong dissipative regime and constructed the inflaton, potential, entropy density, slow-roll parameters, scalar and tensor power spectra, scalar spectral index and tensor-to-scalar ratio. We develop various trajectories such as [Formula: see text], [Formula: see text] and [Formula: see text] (where [Formula: see text] is the spectral index, [Formula: see text] is the running of spectral index, [Formula: see text] is the number of e-folds and [Formula: see text] is tensor-to-scalar ratio) for variable as well as constant dissipation and bulk viscous coefficients at high dissipative regime. It is interesting to remark here that our results of these parameters are compatible with recent observational data such as WMAP [Formula: see text], BICEP[Formula: see text] and Planck data.
Using cosmic strings to relate local geometry to spatial topology
Authors: Duston Christopher Levi
Published: September 2016

In this paper, we will discuss how cosmic strings can be used to bridge the gap between the local geometry of our spacetime model and the global topology. The primary tool is the theory of foliations and surfaces, and together with observational constraints, we can isolate several possibilities for the topology of the spatial section of the observable universe. This implies that the discovery of cosmic strings would not just be significant for an understanding of structure formation in the early universe, but also for the global properties of the spacetime model.