bluuebunny/crossref_metadata_2025 huggingface dataset:
Is Nasal Skin Thickness a Prognostic Indicator to Postoperative Edema and Ecchymosis?
Authors: Aldosari Badi
Published: September 2019

Background:

The size, shape, and symmetry of the nose contribute significantly to the facial aesthetic, so it is understandable why rhinoplasty is one of the most popular cosmetic procedures undertaken nowadays. Several factors are associated with the rates of both success and postoperative complications of rhinoplasty.

Aim:

To determine the relationship between nasal skin thickness and postoperative periorbital ecchymosis and edema among patients who underwent rhinoplasty at King Abdulaziz University Hospital.

Methodology:

A prospective study was conducted among all patients operated on for rhinoplasty at King Abdulaziz University Hospital in the Department of Otolaryngology, Riyadh, Saudi Arabia, between May and December 2018. To determine the relationship between nasal skin thickness and postoperative periorbital edema and ecchymosis, demographic data (gender, age), mean nasal skin thickness, surgical factors (time of surgery, extent of intraoperative bleeding), and scoring for periorbital ecchymosis and edema were obtained. The statistical analysis was done by comparing means and frequency using analysis of variance.

Results:

A total of 54 patients participated in this study with ages ranging from 19 to 33 years and a mean age of 24.43. According to this study, postoperative edema presentation on the first, third, and seventh days upon examination was higher among patients with thicker nasal skin (6 mm), and results are statistically significant ( P = .001). Ecchymosis was also higher among patients with thicker nasal skin (6 mm) on day 1 examinations, but there was no correlation with nasal thickness during the other examinations. Therefore, there is some degree of correlation between ecchymosis and nasal skin thickness overall, but the results are not significant ( P = .26).

Conclusion:

This study concludes that the severity of edema and ecchymosis correlates with nasal skin thickness. The degree of edema and ecchymosis was higher during the initial postoperative examinations, but following that, it was reduced and completely diminished by the 21st day post-surgery.
The Effect of Natural Ocean Sound Exposure and Ocean-Side Relaxation on Chronic Tinnitus Patients: A Pilot Study in Korea
Authors: Lim Kang Hyeon , Nam Kuk Jin , Rah Yoon Chan , Cha Jaehyung , Lee Sung-Jae , Lee Min-Goo , Choi June
Published: September 2019

Sound therapy is a treatment modality for tinnitus patients by increasing the background neuronal activity in the auditory system and inducing relative alleviation of the tinnitus. This study was performed to evaluate the efficacy of natural ocean sound exposure and ocean-side relaxation in chronic tinnitus patients. We prospectively enrolled all 18 chronic tinnitus patients (≥6 months) from July to November 2018. All patients completed 90 hours of our programs. The improvement in their subjective tinnitus severity, moods, the quality of life, and sleep was serially assessed using several questionnaires at baseline, immediately, and 1 month after the program. Changes in serum stress hormone levels of the patients were also compared between the baseline and immediately after the program. Average total Tinnitus Handicap Questionnaire score and factor 2 (hearing difficulty related to tinnitus) score significantly improved over time ( P = .024 and P = .002). Patient’s serum cortisol and epinephrine level did not show significant decrease, and serum norepinephrine and serotonin level significantly increased immediately after our program ( P < .001 and P < .001). Natural ocean sound exposure and ocean-side relaxation for short-term period has a potential efficacy on chronic tinnitus patients.
Evaluating the Clinical Outcomes of Parotid Hemangiomas in the Pediatric Patient Population
Authors: Harris Jacqueline , Phillips James D.
Published: September 2019

Introduction:

Infantile hemangiomas (IHs) are the most common tumor of the parotid gland in children; however, there is no standard protocol for the treatment of IH. The generally accepted practice is to begin the patient on β-blocker therapy if there are no contraindications.

Objective:

The purpose of this study is to better understand the challenges and successes of management of pediatric patients with parotid IH.

Methods:

This retrospective study analyzed 15 patients diagnosed with parotid IH from 2009 to 2016 who were cared for at a tertiary care center. Demographic information, lesion characteristics, and treatment course were obtained through patient chart review.

Results:

Fifteen pediatric patients with parotid IH were evaluated. The female:male ratio was 4:1; the average age of diagnosis was 8.75 months. Most lesions were greater than 3 cm in their widest dimension (73.3%), and 13 patients underwent imaging to further clarify the parotid mass in their clinical workup. Fourteen patients began treatment with propranolol; 10 patients saw complete resolution of their IH (66.7%) and 3 had a partial response to β-blocker therapy (20%). After discontinuation of propranolol, 2 patients had regrowth 2 to 3 months later after regression and were restarted on therapy. The average duration of treatment was 9.9 ± 8.45 months. The known adverse effects of propranolol—hypoglycemia, hypotension, bradycardia, and bronchospasm—were not observed in any patient.

Conclusion:

In the treatment of parotid IH, propranolol is the generally accepted first-line therapy, as compared to corticosteroid or interferon α injections of years past. Parotid hemangiomas, however, have a lower response rate to propranolol and a similar recurrence rate compared to IH at other sites. The treatment duration necessary tends to be longer. Future studies will aim at identifying and evaluating potential predictors of outcomes to help inform the management of parotid hemangiomas.
The Role of Comorbidities in Benign Paroxysmal Positional Vertigo
Authors: Sreenivas V. , Sima Natashya H. , Philip Sumy
Published: September 2019

Purpose:

To assess the correlation between the comorbidities, such as hypertension, diabetes, thyroid disorders, hearing loss, hyperlipidemia, and vitamin D deficiency and benign paroxysmal positional vertigo (BPPV) and to determine the high-risk groups for recurrence of symptoms.

Design:

Descriptive analytical study.

Materials and Methods:

Patients who met the inclusion criteria underwent complete ear, nose, and throat examination, including Dix-Hallpike test and roll-over test and blood pressure recording. Investigations included pure tone audiometry, random blood sugar/fasting blood sugar, serum thyroid-stimulating hormone, fasting serum total cholesterol, and serum vitamin D levels. Patients were followed up for a period of 6 months to 1 year.

Results:

Older age-group has an increased risk of BPPV and recurrence of symptoms. About 45.1% of the patients with BPPV who were detected to have symptoms of hypertension were also more common with hypertensive. Diabetes mellitus was found to have an increased risk of BPPV and its recurrence. The presence of other comorbidities, such as abnormal thyroid function test (9%), sensorineural hearing loss (14%), hypercholesterolemia (46%), and vitamin D deficiency (79%) didn’t show any significant risk for recurrence.

Conclusion:

The presence of comorbidities worsens the status of BPPV, causing more frequent otolith detachment. Hence, it increases the risk of recurrence even after successful repositioning maneuver. Patients presenting with BPPV should therefore be evaluated and treated for these comorbidities along with the repositioning maneuvers.
Rural Accessibility, Rural Development, and Natural Disasters in Bangladesh
Authors: Ahmed Saleh , Eklund Elizabeth
Published: September 2019

Rural accessibility means more than just reliable roads and cost-effective transportation networks. Rural accessibility is critical for achieving social and economic development in low-income developing countries such as Bangladesh where both rural and urban development are constrained by significant infrastructural deficiencies. It is also an important factor that determines the effects of natural disasters on these resource-constrained societies, since both disaster responses and sustainable development are compromised by poor rural accessibility. Using two contrasting case studies from Bangladesh, this article reveals the significance of improved rural accessibility on rural development and the effects of natural disasters on rural areas. The findings of this article suggest that the improvement of rural accessibility should be a top national development priority, since it increases the opportunities for sustainable social and economic development and reduces the adverse effects of natural disasters on the rural areas in developing countries such as Bangladesh.
Not Into Sex: Women’s Experiences of Treatment-Emergent Sexual Dysfunction
Authors: Leveque Erin , Samarron Heather , Shaw Jessica
Published: September 2019

Despite recent studies suggesting that treatment-emergent sexual dysfunction (TESD) in women is much more prevalent than previously thought, it is not often discussed between physicians and female patients prior to prescribing psychotropic medication. Missing from the available quantitative research on TESD are stories from the women themselves, their experiences with disclosure or lack thereof, and the impact TESD has had on their sense of self and in their relationships. Concerned that this could have a significant influence on women’s mental, emotional, and sexual health, we conducted a study where we interviewed 10 women who self-identified as experiencing TESD after taking psychotropic medications for their mental health. Semistructured, in-depth interviews were conducted, informed by critical feminist practice, and grounded in feminist standpoint theory. Transcripts were then analyzed using thematic analysis to demonstrate the impact TESD had on the lives of these women. Six themes emerged from the interviews: (1) inadequate disclosure about TESD from physicians, (2) gender-based difference in how TESD is discussed, (3) the experience of physical side effects, (4) emotional responses to side effects, (5) concerns about how the partners of women living with TESD experience it, and (6) the importance of knowledge sharing. We conclude this article with a discussion of how these stories fit within the larger social context.
Meshing limit line of the conical surface enveloping conical worm pair
Authors: Meng Qingxiang , Zhao Yaping , Yang Zaiyou
Published: September 2019

In this study, the calculating principle of the meshing limit line of the conical surface enveloping conical worm pair is put forward systematically. The tooth face equations, the meshing function and the meshing limit function of a conical worm pair are all acquired. Investigating the meshing limit line is come down to solving an equivalent unary nonlinear equation, which is determined from its original equations with four variables by means of the elimination technique. Based on this, the meshing limit line characteristics are deeply researched after resolving preceding equation correctly. The numerical results declare that there may be two meshing limit lines on each helicoid of one tooth of an enveloping conical worm although not all of them have physical significance. All the significative meshing limit lines usually do not get into the worm helicoid and have no influence on its normal work. Therefore, the active length of the worm depends on the tooth face boundary of the conical worm wheel theoretically. Besides, when the center distance of the worm pair is less, the transmission ratio is larger and the number of thread of the worm is more, the meshing limit line may be closer to the little end of the conical worm e helicoid.
Keeping up with best practices: Library exhibitions at a university library in a small island developing state
Authors: Jones-Edman Genevieve , Lewis Jessica C , Worrell-Johnson Bernadette
Published: September 2019

Libraries over the years have developed best practices for planning, organising, promoting and evaluating exhibitions. Many are based on practices in museums. These best practices have been written into policies and shared with libraries worldwide. However, just as there has been an acknowledgement that some museum practices must be modified to suit the needs of libraries, the same applies to exhibition best practices across countries and libraries with different budgets. Small island developing states are particularly challenged by, among other things, limited resources, high cost of transportation and energy and vulnerability to natural disasters, which can have a direct or indirect impact on libraries and their ability to carry out functions like curating exhibitions. The University of the West Indies (UWI), Mona Library, located on the island of Jamaica and founded in 1948, has a long tradition of curating exhibitions. Planning and executing physical exhibitions at The UWI are guided by Library-adapted policies and guides, recently formalised in an exhibition policy. A review of some of the exhibitions curated by The UWI Mona show that the physical exhibits are, for the most part, executed in keeping with international best practices, but the Library has had to make adjustments primarily because of financial challenges. These financial challenges affect the availability of resources for exhibits, exhibition space, dedicated exhibition staff, how special collections items are used and the magnitude of exhibitions mounted. Exhibition reports, annual reports, photographs and visitor comments books reveal that the Library attempts to follow best practices with regards to planning, designing, executing and evaluating physical exhibitions. On the other hand, the Library is in the early stages of converting its physical exhibitions to digital formats but may have to establish more formal guidelines to ensure that online exhibitions are planned, designed and evaluated in keeping with international best practices to be successful. Successful exhibitions not only satisfy Library organisers and ‘edutain’ users but also build a good reputation for the Library and lead to further collaboration with faculty and benefit students, administrators and sometimes the general public. These practices at The UWI that are guided by policies can serve as an example to other institutions with small budgets on how to successfully plan and deliver physical exhibitions and build relationships with faculty and the wider community. The Library would need to ensure that formal guidelines and practices are followed for online exhibitions to be as effective and successful.
Aquaporin-4-IgG positive neuromyelitis optica spectrum disorder and systemic autoimmune diseases overlap syndrome: a single-center experience
Authors: Martín-Nares E , Hernandez-Molina G , Fragoso-Loyo H
Published: September 2019

Objective

To describe the clinical and radiological characteristics and outcomes of patients with aquaporin-4-immunoglobulin G (AQP4-IgG) seropositive neuromyelitis optica spectrum disorder (NMOSD) coexisting with systemic lupus erythematosus (SLE) and primary Sjögren's syndrome (pSS) in a single center.

Methods

We included patients with diagnosis of NMOSD and a concomitant diagnosis of SLE or pSS. Demographic, clinical, serological and imaging characteristics were retrieved from clinical charts.

Results

Twelve patients were included, of whom 11 (91.7%) were women. Seven (58.3%) had SLE and five (41.7%) pSS. In five (41.7%) patients NMOSD followed SLE/pSS onset, four (33.3%) patients had a simultaneous presentation, and in three (25%) NMOSD preceded pSS onset. The mean age at first neurological event was 39 years. Eleven patients (91.7%) experienced acute transverse myelitis/longitudinally extensive transverse myelitis, five (41.7%) optic neuritis, three (25%) a cerebral syndrome and two (16.7%) each area postrema syndrome, acute brainstem syndrome and cerebellar syndrome. Eleven (91.7%) patients went into either total or partial NMOSD remission at median follow-up of 89.5 months.

Conclusion

AQP4-IgG seropositive NMOSD arose in the context of quiescent SLE and pSS with extraglandular features. As NMOSD coexisting with SLE/pSS is rare, collaborative multicenter studies are needed to clarify the natural history and outcomes of this overlap syndrome.
Instability analysis of a filament-wound composite tube subjected to compression/bending
Authors: Szabó Gyula , Váradi Károly
Published: September 2019

The aim of this study is to investigate the global buckling of a relatively long composite cord–rubber tube subjected to axial compression and its cross-sectional instability due to bending by a macromechanical nonlinear finite element (FE) model (nonlinear buckling analysis). Composite reinforcement layers are modelled as transversely isotropic ones, while elastomer liners are described by a hyperelastic material model that assumes incompressibility. Force–displacement, equivalent strain, equivalent stress results along with oblateness and curvature results for the complete process have been presented. It is justified that bending leads to ovalization of the cross section and results in a loss of the load-carrying capacity of the tube. Strain states in reinforcement layers have been presented, which imply that the probable failure modes of the reinforcement layers are both delamination and yarn-matrix debonding. There is a significant increase in strains due to cross-sectional instability, which proves that the effect of cross-sectional instability on material behaviour of the tube is crucial. A parametric analysis has been performed to investigate the effect of the member slenderness ratio on cross-sectional instability of the composite tube. It shows that Brazier force is inversely proportional to the slenderness ratio. It further shows that higher oblateness parameters occur in case of a lower slenderness ratio and that cross-sectional instability takes place at a lower dimensionless displacement in case of a lower slenderness ratio. FE results have been validated by a compression/bending test experiment conducted on a tensile test machine.
Learning good manufacturing practices in an escape room: Validation of a new pedagogical tool
Authors: Berthod Faustine , Bouchoud Lucie , Grossrieder Febronia , Falaschi Ludivine , Senhaji Salim , Bonnabry Pascal
Published: September 2019

Introduction

Chemotherapies are handled using Good Manufacturing Practices, which ensure asepsis and high-quality production. Continuous education is compulsory and usually includes theoretical and practical exercises.

Objectives

This work aimed to validate an innovative method of teaching good manufacturing practices based on an escape room mixing simulation and gaming.

Method

Pairs of learners were locked in a simulated clean room (Esclean Room) and had 1 hour to produce a chemotherapy and escape by finding solutions to 23 “Good Manufacturing Practices mysteries” linked to combination locks. To measure the experiment’s impact on teaching, questionnaires including the 23 mysteries (in different orders) were filled in before, just after and one month after escape from the Esclean Room. Pharmacy staff’ degrees of certainty were noted for each question. A satisfaction survey was completed.

Results

Seventy-two learners (29% senior pharmacists, 14% junior pharmacists, and 57% pharmacy technicians) escaped the Esclean Room and 56 answered every questionnaire. The educational intervention resulted in increases in correct answers and certainty. Correct answers rose from 57% in the first questionnaire to 80% in the third ( p < 0.001). Certainty scores rose from 50% before the experiment to 70% one month afterwards ( p < 0.001). Despite 68% of learners having never taken part in an escape room game before, 79% liked this educational method.

Conclusion

This study built and tested a pedagogical escape room involving a high risk, professional, pharmacy process. The use of this pharmacy technology simulation had a positive impact on pharmacy staff theoretical knowledge.
Clinical and economic impact of clinical pharmacist intervention in a hematology unit
Authors: Chen Pin-Zi , Wu Chien-Chih , Huang Chih-Fen
Published: September 2019

Background

Medication errors can lead to preventable adverse drug events and associated hospitalization and healthcare cost to patients. Pharmacotherapy in patients with hematologic malignancies is more complex than that in general medicine patients. This study evaluated the clinical and economic impact of clinical pharmacist intervention in a hematology unit.

Methods

This retrospective study compared the number of pharmacist interventions and the economic impact for one year before and after a clinical pharmacist was deployed in a hematology unit. The clinical pharmacist joined the ward rounds and gave patient counseling and recommendations on medication use. For pharmacist intervention analysis, we compared the number and type of interventions. For cost analysis, we calculated the cost savings, estimated the cost avoidance, and compared the benefit–cost ratio between the two periods.

Results

The average length of hospitalization reduced from 19.27 days to 16.69 days after clinical pharmacist deployment. The rate of pharmacist interventions in medication orders increased from 143 out of 42,501 prescriptions (0.34%) to 826 out of 44,175 prescriptions (1.87%) (P < 0.00001). The calculated cost savings (NT$37,080 and NT$252,280), cost avoidance (NT$582,100 and NT$2,304,600), and benefit–cost ratio (0.77 and 3.19) increased after clinical pharmacist deployment.

Conclusion

This study demonstrated that the number of interventions significantly increased after clinical pharmacist deployment. This service could reduce medication errors, preventable adverse drug events, and costs of both medications and potential adverse drug events.
Customer Ethnic Bias in Service Encounters
Authors: Linzmajer Marc , Brach Simon , Walsh Gianfranco , Wagner Tillmann
Published: September 2019

As ethnic diversity continues to rise, customer bias in interethnic service encounters becomes an increasingly problematic issue for the parties involved, the service firms, and society at large. Against this background, the aim of our research is to examine ethnically biased customer responses, their key psychological mechanisms, and the effectiveness of enacted service scripts to shape interethnic service encounters. Building on the aversive racism framework and homophily theory, we propose a baseline effect of majority customers’ ethnic bias toward minority employees in the form of less positive behaviors in interethnic service encounters. In an initial laboratory study, we use experimental video simulations of frontline service encounters and confirm the robustness of this effect across two replications. In a subsequent field experiment, we test an extended framework of customer responses to interethnic service encounters, finding that customers’ experience of rapport and identification with the firm represent two serial mediators that facilitate the effects of interethnic service encounters on customer loyalty intentions. Together, these contributions enrich our understanding of how psychological mechanisms facilitate the incidence of ethnically biased customer behavior and also provide insights into viable ways to improve such encounters.
Investigation of Prognostic Factors of Survival in Breast Cancer Using a Frailty Model: A Multicenter Study
Authors: Yazdani Akram , Yaseri Mehdi , Haghighat Shahpar , Kaviani Ahmad , Zeraati Hojjat
Published: September 2019

Background:

Using data from different health centers can provide more accurate knowledge of the survival prognostic factors and their effect on the patient’s survival. In this multicenter study, we aimed to investigate the role of prognostic factors on breast cancer survival with large data set.

Methods:

This historical cohort study was carried out using data from 1785 participants with breast cancer. Data were gathered from medical records of patients referring to 4 breast cancer research centers in Tehran, Iran, between 1997 and 2013. Age at diagnosis (year), size of the tumor, involve lymph nodes, tumor grade, type of surgery, auxiliary treatment of chemotherapy, radiotherapy, recurrence, and metastasis were the prognosis factors considered in this study. A shared frailty model with a gamma distribution for frailty term was used.

Results:

The median follow-up period was 29.71 months with the interquartile range of 19 to 61 months. During the follow-up period, 337 (18.9%) patients died from breast cancer and 1448 (81.1%) survived. The 1-, 3-, 5-, and 10-year survival rates were 96%, 84%, 76%, and 58%, respectively. In the Cox model by centers, in Center A, the type of surgery, number of nodes involved, and the grade 3 tumor; in center B, age, radiotherapy, metastasis, and between 1 and 3 involved nodes; in center C, age, radiotherapy, recurrence, metastasis, tumor size, and grade 3 tumor; and in center D, chemotherapy, metastasis, and lymph nodes involved were significant. Shared frailty model showed that type of surgery, number of lymph nodes involved, metastasis, radiotherapy, and the tumor grade are the prognostic factors survival in breast cancer. The frailty variance was significant, and it affirmed there was significant variability between centers.

Conclusions:

This study showed it is necessary to consider the frailty term in modeling multicenter survival studies and confirmed the importance of early diagnosis of cancer before the involvement of lymph nodes and the onset of metastasis and timely treatment could lead to longer life and increased quality of life for patients.
Composted Municipal Green Waste Enhances Tree Success in Opencast Coal Land Reclamation in Wales
Authors: Haigh Martin , Desai Mansi , Cullis Mike , D’Aucourt Margaret , Sansom Ben , Wilding Gill , Alun Elanor , Garate Sergio , Hatton Liz , Kilmartin Marianne , Panhuis Wilhemina , Jenkins Rhian
Published: September 2019

The United Kingdom has a problem in the disposal of municipal green waste (MGW). This is unsuitable for landfill, but when properly composted may be beneficial to tree growth. A formal controlled trial of the 11-year growth (height, diameter at breast height [DBH]) and survival of 3 tree species was evaluated on degraded former opencast coal land on the margins of UNESCO’s Blaenavon Industrial Landscape World Heritage site in South East Wales. Forest reclamation is considered a viable cost-effective approach to reclamation but success may be compromised by infertile and seriously compacted substrates, the depleted bio-geoecological system, and a lack of funding. In this trial, trees were (or were not) supplied, on planting, with 0.75 kg per stem of composted MGW – here a mixture of 40% domestic food waste and 60% garden waste. Results show that the application of MGW made no significant difference to either tree height or DBH. Survival rates were highest for Common Alder ( Alnus glutinosa (L.) Gaertn.) followed by Silver Birch ( Betula pendula, Roth) and European Larch ( Larix decidua Mill.). However, Silver Birch and Larch treated with MGW compost had significantly greater survival rates, whereas Alder had significantly lower survival rates, compared with trees planted without MGW treatment.
A general optimization strategy for the annual performance enhancement of a solar concentrating system incorporated in the south-facing wall of a building
Authors: Xuan Qingdong , Li Guiqiang , Lu Yashun , Zhao Xudong , Su Yuehong , Ji Jie , Pei Gang
Published: September 2019

A solar concentrating system incorporated to the south-facing wall could be a promising solution to alleviate the energy demand pressure in buildings. However, concentrating systems incorporated in south-facing walls would require wide acceptance range of concentrators with the purpose of static installation. In order to tackle this problem, this article proposes a novel unitary asymmetric concentrator structure for incorporating the concentrating system in the south-facing wall. A general optimization strategy for the annual performance enhancement of the concentrator is reported. Four kinds of concentrators were designed based on the proposed structure. The annual performance enhancement by this optimization strategy was analysed and compared through the ray-tracing simulation and experimental validation for four typical types of solar concentrators, i.e. Mirror Concentrator, Lens-Mirror Concentrator, Dielectric Concentrator and Air-Gap-Lens-Mirror Concentrator. The optical performance of these concentrators was studied and compared. Their application was analysed and validated through the analysis. The findings have illustrated the optical efficiency of the concentrators for concentrating the photovoltaics or photovoltaic-thermal system incorporated to the south-facing wall either by attachment or embedded into a building structure like a window. These concentrators can be engineered as the main component as a part of the design for a building.
Corrosion analysis and remaining useful life prediction for storage tank bottom
Authors: Feng Yu , Yang Yujiu , Huang Biqing
Published: September 2019

Corrosion of large storage tank bottom has been identified as the main threat to tank security around the world. Corrosion detection becomes the main approach to ensure the safety of large storage tanks. In this article, we propose a two-stage tank bottom corrosion analysis and remaining useful life prediction framework. In the first stage, the causes and mechanisms of tank bottom corrosion are analyzed, the evaluation metric system is established, and the fuzzy comprehensive evaluation method is used to evaluate the health status of tank bottom. The preliminary evaluation result in the first stage determines whether a subsequent remaining useful life prediction is required. If the tank bottom is not in healthy state, in the second stage, the remaining useful life prediction of the tank bottom is implemented by acoustic emission and risk-based inspection. Both qualitative and quantitative evaluation are carried out to provide a basis for the operation and maintenance decision of storage tanks.
Autophagy in the heart is enhanced and independent of disease progression in mus musculus dystrophinopathy models
Authors: Spaulding HR , Ballmann C , Quindry JC , Hudson MB , Selsby JT
Published: September 2019

Background

Duchenne muscular dystrophy is a muscle wasting disease caused by dystrophin gene mutations resulting in dysfunctional dystrophin protein. Autophagy, a proteolytic process, is impaired in dystrophic skeletal muscle though little is known about the effect of dystrophin deficiency on autophagy in cardiac muscle. We hypothesized that with disease progression autophagy would become increasingly dysfunctional based upon indirect autophagic markers.

Methods

Markers of autophagy were measured by western blot in 7-week-old and 17-month-old control (C57) and dystrophic (mdx) hearts.

Results

Counter to our hypothesis, markers of autophagy were similar between groups. Given these surprising results, two independent experiments were conducted using 14-month-old mdx mice or 10-month-old mdx/Utrn± mice, a more severe model of Duchenne muscular dystrophy. Data from these animals suggest increased autophagosome degradation.

Conclusion

Together these data suggest that autophagy is not impaired in the dystrophic myocardium as it is in dystrophic skeletal muscle and that disease progression and related injury is independent of autophagic dysfunction.
An Analysis of Psychological Distress Profiles and their Correlates in Interdisciplinary Health-care Professional Students
Authors: Mladen Samantha , Loughan Ashlee , Kinser Patricia , Crawford MaryKate , Jones Anna , Edwards Sarah , Rybarczyk Bruce , Braun Sarah E
Published: September 2019

Background

Health-care professional (HCP) students experience high levels of burnout, characterized by work- and school-related stress. Burnout is associated with a host of negative psychological and health outcomes. It may also contribute to cognitive dysfunction and decreased work productivity and may be related to trait mindfulness. This study cross-sectionally explored psychological distress and its correlates in a sample of interdisciplinary HCP students using cluster analysis.

Method

Fifty-seven interdisciplinary HCP students completed validated measures of burnout, depressive and anxiety symptoms, perceived stress, and rumination, which were entered into a cluster analysis. A neuropsychological test measured executive function; validated questionnaires assessed work productivity and trait mindfulness. Relationships between cluster membership and classroom productivity, executive function, and trait mindfulness were investigated.

Results

Burnout, depressive symptoms, and perceived stress were reported at high rates in this sample. The cluster analysis yielded 4 clusters, categorized as follows: Healthy, Ruminative Healthy, Moderate Distress, and High Distress. Cluster membership significantly differed based on trait mindfulness and classroom productivity. Trait mindfulness was related to classroom productivity. Although not significant, there were small to medium associations between executive function and both cluster membership and trait mindfulness.

Discussion

Cluster membership was highly related to trait mindfulness and classroom productivity, suggesting these are important correlates of psychological distress in HCP students. Taken together, these results underscore the need for interventions, especially ones that are mindfulness-based, to manage stress and work-relevant functioning in HCP students.
Insights into the role of endoscopic ultrasound–guided vascular therapy
Authors: Oleas Roberto , Robles-Medranda Carlos
Published: September 2019

Gastroesophageal variceal bleeding is a life-threatening complication in patients with liver cirrhosis and portal hypertension. The endoscopic injection of cyanoacrylate is considered as the first-line alternative for gastric varices treatment; however, the incidence of adverse events supports the endoscopic ultrasound–guided approach. Endoscopic ultrasound–guided interventions are a safe and feasible technique for the injection of sclerosants, cyanoacrylate, thrombin, and the deployment of coils into targeted vessels. This review article aims to offer an overview of the role of endoscopic ultrasound–guided vascular therapy and present the available data regarding endoscopic ultrasound–guided management of gastrointestinal bleeding and other vascular therapies. The available data have shown the superiority of endoscopic ultrasound–guided endovascular therapy over the endoscopic technique, which supports the implementation of endoscopic ultrasound–guided therapy in therapeutical algorithms and guidelines. Regarding whether injecting cyanoacrylate, the deployment of coils, or combined therapy, we recommend the endoscopic ultrasound–guided combined therapy in patients with gastric varices due to the high eradication rate with lower rebleeding and reintervention rates. Multicenter worldwide studies are required to confirm the actual clinical applicability of endoscopic ultrasound–guided endovascular therapy and establish treatment algorithms. Endoscopic ultrasound offered a safe and effective alternative in the management of variceal and nonvariceal gastrointestinal bleeding, with the implementation of new diagnostic and treatment options for various gastrointestinal conditions, representing a new territory for research and development.
CT density of cervical thymus, in comparison with mediastinal thymus
Authors: Sen Anitha , Valsalamony Jiji , Raj Jubie
Published: September 2019

Objectives

Cervical component of thymus is noted more in children and young adults than in older age group. CT texture (lobules of soft tissue interspersed with fat), similarity with CT density of mediastinal thymus and continuity with mediastinal thymus on sagittal/coronal images, are given as the criteria for diagnosis of the cervical thymus. But CT densities of cervical and mediastinal components of the thymus may vary. The purpose of our study was to compare CT densities of cervical and mediastinal parts of the thymus, in cases where ultrasonography correlation was available.

Methods

We retrospectively identified 22 patients who had undergone CT between May 2015 and May 2017 and in whom ultrasonography (USG) correlation was available. CT densities of cervical and mediastinal components of thymus were measured.

Results

CT density of cervical thymus is lower than the CT density of mediastinal thymus by ~ 25 HU.

There is a moderate positive correlation between CT densities of cervical and mediastinal parts of the thymus.

CT densities of both cervical and mediastinal thymus were found to reduce with age, but the reduction was statistically significant only in the cervical thymus in this study.

Conclusions

CT densities of cervical and mediastinal components of the thymus may vary, with CT density of cervical thymus being lower. There is a positive correlation between CT densities of cervical and mediastinal parts of the thymus.

CT density of cervical thymus reduces with age.

Understanding these may help avoid confusion on CT and avoid the need for correlative USG, saving time and effort.
An isopentyl transferase gene driven by the senescence-inducible SAG12 promoter improves salinity stress tolerance in cotton
Authors: SHAN Yi , ZHAO Peng , LIU Zhao , LI Fangjun , TIAN Xiaoli
Published: September 2019

Background

Soil salinity seriously affects cotton growth, leading to the reduction of yield and fiber quality. Recently, genetic engineering has become an efficient tool to increase abiotic stress tolerance in crops.

Results

In this study, isopentyl transferase (IPT), a key enzyme involved in cytokinin (CTK) biosynthesis from Agrobacterium tumefaciens, was selected to generate transgenic cotton via Agrobacterium-mediated transformation. A senescence-inducible SAG12 promoter from Arabidopsis was fused with the IPT gene. Ectopic-expression of SAG12::IPT significantly promoted seed germination or seedling tolerance to salt stress. Two IPT transgenic lines, OE3 as a tolerant line during seed germination, and OE8 as a tolerant line at seedling stage, were selected for further physiological analysis. The data showed that ectopic-expression of SAG12::IPT induced the accumulation of CTKs not only in leaves and roots, but also in germinating seeds. Moreover, ectopic-expressing IPT increased the activity of antioxidant enzymes, which was associated with the less reactive oxygen species (ROS) accumulation compared with control plants. Also, ectopic-expression of IPT produced higher K+/Na+ ratio in cotton shoot and root.

Conclusion

The senescence-induced CTK accumulation in cotton seeds and seedlings positively regulates salt stress partially by elevating ROS scavenging capability.
Prevention of Early Postoperative Decline: A Randomized, Controlled Feasibility Trial of Perioperative Cognitive Training
Authors: O’Gara Brian P. , Mueller Ariel , Gasangwa Doris Vanessa I. , Patxot Melissa , Shaefi Shahzad , Khabbaz Kamal , Banner-Goodspeed Valerie , Pascal-Leone Alvaro , Marcantonio Edward R. , Subramaniam Balachundhar
Published: September 2019

BACKGROUND:

Postoperative delirium and postoperative cognitive dysfunction (POCD) are common after cardiac surgery and contribute to an increased risk of postoperative complications, longer length of stay, and increased hospital mortality. Cognitive training (CT) may be able to durably improve cognitive reserve in areas deficient in delirium and POCD and, therefore, may potentially reduce the risk of these conditions. We sought to determine the feasibility and potential efficacy of a perioperative CT program to reduce the incidence of postoperative delirium and POCD in older cardiac surgery patients.

METHODS:

Randomized controlled trial at a single tertiary care center. Participants included 45 older adults age 60–90 undergoing cardiac surgery at least 10 days from enrollment. Participants were randomly assigned in a 1:1 fashion to either perioperative CT via a mobile device or a usual care control. The primary outcome of feasibility was evaluated by enrollment patterns and adherence to protocol. Secondary outcomes of postoperative delirium and POCD were assessed using the Confusion Assessment Method and the Montreal Cognitive Assessment, respectively. Patient satisfaction was assessed via a postoperative survey.

RESULTS:

Sixty-five percent of eligible patients were enrolled. Median (interquartile range [IQR]) adherence (as a percentage of prescribed minutes played) was 39% (20%–68%), 6% (0%–37%), and 19% (0%–56%) for the preoperative, immediate postoperative, and postdischarge periods, respectively. Median (IQR) training times were 245 (136–536), 18 (0–40), and 122 (0–281) minutes for each period, respectively. The incidence of postoperative delirium (CT group 5/20 [25%] versus control 3/20 [15%]; P = .69) and POCD (CT group 53% versus control 37%; P = .33) was not significantly different between groups for either outcome in this limited sample. CT participants reported a high level of agreement (on a scale of 0–100) with statements that the program was easy to use (median [IQR], 87 [75–97]) and enjoyable (85 [79–91]). CT participants agreed significantly more than controls that their memory (median [IQR], 75 [54–82] vs 51 [49–54]; P = .01) and thinking ability (median [IQR], 78 [64–83] vs 50 [41–68]; P = .01) improved as a result of their participation in the study.

CONCLUSIONS:

A CT program designed for use in the preoperative period is an attractive target for future investigations of cognitive prehabilitation in older cardiac surgery patients. Changes in the functionality of the program and enrichment techniques may improve adherence in future trials. Further investigation is necessary to determine the potential efficacy of cognitive prehabilitation to reduce the risk of postoperative delirium and POCD.
Atrial Fibrillation: Current Evidence and Management Strategies During the Perioperative Period
Authors: Karamchandani Kunal , Khanna Ashish K. , Bose Somnath , Fernando Rohesh J. , Walkey Allan J.
Published: September 2019

Atrial fibrillation (AF) is the most common arrhythmia in the perioperative period. Previously considered a benign and self-limited entity, recent data suggest that perioperative AF is associated with considerable morbidity and mortality and may predict long-term AF and stroke risk in some patients. Despite known risk factors, AF remains largely unpredictable, especially after noncardiac surgery. As a consequence, strategies to minimize perioperative risk are mostly supportive and include avoiding potential arrhythmogenic triggers and proactively treating patient- and surgery-related factors that might precipitate AF. In addition to managing AF itself, clinicians must also address the hemodynamic perturbations that result from AF to prevent end-organ dysfunction. This review will discuss current evidence with respect to causes, risk factors, and outcomes of patients with AF, and address current controversies in the perioperative setting.
Does Regulatory Jurisdiction Affect the Quality of Investment-Adviser Regulation?
Authors: Charoenwong Ben , Kwan Alan , Umar Tarik
Published: September 2019

The Dodd-Frank Act shifted regulatory jurisdiction over “ midsize” investment advisers from the SEC to state-securities regulators. Client complaints against midsize advisers increased relative to those continuing under SEC oversight by 30 to 40 percent of the unconditional probability. Complaints increasingly cited fiduciary violations and rose more where state regulators had fewer resources. Advisers responding more to weaker oversight had past complaints, were located farther from regulators, faced less competition, had more conflicts of interest, and served primarily less-sophisticated clients. Our results inform optimal regulatory design in markets with informational asymmetries and search frictions. (JEL G24, G28, K22, L51, L84)
Quantifying Information and Uncertainty
Authors: Frankel Alexander , Kamenica Emir
Published: September 2019

We examine ways to measure the amount of information generated by a piece of news and the amount of uncertainty implicit in a given belief. Say a measure of information is valid if it corresponds to the value of news in some decision problem. Say a measure of uncertainty is valid if it corresponds to expected utility loss from not knowing the state in some decision problem. We axiomatically characterize all valid measures of information and uncertainty. We show that if measures of information and uncertainty arise from the same decision problem, then they are coupled in that the expected reduction in uncertainty always equals the expected amount of information generated. We provide explicit formulas for the measure of information that is coupled with any given measure of uncertainty and vice versa. Finally, we show that valid measures of information are the only payment schemes that never provide incentives to delay information revelation. (JEL D81, D83)
Influência da renda e do nível educacional sobre a condição de saúde percebida e autorreferida de pessoas idosas
Authors: Oliveira Janayne de Sousa , Freitas Sandy Kaena Soares de , Vilar Nathalie Barreto Saraiva , Saintrain Suzanne Vieira , Bizerril Davi Oliveira , Saintrain Maria Vieira de Lima
Published: September 2019

Resumo: Objetivo: levantar a condição da saúde percebida e autorreferida de pessoas idosas no que tange à questão da renda financeira e do nível educacional. Métodos: estudo transversal e descritivo, cujo universo foi constituído por pessoas residentes no Município de Fortaleza, no Estado do Ceará - Brasil. A amostra foi constituída por um corte da população por gênero do Município de Fortaleza. A coleta de dados foi realizada mediante entrevistas individuais, em que se utilizou um questionário contendo questões fechadas (dicotômicas e de múltipla escolha) sobre dados sociodemográficos (idade, sexo, estado civil, renda, escolaridade), saúde sistêmica (doenças autorreferidas) e percepção sobre a saúde geral (excelente, razoável e/ou ruim). Resultados: o nível educacional dos idosos revelou diferenças quanto à renda e à condição de saúde autorreferida, mostrando que quanto mais anos de estudo, mais chances de melhor renda salarial e menor chance de adoecer, haja vista a diferença na percepção da saúde. Conclusão: há influencia nas condições de saúde geral dos idosos mediante o nível de renda e de educação.
Atividade artística para avaliar o consumo alimentar e os conhecimentos de nutrição em crianças com excesso de peso
Authors: Vinhal Caroline Andrade , Lisboa Luciane Cristina de Oliveira , Gontijo Michele Cristina Faria , Almeida Martha Elisa Ferreira de
Published: September 2019

Objetivo: avaliar o consumo alimentar e os conhecimentos em nutrição por meio de atividades artísticas, em crianças com excesso de peso antes e depois de atividades de educação alimentar e nutricional. Métodos: utilizaram-se algumas atividades de educação alimentar e nutricional como uma gincana para avaliar os órgãos dos sentidos, a pirâmide alimentar e um semáforo, bem como a montagem artística de dois pratos referentes a uma refeição. Analisaram-se os dados da gincana pelo Teste do χ2 a 5% de significância. Resultados: o feijão foi o único alimento que apresentou diferença estatística (p<0,05) em relação ao tato. Todos os avaliados colocaram os alimentos corretamente na pirâmide alimentar, e, na prova do semáforo, os meninos apresentaram mais acertos. O feijão permaneceu no prato de todos os participantes depois das atividades trabalhadas, havendo a retirada do arroz pelas crianças obesas e os meninos com sobrepeso. Em alguns pratos, houve a retirada das carnes, dos ovos, das frutas e hortaliças, e outros permaneceram com os alimentos ricos em óleos e gorduras, açúcares e doces. Conclusão: as atividades de educação alimentar e nutricional melhoraram a percepção quanto à alimentação, e, consequentemente, o consumo alimentar expresso por meio da atividade artística, fazendo-se necessárias outras ações para trabalhar a ingestão de açúcares e doces, óleos e gorduras e refrigerantes.