bluuebunny/crossref_metadata_2025 huggingface dataset:
A Categorized Resource Sharing Mechanism for Device-to-Device Communications in Cellular Networks
Authors: Chen Jie , Liu Chang , Li Husheng , Li Xulong , Li Shaoqian
Published: November 2016

Device-to-Device (D2D) communications are considered one of the key technologies for 5G wireless communication systems. In this paper, a resource sharing mechanism, which applies different policies for different cases (thus being categorized), is proposed. In this scheme, all D2D pairs are divided into three groups by comparing the minimum transmit power with the maximum transmit power of each cellular UE. The proposed mechanism enables multiple D2D pairs in the second group to share the resource with cellular user equipment (UE) simultaneously, by adjusting the transmit powers of these D2D transmitters. At the same time, D2D pairs in the first group and the third group share resource with cellular UE based on the transmit power minimization principle. Simulation results show that the proposed scheme can achieve relatively higher network throughput and lower transmit power consumption of the D2D system.
Pedagogical Content Knowledge-Guided Lesson Study: Effects on Teacher Competence and Students’ Achievement in Chemistry
Authors: Lucenario John Lou S. , Yangco Rosanelia T. , Punzalan Amelia E. , Espinosa Allen A.
Published: November 2016

This study aimed to investigate the effectiveness of Pedagogical Content Knowledge-Guided Lesson Study (PCKLS) as an intervention to develop PCK competencies among teachers and consequently enhance student achievement in terms of conceptual understanding and problem-solving skills. Using quasi-experimental design, teacher competencies and student achievement in the PCKLS group and the conventional group were compared. In the PCKLS group, the intervention involved planning the lesson by the research team, teaching the planned lesson while PCK observations were made by the researcher and another teacher from the group, including a feedback meeting, implementing the improvements in the reteach stage of the lesson study cycle by another teacher from the research team, and, finally, revising lesson plans based on the consolidated suggestions for improvement. Analyses of data showed that there was a significant difference in the science teacher competencies of the PCKLS group teacher respondents compared to those of the conventional group. Also, student respondents showed a significant increase on mean scores in terms of conceptual understanding and problem-solving skills. Therefore, it was concluded that PCKLS was an effective method to develop the teachers’ PCK competencies and student achievement in terms of conceptual understanding and problem solving. This study recommends that this intervention be used across chemistry topics and in other science classes such as Biology, Earth and Environmental Science, Physics, and Mathematics.
Combination of Five Body Positions Can Effectively Improve the Rate of Gastric Mucosa’s Complete Visualization by Applying Magnetic-Guided Capsule Endoscopy
Authors: Qian Yuting , Wu Sheng , Wang Qi , Wei Lumin , Wu Wei , Wang Lifu , Chu Ye
Published: November 2016

Objectives. Achieving a comprehensive view of gastric mucosa has been a challenge for magnetic-guided capsule endoscopy (MGCE) for years. This study works on optimizing the performance of MGCE by changing the conventional positions to the five body positions. Methods. Sixty patients were enrolled in the study and underwent MGCE. All patients were asked to adopt five body positions (left lateral, supine, right lateral, knee-chest, and sitting). In each position, the ability to visualize the six gastric landmarks (cardia, fundus, body, angulus, antrum, and pylorus) was assessed. Rates of complete visualization were calculated for different position combinations. Results. Supine position was the best for cardia and body visualization (91.7% and 86.7%, resp., p<0.001). Left lateral position was the best for fundus visualization (91.7%, p<0.001). Knee-chest position was the best for angulus observation (80.0%, p<0.001). Right lateral and sitting positions were the best for antrum observation (88.3% and 90.0%, resp., p<0.001). Right lateral position was the best for pylorus observation (81.7%, p<0.001). The supine + right lateral + knee-chest combination achieved better angulus visualization than conventional 3-position combination (93.3% versus 63.3%, p<0.001). Five-position combination significantly improved the comprehensive gastric landmark visualization (93.3%, p<0.001). Conclusion. Compared with 3-position combination, 5-position combination should be adopted for gastric mucosal visualization by MGCE.
Pure Cold-Induced Cholinergic Urticaria in a Pediatric Patient
Authors: Abraham Tina , McGarry David P. , Frith John , Casselman Jason , Tcheurekdjian Haig , Hostoffer Robert
Published: November 2016

Cold urticaria and cholinergic urticaria are two distinct entities. The presentation of exclusive cold-induced cholinergic urticaria is very rare. The patient described herein had experienced urticaria in the exclusive setting of exercising in a cold environment. Urticarial testing including laboratory and in-office testing was all negative. The patient has prevented urticaria symptoms with oral antihistamine therapy. Pure cold-induced cholinergic urticaria is rarely described in literature. This form of urticaria has yet to be described in a pediatric patient.
A Comparison of Barbed Sutures and Standard Sutures with regard to Wound Cosmesis in Panniculectomy and Reduction Mammoplasty Patients
Authors: Aliano Kristen , Trostler Michael , Fromm Indira Michelle , Dagum Alexander , Khan Sami , Bui Duc
Published: November 2016

Cosmesis is a vital concern for patients undergoing plastic and reconstructive surgery. Many variations in wound closure are employed when attempting to minimize a surgical scar’s appearance. Barbed sutures are one potential method of achieving improved wound cosmesis and are more common in recent years. To determine if barbed sutures differ from nonbarbed in wound cosmesis, we conducted a single-blinded, randomized, controlled trial of 18 patients undergoing bilateral reduction mammoplasty or panniculectomy. Patients were their own controls, receiving barbed sutures on one side and standard sutures on the contralateral side. Surgical scars were evaluated postoperatively by patient preference self-assessment and an observer. Ten patients were evaluated at 3 months postoperatively, yielding a mean Stony Brook Scar Evaluation Scale (SBSES) rating of 4.4 for barbed suture and 3.5 for regular suture (p=0.15). At 6 months, 8 patients performed self-assessment to determine their preference; 4 preferred the barbed sutures, 1 preferred the regular sutures, and 3 had no preference. Further research with larger sample sizes is needed to determine if barbed sutures convey any advantage over standard sutures in wound healing. However, our results suggest that barbed sutures are a reasonable alternative to standard sutures particularly with regard to wound cosmesis.
Systemic Light Chain Amyloidosis Mimicking Rheumatic Disorders
Authors: Rao Rohit R. , Yong Wai Chung , Wasko Mary Chester
Published: November 2016

Secondary amyloidosis can complicate chronic inflammatory autoimmune diseases. However, the clinical findings of primary amyloidosis may mimic those of primary rheumatologic disorders. We present the case of a 53-year-old woman who presented with dystrophic nail changes, dry eyes, bilateral carpal tunnel syndrome, Raynaud’s phenomenon, and high titer positive nucleolar pattern antinuclear antibody. She was initially misdiagnosed as having Undifferentiated Connective Tissue Disease (UCTD). On further workup, she was eventually diagnosed with lambda light chain systemic amyloidosis by abdominal fat pad biopsy. Her symptoms completely resolved after autologous stem cell transplantation. With this case, we would like to highlight the similarities in the clinical features between light chain amyloidosis and rheumatological disorders. We would also like to emphasize the importance of the prompt recognition of the clinical features of amyloidosis which are crucial to triggering appropriate diagnostic procedures, since early diagnosis is a key to improving outcomes in this disease with an otherwise poor prognosis.
A Gas Cell Based on Hollow-Core Photonic Crystal Fiber (PCF) and Its Application for the Detection of Greenhouse Gas (GHG): Nitrous Oxide (N2O)
Authors: Valiunas Jonas K. , Tenuta Mario , Das Gautam
Published: November 2016

The authors report the detection of nitrous oxide gas using intracavity fiber laser absorption spectroscopy. A gas cell based on a hollow-core photonic crystal fiber was constructed and used inside a fiber ring laser cavity as an intracavity gas cell. The fiber laser in the 1.55 μm band was developed using a polarization-maintaining erbium-doped fiber as the gain medium. The wavelength of the laser was selected by a fiber Bragg grating (FBG), and it matches one of the absorption lines of the gas under investigation. The laser wavelength contained multilongitudinal modes, which increases the sensitivity of the detection system. N2O gas has overtones of the fundamental absorption bands and rovibrational transitions in the 1.55 μm band. The system was operated at room temperature and was capable of detecting nitrous oxide gas at sub-ppmv concentration level.
A Novel Concept for Guidance and Control of Spacecraft Orbital Maneuvers
Authors: Dentis Matteo , Capello Elisa , Guglieri Giorgio
Published: November 2016

The purpose of this paper is the design of guidance and control algorithms for orbital space maneuvers. A 6-dof orbital simulator, based on Clohessy-Wiltshire-Hill equations, is developed in C language, considering cold gas reaction thrusters and reaction wheels as actuation system. The computational limitations of on-board computers are also included. A combination of guidance and control algorithms for an orbital maneuver is proposed: (i) a suitably designed Zero-Effort-Miss/Zero-Effort-Velocity (ZEM/ZEV) algorithm is adopted for the guidance and (ii) a linear quadratic regulator (LQR) is used for the attitude control. The proposed approach is verified for different cases, including external environment disturbances and errors on the actuation system.
Impact of Polypharmacy on the Rehabilitation Outcome of Japanese Stroke Patients in the Convalescent Rehabilitation Ward
Authors: Kose Eiji , Maruyama Riku , Okazoe Susumu , Hayashi Hiroyuki
Published: November 2016

Background. A risk factor associated with stroke onset is chronic kidney disease (CKD). To prevent stroke reoccurrence, it is necessary to strictly manage blood pressure, lipids, and plasma glucose. Therefore, some cases are forced to polypharmacy, elderly patients in particular. Polypharmacy often leads to adverse drug reactions and has the potential to negatively affect the rehabilitation of stroke patients. The aim of the present study was to investigate the effects of polypharmacy using a functional independence measure (FIM).Methods. A total of 144 stroke patients with CKD were included in the present analysis. We divided stroke patients into those taking six or more drugs (polypharmacy group) and those taking less than six drugs (nonpolypharmacy group) upon admission. Patient background features, laboratory data, and FIM scores were compared.Results. FIM-Motor (FIM-M) efficiency, age, and diabetes mellitus were positively associated with polypharmacy. FIM-M efficiency in the polypharmacy group was significantly lower than in the nonpolypharmacy group.Conclusion. Polypharmacy interferes with the effect of rehabilitation in stroke patients with CKD. Pharmacists and doctors should make efforts to optimize medications to be able to respond to the outcome of each patient.
How Do Emotions Impact Mobile Services Acceptance? A Systematic Literature Review
Authors: Ovčjak Boris , Heričko Marjan , Polančič Gregor
Published: November 2016

Mobile data services have been rapidly developing and expanding in the recent years; therefore many studies focus on researching their acceptance and use in general or by observing different viewpoints. One of these is emotions, which influence our beliefs and attitudes that impact our decisions and actions. The objective of our research was therefore to explore the field of mobile data services acceptance in regard to emotional factors. We performed a systematic literature review of emotional concepts and their relationships, provided by 43 primary studies. Consequently, our study includes an aggregation of emotional factors obtained from related and reviewed literature, with their definitions and the extent of their usage. Furthermore, it analyses the proportion of emotional factors against all acceptance-related factors as well as the extent of their use through time. Our study tries to guide future work by aggregating the relations that include at least one emotional factor and by providing the rate of their significance. Finally, the study tends to determine the viability of the emotional factors by observing their direct influences on users’ intention and proposes a generic theoretical model for supporting future mobile services research.
Comparison of the Emotional Intelligence Levels of Students Receiving Education in Different Fields
Authors: Karaman Özlü Zeynep , Avşar Gülçin , Gökalp Kübra , Ejder Apay Serap , Altun Özlem Şahın , Yurttaş Afife
Published: November 2016

Aim. This descriptive study was conducted to determine and compare the emotional intelligence levels of senior students receiving education in different fields of Ataturk University.Methods. The population of the study consisted of senior students receiving education in different fields of Atatürk University. The sample group of study consisted of 305 senior students receiving education in different fields (health, social, and natural) and they were selected by using the simple random sampling method. Three faculties from three different fields were selected. Data of the study were obtained by using the personal information form, which was prepared by researchers in the light of the literature and involved sociodemographic characteristics and the “Emotional Intelligence Evaluation Scale.”Results. It was determined that while natural science students had the lowest total mean score of emotional intelligence scale, students of social sciences had the highest total mean score according to departments. Examining the difference between the mean scores of three different educational fields, it was determined that this difference was statistically significant.Conclusion. Consequently, the emotional intelligence level was determined to be lower in natural science students and moderate in students of health and social sciences.
Distinctive Structural and Effective Connectivity Changes of Semantic Cognition Network across Left and Right Mesial Temporal Lobe Epilepsy Patients
Authors: Fan Xiaotong , Yan Hao , Shan Yi , Shang Kun , Wang Xiaocui , Wang Peipei , Shan Yongzhi , Lu Jie , Zhao Guoguang
Published: November 2016

Occurrence of language impairment in mesial temporal lobe epilepsy (mTLE) patients is common and left mTLE patients always exhibit a primary problem with access to names. To explore different neuropsychological profiles between left and right mTLE patients, the study investigated both structural and effective functional connectivity changes within the semantic cognition network between these two groups and those from normal controls. We found that gray matter atrophy of left mTLE patients was more severe than that of right mTLE patients in the whole brain and especially within the semantic cognition network in their contralateral hemisphere. It suggested that seizure attacks were rather targeted than random for patients with hippocampal sclerosis (HS) in the dominant hemisphere. Functional connectivity analysis during resting state fMRI revealed that subregions of the anterior temporal lobe (ATL) in the left HS patients were no longer effectively connected. Further, we found that, unlike in right HS patients, increased causal linking between ipsilateral regions in the left HS epilepsy patients cannot make up for their decreased contralateral interaction. It suggested that weakened contralateral connection and disrupted effective interaction between subregions of the unitary, transmodal hub of the ATL may be the primary cause of anomia in the left HS patients.
Extending the Touchscreen Pattern Lock Mechanism with Duplicated and Temporal Codes
Authors: Colley Ashley , Seitz Tobias , Lappalainen Tuomas , Kranz Matthias , Häkkilä Jonna
Published: November 2016

We investigate improvements to authentication on mobile touchscreen phones and present a novel extension to the widely used touchscreen pattern lock mechanism. Our solution allows including nodes in the grid multiple times, which enhances the resilience to smudge and other forms of attack. For example, for a smudge pattern covering 7 nodes, our approach increases the amount of possible lock patterns by a factor of 15 times. Our concept was implemented and evaluated in a laboratory user test (n=36). The test participants found the usability of the proposed concept to be equal to that of the baseline pattern lock mechanism but considered it more secure. Our solution is fully backwards-compatible with the current baseline pattern lock mechanism, hence enabling easy adoption whilst providing higher security at a comparable level of usability.
Costing of Paediatric Treatment alongside Clinical Trials under Low Resource Constraint Environments: Cotrimoxazole and Antiretroviral Medications in Children Living with HIV/AIDS
Authors: Chitah Bona M.
Published: November 2016

Introduction. Costing evidence is essential for policy makers for priority setting and resource allocation. It is in this context that the clinical trials of ARVs and cotrimoxazole provided a costing component to provide evidence for budgeting and resource needs alongside the clinical efficacy studies.Methods. A micro based costing approach was adopted, using case record forms for maintaining patient records. Costs for fixed assets were allocated based on the paediatric space. Medication and other resource costs were costed using the WHO/MSH Drug Price Indicators as well as procurement data where these were available.Results. The costs for cotrimoxazole and ARVs are significantly different. The average costs for human resources were US$22 and US$71 for physician costs and $1.3 and $16 for nursing costs while in-patient costs were $257 and $15 for the cotrimoxazole and ARV cohorts, respectively. Mean or average costs were $870 for the cotrimoxazole cohort and $218 for the ARV. The causal factors for the significant cost differences are attributable to the higher human resource time, higher infections of opportunistic conditions, and longer and higher frequency of hospitalisations, among others.
Amniotic Band Syndrome, Perinatal Hospice, and Palliative Care versus Active Management
Authors: Rezai Shadi , Faye Justin , Chadee Annika , Gottimukkala Sri , Upadhyay Ruchi , Lara Carla , Rajegowda Benamanahalli H. , Corwin Andrew D. , Lala Rasila V. , Vernon Jessica , Nuritdinova Dilfuza , Chasen Stephen , Henderson Cassandra E.
Published: November 2016

Introduction. Amniotic band syndrome and sequence are a relatively rare condition in which congenital anomalies occur as a result of the adherence and entrapment of fetal parts with coarse fibrous bands of the amniotic membrane. A large percentage of reported cases have an atypical gestational history. The frequency of this obstetric complication is not affected by fetal gender, genetic abnormality, or prenatal infection. Case. A 21-year-old, G1P0 female parturient at 18 weeks and 5 days with a single intrauterine gestation during a routine ultrasound evaluation was noted to have amniotic band sequence. The pregnancy was subsequently complicated by preterm premature rupture of membranes with oligohydramnios, resulting in a surviving neonate scheduled for rehabilitative treatment. Conclusion. Amniotic band syndrome is an uncommon congenital anomaly resulting in multiple disfiguring and disabling manifestations. Several theories are proposed with most involving early rupture of the amnion and entanglement of fetal parts by amniotic bands. This syndrome can be manifested by development of multiple malformations, with the majority of the defects being limb abnormalities of a disorganized nature, as in the case we present. In the absence of a clear etiology of consequential congenital abnormalities, obstetric management guidelines should use shared decision models to focus on the quality of life for the offspring.
Fuzzy Logic Controller Based Distributed Generation Integration Strategy for Stochastic Performance Improvement
Authors: Sharma Jagdish Prasad , Kamath H. Ravishankar
Published: November 2016

In the restructured environment, distributed generation (DG) is considered as a very promising option due to a high initial capital cost of conventional plants, environmental concerns, and power shortage. Apart from the above, distributed generation (DG) has also abilities to improve performance of feeder. Most of the distribution feeders have radial structure, which compel to observe the impact of distributed generations on feeder performance, having different characteristics and composition of time varying static ZIP load models. Two fuzzy-based expert system is proposed for selecting and ranking the most appropriated periods to an integration of distributed generations with a feeder. Madami type fuzzy logic controller was developed for sizing of distributed generation, whereas Sugeno type fuzzy logic controller was developed for the DG location. Input parameters for Madami fuzzy logic controller are substation reserve capacity, feeder power loss to load ratio, voltage unbalance, and apparent power imbalances. DG output, survivability index, and node distance from substation are chosen as input to Sugeno type fuzzy logic controller. The stochastic performance of proposed fuzzy expert systems was evaluated on a modified IEEE 37 node test feeder with 15 minutes characteristics time interval varying static ZIP load models.
Molecular Pathways: Deciphering Mechanisms of Resistance to Macrophage-Targeted Therapies
Authors: Quail Daniela F. , Joyce Johanna A.
Published: November 2016

Tumor-associated macrophages (TAMs) are a major cellular component of numerous tumor types. TAM-targeted therapies include depletion strategies, inhibiting their effector functions or reprogramming toward an antitumorigenic phenotype, with varying degrees of efficacy. Here, we review preclinical and clinical strategies to target macrophages in cancer and discuss potential explanations for why some strategies are effective while other approaches have shown limited success. Clin Cancer Res; 23(4); 876–84. ©2016 AACR.
Maternal Depression Increases Childhood Dental Caries: A Cohort Study in Brazil
Authors: dos Santos Pinto Gabriela , de Ávila Quevedo Luciana , Britto Correa Marcos , Sousa Azevedo Marina , Leão Goettems Marília , Tavares Pinheiro Ricardo , Demarco Flávio Fernando
Published: November 2016

Aim: To investigate the relationship between maternal depression and childhood caries in a cohort of adolescent mothers. Methods: This cross-sectional study nested in a cohort evaluated a sample of 538 mother/child dyads. When the children were 24-36 months of age, data regarding oral health from children and mothers were collected by clinical dental examination. A mother's major depressive disorder was assessed by using the Mini International Neuropsychiatric Interview (MINI [Plus]), at the current moment. Independent variables were obtained by using questionnaires. The outcome on dental caries experience was dichotomized by using 2 cut points: dmfs ≥1 and dmfs ≥3. Poisson regression analysis, using a hierarchical approach, was applied to assess the association between major depressive disorder in mothers with and those without caries experience and the outcome. Results: The prevalence of dental caries in children was 15.1% (n = 82). The mean dmfs index was 1.12 (SD = 3.72). The prevalence of major depressive disorder was 32.6% (n = 168). An interaction between caries status and depressive disorder was found, and after adjusted analysis, children from mothers with major depressive disorder with negative caries experience presented a higher caries prevalence (prevalence ratio 4.00, 95% confidence interval 1.29-12.41). Conclusion: Our findings suggest that maternal psychiatric disorders could have a negative impact on children's oral health.
The Rise and Rise of Exome Sequencing
Authors: Ku Chee-Seng , Cooper David N. , Patrinos George P.
Published: November 2016

Beginning in 2009, the advent of exome sequencing has contributed significantly towards new discoveries of heritable germline mutations and de novo mutations for rare Mendelian disorders with hitherto unknown genetic aetiologies. Exome sequencing is an efficient tool to identify disease mutations without the need of a multi-generational pedigree. Sequencing a single proband or multiple affected individuals has been shown to be successful in identifying disease mutations, but parents would be required in the case of de novo mutations. In addition to heritable germline and de novo mutations, exome sequencing has also succeeded in unravelling somatic driver mutations for a wide range of cancers through individual studies or international collaborative effort such as the Cancer Genome International Consortium. By contrast, the application of exome sequencing in complex diseases is relatively limited; probably it would be too expensive were it applied to thousands of samples to achieve the statistical power for rare or low frequency variants (<1%). On top of research discoveries, the application of exome sequencing as a diagnostic tool is also increasingly evident. In this article, we summarize and discuss the progress that has been made in these areas during almost a decade.
Refractory Cutaneous IgA Vasculitis Treated with Omega-3 Fatty Acids
Authors: Barnadas Maria A. , Díaz Encarnación Montserrat M.
Published: November 2016

Background: Omega-3 fatty acids (O3FA) have been used to treat IgA nephropathy (IgAN) but not cutaneous IgA vasculitis (IgAV). Case Report: A 47-year-old female was referred for cutaneous vasculitis. She had a 24-year history of flares of palpable purpura, arthralgia associated with hematuria, and proteinuria. We diagnosed cutaneous IgAV associated with IgAN. We administered prednisone at doses ranging from 10 to 45 mg/day to control the flares. To reduce prednisone exposure, different therapeutic strategies (colchicine, diphenhydramine, hydroxyzine, azathioprine, benzathine penicillin, and mycophenolate mofetil) were applied without success. After 11 years, therapy with O3FA capsules containing 460 mg eicosapentaenoic acid and 380 mg of docosahexaenoic acid t.i.d. was introduced, allowing the prednisone to be stopped 2 years later. When the dose of O3FA was decreased to 1 capsule on alternate days, the cutaneous flares reappeared, but they were again controlled when the patient took 1 O3FA capsule daily. Conclusions: O3FA can be useful to control cutaneous IgAV.
Down-Regulation of LncRNA DGCR5 Correlates with Poor Prognosis in Hepatocellular Carcinoma
Authors: Huang Ruyi , Wang Xiaochen , Zhang Wenjie , Zhangyuan Guangyan , Jin Kangpeng , Yu Weiwei , Xie Yu , Xu Xiaoliang , Wang Hai , Sun Beicheng
Published: November 2016

Background/Aims: Long non-coding RNAs (lncRNAs) have been reported to play pivotal roles in multiple tumors and can act as tumor biomarkers. In this study, we explored the association of the expression of an lncRNA, DGCR5 with clinicopathological features and prognosis in HCC. Methods: Expression levels of DGCR5 were detected by quantitative real-time PCR (qRT-PCR) and the clinical data was obtained, including basic information, data of clinicopathology and cancer specific survival rate. Receiver operating characteristic (ROC) curve, Kaplan-Meier methods and multivariable Cox regression models were used to analyze predictive efficiency, long-term survival outcomes and risk factors. Results: DGCR5 was found down-regulated in HCC tissues (P<0.001) and serum (P = 0.0035) and low expression of DGCR5 was correlated with a poor cancer specific survival (CSS) (P = 0.0019), as the overall 5-year CSS rates were 10.3% (low expression group) and 36.6% (high expression group), respectively. A stratified analysis demonstrated that low DGCR5 expression was an independent negative prognostic factor for HCC. In addition, the area under the ROC curve was 0.782 with a sensitivity of 0.633 and a specificity of 0.833. Conclusions: Our results suggest that DGCR5 may be a participator in HCC and can serve as potential biomarker for the diagnosis and prognosis in HCC.
Hypotension and Adverse Outcomes in Prematurity: Comparing Definitions
Authors: St. Peter Deidre , Gandy Christiana , Hoffman Suma B.
Published: November 2016

Background: In the premature neonate, there is no consensus regarding normal blood pressure (BP). The most common definition used is a mean arterial BP (MAP) less than the gestational age (GA); however, studies indicate that the neuroprotective mechanism of autoregulation is lost below a MAP of 30 mm Hg. Objective: To determine whether hypotension defined as MAP <30 mm Hg or MAP less than the infant's GA better predicts adverse outcomes of intraventricular hemorrhage (IVH) and death. Study Design: For this retrospective study, demographic, clinical, and BP data in epochs of 12 h were collected during the first 72 h of life in 188 subjects 24-28 weeks of gestation. For each definition, outcomes of severe IVH (grade 3 or 4), death, or the composite outcome of either were evaluated using bivariate testing. Logistic regression determined independent predictors of composite outcome of death and/or grade 3 or 4 IVH. Results: Hypotension by either definition was significant for death and the composite outcome (p < 0.0001). Only the MAP <30 mm Hg definition was associated with severe IVH (p = 0.02). On logistic regression, significant predictors of the composite outcome were GA (OR 0.59, 95% CI 0.39-0.89) and vasopressor therapy (OR 5.5, 95% CI 2-17). Conclusions: Neither definition of hypotension independently predicts adverse outcome in multivariate logistic regression. Vasopressor therapy, however, is an independent predictor of IVH and death in premature infants.
Heads-Up Macular Surgery with a 27-Gauge Microincision Vitrectomy System and Minimal Illumination
Authors: Kunikata Hiroshi , Abe Toshiaki , Nakazawa Toru
Published: November 2016

Objective: We combined heads-up 3-dimensional (3D) 27-gauge microincision vitrectomy surgery (27GMIVS) with a very low-intensity illumination system. Methods: This study was based on a retrospective, interventional case series of 6 eyes of 6 patients with macular disease. All patients underwent heads-up 3D 27GMIVS and the power of the intraocular illuminator was set to its minimum level, 1% (approximately 0.1 lm), throughout the surgery. Results: We found that the procedure was easy when the heads-up 3D system was used, but not through the eyepiece of a microscope. All surgeries were successfully finished without any complications. Postoperative visual acuity was restored or maintained in all eyes during the follow-up period. Conclusion: Heads-up, 3D system-assisted 27GMIVS with minimal illumination enabled excellent intraoperative visualization of retinal tissues, caused minimal phototoxicity to the macular retinal cells, and might therefore represent the next step in the development of an ideal, minimally invasive method of treating macular disease.
Recent Update on Carotid Endarterectomy versus Carotid Artery Stenting
Authors: Noiphithak Raywat , Liengudom Anusak
Published: November 2016

Carotid artery stenosis (CS) is a major cause of ischemic stroke. Treatment of CS consists of best medical treatment and carotid revascularization (CR), including carotid endarterectomy (CEA) and carotid artery stenting (CAS). Both CR techniques have their own procedural risks. Therefore, selection of the appropriate treatment for patients with CS is relatively complicated. Many studies and guidelines have reported the efficacy of each treatment for both symptomatic and asymptomatic patients. However, the results are still controversial, especially concerning the efficacy and safety of CEA and CAS. In this paper, we review and discuss the current evidence and compare results from studies of CEA and CAS, including major randomized trials, meta-analyses and ongoing trials. Moreover, based on the current data, we propose a new comprehensive decision-making for the management of CS.
High Pulse-Wave Velocity Defines a Very High Cardiovascular Risk Cohort of Dialysis Patients under Age 60
Authors: Ferreira João Pedro , Girerd Nicolas , Pannier Bruno , Rossignol Patrick , London Gerard M.
Published: November 2016

Background: Patients with end-stage renal disease (ESRD) are at a high risk of cardiovascular mortality (CVM). In patients with ESRD, arterial stiffness increases at an earlier age when compared to the general population and this contributes to the overall risk of cardiovascular mortality. The main objective of this study was to clarify the interplay between age and cardiovascular alterations in ESRD. Methods: Prospective, observational cohort study initiated in April 1987 until the end of 1998 with events recorded until the end of the year 2000 at the F.H. Manhes Hospital Center, Fleury-Mérogis (in the Paris/Ile de France area). Results: The study population consisted of 278 ESRD patients undergoing dialysis therapy. The mean ± SD age was 53 ± 16 years. The mean pulse-wave velocity (PWV) was ∼11 m/s, with ∼37% of patients having a PWV >12 m/s. During the follow-up period, 91 patients died from CV causes. PWV >12 m/s was associated with CVM in the unadjusted model but lost its prognostic value in patients >60 years (p for interaction = 0.008). In patients ≤60 years, PWV was found to be a strong and independent predictor of CVM with hazards ratio (95% CI) of 14.382 (7.120-29.047), p < 0.001, and it improved the prognostic reclassification of a model containing well-established prognostic variables. According to multivariable regression analysis, aortic PWV was strongly associated with age (R2 = 0.37, p < 0.001). Conclusion: A PWV >12 m/s provides important prognostic information in ESRD patients under 60 years of age, whereas in older patients, its prognostic relevance is lost. These findings are of critical relevance for early intervention guidance and trial end-point/treatment effect interpretation.
Endoscopic and Photodynamic Therapy of Cholangiocarcinoma
Authors: Meier Benjamin , Caca Karel
Published: November 2016

Background: Most patients with cholangiocarcinoma (CCA) have unresectable disease. Endoscopic bile duct drainage is one of the major objectives of palliation of obstructive jaundice. Methods/Results: Stent implantation using endoscopic retrograde cholangiography is considered to be the standard technique. Unilateral versus bilateral stenting is associated with different advantages and disadvantages; however, a standard approach is still not defined. As there are various kinds of stents, there is an ongoing discussion on which stent to use in which situation. Palliation of obstructive jaundice can be augmented through the use of photodynamic therapy (PDT). Studies have shown a prolonged survival for the combinations of PDT and different stent applications as well as combinations of PDT and additional systemic chemotherapy. Conclusion: More well-designed studies are needed to better evaluate and standardize endoscopic treatment of unresectable CCA.
Association Between Poorer Cognitive Function and Reduced Objectively Monitored Medication Adherence in Patients With Heart Failure
Authors: Dolansky Mary A. , Hawkins Misty A.W. , Schaefer Julie T. , Sattar Abdus , Gunstad John , Redle Joseph D. , Josephson Richard , Moore Shirley M. , Hughes Joel W.
Published: November 2016

Background—

Subclinical cognitive impairment is prevalent in heart failure (HF); however, its role in important clinical outcomes, such as HF treatment adherence, is unclear. Given the complex polypharmacy in HF treatment, cognitive deficits may be important in predicting medication management. Thus, the objective of the current study was to examine the impact of cognitive function on medication adherence among community-dwelling patients with HF using objective assessments.

Methods and Results—

A prospective observational cohort design of 309 community-dwelling patients with HF (59.7% male, 68.7±9.7 years) and no history of dementia or neurological disease. Cognition was assessed using a neuropsychological battery at baseline. Medication adherence was objectively measured for 21 days using an electronic pillbox. Regression analyses tested whether attention, executive function, or memory predicted 21-day medication adherence. In unadjusted analyses, lower scores on all 3 cognitive domains predicted poorer medication adherence (
β
=0.52–85;
P
=0.001–0.009). After adjusting for demographic, clinical, and psychosocial variables, memory continued to predict medication adherence (
β
=0.51;
P
=0.008), whereas executive function (
β
=0.24;
P
=0.075) and attention were no longer a predictor (
β
=0.34;
P
=0.131).

Conclusions—

Poorer cognitive function, especially in regard to memory, predicted reduced medication adherence among patients with HF and no history of dementia. This effect remained after adjustment for factors known to predict adherence, such as depressed mood, social support, and disease severity level. Future studies should examine the link from cognitive impairment and medication nonadherence to clinical outcomes (eg, hospitalization and mortality).

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01461629.
Cardiorespiratory Fitness and Highly Sensitive Cardiac Troponin Levels in a Preventive Medicine Cohort
Authors: DeFina Laura F. , Willis Benjamin L. , Radford Nina B. , Christenson Robert H. , deFilippi Christopher R. , de Lemos James A.
Published: November 2016

Background

Cardiorespiratory fitness (
CRF
) and highly sensitive cardiac troponin T (hs‐
cTnT
) are associated with risk of all‐cause and cardiovascular mortality as well as incident heart failure. A link of low
CRF
to subclinical cardiac injury may explain this association. We hypothesized that
CRF
would be inversely associated with hs‐
cTnT
measured in healthy adults over age 50.

Methods and Results

We evaluated 2498 participants (24.7% female, mean age 58.7 years) from the Cooper Center Longitudinal Study between August 2008 and January 2012. Plasma specimens obtained shortly before
CRF
estimates by Balke treadmill testing were used for hs‐
cTnT
assays.
CRF
was grouped into low
CRF
(category 1), moderate
CRF
(categories 2–3), and high
CRF
(categories 4–5). Multivariable logistic regression was used to estimate the association of
CRF
with hs‐
cTnT
. The prevalence of measurable hs‐
cTnT
(≥3 ng/L) was 78.5%. In multivariable analyses, low‐fit individuals were significantly more likely than high‐fit individuals to have elevated hs‐
cTnT
(≥14 ng/L) (odds ratio 2.47, 95%
CI
1.10–5.36).

Conclusions

In healthy older adults,
CRF
is inversely associated with hs‐
cTnT
level adjusted for other risk factors. Prospective studies are needed to evaluate whether improving
CRF
is effective in preventing subclinical cardiac injury.
Prognostic Value of Cardiac Troponin T and Sex in Patients Undergoing Elective Percutaneous Coronary Intervention
Authors: Harada Yukinori , Michel Jonathan , Koenig Wolfgang , Rheude Tobias , Colleran Roisin , Giacoppo Daniele , Kastrati Adnan , Byrne Robert A.
Published: November 2016

Background

In patients with stable coronary artery disease undergoing elective percutaneous coronary intervention, the prognostic value of high‐sensitivity cardiac troponin T (hs‐
cTnT
) and the influence of sex remain poorly defined.

Methods and Results

Consecutive patients with stable coronary artery disease who underwent elective percutaneous coronary intervention were included. Primary endpoint was all‐cause mortality. Unadjusted hazard ratio (HR) in overall and sex‐specific population and multivariable adjusted HR were calculated by using Cox proportional hazard models. In a total of 5626 patients, elevated hs‐
cTnT
levels, more than the sex‐specific 99th percentile upper reference limit of normal (
URL
), were observed in 2221 patients (39%) at baseline. During follow‐up (median, 14.5 months; 25th–75th percentiles, 6.4–27.2 months), 265 patients died. Mortality was higher in patients with the sex‐specific 99th percentile
URL
compared to those with normal hs‐
cTnT
(17.3% vs 3.4%; HR=6.10; 95% CI, 4.58–8.14;
P
<0.001). hs‐
cTnT
was an independent predictor of mortality in multivariable adjusted models. The C‐statistic was significantly increased by adding hs‐
cTnT
to the basic prediction model for mortality (0.793–0.815;
P
<0.001). There was a significant interaction between hs‐
cTnT
and sex on mortality. Differences in all‐cause mortality between patients with more than the sex‐specific 99th percentile
URL
and those with normal hs‐
cTnT
were numerically larger in male than female patients (male, HR=6.45; 95% CI, 4.68–8.87,
P
<0.001; female, HR=4.29, 95% CI, 2.36–9.03;
P
<0.001).

Conclusions

In patients with stable coronary artery disease undergoing elective percutaneous coronary intervention, preprocedural hs‐
cTnT
was a strong predictor of mortality in both men and women.
The Effects of Face Inversion and Face Race on the P100 ERP
Authors: Colombatto Clara , McCarthy Gregory
Published: November 2016

Research about the neural basis of face recognition has investigated the timing and anatomical substrates of different stages of face processing. Scalp-recorded ERP studies of face processing have focused on the N170, an ERP with a peak latency of ∼170 msec that has long been associated with the initial structural encoding of faces. However, several studies have reported earlier ERP differences related to faces, suggesting that face-specific processes might occur before N170. Here, we examined the influence of face inversion and face race on the timing of face-sensitive scalp-recorded ERPs by examining neural responses to upright and inverted line-drawn and luminance-matched white and black faces in a sample of white participants. We found that the P100 ERP evoked by inverted faces was significantly larger than that evoked by upright faces. Although this inversion effect was statistically significant at 100 msec, the inverted-upright ERP difference peaked at 138 msec, suggesting that it might represent an activity in neural sources that overlap with P100. Inverse modeling of the inversion effect difference waveform suggested possible neural sources in pericalcarine extrastriate visual cortex and lateral occipito-temporal cortex. We also found that the inversion effect difference wave was larger for white faces. These results are consistent with behavioral evidence that individuals process the faces of their own races more configurally than faces of other races. Taken together, the inversion and race effects observed in the current study suggest that configuration influences face processing by at least 100 msec.
Acute Exercise Modulates Feature-selective Responses in Human Cortex
Authors: Bullock Tom , Elliott James C. , Serences John T. , Giesbrecht Barry
Published: November 2016

An organism's current behavioral state influences ongoing brain activity. Nonhuman mammalian and invertebrate brains exhibit large increases in the gain of feature-selective neural responses in sensory cortex during locomotion, suggesting that the visual system becomes more sensitive when actively exploring the environment. This raises the possibility that human vision is also more sensitive during active movement. To investigate this possibility, we used an inverted encoding model technique to estimate feature-selective neural response profiles from EEG data acquired from participants performing an orientation discrimination task. Participants (n = 18) fixated at the center of a flickering (15 Hz) circular grating presented at one of nine different orientations and monitored for a brief shift in orientation that occurred on every trial. Participants completed the task while seated on a stationary exercise bike at rest and during low- and high-intensity cycling. We found evidence for inverted-U effects; such that the peak of the reconstructed feature-selective tuning profiles was highest during low-intensity exercise compared with those estimated during rest and high-intensity exercise. When modeled, these effects were driven by changes in the gain of the tuning curve and in the profile bandwidth during low-intensity exercise relative to rest. Thus, despite profound differences in visual pathways across species, these data show that sensitivity in human visual cortex is also enhanced during locomotive behavior. Our results reveal the nature of exercise-induced gain on feature-selective coding in human sensory cortex and provide valuable evidence linking the neural mechanisms of behavior state across species.
Chemical cues influence retreat-site selection by flat rock spiders
Authors: Penfold Scott , Dayananda Buddhi , Webb Jonathan K.
Published: November 2016

Many animals use chemical cues to detect conspecifics and predators. On sandstone outcrops, flat rock spidersMorebilus plagusiusandPolyrachisants use sun-exposed rocks as nest sites, and defend rocks from intruders. We investigated whether chemical cues influenced retreat-site selection by spiders. In the field, spiders showed significant avoidance of rocks used by ants. In laboratory trials, we gave spiders the choice between conspecific-scented and unscented refuges, and ant-scented and unscented refuges. In conspecific scent trials, spiders showed no avoidance of spider scented refuges during the night, but significantly more spiders chose unscented refuges as their diurnal retreat-site. In ant scent trials, spiders made more visits to unscented refuges than ant-scented refuges during the night, and significantly more spiders chose unscented refuges as their diurnal retreat site. Our results demonstrate that spiders can detect chemical cues from ants and conspecifics, and that such cues influence retreat-site selection.
The Feasibility of Ottomanism as a Nationalist Project: The View of Albanian Young Turk İsmail Kemal
Authors: Taglia Stefano
Published: November 2016

This article surveys the appeal of Ottomanism for non-dominant group members of the Young Turk organisation. It focuses on a specific reading of Ottomanism as a nationalist discourse articulated by Young Turk intellectuals in exile. The article analyses the actions, thoughts and writings of Ottoman Albanian İsmail Kemal who, in 1900, after an influential career in Ottoman officialdom, escaped to Europe and affiliated himself with the leaders of the organisation in exile. What emerges from this study is that Ottomanism was, until the Committee of Union and Progress adopted an authoritarian and pro-Turkist stance, a feasible discourse for Young Turk activists from both a dominant and non-dominant background. The article also suggests that an assessment of the role of Young Turks from a non-Muslim or non-Turkish background needs to include a consideration of a simultaneous and compatible role of such members as working for imperial reform and for the improvement and protection of their own particular community.