bluuebunny/crossref_metadata_2025 huggingface dataset:
Experimental Study on Spray Characteristics of Gasoline/Hydrogenated Catalytic Biodiesel under GCI Conditions
Authors: Yuan Wenhua , Liao Jingjing , Li Bei , Zhong Wenjun
Published: May 2020

The new blended fuel (gasoline/hydrogenated catalytic biodiesel) is expected to address the cold start problem under low temperature of gasoline compression ignition due to its excellent ignition performance. Additionally, its spray behavior as the combustion boundary condition could have a direct impact on the characteristics of subsequent combustion. Therefore, the objective of this study is to reveal the effects of hydrogenated catalytic biodiesel/gasoline on the spray characteristics under various ambient conditions. As a significant index of spray characteristics, the spray penetration was achieved by applying Mie scattering methods under nonevaporation and evaporation conditions on a constant volume combustion chamber. In addition, the experimental results were compared against the calculated values of the models. As demonstrated by the results, a better spray performance can be achieved by the blended fuel than diesel and hydrogenated catalytic biodiesel. In respect of spray penetration, there is almost no difference among the three fuels under the ambient temperature of 323 K. Nevertheless, the blended fuel is lower than that of hydrogenated catalytic biodiesel and diesel when the ambient temperature is 434 K and 523 K. Moreover, the blended fuel is the first to reach the stable state, and the hydrogenated catalytic biodiesel is earlier than diesel for the spray penetration. Meanwhile, the spray model is identified as suitable for the blended fuel.
Transcutaneous Electrical Stimulation and Dysphagia Rehabilitation: A Narrative Review
Authors: Barikroo Ali
Published: May 2020

Transcutaneous electrical stimulation (TES) was introduced as a modality for dysphagia rehabilitation more than a decade ago. The underlying premise of this modality is improving the structural movements and enhancing neural activation based on stimulation-induced muscle contractions. However, divisive evidence exists regarding the effectiveness of this treatment modality. This manuscript reviews current evidence regarding the effects of transcutaneous electrical stimulation (TES) on clinical and physiological aspects of swallowing function. Furthermore, this narrative review delineates the knowledge gap in this area and recommends future research roadmap. This review gives a comprehensive picture regarding current knowledge of TES to practicing speech and language pathologists and interested researchers. It highlights the need for more robust studies in this area. It also encourages researchers to focus more on the physiologic studies to understand the physiologic underpinning behind this treatment modality.
Alveolar Echinococcosis in Children
Authors: Jonaitytė Emilija , Judickas Martynas , Tamulevičienė Eglė , Šeškutė Milda
Published: May 2020

Alveolar echinococcosis (AE) is an infectious zoonotic disease that is caused by Echinococcus multilocularis. The disease is generally identified accidentally because of the long asymptomatic period, has a malignant behaviour, and mainly occurs in the liver. Usually it is diagnosed in adults and is very rare in pediatric patients. We report two cases of AE and 1 differential case between AE and cystic echinococcosis (CE) in children: two of them had lesions in the liver and one had rare extrahepatic presentation of a cyst in the spleen. All our patients received chemotherapy with albendazole because surgical treatment was not recommended. The children were followed-up from 10 to 30 months and no significant improvement was seen. In this report we discuss the difficulties we faced in the treatment and follow-up of these patients. We also review the main clinical manifestations, general diagnostic methods, and treatment options of AE according to the current literature.
Multiscale Laboratory Study and Numerical Analysis of Water‐Weakening Effect on Shale
Authors: Li Zhen , Liu Shangge , Ren Wentao , Fang Jinjin , Zhu Qinghua , Dun Zhilin
Published: May 2020

Water‐weakening effect is one of the most important factors inducing large deformation and stability problems of shale strata in the Huangjiazhai Tunnel. The influence of water on shale with various water contents and its mechanism still needs more study. In this paper, the X‐ray diffraction and water absorption test were first conducted to determine the influence of mineral components on water‐rock interaction. Then, a series of rock mechanical tests, including uniaxial compressive test, Brazilian disk test, and triaxial compressive test, were carried out on shale under dried condition, wetted condition with various water contents, and saturated condition. For the uniaxial compression, tension, and triaxial compression, the softening coefficient could reach 0.38, 0.63, and 0.52, respectively. Based on the macroscale experiments, a numerical case study of tunnel excavation was investigated to evaluate the water effect. Finally, with the aid of scanning electron microscope and failure morphology, the mechanism of water‐weakening effect on shale was discussed from microscopic and macroscopic perspectives. The thickness of the double layer increases with the increase of water immersion time. This paper provides a set of useful data for reference in construction in shale strata, and a methodology to evaluate water‐weakening effect through laboratory and numerical modelling approaches.
Some Properties of Prequasi Normed Generalized de La Vallée Poussin’s Mean Sequence Space
Authors: Bakery Awad A. , Mohammed Mustafa M.
Published: May 2020

In this article, we study some topological properties of the multiplication operator on generalized de La Vallée Poussin’s mean sequence space equipped with the prequasi norm and the prequasi operator ideal generated by s-numbers and this sequence space.
Health‐Related Quality of Life in Patients with Lung Cancer Applying Integrative Oncology Concepts in a Certified Cancer Centre
Authors: Thronicke Anja , von Trott Phillipp , Kröz Matthias , Grah Christian , Matthes Burkhard , Schad Friedemann
Published: May 2020

Background. Pretreatment health‐related quality of life (HRQOL) is associated with survival outcome in lung cancer patients. There is a lack of systematic research on pretreatment HRQOL in lung cancer patients who receive integrative oncology (IO). We evaluated patient‐reported outcomes in these patients at time of diagnosis at a certified oncology and lung cancer centre. Methods. The present analysis is a prospective real‐world data study. Clinical and demographic data were obtained from the accredited Network Oncology cancer registry. Pretreatment HRQOL was evaluated (international standardized questionnaires) for people with all‐stage lung cancer at first diagnosis that received IO consisting of standard therapy and multimodal add‐on complementary concepts. Univariate and adjusted multivariate regression analyses were performed with R. Results. Eighty seven patients with all‐stage lung cancer were eligible for the questionnaire analysis (median age 68.0 years, IQR 59.0–74.4). Thirty percent of the total cohort reported financial difficulties. Self‐reported pretreatment financial difficulty was associated with younger age (p = 0.007), pretreatment pain (p = 0.006), anxiety (p = 0.04), and low mood (p = 0.03). Pain (p = 0.03) and young age (p = 0.02) in the early‐ and late‐stage lung cancer were associated with financial difficulties. Conclusion. We suggest physicians screen lung cancer patients at working age (broadly aged ≤65 years) and/or who report increased pain at the time of diagnosis as they might be at particular risk for emotional, physical, and financial problems. Our results emphasize to address emotional and physical needs before and during early treatment in lung cancer patients as suggested in integrative and supportive cancer concepts.
Pricing Catastrophe Equity Put Options in a Mixed Fractional Brownian Motion Environment
Authors: Deng Guohe
Published: May 2020

This paper considers the pricing of the CatEPut option (catastrophe equity put option) in a mixed fractional model in which the stock price is governed by a mixed fractional Brownian motion (mfBM model), which manifests long-range correlation and fluctuations from the financial market. Using the conditional expectation and the change of measure technique, we obtain an analytical pricing formula for the CatEPut option when the short interest rate is a deterministic and time-dependent function. Furthermore, we also derive analytical pricing formulas for the catastrophe put option and the influence of the Hurst index when the short interest rate follows an extended Vasicek model governed by another mixed fractional Brownian motion so that the environment captures the long-range dependence of the short interest rate. Based on the numerical experiments, we analyze quantitatively the impacts of different parameters from the mfBM model on the option price and hedging parameters. Numerical results show that the mfBM model is more close to the realistic market environment, and the CatEPut option price is evaluated accurately.
Study of a Class of Generalized Multiterm Fractional Differential Equations with Generalized Fractional Integral Boundary Conditions
Authors: Shammakh Wafa , Alzumi Hadeel Z. , Albarqi Zahra
Published: May 2020

The aim of this work is to study the new generalized fractional differential equations involving generalized multiterms and equipped with multipoint boundary conditions. The nonlinear term is taken from Orlicz space. The existence and uniqueness results, with the help of contemporary tools of fixed point theory, are investigated. The Ulam stability of our problem is also presented. The obtained results are well illustrated by examples.
Natural Products as Sources of Antimalarial Drugs: Ethnobotanical and Ethnopharmacological Studies
Authors: Oladeji Oluwole Solomon , Oluyori Abimbola Peter , Bankole Deborah Temitope , Afolabi Tokunbo Yemisi
Published: May 2020

Ethnopharmacological Relevance. Malaria is one of the lethal diseases of man, contributing to about 17 million deaths annually, leading to sociocultural, economic, and health influences. Aim of the Study. The study explores the ethnobotanical and ethnopharmacological appraisal of antimalarial plants used by people of Omu Aran, Ogbomoso, Ado Ekiti, and Sagamu communities in Nigeria. Materials and Methods. For this study, relevant information was procured from the inhabitants via a structured questionnaire to procure the general knowledge of antimalarial medicinal plants. Results and Discussion. A total of 90 interviewees (44 men and 46 women) were involved in this survey. A total of 59 medicinal species were identified, which were dispersed in 33 families (Asteraceae (6), Apocynaceae (5), Anacardiaceae, Annonaceae, Fabaceae, Malvaceae, Meliaceae, Poaceae, and Rubiaceae (3 each), Phyllanthaceae (2)) totaling 49% of the cited species. The most cited plants are Azadirachta indica (42), Mangifera indica (38), Carica papaya (28), Cymbopogon citratus (27), Cassia fistula (15), Morinda lucida (14), Anacardium occidentale and Vernonia amygdalina (13 each), Helianthus annuus (11), Enantia chlorantha (10), and Moringa oleifera (9) A total of 105 citations were recorded for the plant parts used (leaf (46), bark (17), fruits (9), root (9), latex (11), stem (11), and inflorescence (2)) while decoction (59%), maceration (25%), infusion (9%), and exudation (7%) were the methods of preparation. Use Values (UVs) of 0.47 to 0.11 were recorded for the frequently used antimalarial plants. The Efficiency Levels (ELs) of 11 different medicinal plants stated by the respondents were Azadirachta indica, Cassia fistula and Morinda lucida (12), Chromolaena odorata (10), Mangifera indica, Enantia chlorantha and Helianthus annuus (8), Cymbopogon citratus (7), Gossypium arboretum (4), Landolphia dulcis (3), and Aloe vera (2) Cocos nucifera, Curcuma longa, Forkia biglobosa, and Musa acuminate are mentioned for the first time in the study area with little or no reported antiplasmodial activities. Conclusion. The study appraised the commonly used antimalarial plants in the study areas. Therefore, commitment to scientifically explore the bioactive compounds, antimalarial potential and toxicological profile of these plants is inevitable as they could lead to novel natural products for effective malaria therapy.
Pipeline Gaussian Particle Filter and Hardware Design for Attitude Estimation with UAV
Authors: Xue Yali , Chen Hu , Chen Jie , Wang Jiahui
Published: May 2020

This paper based on the Gaussian particle filter (GPF) deals with the attitude estimation of UAV. GPF algorithm has better estimation accuracy than the general nonlinear non-Gaussian state estimation and is usually used to improve the system’s real-time performance whose noise is specific such as Gaussian noise during the mini UAV positioning and navigation. The attitude estimation algorithm is implemented on FPGA to verify the effectiveness of the Gaussian particle filter. Simulation results have illustrated that the GPF algorithm is effective and has better real-time performance than that of the particle filter.
Work-Family Conflict among Iranian Emergency Medical Technicians and Its Relationship with Time Management Skills: A Descriptive Study
Authors: Beyramijam Mehdi , Akbari Shahrestanaki Yousof , Khankeh Hamidreza , Aminizadeh Mohsen , Dehghani Ali , Hosseini Mohammad Ali
Published: May 2020

Background. Work-Family Conflict (WFC) is a form of interrole conflict in which an active participation in occupational activities causes strain and interferes with family roles of workers and vice versa. It is a major source of occupational stress among workers and personnel. Emergency Medical Technicians (EMTs) are an important part of the healthcare system that respond to emergencies. The EMTs experience high level of job stress, which may affect their ability to perform their family roles, and, on the other hand, actively performing their family responsibilities may interfere with the effective delivery of the already stressful activities at workplace. Objective. The aim of this study was to determine the prevalence of WFC among Emergency Medical Technicians in Iran and its relationship with time management skills. Methods. This was a descriptive study. In this study, 271 EMTs from the western part of Iran completed the questionnaire for the assessment of WFC. The Carlson Family-Conflict Questionnaire and the “Time Management Behaviors Scale” developed by Macan were used as evaluation instruments. The data were analyzed by SPSS software version 16. Appropriate statistical analysis such as mean and standard deviation, Pearson correlation, and Spearman rank correlation was applied for analyzing the data in SPSS. Results. The majority of the participants reported some degrees of WFC. Statistical analysis showed a significant inverse correlation between total WFC score and total “Time Management Behaviors scale” score (r = −0/381، p<0/0001). In the present study, there was no significant correlation between total WFC score and demographic factors such as educational level, age, sex, marital status, number of family members, need for family member care, and work experience (p>0.05). Conclusions. The findings of this study indicate that time management behaviors and skills can reduce WFC among Emergency Medical Technicians. Therefore, it is recommended that prehospital emergency authorities and policymakers plan and implement measures such as reducing the duration of shift-work schedules, decreasing shift-change restrictions, and organizing regular time management courses. Also, employment of local inhabitants is preferred to geographically distant individuals with similar qualification as this will reduce the distance between home and workplace.
Electrocardiography Interpretation Competency of Medical Interns: Experience from Two Ethiopian Medical Schools
Authors: Getachew Melaku , Beyene Temesgen , Kebede Sofia
Published: May 2020

Background. Electrocardiography (ECG) is the graphical display of electrical potential differences of an electric field originating in the heart. Interpretation of ECG is a core clinical skill in the department of emergency medicine. The main aim of this survey was to assess competency of ECG interpretation among 2018 graduating class medical students in Addis Ababa University and Haramaya University. Methodology. A cross-sectional survey was conducted on medical interns at Addis Ababa University and Haramaya University. Data had been collected from October 01, 2018, to October 30, 2018, by using structured questionnaires. Data were entered, cleaned, edited, and analyzed by using SPSS version 25.0 statistical software. Descriptive statistics, cross-tabs, chi-squared test, Mann–Whitney U test, and binary logistic regression were utilized. Results. Two-hundred and two graduating medical students were involved on this survey, out of which 61.3% (95% CI 56.3–66.3%) and 32.75% (95% CI 28.25–37.25) were able to correctly interpret the primary ECG parameters and the arrest rhythm of ECG abnormalities, respectively. The ability to detect from common emergency ECG abnormalities of anterioseptal ST segment elevation myocardial infraction, atrial fibrillation, and first-degree atrioventricular block was 42.6%, 39.1%, and 32.1%, respectively. Conclusion. This survey showed graduating medical students had low competency in ECG interpretations.
Treatment a New Approximation Method and Its Justification for Sturm–Liouville Problems
Authors: Mukhtarov O. Sh. , Yücel M. , Aydemir K.
Published: May 2020

In this paper, we propose a new approximation method (we shall call this method as α-parameterized differential transform method), which differs from the traditional differential transform method in calculating the coefficients of Taylor polynomials. Numerical examples are presented to illustrate the efficiency and reliability of our own method. Namely, two Sturm–Liouville problems are solved by the present α-parameterized differential transform method, and the obtained results are compared with those obtained by the classical DTM and by the analytical method. The result reveals that α-parameterized differential transform method is a simple and effective numerical algorithm.
Diagnosis and Management of Graves’ Disease in Thailand: A Survey of Current Practice
Authors: Sriphrapradang Chutintorn
Published: May 2020

Background. The data on clinical practice patterns in the evaluation and management of Graves’ disease (GD) are limited in Asia. The aims of this survey were to report the current practices in the management of GD in Thailand and to examine any international differences in the management of GD. Methods. Members of the Endocrine Society of Thailand who were board certified in endocrinology (N = 392) were invited to participate in an electronic survey on the management of GD using the same index case and questionnaire as in previous North American and European surveys. Results. One hundred and twenty responses (30.6%) from members were included. TSH receptor antibody measurement (29.2%), thyroid ultrasound (6.7%), and isotopic studies (5.9%) were used less frequently to confirm the etiology compared with those in North American and European surveys. Treatment with an antithyroid drug (ATD) was the preferred first choice of therapy (90.8%). Methimazole at 10–15 mg/day with a beta-blocker was the initial treatment of choice. The preferred ATD in pregnancy was propylthiouracil in the first trimester and methimazole in the second and third trimesters, which was similar to the North American and European surveys. Conclusion. Ultrasound and isotopic studies will be requested only by a small proportion of Thai endocrinologists. Higher physician preference for ATD is similar to Europe, Latin America, and other Asian countries. Geographical differences in the use of ATD, radioactive iodine, and thyroidectomy exist.
An Intelligent Calculation Method of Volterra Time-Domain Kernel Based on Time-Delay Artificial Neural Network
Authors: Zhong Kaiyang , Chen Lerui
Published: May 2020

To solve the problems of high complexity and low accuracy in Volterra time-domain kernel calculation of a nonlinear system, this paper proposes an intelligent calculation method of Volterra time-domain kernel by time-delay artificial neural networks (TDANNs) and also designs a root mean square error (RMSE) index to choose the neuron number of the network input layer. Firstly, a three-layer TDANN is designed according to the characteristics of the Volterra model. Secondly, the relationship between parameters of TDANN and Volterra time-domain kernel is analyzed, and then three-order expressions of Volterra time-domain kernel are derived. The calculation of Volterra time-domain kernel is completed by network training. Finally, it is verified by a nonlinear system. Simulation results indicate that compared with traditional methods, the new method has higher accuracy, and it can realize the batch calculation of Volterra kernel, which not only improves the calculation efficiency but also provides accurate data for fault diagnosis based on Volterra kernel in further research work.
Biological Evaluation of Newly Synthesized Biaryl Guanidine Derivatives to Arrest β‐Secretase Enzymatic Activity Involved in Alzheimer’s Disease
Authors: Ali Sayyad , Asad Muhammad Hassham Hassan Bin , Khan Fahad , Murtaza Ghulam , Rizvanov Albert A. , Iqbal Jamshed , Babak Borhan , Hussain Izhar
Published: May 2020

Proteases BACE1 (β‐secretases) enzymes have been recognized as a promising target associated with Alzheimer’s disease (AD). This study was carried out on the principles of molecular docking, chemical synthesis, and enzymatic inhibition of BACE1 enzymes via biaryl guanidine‐based ligands. Based on virtual screening, thirteen different compounds were synthesized and subsequently evaluated via in vitro and in vivo studies. Among them, 1,3‐bis(5,6‐difluoropyridin‐3‐yl)guanidine (compound (9)) was found the most potent (IC50 = 97 ± 0.91 nM) and active to arrest (99%) β‐secretase enzymes (FRET assay). Furthermore, it was found to improve the novel object recognition test and Morris water maze test significantly (p < 0.05). Improved pharmacokinetic parameters, viz., Log Po/w (1.76), Log S (‐2.73), and better penetration to the brain (BBB permeation) with zero Lipinski violation, made it possible to hit the BACE1 as a potential therapeutic source for AD.
Therapeutic Targeting of the Secreted Lysophospholipase D Autotaxin Suppresses Tuberous Sclerosis Complex-Associated Tumorigenesis
Authors: Feng You , Mischler William J. , Gurung Ashish C. , Kavanagh Taylor R. , Androsov Grigoriy , Sadow Peter M. , Herbert Zachary T. , Priolo Carmen
Published: May 2020

Tuberous sclerosis complex (TSC) is an autosomal dominant disease characterized by multiorgan hamartomas, including renal angiomyolipomas and pulmonary lymphangioleiomyomatosis (LAM). TSC2 deficiency leads to hyperactivation of mTOR Complex 1 (mTORC1), a master regulator of cell growth and metabolism. Phospholipid metabolism is dysregulated upon TSC2 loss, causing enhanced production of lysophosphatidylcholine (LPC) species by TSC2-deficient tumor cells. LPC is the major substrate of the secreted lysophospholipase D autotaxin (ATX), which generates two bioactive lipids, lysophosphatidic acid (LPA) and sphingosine-1-phosphate (S1P). We report here that ATX expression is upregulated in human renal angiomyolipoma-derived TSC2-deficient cells compared with TSC2 add-back cells. Inhibition of ATX via the clinically developed compound GLPG1690 suppressed TSC2-loss associated oncogenicity in vitro and in vivo and induced apoptosis in TSC2-deficient cells. GLPG1690 suppressed AKT and ERK1/2 signaling and profoundly impacted the transcriptome of these cells while inducing minor gene expression changes in TSC2 add-back cells. RNA-sequencing studies revealed transcriptomic signatures of LPA and S1P, suggesting an LPA/S1P-mediated reprogramming of the TSC lipidome. In addition, supplementation of LPA or S1P rescued proliferation and viability, neutral lipid content, and AKT or ERK1/2 signaling in human TSC2-deficient cells treated with GLPG1690. Importantly, TSC-associated renal angiomyolipomas have higher expression of LPA receptor 1 and S1P receptor 3 compared with normal kidney. These studies increase our understanding of TSC2-deficient cell metabolism, leading to novel potential therapeutic opportunities for TSC and LAM.

Significance:

This study identifies activation of the ATX–LPA/S1P pathway as a novel mode of metabolic dysregulation upon TSC2 loss, highlighting critical roles for ATX in TSC2-deficient cell fitness and in TSC tumorigenesis.
Fibroblasts from Distinct Pancreatic Pathologies Exhibit Disease-Specific Properties
Authors: Barrera Lawrence N. , Evans Anthony , Lane Brian , Brumskill Sarah , Oldfield Frances E. , Campbell Fiona , Andrews Timothy , Lu Zipeng , Perez-Mancera Pedro A. , Liloglou Triantafillos , Ashworth Milton , Jalali Mehdi , Dawson Rebecca , Nunes Quentin , Phillips Phoebe A. , Timms John F. , Halloran Christopher , Greenhalf William , Neoptolemos John P. , Costello Eithne
Published: May 2020

Although fibrotic stroma forms an integral component of pancreatic diseases, whether fibroblasts programmed by different types of pancreatic diseases are phenotypically distinct remains unknown. Here, we show that fibroblasts isolated from patients with pancreatic ductal adenocarcinoma (PDAC), chronic pancreatitis (CP), periampullary tumors, and adjacent normal (NA) tissue (N = 34) have distinct mRNA and miRNA profiles. Compared with NA fibroblasts, PDAC-associated fibroblasts were generally less sensitive to an antifibrotic stimulus (NPPB) and more responsive to positive regulators of activation such as TGFβ1 and WNT. Of the disease-associated fibroblasts examined, PDAC- and CP-derived fibroblasts shared greatest similarity, yet PDAC-associated fibroblasts expressed higher levels of tenascin C (TNC), a finding attributable to miR-137, a novel regulator of TNC. TNC protein and transcript levels were higher in PDAC tissue versus CP tissue and were associated with greater levels of stromal activation, and conditioned media from TNC-depleted PDAC-associated fibroblasts modestly increased both PDAC cell proliferation and PDAC cell migration, indicating that stromal TNC may have inhibitory effects on PDAC cells. Finally, circulating TNC levels were higher in patients with PDAC compared with CP. Our characterization of pancreatic fibroblast programming as disease-specific has consequences for therapeutic targeting and for the manner in which fibroblasts are used in research.

Significance:

Primary fibroblasts derived from various types of pancreatic diseases possess and retain distinct molecular and functional characteristics in culture, providing a series of cellular models for treatment development and disease-specific research.
Propensity Score Matching Analysis for the Role of Surgery in Small Cell Lung Cancer
Authors: Wei Shenhai , Wei Bo , Tian Jintao , Song Xiaoping , Wu Bingqun , Hu Pengcheng
Published: May 2020

Background: The role of surgery for small cell lung cancer (SCLC) is not clear. We aimed to evaluate this issue using a population-based database. Methods: Patients diagnosed between 2004 and 2014 with SCLC staged T1–4 N0–2 M0 disease were retrieved from the Surveillance, Epidemiology, and End Results database. Propensity score matching (PSM) was used to reduce bias between the surgical and nonsurgical patient groups. The Kaplan-Meier method and Cox regression analysis were used to compare overall survival (OS) for the matched patients. Results: A total of 8,811 patients were retrieved, including 863 patients who underwent surgical resection. After 1:1 PSM, a matched cohort with 1,562 patients was generated. In the matched cohort, surgery was associated with 5-year OS improvement (from 16.8 to 36.7%, p < 0.001) and lung cancer-specific survival improvement (from 21.6 to 43.2%, p < 0.001). Survival benefits of surgery were significant in all subgroups, including N1–2 disease, except for patients with a tumor size >5.0 cm or T3 disease. Conclusions: Patients with SCLC of limited stage can benefit from surgery, including N1–2 disease. However, patients with a tumor size >5.0 cm or advanced T stage may be unable to benefit from surgery.
Management des Spontanpneumothorax: Die Therapieentscheidung mit digitaler pleuraler Manometrie beeinflussen
Authors: Keymel Stefanie
Published: May 2020

Background: The initial management of pneumothorax remains controversial, and we speculated that this might be because there is no method available for evaluation of air leak during initial management. We have developed a system for measurement of intrapleural pressure in pneumothorax to address air leak without the need for chest drainage. The aim of this clinical study was to confirm the ability of this measurement system and to determine the clinical impact of management of air leak. Methods: Patients in whom need aspiration was indicated for spontaneous pneumothorax were enrolled in the study. The intrapleural pressure was measured during stable breathing and data recorded when patients were coughing were excluded. Results: Eleven patients were enrolled in the study between December 2016 to July 2017. The patterns in change of intrapleural pressure varied widely depending on the state of the pneumothorax. The mean intrapleural pressure values on end-inspiration and end-expiration in patients with persistent air leak was significantly lower than those in patients without persistent air leak (p = 0.020). The number of negative mean pressure recordings in endinspiration and end-expiration was significantly lower in patients with persistent air leak than in those without persistent air leak (p = 0.0060). Conclusions: In this study, we demonstrated that intrapleural pressure could be successfully measured and visualized in patients with pneumothorax. Whether or not the pressure value is a predictor of persistent air leak needs to be confirmed in the future.
Reducing Aortic Barotrauma and Vascular Extracellular Matrix Degradation by Pacemaker‐Mediated QRS Widening
Authors: Sezer Murat , Atici Adem , Coskun Isa , Cizgici Yaşar , Ozcan Alp , Umman Berrin , Bugra Zehra , Ozcan Ilke , Hasdemir Hakan , Kocaaga Mehmet , Davies Justin E. , Umman Sabahattin
Published: May 2020

Background

The extent of pressure‐related damage might be related to acceleration rate of the applied pressure (peak
dP
/dt) in the vascular system. In this study, we sought to determine whether
dP
/dt applied to the aortic wall (aortic
dP
/dt) and in turn vascular extracellular matrix degradation can be mitigated via modulation of left ventricular (
LV
) contractility (
LV dP
/dt) by pacemaker‐mediated desynchronization.

Methods and Results

First, in 34 patients, changes in aortic
dP
/dt values in 3 aortic segments in response to pacemaker‐mediated stepwise
QRS
widening leading to gradual desynchronization of the
LV
contraction by means of steadily changed atrioventricular delay (
AVD
) with temporary dual‐chamber pacing was examined before and after beta‐blocker (15 mg
IV
metoprolol) administration. Second, serum matrix metalloproteinase‐9 levels were measured in the 20 patients with permanent pacemaker while they were on sinus rhythm with normal
QRS
width and 3 weeks after wide
QRS
rhythm ensured by dual pacing, dual sensing, and dual response to sensing with short
AVD
.
LV dP
/dt substantially correlated with
dP
/dt measured in ascending (
r
=0.83), descending (
r
=0.89), and abdominal aorta (
r
=0.96).
QRS
width strongly correlated with
dP
/dt measured in ascending (
r
=−0.95), descending (
r
=−0.92), and abdominal (
r
=−0.96) aortic segments as well. In patients with permanent pacemaker, wide
QRS
rhythm led to a significant reduction in serum matrix metalloproteinase‐9 levels (from 142.5±32.9 pg/mL to 87.5±32.4 pg/mL [
P
<0.001]) at the end of 3 weeks follow‐up.

Conclusions

QRS
prolongation by short
AVD
dual pacing, dual sensing, and dual response to sensing results in concomitant decreases in peak
dP
/dt values in the
LV
and in all aortic segments with or without background beta‐blocker administration, which in turn led to a significant reduction in circulating matrix metalloproteinase‐9 levels.

Registration

URL
:
https://www.clini​caltr​ials.gov
; Unique identifier:
NCT
03665558.
Red Blood Cell Transfusion After Stage I Palliation Is Associated With Worse Clinical Outcomes
Authors: Mille Felina K. , Badheka Aditya , Yu Priscilla , Zhang Xuemei , Friedman David F. , Kheir John , van den Bosch Sarah , Cabrera Antonio G. , Lasa Javier J. , Katcoff Hannah , Hu Paula , Borasino Santiago , Hock Krissie , Huskey Jordan , Weller Jamie , Kothari Harsh , Blinder Joshua
Published: May 2020

Background

Packed red blood cell transfusion may improve oxygen content in single‐ventricle neonates, but its effect on clinical outcomes after Stage 1 palliation is unknown.

Methods and Results

Retrospective multicenter analysis of packed red blood cell transfusion exposures in neonates after Stage 1 palliation, excluding those with intraoperative mortality or need for extracorporeal membrane oxygenation. Transfusion practice variability was assessed, and multivariable regression used to identify transfusion risk factors. After propensity score adjustment for severity of illness, clinical outcomes were compared between transfused and nontransfused subjects. Of 396 subjects, 323 (82%) received 930 postoperative red blood cell transfusions. Packed red blood cell volume (median 9–42 mL/kg [
P
<0.0001]), donor exposures (1–2 [
P
<0.0001]), transfusion number (1–3 [
P
<0.0001]), and pretransfusion hemoglobin (12.1–13 g/dL,
P
=0.0049) varied between sites. Cyanosis (
P
=0.02), chest tube output (
P
=0.0003), and delayed sternal closure (
P
=0.0033) increased transfusion risk. Transfusion was associated with prolonged mechanical ventilation (6 [interquartile range 4, 12] versus 3 [1, 5] days,
P
=0.02) and intensive care unit stay (19 [12, 33] versus 9 [6, 19] days,
P
=0.016). When stratified by number of transfusions (0, 1, or >1), duration of mechanical ventilation (3 [1, 5] versus 4 [3, 6] versus 9 [5, 16] days [
P
<0.0001]) and intensive care unit stay (9 [6, 19] versus 13 [8, 25] versus 21 [13, 38] days [
P
<0.0001]) increased for those transfused more than once. Most subjects who died were transfused, though the association with mortality was not significant.

Conclusions

Packed red blood cell transfusion after Stage 1 palliation is common, and transfusion practice is variable. Transfusion is a significant predictor of longer intensive care unit stay and mechanical ventilation. Further studies to define evidence‐based transfusion thresholds are warranted.
Trends in Active Cigarette Smoking Among Stroke Survivors in the United States, 1999 to 2018
Authors: Parikh Neal S. , Chatterjee Abhinaba , Díaz Iván , Merkler Alexander E. , Murthy Santosh B. , Iadecola Costantino , Navi Babak B. , Kamel Hooman
Published: May 2020

Background and Purpose—

Patients who continue to smoke after a stroke face a higher risk of recurrent stroke. While several effective drugs for smoking cessation became available over the past 2 decades, whether active smoking has decreased among stroke survivors is unknown. We, therefore, evaluated trends in active smoking among stroke survivors during this period.

Methods—

We performed trends analyses using cross-sectional data collected every 1 to 2 years from 2 US health surveys spanning 1999 to 2018. In the National Health and Nutrition Examination Survey (NHANES) and the Behavioral Risk Factor Surveillance System (BRFSS) survey, participants were asked about prior stroke and active tobacco smoking. In NHANES, serum cotinine levels were available as a secondary measure of active smoking. We used multivariable logistic regression models for survey data to assess trends in active smoking among participants with and without prior stroke.

Results—

Among 49 375 participants in NHANES during 1999 to 2016 and 3 621 741 participants in BRFSS during 2011 to 2018, the prevalence of stroke was ≈3%. The overall prevalence of active smoking among stroke survivors was 24% in NHANES and 23% in BRFSS. Among individuals without prior stroke, the odds of smoking decreased over time in both NHANES (odds ratio, 0.95 per 2 years [95% CI, 0.93–0.96]) and BRFSS (odds ratio, 0.96 per year [95% CI, 0.96–0.96]). In contrast, there was no decrease in smoking among stroke survivors in NHANES (odds ratio, 1.00 [95% CI, 0.93–1.07]) or BRFSS (odds ratio, 0.99 [95% CI, 0.98–1.004]). Results were consistent in secondary analysis using biochemical ascertainment of active smoking in NHANES and in sensitivity analyses accounting for potential demographic changes in stroke epidemiology.

Conclusions—

In contrast to the general population, the prevalence of active smoking among stroke survivors has not decreased during the past 2 decades.
Urocystis piptatheri sp. nov. (Urocystaceae), a new species of smut fungus on Piptatherum laterale (Poaceae) from Pakistan

Authors: AFSHAN NAJAM-UL-SAHAR , ANWAR AYESHA , RIAZ MARIA , DIN SIRAJ UD , KHALID ABDUL NASIR
Published: May 2020

A new species of smut fungi, Urocystis piptatheri is described from Kumrat Valley, Pakistan based on morphological characters and molecular phylogenetic analysis of nuclear ribosomal DNA comprising the internal transcribed spacer (ITS) regions along with large subunit (LSU). The new species is characterized by the large size of its spore balls, size and number of central spores, spore wall thickness, sori in leaves and by the host plant species (Piptatherum laterale). Phylogenetic analysis of nuclear ribosomal ITS and LSU nucleotide sequences confirmed the novelty of Urocystis piptatheri. A key for the identification of Urocystis species on Pipthatherum spp. is provided.
Thalictrum punduanum var. hirtellum (Ranunculaceae), another new synonym of T. neurocarpum

Authors: ZENG YOU-PAI , YUAN QIONG , YANG QIN-ER
Published: May 2020

We have previously placed Thalictrum austrotibeticum (Ranunculaceae) in synonymy with T. neurocarpum. Based on critical observations on herbarium specimens and living plants in the wild, we demonstrate that T. punduanum var. hirtellum, recently described from southern Xizang (Tibet), China, is also identical with T. neurocarpum. We therefore reduce T. punduanum var. hirtellum to the synonymy of T. neurocarpum herein. We also further clarify the morphological distinction between T. neurocarpum and T. reniforme, which were often regarded as conspecific.
Eugenia sphaerocarpa (Myrtaceae), a new species from Western Ghats of Kerala, India

Authors: VADHYAR RAKESH G. , SUJANA K. A. , BENJAMIN J. H. FRANKLIN , MURTHY G.V. S.
Published: May 2020

Eugenia sphaerocarpa, from Malabar Wildlife Sanctuary of Kozhikode district in Kerala, India, is described and illustrated. It has some morphological similarities with Eugenia codyensis, but characteristically differs by having obconic hypanthium, round staminal disk and glossy lemon-yellow coloured fruits. Palynological studies evidenced that the new species have cryptic androdioecy, a feature that is reported in Indian Eugenia for the first time.
An annotated checklist of the Niphargidae (Crustacea: Amphipoda) of Greece
Authors: NTAKIS ALEXANDROS , KARAOUZAS IOANNIS , FIŠER CENE , STOCH FABIO
Published: May 2020

Despite Greece being a global hotspot of subterranean biodiversity, its hypogean fauna is largely neglected from both an ecological and conservational point of view. An overview of the Niphargidae occurring in Greece is presented as an annotated list of all available published records. These records have resulted in an updated species list reflecting taxonomic corrections and species distribution range in the Greek peninsula. A total of 23 species, attributed to 3 genera, is up to date known from Greece with a high rate of endemicity found particularly in Crete. The endemic species of Greece amount to 21 (91% of total species richness), with the remaining species distributing also in the Republic of North Macedonia. Currently, none of them is listed in the national, European or global IUCN Red Lists of Threatened Species. Considering the increasing habitat degradation due to anthropic pressure, groundwater harvesting and climate change we could lose rare and endemic species without even acknowledging their existence.
A new species of the Oriental leafhopper genus Kutara Distant (Hemiptera: Cicadellidae: Deltocephalinae) from Vietnam
Authors: XU DELIANG , DIETRICH CHRISTOPHER H. , WEBB M. D. , ZHANG YALIN
Published: May 2020

The Oriental leafhopper genus Kutara Distant, 1908 (Cicadellidae: Deltocephalinae: Drabescini: Paraboloponina) is newly recorded from Vietnam with description of a new species K. trispinosa Xu & Zhang sp. nov.. An updated checklist, with distribution and a key to males of Kutara, are also provided. The type specimens of the new species are deposited in the Muséum National d’Histoire Naturelle, Paris, France (MNHN) and the Illinois Natural History Survey, University of Illinois, Champaign, Illinois, USA (INHS).
Hemifacial Spasm as a Rare Clinical Presentation of Idiopathic Intracranial Hypertension: Case Report and Literature Review
Authors: Poff Charles B. , Lipschitz Noga , Kohlberg Gavriel D. , Breen Joseph T. , Samy Ravi N.
Published: May 2020

Objectives:

To report a rare case of idiopathic intracranial hypertension (IIH) presenting with hemifacial spasm (HFS) and review the current literature.

Methods:

Case report and literature review. The patient’s medical record was reviewed for demographic and clinical data. For literature review, all case reports or other publications published in English literature were identified using PUBMED.

Results:

A 43-year-old obese female presented with a 2-year history of left HFS. Electroencephalography and head computed tomography were unremarkable. Magnetic resonance imaging demonstrated bilateral anterior inferior cerebellar artery vascular loops involving the internal auditory canals as well as IIH-associated findings. A lumbar puncture was performed and revealed an elevated opening pressure of 26 cm H20 cerebrospinal fluid. Acetazolamide treatment was then initiated, resulting in complete resolution of the HFS.

Conclusion:

HFS may be a rare presenting manifestation of IIH, and treatment of IIH may result in improvement of HFS symptoms. This is the first report of IIH presenting with HFS in the absence of headache or visual change. As a result, this is the first report of HFS as a presenting manifestation of IIH in Otolaryngology literature.
Prevalence of Hip Ultrasound Abnormalities in Newborns With a Hip Click
Authors: Gaffney John T. , Spellman John
Published: May 2020

A hip click on examination of the newborn hip is believed to be the result of a ligament or myofascial structure and thought to be benign. Some studies suggest a link between hip clicks and developmental dysplasia of the hip. The purpose of our study is to estimate the prevalence of ultrasound hip abnormalities in newborns with a hip click and an otherwise normal physical examination. Results. Ninety patients meeting inclusion criteria of a hip click with an otherwise normal physical examination underwent diagnostic ultrasound with a 17.8% prevalence of hip abnormalities found (95% confidence interval ±7.9% [range of 9.9% to 25.7%]). Our study had 64 (71%) females and 26 (29%) males. The prevalence of hip pathology for females was 18.8% (12 of 64 patients) and for males was 15.4% (4 of 26 patients). Thirty-three patients were found to have bilateral hip clicks on presentation, with 21.2% (7 of 33) of those patients found to have hip pathology on ultrasound (3 of the 7 had pathology of both hips). Six patients had a family history of hip dysplasia and 1 of these patients (16.7%) had pathology on ultrasound. The average age to hip sonography was 6.6 weeks. Conclusions. In all, 17.8% of newborns with a hip click were found to have hip abnormalities on ultrasound. The prevalence of hip pathology, on ultrasound, suggests that additional larger, prospective studies are needed to clarify the association between a hip click and abnormal ultrasound found at 6 weeks of age or greater.
Chaos on Campus: Universities and Mass Political Protest
Authors: Dahlum Sirianne , Wig Tore
Published: May 2020

History suggests universities are hotbeds of political protest. However, the generality and causal nature of this relationship has never been quantified. This article investigates whether universities give rise to political protest, drawing on geocoded information on the location and characteristics of universities and protest events in the 1991–2016 period, at the subnational level in 62 countries in Africa and Central America. Our analysis indicates that university establishments increase protest. We use a difference-in-differences and fixed-effect framework leveraging the temporal variation in universities within subnational grid-cells to estimate the effect of universities on protest. Our analysis indicates that localities with increases in number of universities experience more protest. We suggest a causal interpretation, after performing different tests to evaluate whether this reflects confounding trends specific to locations that establish universities, finding no support for this. We also provide descriptive evidence on the nature of university-related protests, showing that they are more likely to emerge in dictatorships and that protests in university locations are more likely to concern democracy and human rights. These findings yield important general insights into universities’ role as drivers of contentious collective action.
The value of Theodore Beza’s inaugural address at the Geneva Academy for Christian Higher Education
Authors: Diedericks Morne
Published: May 2020

At the founding of the Academy of Geneva, Theodore Beza was appointed rector, and he had to give the inaugural address. Beza’s inaugural address provides a crucial window into the ideas of the founders of the Academy of Geneva. This Academy can rightly be regarded as one of the most influential instruments for the spread of the Reformation of the sixteenth century. Today, the founding and management of the Academy of Geneva serves as a valuable example for a deeper understanding of Christian higher education. Although today’s curriculum, assessment and academic structures will not look like that of the Academy of Geneva, the principles are still as relevant as they were in the sixteenth century. Beza’s short inaugural address provides an important window into the core principles of Christian higher education through the ages. Some of these core principles include creating a disciplined environment where students learn a Christian worldview, create a healthy learning culture while not losing sight of their duty to help reform society.