bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis and experiments on a novel smoothly moving low-DoF multilegged robot
Authors: Ruan Qiang , Yao Yan-an , Wu Jian-xu
Published: May 2019

SmooBot, a novel low-degree-of-freedom multilegged robot with a smoothly moving platform is proposed in the paper, which is aimed at helping people do the delivery jobs in the industrial site. Cam compensation mechanisms are applied to the robot so the platform keeps smoothly moving while the robot is walking. With the special design of the compensation mechanism, the height, velocity, and attitude of the platform almost keep constant. The motion input of the compensation mechanism shares the same continuous rotation with the mechanical legs and remain the compact structure. The cam mechanisms are designed based on the kinematics analysis of the mechanical legs. The walking simulations and prototype experiments are carried out to testify the theoretical analysis. Based on the simulation and experiment results, the enhancements of the compensation mechanisms in the platform smoothness and the energy efficiency are discussed. The study in the paper provides a new idea to enable a low-degree-of-freedom multilegged robot to have a smoothly moving platform and to carry heavy load at a high speed by using the cam compensation mechanisms.
Dynamic modeling and experimental validation of skid-steered wheeled vehicles with low-pressure pneumatic tires on soft terrain
Authors: Tang Shouxing , Yuan Shihua , Li Xueyuan , Zhou Junjie
Published: May 2019

Wheeled skid-steered technology has an increasing interest in its use for off-road unmanned ground vehicles, because of its great mobility and compact mechanical structure. By integrating multibody dynamics model and semi-empirical tire-terrain model, this paper presents a dynamic modeling approach for skid-steered wheeled vehicles with low-pressure pneumatic tires on soft terrain to predict and investigate its steering performance. The forward dynamics equations are built by spatial vector algebra. The tire–terrain model estimates flexible deformation and sinkage of the tire, and calculates forces and torques exerted on the tire according to relative motions of tire–terrain contact. The combined longitudinal slip and lateral skid of tires, and the vertical coupled deformations of tires and terrain are also considered in tire-terrain model. This approach optimizes the solution procedure and improves the computing efficiency. The simulation results show that the proposed tire–terrain model can predict the effects of rigid and flexible operation modes of tires on mechanical properties of tires and steering performances of the vehicle. The proposed dynamic model is validated on a six-wheeled skid-steered vehicle. The comparisons between experimental results and simulations show that the proposed dynamic model provides a better accuracy of steering performance simulation for skid-steered vehicles.
Cost of antiretroviral treatment for HIV patients in two centres of North India
Authors: Sharma Atul , Prinja Shankar , Sharma Aman , Gupta Aditi , Arora Sunil K
Published: May 2019

There is paucity of evidence on cost of antiretroviral therapy (ART) delivered through the public sector in India. Moreover, the Government of India is considering changing the criteria for introduction of ART to HIV patients, which is likely to have significant economic implications. In this paper, we assess the health system cost of ART services at two levels of health care delivery. Bottom-up costing was used to collect data on capital and recurrent resources consumed over a period of one year (April 2014–March 2015). Capital costs were annualized and shared costs apportioned to calculate annual and unit costs of providing ART care. Sensitivity analysis was undertaken to measure the extent of uncertainty in input prices. The annual per capita cost of ART therapy was INR 48,975 (USD738) in the Centre of Excellence (COE) and INR 24,954 (USD376) in the ART centre. Drugs contributed around 70% and 65% of total annual cost, followed by human resource (19% each) and capital cost (7%; 12%) in COE and ART centres, respectively. These provide a comprehensive assessment of the cost of ART care in India. The study estimates could be used for planning of services, as well as undertaking further cost-effectiveness studies.
A note on Mahalanobis and related distance measures in WinISI and The Unscrambler
Authors: Garrido-Varo A , Garcia-Olmo J , Fearn T
Published: May 2019

In identifying spectral outliers in near infrared calibration it is common to use a distance measure that is related to Mahalanobis distance. However, different software packages tend to use different variants, which lead to a translation problem if more than one package is used. Here the relationships between squared Mahalanobis distance D2, the GH distance of WinISI, and the T2 and leverage (L) statistics of The Unscrambler are established as D2 = T2 ≈ L × n ≈ GH × k, where n and k are the numbers of samples and variables, respectively, in the set of spectral data used to establish the distance measure. The implications for setting thresholds for outlier detection are discussed. On the way to this result the principal component scores from WinISI and The Unscrambler are compared. Both packages scale the scores for a component to have variances proportional to the contribution of that component to total variance, but the WinISI scores, unlike those from The Unscrambler, do not have mean zero.
Amphetamine-type-substance-related presentations to the Emergency Department Mental Health Team of a local health district in Australia
Authors: Chivaurah Bernard M , Lienert David , Coates Dominiek
Published: May 2019

Objectives:

To identify the prevalence and profile of amphetamine-type-substance-related presentations to the Emergency Department Mental Health Team of a local health district in Australia.

Methods:

Data was collected from medical records of all amphetamine-type-substance presentations to the Emergency Department Mental Health Team over a 1-year period, between 1 January 2015 and 31 December 2015.

Results:

Of all presentations referred to the Emergency Department Mental Health Team, 0.15% ( N = 189) were amphetamine-type-substance related. Of these, the majority were male, the average age was 32, 19.0% engaged in intravenous drug use, some were aggressive and 15.9% required tranquilisation. The most common presenting issues were psychosis and suicidal threats, intent and behaviour (including intentional overdose). Multiple comorbid conditions were identified. On discharge, 34.4% were admitted into a psychiatric hospital and 32.8% were referred to Community Mental health teams.

Conclusions:

Amphetamine-type-substance users suffer from multiple comorbidities and pose a significant burden on emergency services.
Mindfulness-based intervention to reduce burnout and psychological distress, and improve wellbeing in psychiatry trainees: a pilot study
Authors: Kang Matthew , Selzer Rob , Gibbs Harry , Bourke Katie , Hudaib Abdul-Rahman , Gibbs Jo
Published: May 2019

Background:

Healthcare professionals including psychiatry trainees experience high amounts of occupational stress. This pilot study aims to assess the impacts and feasibility of a mindfulness-based intervention program as an occupational intervention in a metropolitan hospital.

Method:

Psychiatry trainees participated in an mindfulness-based intervention training program consisting of 1-h weekly sessions over 8 weeks. Levels of psychological distress and mindfulness were measured pre and post-intervention. Qualitative data through an open-ended feedback survey were also collected.

Results

There was an improved level of mindfulness and a decreased level of burnout among trainees post-intervention. Advantages of the program included having a compassionate facilitator and the program being tailored to healthcare staff. Limiting factors included time restraints and clinical responsibilities.

Conclusion:

Psychiatry trainees can benefit from an occupational MBI program. This can positively impact their health as well as improve their work performance. A number of factors important for implementation of a mindfulness-based intervention program were also identified.
Planning and Implementing a Mutually Beneficial International University Partnership in Educational Leadership Between U.S. and Middle Eastern Institutions
Authors: Tekleselassie Abebayehu , Ford Angela
Published: May 2019

Responding to the forces of internationalization and globalization, universities are partnering across national borders to expand their outreach, increase capacity, expand research possibilities, and for a list of other reasons. This study looks at one international university partnership between an institution in the United States and one in the Middle East. This article examines the impetus for partnership, the steps and decisions of formation, the benefits, and challenges experienced, the lessons learned, as well as the implications and the possible paths forward. This study will provide the conceptualization and practical framework for those interested in forming international partnerships.
Evaluation of the role of pharmacy technicians in reviewing the eligibility for Oncotype DX genomic test and the impact of the test on treatment plans in breast cancer patients
Authors: Cheng Vian , Markarian Adeline , de Lemos Mario L , Schaff Kimberly
Published: May 2019

Purpose/Objectives

The Oncotype DX genomic test is a treatment decision-making tool. Test results are presented as recurrence scores which are used to help decide between adjuvant hormonal therapy (low recurrence score) or chemotherapy (high recurrence score). Since 2014, the Oncotype DX test has been funded at the cancer treatment centres in our province for patients with early breast cancer. Eligibility criteria for funding include patient and tumour characteristics. Pharmacy technicians were assigned to review and approve requests based on the eligibility criteria and with access to consultation to an oncology pharmacist and a medical oncologist. We assessed the clinical role of pharmacy technicians in this review process and the impact of recurrence score on treatment decisions.

Methods

This was a retrospective, multi-centre study to evaluate the Oncotype DX test eligibility review process from June 2014 to May 2015. The main objectives were to assess (1) the discrepancy rate of approval by the pharmacy technicians in this review process and (2) the concordance rate between the recurrence score from the Oncotype DX test and the adjuvant treatment given.

Results

Four hundred and forty requests for Oncotype DX test were received during the study period. A total of 90.8% of requests were approved and 9.2% were denied. The discrepancy rate of approval by pharmacy technicians was 1.1%. The average review time was 13.8 min, with the reviewing pharmacist and oncologist consulted in 5.5 and 15.2% of the requests, respectively. The concordance rate between the recurrence score and given treatment was 96%.

Discussion

The discrepancy rate of our pharmacy technicians appears to be similar to that reported with other expanded technician roles in literature, suggesting that the current task and other similar clinical tasks can be reliably delegated to technicians. The concordance rate of the recurrence score and given treatment in our study was higher than what has been reported in literature, suggesting that most of our patients were treated in accordance to recurrence score-based recommendations.

Conclusion

Pharmacy technicians were able to expand their clinical role by accurately reviewing the Oncotype DX test requests with a low discrepancy rate. The Oncotype DX test results appeared to successfully guide the adjuvant treatment given to patients in accordance to recurrence score-based recommendations.
Antibody response to feline herpesvirus-1 vaccination in healthy adult cats
Authors: Bergmann Michèle , Speck Stephanie , Rieger Anna , Truyen Uwe , Hartmann Katrin
Published: May 2019

Objectives

Vaccination against feline herpesvirus-1 (FHV-1) is recommended for all cats. However, it is unknown how adult healthy cats with different pre-vaccination antibodies respond to FHV-1 vaccination in the field. The aim of the study was to determine the prevalence of neutralising antibodies against FHV-1 in healthy adult cats and the response to FHV-1 vaccination within 28 days of vaccination.

Methods

One hundred and ten cats (⩾1 year of age) that had not received a vaccination within the past 12 months were vaccinated with a combined FHV-1 vaccine. Antibodies against FHV-1 were determined before vaccination (day 0), on day 7 and day 28 by serum neutralisation test. Uni- and multivariate statistical analyses were used to determine factors associated with the presence of pre-vaccination antibodies and response to vaccination.

Results

Pre-vaccination neutralising antibody titres (⩾10) were present in 40.9% of cats (45/110; 95% confidence interval [CI] 32.2–50.3); titres were generally low (range 10–640). Antibody response to vaccination (⩾four-fold titre increase) was observed in 8.3% (9/109; 95% CI 4.2–15.1). Cats ⩾2 years of age were more likely to have pre-vaccination neutralising antibodies than cats aged between 1 and 2 years (odds ratio [OR] 24.619; P = 0.005). Cats from breeders were more likely to have pre-vaccination neutralising antibodies than privately owned cats (OR 7.070; P = 0.007). Domestic shorthair cats were more likely to have an at least four-fold titre increase vs purebred cats (OR 11.22; P = 0.027).

Conclusions and relevance

Many cats have no detectable neutralising antibodies against FHV-1 despite previous vaccinations and fail to develop a ⩾four-fold titre increase after vaccination. This is likely because older cats and cats with a higher FHV-1 exposure risk are more likely to get infected with FHV-1 and thus to have FHV-1 neutralizing antibodies. Purebred cats more often fail to develop a ⩾four-fold titre increase after vaccination.
Tuberculosis due to Mycobacterium bovis in pet cats associated with feeding a commercial raw food diet
Authors: O’Halloran Conor , Ioannidi Olympia , Reed Nicki , Murtagh Kevin , Dettemering Eili , Van Poucke Stefaan , Gale John , Vickers Julie , Burr Paul , Gascoyne-Binzi Deborah , Howe Raymond , Dobromylskyj Melanie , Mitchell Jordan , Hope Jayne , Gunn-Moore Danièlle
Published: May 2019

Objectives

Mycobacterium bovis, a member of the Mycobacterium tuberculosis complex, can infect cats and has proven zoonotic risks for owners. Infected cats typically present with a history of outdoor lifestyle and hunting behaviour, and cutaneous granulomas are most commonly observed. The aim of this study is to describe an outbreak of tuberculous disease commencing with six young cats, living exclusively indoors in five different households across England, being presented to separate veterinarians across the UK with a variety of clinical signs.

Methods

Investigations into the pyogranulomatous lesions, lymphadenopathy and/or pulmonary disease of these cases consistently identified infection with M bovis. Infection was confirmed by PCR, where possible, or was indicated with a positive interferon-gamma release assay (IGRA), where material for PCR was unavailable. In-contact, cohabiting cats were screened by IGRA and follow-up testing was undertaken/advised where results were positive. A lifestyle investigation was undertaken to identify the source of infection.

Results

Six clinically sick cats and seven in-contact cats were identified with evidence of M bovis infection. Five clinical cases were either too sick to treat or deteriorated despite therapy, giving a mortality rate of 83%. Lifestyle investigations revealed the common factors between clusters to be that affected cats had mycobacterial infections speciated to M bovis, were exclusively indoor cats and were fed a commercially available raw food product produced by a single manufacturer. The Food Standards Agency, Animal & Plant Health Agency, Public Health England and the food manufacturer concerned have been notified/informed. Other possible sources of exposure for these cats to M bovis were explored and were excluded, including wildlife contact, access to raw milk, the presence of rodent populations inside the buildings in which the cats lived and exposure to known infectious humans.

Conclusions and relevance

Upon investigations, our results provide compelling, if circumstantial, evidence of an association between the commercial raw diet of these cats and their M bovis infections.
Repeated assessment of key clinical walking measures can induce confounding practice effects
Authors: Meyer Christian , Killeen Tim , Lörincz Lilla , Curt Armin , Bolliger Marc , Linnebank Michael , Zörner Björn , Filli Linard
Published: May 2019

Accurate functional outcome measures are critical for both clinical trials and routine patient assessments. Many functional outcomes improve with test repetition, a phenomenon that can confound the findings of longitudinal assessments. In this viewpoint, we tackle the poorly considered issue of practice effects in prevailing clinical walking tests based on current literature, while also presenting the original data from our own work, in which we investigated practice effects in the timed 25-foot walk (T25FW), timed-up and go (TUG), and 2-minute walk test (2MWT). In these tests, performed on 3 consecutive days in 10 patients with multiple sclerosis and 40 healthy controls, we observed significant practice effects in several established walking outcomes, including a 9.0% improvement in patients’ TUG performance ( p = 0.0146). Pre-training in these walking tests prior to baseline measurement may mitigate practice effects, thereby improving the accuracy and value of their repeated use in research and clinical settings.
Drawing the mind: Aesthetics of representing mental illness in select graphic memoirs
Authors: Venkatesan Sathyaraj , Saji Sweetha
Published: May 2019

Representation of psychological experiences necessitates a creative use of means of expression. In the field of graphic medicine, autobiographical narratives on mental illness find expression through the unique semiotic nature of comics, which facilitates the encapsulation of complex psychic-scapes and embodiment of the artist’s experiences. In so doing, these verbal–visual techniques provide vividness and easily digested expression, translating the sufferer’s altered mental perspective effectively for the reader. The deployment of such elements inherent in the medium facilitates multilayered connections to the patient narrative, which provide a depth beyond the raw medical discourse. The present essay, with reference to Ellen Forney’s Marbles: Mania, Depression, Michelangelo, & Me: A Graphic Memoir and Allie Brosh’s Hyperbole and a Half: Unfortunate Situations, Flawed Coping Mechanisms, Mayhem, and other Things That Happened, investigates the mediative value of rhetorical devices unique to the medium of comics in actualizing the subjective experience of mental illness. The essay also seeks to delineate the cultural power of graphic memoirs by positioning them at the crossroads of sufferer’s experiences and clinical description, drawing on theoretical insights from George Lakoff and Mark Johnson and other graphic pathographers/theorists, such as Ian Williams and Elisabeth El Refaie.
‘Social work is not just a job’: The qualities of social workers from the perspective of service users
Authors: Kam Ping Kwong
Published: May 2019

The social work profession emphasises the development of the personal qualities of social workers in addition to requiring them to possess the necessary professional values, knowledge, theories and practice skills. Until now, we have tended to rely on the perspective of social work professional bodies, educators and employers to assess the personal qualities of social workers. We have seldom inquired about the views of service users on the qualities of social workers, thus disregarding their perspective. This article focuses on identifying the important qualities of social workers from the perspective of service users.

Findings

This paper reports on qualitative research on the personal qualities of social workers that service users value in Hong Kong. It draws on a diverse range of service users with direct experiences of the services provided by social workers. A total of 47 service users from 7 core social welfare service settings and 32 service units participated in an in-depth qualitative interview. Six significant personal qualities of social workers from the service users’ perspective are identified and discussed.

Applications

The findings have several implications for examining directions for development of the social work profession, the relationship between service users and social workers, effective ways to develop the personal qualities of students in social work education and ways to resolve the dilemma between service users’ expectations and the existing mode of social work service delivery. Issues of particular relevance to Hong Kong are highlighted in discussing these implications.
Route-dependent optimal control of the after-treatment system of diesel engines
Authors: Xu Fuguo , Matsunaga Hideki , Kato Atsushi , Yasui Yuji , Shen Tielong
Published: May 2019

In this article, the optimal control problem for nitrogen oxide emission reduction is investigated for diesel engines with a lean nitrogen oxide trap. First, a control-oriented model is developed based on conservation laws. Then, the optimal control problem is formulated as a multistage decision problem and solved using a dynamic programming algorithm under dynamical model constraints. A trade-off between fuel economy and nitrogen oxide emission is considered in the cost function of optimization. To demonstrate the obtained optimal control scheme, the parameters of the lean nitrogen oxide trap model are identified with data obtained from a GT-power-based diesel engine simulator. The numerical simulation results for two standard driving cycles and a stochastically generated driving cycle in comparison to a conventional logic-based control scheme are provided using the identified model in the MATLAB/Simulink platform.
Efficacy of ertugliflozin in monotherapy or combination therapy in patients with type 2 diabetes: A pooled analysis of placebo-controlled studies
Authors: Liu Jie , Tarasenko Lisa , Terra Steven G , Huyck Susan , Wu Larry , Pong Annpey , Calle Roberto A , Gallo Silvina , Darekar Amanda , Mancuso James P
Published: May 2019

Background:

This pooled analysis assessed the efficacy of ertugliflozin versus placebo as monotherapy or with other antihyperglycaemic agents across patient subgroups defined by demographic and disease characteristics.

Methods:

Data from three phase III randomised, placebo-controlled, double-blind studies (NCT01958671, NCT02033889 and NCT02036515) with similar designs and populations were pooled ( N = 1544).

Results:

At Week 26, placebo-adjusted least squares mean changes from baseline in glycated haemoglobin with ertugliflozin 5 and 15 mg were −0.8% (95% confidence interval: −0.9, −0.7) and −0.9% (–1.0, −0.8), respectively. Reductions were consistent across subgroups. Placebo-adjusted least squares mean changes in body weight were −1.8 kg (−2.2, −1.4) for both ertugliflozin doses; for systolic blood pressure, these were −3.4 mmHg (−4.8, −2.0) and −3.5 mmHg (−4.9, −2.0) for ertugliflozin 5 and 15 mg, respectively. Higher proportions of patients receiving ertugliflozin had glycated haemoglobin <7.0%, weight loss ⩾5% and systolic blood pressure <130 mmHg versus placebo. Ertugliflozin and placebo safety profiles were similar, including incidences of hypoglycaemia, urinary tract infection and hypovolaemia. Genital mycotic infection and adverse events related to osmotic diuresis were more common with ertugliflozin.

Conclusion:

Ertugliflozin demonstrated efficacy as monotherapy or with other antihyperglycaemic agents in patients with different demographic and disease characteristics and was generally well tolerated.
A System of Prevention: Applying a Systems Approach to Public Health
Authors: Sims Juliet , Aboelata Manal J.
Published: May 2019

Among public health and health care practitioners, there is growing understanding that individuals make choices about their health not in a vacuum but based on the social, physical, and economic environments surrounding them and the resources available to them. Furthermore, we know that we, as a society, have designed these environments and resource allocation processes and that those in turn can produce better or worse health outcomes. In recognition of this, some practitioners are turning toward systems thinking as a way of understanding the many sectors and factors that influence health, and as a strategy for influencing broad and sustained health interventions. In October 2018, Prevention Institute released System of Prevention, a book that uses graphic design to illustrate Prevention Institute’s framework for a systems approach to population health that can achieve health equity. The book draws upon learning in the primary prevention arena and presents it in an innovative format designed to be accessible to the many sectors outside of public health that collectively shape the social and community determinants of health. It aims to spark dialogue and catalyze collaboration among the sectors and stakeholders that can together work for a healthy and equitable future for all communities.
The Development of Sports: A Comparative Analysis of the Early Institutionalization of Traditional Sports and E-Sports
Authors: Summerley Rory
Published: May 2019

This article takes the definition of a sport as “an institutionalized game” under which both “traditional sports” and “E-sports” fall. It takes a comparative analytical approach that examines the historical documentation and cultural output of these two major categories of sports and their early institutionalization. Given the increasing interest in, engagement with and spectator numbers of E-sports, it is worth considering the key similarities and differences between various institutions. This article examines traditional sports institutions from the mid-19th to late 19th century alongside E-sports institutions that emerged from the mid-1990s to the present day. Firstly, the processes of institutionalization are analyzed with these examples in mind and, secondly, are compared to draw out the significant differences and similarities between the factors affecting early institutionalization.
Low Hemoglobin Is Associated With Low Bone Mineral Density and High Risk of Bone Fracture in Male Adults: A Retrospective Medical Record Review Study
Authors: Chuang Mei-Hua , Chuang Tzyy-Ling , Koo Malcolm , Wang Yuh-Feng
Published: May 2019

The aim of this study was to examine the association between serum hemoglobin level, bone mineral density, and fracture risks based on the estimated score of the Fracture Risk Assessment Tool (FRAX) in Asian male adults. The medical records of 662 male patients who underwent health examinations at a regional teaching hospital in southern Taiwan were reviewed. The medical history, demographic characteristics, clinical laboratory results, and bone mineral density of the patients were ascertained from their medical records. Simple and multiple linear regression analyses were conducted to evaluate the association of hemoglobin levels with bone mineral density, the 10-year risk of hip fracture, and the 10-year risk of major osteoporotic fracture (clinical spine, forearm, hip, or shoulder fracture) as assessed by FRAX. The mean age of the patients was 53.1 years. Results from simple linear regression analysis indicated that hemoglobin was positively associated with bone mineral density but inversely associated with both hip fracture risk and major osteoporotic fracture risk. Similar results were obtained when potential confounding variables were adjusted using multiple linear regression analysis. Low serum hemoglobin levels might be an important indicator for predicting bone mineral loss and the risk of both major osteoporotic fracture and hip fracture in male patients. Bone mineral density should be closely monitored in patients receiving treatment for anemia.
Fluid management and deresuscitation practices: A survey of critical care physicians
Authors: Silversides Jonathan A , McAuley Daniel F , Blackwood Bronagh , Fan Eddy , Ferguson Andrew J , Marshall John C
Published: May 2019

Accumulation of a positive fluid balance is common in critically ill patients, and is associated with adverse outcomes, including mortality. However, there are few randomised clinical trials to guide clinicians as to the most appropriate fluid strategy following initial resuscitation and on the use of deresuscitation (removal of accumulated fluid using diuretics and/or renal replacement therapy). To inform the design of randomised trials, we surveyed critical care physicians with regard to perceptions of fluid overload in critical care, self-reported practice, acceptability of a variety of approaches to deresuscitation, appropriate safety parameters, and overall acceptability of a randomised trial of deresuscitation. Of 524 critical care specialists completing the survey, the majority practiced in mixed medical/surgical intensive care units in the United Kingdom. Most (309 of 363 respondents, 85%) believed fluid overload to be a modifiable source of morbidity; there was strong support (395 of 457, 86%) for a randomised trial of deresuscitation in critical illness. Marked practice variability was evident among respondents. In a given clinical scenario, self-reported practice ranged from the administration of fluid (N = 59, 14%) to the administration of a diuretic (N = 285, 67%). The majority (95%) considered it appropriate to administer diuretics for fluid overload in the setting of noradrenaline infusion and to continue to administer diuretics despite mild dysnatraemias, hypotension, metabolic alkalosis, and hypokalaemia. The majority of critical care physicians view fluid overload as a common and modifiable source of morbidity; deresuscitation is widely practiced, and there is widespread support for randomised trials of deresuscitation in critical illness.
FAM84B promotes prostate tumorigenesis through a network alteration
Authors: Jiang Yanzhi , Lin Xiaozeng , Kapoor Anil , He Lizhi , Wei Fengxiang , Gu Yan , Mei Wenjuan , Zhao Kuncheng , Yang Huixiang , Tang Damu
Published: May 2019

Background:

The aim of this study was to investigate the contributions of FAM84B in prostate tumorigenesis and progression.

Methods:

A FAM84B mutant with deletion of its HRASLS domain (ΔHRASLS) was constructed. DU145 prostate cancer (PC) cells stably expressing an empty vector (EV), FAM84B, or FAM84B (ΔHRASLS) were produced. These lines were examined for proliferation, invasion, and growth in soft agar in vitro. DU145 EV and FAM84B cells were investigated for tumor growth and lung metastasis in NOD/SCID mice. The transcriptome of DU145 EV xenografts ( n = 2) and DU145 FAM84B tumors ( n = 2) was determined using RNA sequencing, and analyzed for pathway alterations. The FAM84B-affected network was evaluated for an association with PC recurrence.

Results:

FAM84B but not FAM84B (ΔHRASLS) increased DU145 cell invasion and growth in soft agar. Co-immunoprecipitation and co-localization analyses revealed an interaction between FAM84B and FAM84B (ΔHRASLS), suggesting an intramolecular association among FAM84B molecules. FAM84B significantly enhanced DU145 cell-derived xenografts and lung metastasis. In comparison with DU145 EV cell-produced tumors, those generated by DU145 FAM84B cells showed a large number of differentially expressed genes (DEGs; n = 4976). A total of 51 pathways were enriched in these DEGs, which function in the Golgi-to-endoplasmic reticulum processes, cell cycle checkpoints, mitochondrial events, and protein translation. A novel 27-gene signature (SigFAM) was derived from these DEGs; SigFAM robustly stratifies PC recurrence in two large PC populations ( n = 490, p = 0; n = 140, p = 4e−11), and remains an independent risk factor of PC recurrence after adjusting for age at diagnosis, Gleason scores, surgical margin, and tumor stages.

Conclusions:

FAM84B promotes prostate tumorigenesis through a complex network that predicts PC recurrence.
Serum potassium level on hospital arrival and survival after out-of-hospital cardiac arrest: The CRITICAL study in Osaka, Japan
Authors: Shida Haruka , Matsuyama Tasuku , Iwami Taku , Okabayashi Satoe , Yamada Tomoki , Hayakawa Koichi , Yoshiya Kazuhisa , Irisawa Taro , Noguchi Kazuo , Nishimura Tetsuro , Uejima Toshifumi , Yagi Yoshiki , Kiguchi Takeyuki , Kishimoto Masafumi , Matsuura Makoto , Hayashi Yasuyuki , Sogabe Taku , Morooka Takaya , Sado Junya , Kishimori Takefumi , Kiyohara Kosuke , Shimazu Takeshi , Kitamura Tetsuhisa , Kawamura Takashi
Published: May 2019

Background:

Little is known about the association between serum potassium level on hospital arrival and neurological outcome after out-of-hospital cardiac arrest (OHCA). We investigated whether the serum potassium level on hospital arrival had prognostic indications for patients with OHCA.

Methods:

This prospective, multicenter observational study conducted in Osaka, Japan (CRITICAL study) enrolled consecutive patients with OHCA transported to 14 participating institutions from 2012 to 2016. We included adult patients aged ⩾18 years with OHCA of cardiac origin who achieved return of spontaneous circulation and whose serum potassium level on hospital arrival was available. Based on the serum potassium level, patients were divided into four quartiles: Q1 (K ⩽3.8 mEq/L), Q2 (3.8< K⩽4.5 mEq/L), Q3 (4.5< K⩽5.6 mEq/L) and Q4 (K >5.6 mEq/L). The primary outcome was one-month survival with favorable neurological outcome, defined as cerebral performance category scale 1 or 2.

Results:

A total of 9822 patients were registered, and 1516 of these were eligible for analyses. The highest proportion of favorable neurological outcome was 44.8% (189/422) in Q1 group, followed by 30.3% (103/340), 11.7% (44/375) and 4.5% (17/379) in the Q2, Q3 and Q4 groups, respectively (p<0.001). In the multivariable analysis, the proportion of favorable neurological outcome decreased as the serum potassium level increased (p<0.001).

Conclusions:

High serum potassium level was significantly and dose-dependently associated with poor neurological outcome. Serum potassium on hospital arrival would be one of the effective prognostic indications for OHCA achieving return of spontaneous circulation.
On the origins, persistence and termination of spatial and positional rivalries in world politics: Elaborating a two-issue theory of conflict escalation
Authors: Sakuwa Kentaro , Thompson William R
Published: May 2019

What drives the dynamics of rivalry? We propose a general explanation of why international rivalries originate, persist, and terminate. We argue that rivalries persist as long as contested issues are present. Rivalries tend to form between actors with spatial or positional disputes. As rivals cease disputing spatial or positional issues, they are less likely to maintain hostility or manifest overt conflict toward each other. Particularly focusing on the role of territorial issues, we test an issue-based explanation of rivalry processes utilizing an extended boundary dispute dataset. The empirical analysis reveals that the effect of territorial disputes is contingent on the type of rivalry. Spatial rivalries, as opposed to positional rivalries, tend to develop when there are boundary disputes. When these spatial disputes are resolved, spatial rivalries tend to end, while positional rivalries and “mixed” (both spatial and positional) rivalries are less affected by the absence of boundary disputes. Rivalries tend to be conflictual, but only as long as the relevant issues persist. Such results show the importance of contested issues driving the rivalry processes.
Spinal fractures in diffuse idiopathic skeletal hyperostosis: Advantages of percutaneous pedicle screw fixation
Authors: Okada Eijiro , Shiono Yuta , Nishida Mitsuhiro , Mima Yuichiro , Funao Haruki , Shimizu Kentaro , Kato Masanori , Fukuda Kentaro , Fujita Nobuyuki , Yagi Mitsuru , Nagoshi Narihito , Tsuji Osahiko , Ishii Ken , Nakamura Masaya , Matsumoto Morio , Watanabe Kota
Published: May 2019

Purpose:

To validate the effectiveness of percutaneous pedicle screw (PPS) fixation for spinal fractures associated with diffuse idiopathic skeletal hyperostosis (DISH) by comparing surgical outcomes for PPS fixation and conventional open posterior fixation. Patients with DISH are vulnerable to unstable spinal fractures caused by trivial trauma, and these fractures have high rates of delayed paralysis, postoperative complications, and mortality.

Methods:

This retrospective study assessed surgical outcomes for 16 patients with DISH (12 men; mean age 76.1 ± 9.4 years) who underwent PPS fixation for spinal fractures (pedicle screw (PS) group), and for a control group of 25 patients with DISH (18 men; mean age 77.9 ± 9.9 years) who underwent conventional open fixation (O group) at our affiliated hospitals from 2007 to 2017. We evaluated the preoperative physical condition (American Society of Anesthesiologists (ASA) classification), neurological status (Frankel grade), and improvement after surgery, fusion length, operating time, estimated blood loss, and perioperative complications.

Results:

Preoperatively, the PS group consisted of one ASA-1 patient, eight ASA-2 patients, six ASA-3 patients, and one ASA-4 patient; by Frankel grade, there were 2 grade B patients, 13 grade C, 4 grade D, and 6 grade E patients. The O group had 2 ASA-1 patients, 13 ASA-2, 9 ASA-3, and 1 ASA-4 patients. Frankel grades in the O group reflected severe neurological deficits, with 3 grade C patients, 2 grade D, and 11 grade E ( p = 0.032) patients. The two groups had similar rates of neurological improvement (33.3% of PS and 40.0% of O patients; p = 0.410) and mean fusion length (PS 5.1 ± 0.8 segments; O 4.9 ± 1.2). The mean operating time and estimated blood loss were 168.1 ± 46.7 min and 133.9 ± 116.5 g, respectively, in the PS group, and 224.6 ± 49.8 min and 499.9 ± 368.5 g in the O group. Three O-group patients died of hypovolemic shock, respiratory failure, and pneumonia, respectively, within a year of surgery.

Conclusion:

Conventional open posterior fixation and PPS fixation for DISH-related spinal fractures were similar in fusion length and neurological improvement. However, PPS fixation was less invasive and had lower complication rates.
RASopathy in Patients With Isolated Sagittal Synostosis
Authors: Davis Amani Ali , Zuccoli Giulio , Haredy Mostafa M. , Losee Joseph , Pollack Ian F. , Madan-Khetarpal Suneeta , Goldstein Jesse A. , Nischal Ken K.
Published: May 2019

RASopathy is caused by dysfunction in the MAPK pathway, and include syndromes like Noonan syndrome (NS), NS with multiple lentigines (formerly known as Leopard syndrome), cardiofaciocutaneous (CFC), Legius syndrome, capillary malformation–arteriovenous malformation, neurofibromatosis type 1, and Costello syndrome. When counted together, RASopathies affect 1/1000 live births, and are characterized by cardiovascular manifestations, short stature, developmental delay, renal, urogenital, skin/skeletal abnormalities, and dysmorphic appearance. NS—one of the most common RASopathies—occurs in 1/1000 to 1/2500 live births. On the other hand, the frequency of CFC is unknown, but it is one of the rarest RASopathies, with estimates of only a few hundred cases worldwide. However, its phenotype overlaps with that of NS. In this case series, we describe 5 patients with a clinical and genetic diagnosis of RASopathy—either NS or CFC—all of whom were also diagnosed with isolated sagittal synostosis (ISS). Medical records from ophthalmology, cardiology, plastic surgery, medical genetics, cleft craniofacial, and neurosurgery were used to determine patient history. In our cohort, late presentation of ISS was the predominant form of ISS presentation. We hope this report further characterizes the burgeoning relationship between RASopathy and ISS. Furthermore, these findings support including sagittal synostosis among the presenting features in the clinical phenotype of RASopathies. Ethical approval was obtained from the university’s institutional review board.
MXD6 in film manufacturing: State of the art and recent advances in the synthesis and characterization of new copolyamides
Authors: Vannini Micaela , Marchese Paola , Celli Annamaria , Lorenzetti Cesare
Published: May 2019

Semiaromatic polyamides belong to a large family of polymers commonly utilized in demanding engineering applications due to a unique set of outstanding mechanical properties as well as in terms of thermal and chemical resistance. Somewhat less understood is the use of certain members of this family in packaging applications such as the manufacturing of films and sheets or thin-walled containers, as well as the motivations and limitations in designing film structures containing them. This article reviews how m-xylylene diamine (MXD)-based polyamides are used in packaging applications. Attention is also given to film manufacturing and criticalities in its processing. Recent developments in MXD-based polyamides for gas barrier applications are also reported, while examining future perspectives in speciality film manufacturing. The new described copolymers based on MXD6 were synthesized by introducing different co-units, like isophthalic acid, 2,6-naphthalenedicarboxylic acid, glutaric acid, oxalic acid or 1,6-hexamethylene diamine. The performed characterization analyses (DMTA, DSC, density and OTR) allowed the polymer structures and properties to be correlated. Introducing 2,6-naphthalenedicarboxylic acid along the MXD6 chain led to the highest Tg (101°C) and density (1.233 g/cm3) and the lowest OTR (0.0035 cm3·cm/m2·day·atm, up to one order of magnitude lower).
Your New Paradigm for Understanding and Applying Sonographic Principles
Authors: Kremkau Frederick W.
Published: May 2019

A new paradigm for understanding and applying sonographic principles is needed because two alternative fundamental principles of operation are now present in the array of commercially available sonographic equipment. The first, which is termed conventional sonography, has been the operating principle for more than 50 years. Recently, a second principle has appeared, termed virtual-beam sonography. These two operating principles are fundamentally different, and there are implications for the resulting anatomic images and motion information presented. Virtual-beam sonography improves nearly every aspect of sonographic, anatomic imaging and motion presentation.
Clinicopathologic and genetic characterization of nonacute NPM1-mutated myeloid neoplasms
Authors: Patel Sanjay S. , Ho Caleb , Ptashkin Ryan N. , Sadigh Sam , Bagg Adam , Geyer Julia T. , Xu Mina L. , Prebet Thomas , Mason Emily F. , Seegmiller Adam C. , Morgan Elizabeth A. , Steensma David P. , Winer Eric S. , Wong Waihay J. , Hasserjian Robert P. , Weinberg Olga K.
Published: May 2019

Key Points

Nonacute NPM1-mutated myeloid neoplasms are biologically distinct from nonacute NPM1 wild-type myeloid neoplasms. Nonacute NPM1-mutated myeloid neoplasms are associated with poorer survival compared with NPM1-mutated AML and NPM1-WT myeloid neoplasms.
Ketamine Infusions for Chronic Pain: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Authors: Orhurhu Vwaire , Orhurhu Mariam Salisu , Bhatia Anuj , Cohen Steven P.
Published: May 2019

BACKGROUND:

IV ketamine is widely used to treat patients with chronic pain, yet the long-term impact remains uncertain. We synthesized evidence from randomized control trials to investigate the effectiveness of IV ketamine infusions for pain relief in chronic conditions and to determine whether any pain classifications or treatment regimens are associated with greater benefit.

METHODS:

We searched Medline, Embase, and Google Scholar, as well as the clinicaltrials.gov website from inception through December 16, 2017 for randomized control trials comparing IV ketamine to placebo infusions for chronic pain that reported outcomes for ≥48 hours after the intervention. Three authors independently screened the studies, pooled the data, and appraised risk of bias. Random-effects model was used to calculate weighted mean differences for pain scores and secondary outcomes. Our primary outcome was the lowest recorded pain score ≥48 hours after cessation of treatment. Secondary outcomes included responder rate and adverse effects.

RESULTS:

Among 696 studies assessed for eligibility, 7 met inclusion criteria. All studies except one were at high risk of bias. These studies randomly assigned 211 patients with neuropathic (n = 2), mixed (n = 2), and nonneuropathic (nociplastic or nociceptive) (n = 3) pain. Three studies reported significant analgesic benefit favoring ketamine, with the meta-analysis revealing a small effect up to 2 weeks after the infusion (mean difference in pain scores, −1.83 points on a 0–10 numerical rating scale; 95% CI, −2.35 to −1.31 points; P < .0001). In the 3 studies that reported responder rates, the proportion with a positive outcome was greater in the ketamine than in the placebo group (51.3% vs 19.4%; relative risk, 2.43; 95% CI, 1.10–5.40; P = .029; I
2 = 0.0%). No differences were noted based on pain classification or condition. Compared to low-dose ketamine studies and investigations that evaluated non–complex regional pain syndrome conditions, a small but nonsignificant greater reduction in pain scores was found among studies that either utilized high-dose ketamine therapy (P = .213) or enrolled complex regional pain syndrome patients (P = .079).

CONCLUSIONS:

Evidence suggests that IV ketamine provides significant short-term analgesic benefit in patients with refractory chronic pain, with some evidence of a dose–response relationship. Larger, multicenter studies with longer follow-ups are needed to better select patients and determine the optimal treatment protocol.
Differential glycogen utilization in shark acid- and base-regulatory gill cells
Authors: Roa Jinae N. , Tresguerres Martin
Published: May 2019

Na+/K+-ATPase (NKA)- and vacuolar H+-ATPase (VHA)-rich cells in shark gills respectively secrete excess acid and base to seawater to maintain blood acid-base homeostasis. Both cell types are rich in mitochondria indicating high ATP demand; however, their metabolic fuel is unknown. Here we report that NKA- and VHA-rich cells have large glycogen stores. Glycogen abundance in NKA-rich cells was lower in starved sharks compared to 24h post-fed sharks, reflecting higher energy demand for acid secretion during normal activity and glycogen replenishment during the post-feeding period. Conversely, glycogen abundance in VHA-rich cells was high in starved sharks and it became depleted post-feeding. Furthermore, inactive cells with cytoplasmic VHA had large glycogen stores and active cells with basolateral VHA had depleted glycogen stores. These results indicate glycogen is a main energy source in both NKA- and VHA-rich cells, and point to differential energy use associated with net acid and net base secretion, respectively.