bluuebunny/crossref_metadata_2025 huggingface dataset:
Early low-energy versus high-energy enteral nutrition support in patients with traumatic intracerebral haemorrhage: protocol for a randomised controlled trial
Authors: Shen Yanfei , Cheng Xuping , Ying Manzhen , Zhang Weimin , Jiang Xuandong , Du Kailei
Published: November 2017

Background

Early enteral nutrition (EN) is associated with shorter hospital stay and lower infection and mortality rates in patients with intracerebral haemorrhage. However, high-energy support always causes clinical complications, such as diarrhoea and aspiration pneumonia, and the true benefit of high-energy support in these patients has not been investigated. The appropriate amount of energy support still needs further investigation. Therefore, we are performing a randomised controlled trial to investigate whether early low-energy EN can decrease mortality and feeding-related complications and improve neurological outcomes as compared with high-energy EN in traumatic intracerebral haemorrhage (TICH) patients.

Methods/analysis

This is a randomised, single-blind clinical trial performed in one teaching hospital. 220 TICH patients will be randomly allocated to one of two groups in a 1:1 ratio: an intervention group, and a control group. The intervention group will receive early low-energy EN (10 kcal/kg/day) and the control group will receive high-energy EN (25 kcal/kg/day) for 7 days. All these patients will be followed up for 90 days. The primary outcome is all-cause 90-day mortality. Secondary outcomes include the modified Rankin score, Glasgow Outcome Scale (GOS) and the National Institutes of Health Stroke Scale (NIHSS). Outcomes will be assessed at admission, 7, 30 and 90 days after onset of this trial. The safety of EN strategies will be assessed every day during hospitalisation.

Ethics and dissemination

The trial will be conducted in accordance with the Declaration of Helsinki and has been approved by the ethics committee of Dongyang People’s Hospital. The findings will be published in peer-reviewed medical journals.

Trial registration number

ChiCTR-INR-17011384; Pre-results.
Marriage and risk of dementia: systematic review and meta-analysis of observational studies
Authors: Sommerlad Andrew , Ruegger Joshua , Singh-Manoux Archana , Lewis Glyn , Livingston Gill
Published: November 2017

Background

Being married is associated with healthier lifestyle behaviours and lower mortality and may reduce risk for dementia due to life-course factors. We conducted a systematic review and meta-analysis of studies of the association between marital status and the risk of developing dementia.

Methods

We searched medical databases and contacted experts in the field for relevant studies reporting the relationship, adjusted for age and sex, between marital status and dementia. We rated methodological quality and conducted random-effects meta-analyses to summarise relative risks of being widowed, divorced or lifelong single, compared with being married. Secondary stratified analyses with meta-regression examined the impact of clinical and social context and study methodology on findings.

Results

We included 15 studies with 812 047 participants. Compared with those who are married, lifelong single (relative risk=1.42 (95% CI 1.07 to 1.90)) and widowed (1.20 (1.02 to 1.41)) people have elevated risk of dementia. We did not find an association in divorced people.

Further analyses showed that less education partially confounds the risk in widowhood and worse physical health the elevated risk in lifelong single people. Compared with studies that used clinical registers for ascertaining dementia diagnoses, those which clinically examined all participants found higher risk for being unmarried.

Conclusions

Being married is associated with reduced risk of dementia than widowed and lifelong single people, who are also underdiagnosed in routine clinical practice. Dementia prevention in unmarried people should focus on education and physical health and should consider the possible effect of social engagement as a modifiable risk factor.
Coherence of two-level atoms within cavity QED
Authors: Li Shuang , Shi Jia-Dong , Sun Wen-Yang , Wang Dong , Ye Liu
Published: November 2017

In this work, we investigate the dynamics of the coherence of two atoms trapped in one cavity with resonance and large detuned characters, respectively. By means of tracing over the freedom of the cavity, the evolution coherent state can be obtained. Subsequently, the coherence within the two different scenarios is discussed. Remarkably, an interesting result is obtained as the coherence can be enhanced to a large extent in the framework of large detuning. Besides, we find that there exists a distinctive phenomenon of recovery of the coherence with the interaction time of atom–cavity.
Proactivity and Retroactivity of Firms and Information Sharing of Hackers
Authors: Hausken Kjell
Published: November 2017

One firm defends proactively or retroactively against a first hacker, and thereafter against a second hacker, in four four-period games. The hackers share information for financial gain, mutual advantage, and reputation. The first hacker’s attack and information sharing are strategic substitutes. When the firm is proactive in period 1, the first hacker’s information sharing decreases as the second hacker’s attack cost increases. The deterring effort in eight corner solutions is proportional to the deterred player’s valuation and inverse proportional to the deterred player’s unit effort cost. When the first hacker exerts higher effort and shares more information, lower defense by the firm is sufficient to deter the second hacker. When the firm is deterred by the first hacker, the first hacker attacks less and shares more information than in the interior solution. For the first hacker and the firm, both players commonly prefer the disadvantaged player to move first. The exception is that the firm prefers to deter the first disadvantaged hacker when the two hackers benefit substantially from information sharing, reputation gain, or the second player is advantaged. The results contrast with the literature where the advantaged player commonly prefers to move first, with conflicting sequence preferences.
Reliability Estimation of Stochastic Dynamical Systems with Fractional Order PID Controller
Authors: Li Wei , Chen Lincong , Zhao Junfeng , Trisovic Natasa
Published: November 2017

In this paper, the reliability of stochastic dynamical systems under Gaussian white noise excitations with fractional order proportional–inegral–derivative (FOPID) controller is estimated. First, the FOPID controller is approximated by a set of combination of displacement and velocity based on the generalized van der Pol transformation. Then, the stochastic averaging method of energy envelope is applied to obtain a diffusive differential equation, from which the Backward Kolmogorov equation, governing the conditional reliability function, and the Generalized Pontryagin equation, governing the statistical moments of first-passage time, are derived from the averaged equation and solved numerically. Finally, in the two examples, the critical parameters in the FOPID controller are shown to be capable of improving the reliability of the stochastic dynamical system apparently, and all numerical results are verified to be efficient and correct by the Monte Carlo simulation.
Analytical Techniques for Decision Making on Information Security for Big Data Breaches
Authors: Albeshri Aiiad , Thayananthan Vijey
Published: November 2017

In the big data processes, management and analytics are primary areas where we can introduce the decision making on information security to mitigate the big data breaches. According to the growing number of online systems and big data handling, mitigating the big data breaches is the serious problem during the processing period which needs to be monitored using appropriate technique. The goal of this research is to prevent the big data breaches using correct decision making based on information security concepts such as access control with authentication which depend on the management policies. The analytical approach of information security solution can also be useful for securing the big data infrastructure and key management that improve the big data breaches. As an analytical method, information security which focuses on detecting and securing the big data breaches is considered with access control. Here, we have introduced the multi-priority model influenced with the network calculus and access control which monitors the breaches during the big data processing. In the results and analysis, we can provide a graph which shows the monitoring improvement for decision making during the mitigation of big data breaches.
e-Service Quality Model for Spanish Textile and Fashion Sector: Positioning Analysis and B2C Ranking by F-Topsis
Authors: Castro-Lopez Adrian , Puente Javier , Vazquez-Casielles Rodolfo
Published: November 2017

This paper proposes and validates an e-service quality (eSQ) evaluation model for B2C websites in the textile-and-fashion (TF) sector in Spain. The research allows to represent the positioning of the main websites of this sector according to different utilitarian and hedonic quality dimensions and to establish the global ranking of these websites by using the F-TOPSIS methodology. After a thorough bibliographic review of the most common attributes used to evaluate eSQ of B2C websites, an expert panel has assisted in both, their precise wording and grouping them into the factors and latent dimensions of the proposed model. Later, model validation was carried out through the psychometric analysis of a survey conducted over a sample of 405 users searching/buying on TF industry online sales platforms. The paper already shows the perceptual maps for the eSQ dimensions analyzed for different TF B2C websites. Finally, in order to be able to process the intrinsic uncertainty inherent to the valuations given by the users, the F-TOPSIS method was used to sort the main TF websites. The study has demonstrated the validity of the proposed model, making it replicable in other countries and allowing to obtain the positioning and ranking of the six main websites analyzed in Spain, where Asos and Zara were the leaders.
Approximate symmetry analysis of nonlinear Rayleigh-wave equation
Authors: Rashidi Saeede , Hejazi S. Reza , Dastranj Elham
Published: November 2017

In this paper, the Lie approximate symmetry analysis is applied to investigate the new exact solutions of the Rayleigh-wave equation. The power series method is employed to solve some of the obtained reduced ordinary differential equations with a small parameter. We yield the new analytical solutions with small parameter which is effectively obtained by the proposed method. The concept of nonlinear self-adjointness is used to construct the conservation laws for Rayleigh-wave equation. It is shown that this equation is approximately nonlinearly self-adjoint and therefore desired conservation laws can be found using appropriate formal Lagrangians.
Evolution of expansion-free spherically symmetric self-gravitating non-dissipative fluids and some analytical solutions
Authors: Kumar Rajesh , Srivastava Sudhir Kumar
Published: November 2017

We consider the distribution of spherically symmetric self-gravitating non-dissipative (but anisotropic) fluids under the expansion-free condition which requires the existence of vacuum cavity within the fluid distribution. The Darmois junction condition is investigated for matching the spherically symmetric metric to an internal vacuum cavity (Minkowski space-time). We have studied some analytical models, total of three family of solutions out of which two satisfy the junction conditions over both the hypersurfaces. The models are investigated under some known dynamical assumptions which further provide analytical solution in each family.
A plant–pollinator system: How learning versus cost-benefit can induce periodic oscillations
Authors: Vázquez Virgilio , Barradas Ignacio
Published: November 2017

In this paper, we propose a model describing the interaction between two species: a plant population that gets pollinated by an insect population. We assume the plant population is divided into two groups: the first group in mutualistic relationship with the insect and the second group attracting the insects while deceiving them and not delivering any reward. In addition, we assume that the insect population reduces the number of visits to the plants after several unsuccessful visits. We are interested in the conditions for the coexistence of both species, especially in the appearance of damped or sustained oscillations. We focus the analysis on the parameters that measure the balance among deceit, the benefit that the insect gets from the plant, and the learning by the pollinators. We are especially interested in analyzing the effect of learning by the insect population due to unsuccessfully visiting the deceiving plants.
In situ microcalorimetric investigation on the formation of cadmium-organic framework based on 5-mercaptoisophthalic acid
Authors: Cen Huoshi , Liu Wenlong , Nan Zhaodong
Published: November 2017

In situ microcalorimetry was first used to study the crystal formation processes of porous metal-organic frameworks (MOF), [((CH[Formula: see text]NH[Formula: see text]Cd(MIPA)][Formula: see text][Formula: see text], where H3MIPA is 5-Mercaptoisophthalic acid, G represents guest of DMA and H2O. An endothermic process occurred firstly, which is corresponding to the chemical reaction among the reactants. Exothermic processes followed the endothermal process are corresponding to crystal nucleation and growth. The experimental results demonstrate that a solid sample was first obtained at 150[Formula: see text]C for 24[Formula: see text]h. X-ray powder diffraction (XRD) peaks of the samples enhanced with the experimental time increasing from 24 to 60[Formula: see text]h (as 24, 35, 48 and 60[Formula: see text]h). The adsorption properties of the crystal obtained at 150[Formula: see text]C for 60[Formula: see text]h are more excellent than those reported and the same MOF synthesized at 150[Formula: see text]C for 72[Formula: see text]h. This study may give a method for investigation on MOFs formation mechanism and help to synthesize this kind of functional materials.
Monophonic convexity in weighted graphs
Authors: Mathew Jill K. , Mathew Sunil
Published: November 2017

In this paper, the concept of monophonic convexity is extended to weighted graphs. Set theoretic operations of monophonic convex sets and some of their properties are discussed. The notions of weighted monophonic block, weighted monophonic boundary and interior points are also studied and their characterizations are obtained.
SIGWEB annual report
Authors: Bulterman Dick C. A.
Published: November 2017

This is my second Chair's report for SIGWEB. In this report, I will update our membership on our activities and some of our key performance indicators. In doing so, all of us involved with the SIG realize that it is the SIG membership that is the key component to ensuring our current and future success.
"Real-time recommendations in a multi-domain environment" by Emanuel Lacic with Prateek Jain as coordinator
Authors: Lacić Emanuel
Published: November 2017

Emanuel Lacić is a Software Engineer and Scientific Researcher in the Social Computing division at the Know-Center. Additionally, he is a PhD student at the Interactive Systems & Data Science Institute of Graz University of Technology. He has a M.Sc. and B.Sc. in Software Engineering and Information Systems from the Faculty of Electrical Engineering and Computing at the University of Zagreb. His PhD focus is on real-time recommender systems in large-scale settings. Apart from that, his research is utilized in several industry and European-funded projects such as Learning Layers, AFEL or MoreGrasp. His main research interests are in the fields of Recommender Systems, Deep Learning, Information Retrieval, Big Data, as well as Social and Complex Network Analysis. For more information please see https://lacic.github.io/
Building tools to help students learn to program
Authors: Guo Philip
Published: November 2017

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Philip Guo summarizes his first three years of research into building tools to support those learning computer programming.
Technology-driven changes in work and employment
Authors: Montealegre Ramiro , Cascio Wayne F.
Published: November 2017

Even when surrounded by ubiquitous computing, humans should be encouraged to do what they do better than machines.
The Vasodilatory Effects of Anti‐Inflammatory Herb Medications: A Comparison Study of Four Botanical Extracts
Authors: Zhang Hong Ping , Zhang Dan-Dan , Ke Yan , Bian Ka
Published: November 2017

Inflammation plays a pivotal role in the development and progression of cardiovascular diseases, in which, the endothelium dysfunction has been a key element. The current study was designed to explore the vasodilatory effect of anti‐inflammatory herbs which have been traditionally used in different clinical applications. The total saponins from Actinidia arguta radix (SAA), total flavonoids from Glycyrrhizae radix et rhizoma (FGR), total coumarins from Peucedani radix (CPR), and total flavonoids from Spatholobi caulis (FSC) were extracted. The isometric measurement of vasoactivity was used to observe the effects of herbal elements on the isolated aortic rings with or without endothelium. To understand endothelium‐independent vasodilation, the effects of herb elements on agonists‐induced vasocontractility and on the contraction of endothelium‐free aortic rings exposed to a Ca2+‐free medium were examined. Furthermore, the role of nitric oxide signaling in endothelium‐dependent vasodilation was also evaluated. In summary, FGR and FSC exhibit potent anti‐inflammatory effects compared to CPR and SAA. FGR exerts the strongest vasodilatory effect, while CPR shows the least. The relaxation induced by SAA and FSC required intact endothelia. The mechanism of this vasodilation might involve eNOS. CPR‐mediated vasorelaxation appears to involve interference with intracellular calcium homeostasis, blocking Ca2+ influx or releasing intracellular Ca2+.
Acute Cervical Dystonia Induced by Clebopride
Authors: Choi Jin Kyo , Hong Jin Yong
Published: November 2017

Antidopaminergic drugs are known to induce extrapyramidal symptoms. Clebopride, a dopamine antagonist, also can produce parkinsonism, tardive dyskinesia, tardive dystonia, hemifacial dystonia, or oculogyric crisis; however, acute dystonic reaction caused by clebopride has not been reported in adults. We report two young men who experienced acute cervical dystonia within a few days of taking clebopride. The patients recovered after discontinuation of the drug. Physicians prescribing clebopride should be aware of the adverse effects of this drug.
Effectiveness of Antihyperglycemic Effect of Momordica charantia: Implication of T‐Cell Cytokines
Authors: Fachinan Rufine , Yessoufou Akadiri , Nekoua Magloire Pandoua , Moutairou Kabirou
Published: November 2017

Background/Objective. We investigate the effect of antidiabetic Momordica charantia fruit juice on T cells’ differentiation, through plasmatic cytokine quantification in type 1 diabetic rats (T1D). Methods. Male Wistar rats were rendered diabetic by the injection of five low doses of streptozotocin. Then, animals were treated with Momordica charantia fruit juice for 28 consecutive days. Plasmatic levels of Th1 interleukin‐ (IL‐) 02 and interferon‐ (IFN‐) γ, Th2 (IL‐4), and regulatory (IL‐10) cytokines were determined in rats. Results. We observed that fruit juice induced a significant decrease in blood glucose of T1D rats. Besides, the concentrations of IL‐2 and IFN‐γ significantly increased while those of IL‐4 and IL‐10 diminished in diabetic rats compared to control animals. Interestingly, after treatment with Momordica charantia fruit juice, IL‐4 and IL‐10 levels significantly increased in diabetic rats, while IL‐2 and IFN‐γ concentrations decreased, suggesting a Th2 phenotype in these animals. Phytochemical analysis of the fruit juice revealed the presence of tannins, flavonoids, and coumarins, compounds which possess antioxidant activity. Conclusion. This study shows that Momordica charantia fruit juice, by lowering the hyperglycemia, induced a shift of proinflammatory Th1 phenotype in T1D rats towards a favorable anti‐inflammatory Th2 status. These effects might be due to the presence of antioxidant compounds in the juice and confirms the use of this plant in the treatment of autoimmune type 1 diabetes.
Novel Splicing Mutation in B3GAT3 Associated with Short Stature, GH Deficiency, Hypoglycaemia, Developmental Delay, and Multiple Congenital Anomalies
Authors: Bloor Samuel , Giri Dinesh , Didi Mohammed , Senniappan Senthil
Published: November 2017

B3GAT3, encoding β-1,3-glucuronyltransferase 3, has an important role in proteoglycan biosynthesis. Homozygous B3GAT3 mutations have been associated with short stature, skeletal deformities, and congenital heart defects. We describe for the first time a novel heterozygous splice site mutation in B3GAT3 contributing to severe short stature, growth hormone (GH) deficiency, recurrent ketotic hypoglycaemia, facial dysmorphism, and congenital heart defects. A female infant, born at 34 weeks’ gestation to nonconsanguineous Caucasian parents with a birth weight of 1.9 kg, was noted to have cloacal abnormality, ventricular septal defect, pulmonary stenosis, and congenital sensorineural deafness. At 4 years of age, she was diagnosed with GH deficiency due to her short stature (height < 2.5 SD). MRI of the pituitary gland revealed a small anterior pituitary. She has multiple dysmorphic features: anteverted nares, small upturned nose, hypertelorism, slight frontal bossing, short proximal bones, hypermobile joints, and downslanting palpebral fissures. Whole exome sequencing (WES) was performed on the genomic DNA from the patient and biological mother. A heterozygous mutation in B3GAT3 (c.888+262T>G) in the invariant “GT” splice donor site was identified. This variant is considered to be pathogenic as it decreases the splicing efficiency in the mRNA.
Brain-Specific SNAP-25 Deletion Leads to Elevated Extracellular Glutamate Level and Schizophrenia-Like Behavior in Mice
Authors: Yang Hua , Zhang Mengjie , Shi Jiahao , Zhou Yunhe , Wan Zhipeng , Wang Yicheng , Wan Yinghan , Li Jun , Wang Zhugang , Fei Jian
Published: November 2017

Several studies have associated reduced expression of synaptosomal-associated protein of 25 kDa (SNAP-25) with schizophrenia, yet little is known about its role in the illness. In this paper, a forebrain glutamatergic neuron-specific SNAP-25 knockout mouse model was constructed and studied to explore the possible pathogenetic role of SNAP-25 in schizophrenia. We showed that SNAP-25 conditional knockout (cKO) mice exhibited typical schizophrenia-like phenotype. A significantly elevated extracellular glutamate level was detected in the cerebral cortex of the mouse model. Compared with Ctrls, SNAP-25 was dramatically reduced by about 60% both in cytoplasm and in membrane fractions of cerebral cortex of cKOs, while the other two core members of SNARE complex: Syntaxin-1 (increased ~80%) and Vamp2 (increased ~96%) were significantly increased in cell membrane part. Riluzole, a glutamate release inhibitor, significantly attenuated the locomotor hyperactivity deficits in cKO mice. Our findings provide in vivo functional evidence showing a critical role of SNAP-25 dysfunction on synaptic transmission, which contributes to the developmental of schizophrenia. It is suggested that a SNAP-25 cKO mouse, a valuable model for schizophrenia, could address questions regarding presynaptic alterations that contribute to the etiopathophysiology of SZ and help to consummate the pre- and postsynaptic glutamatergic pathogenesis of the illness.
The Relationship of Triphasic Waves with Intracranial Pressure as a Possible Prognostic Marker in Traumatic Brain Injury
Authors: Katyal Nakul , Sarwal Aarti , George Pravin , Banik Biswajit , Newey Christopher R.
Published: November 2017

Background.Continuous electroencephalography (CEEG) monitoring is used for detection of convulsive and nonconvulsive seizures and assessing the degree of encephalopathy in critically ill patients. A commonly seen encephalopathic pattern on CEEG is generalized periodic discharges with triphasic wave (TW) morphology. The underlying role and prognostic significance of TW in relationship to intracranial pressure (ICP) remain unknown. We present a case highlighting the relationship of TW with ICP in a case with severe traumatic brain injury (TBI).Method.Case report.Results.A patient with severe TBI and no underlying metabolic abnormalities was admitted to the neurocritical care unit. TW were seen on CEEG. The TW diminished during episodes of intracranial hypertension but reappeared with reduction of the intracranial pressure.Conclusion.This study highlights a possible favorable prognostic marker of finding TW in a patient with intracranial hypertension. We have proposed a preliminary understanding of the relationship between TW and intracranial hypertension, which may be helpful in formulating future studies involving larger cohorts.
Effect of Moringa oleifera Leaf Capsules on Glycemic Control in Therapy‐Naïve Type 2 Diabetes Patients: A Randomized Placebo Controlled Study
Authors: Taweerutchana Rutchaporn , Lumlerdkij Natchagorn , Vannasaeng Sathit , Akarasereenont Pravit , Sriwijitkamol Apiradee
Published: November 2017

Background. Studies showed effects of Moringa oleifera (MO) on lowering blood sugar levels in animal and diabetes patients. The aims of this study were to determine the effect of MO leaf capsules on glucose control in therapy‐naïve type 2 diabetes mellitus (T2DM) and to evaluate its safety. Method. This was a prospective randomized placebo controlled study. Therapy‐naïve T2DM was randomly assigned to receive either 8 grams per day of MO leaf capsules (MO leaf group) or placebo for 4 weeks. Clinical and laboratory characteristics were recorded at screening and at the end of 4‐week study. 9‐point plasma glucose was obtained before and every week during the study. Results. Thirty‐two T2DM patients were enrolled. The mean age was 55 years and the mean HbA1C was 7.0%. There was no significant difference in FPG and HbA1C between groups. MO leaf group had SBP reduction by 5 mmHg as compared to baseline but this difference had no statistical significance. There were no adverse effects of MO leaf. Conclusions. Moringa oleifera leaf had no effect on glycemic control and no adverse effects in T2DM. Interestingly, this study demonstrated that MO leaf had a tendency on blood pressure reduction in T2DM, and this result needs further investigation.
Virtual Planning of a Complex Three-Part Bimaxillary Osteotomy
Authors: Di Blasio Chiara , Anghinoni Marilena Laura , Di Blasio Alberto
Published: November 2017

In maxillofacial surgery, every patient presents special problems requiring careful evaluation. Conventional methods to study the deformities are still reliable, but the advent of tridimensional (3D) imaging, especially computed tomography (CT) scan and laser scanning of casts, created the opportunity to better understanding the skeletal support and the soft tissue structures. Nowadays, virtual technologies are increasingly employed in maxillofacial surgery and demonstrated precision and reliability. However, in complex surgical procedures, these new technologies are still controversial. Especially in the less frequent cases of three-part maxillary surgery, the experience is limited, and scientific literature cannot give a clear support. This paper presents the case of a young patient affected by a complex long face dentofacial deformity treated by a bimaxillary surgery with three-part segmentation of the maxilla. The operator performed the surgical study completely with a virtual workflow. Pre- and postoperative CT scan and optical scanning of plaster models were collected and compared. Every postoperatory maxillary piece was superimposed with the presurgical one, and the differences were examined in a color-coded map. Only mild differences were found near the osteotomy lines, when the bony surface and the teeth demonstrated an excellent coincidence.
Incidence and Factors Associated with Burnout in Anesthesiology: A Systematic Review
Authors: Sanfilippo Filippo , Noto Alberto , Foresta Grazia , Santonocito Cristina , Palumbo Gaetano J. , Arcadipane Antonio , Maybauer Dirk M. , Maybauer Marc O.
Published: November 2017

Background. Burnout syndrome has reached epidemic levels among physicians (reported around 50%). Anesthesiology is among the most stressful medical disciplines but there is paucity of literature as compared with others. Analysis of burnout is essential because it is associated with safety and quality of care. We summarize evidence on burnout in anesthesiology. Methods. We conducted a systematic review (MEDLINE up to 30.06.2017). We included studies reporting burnout in anesthesiology with no restriction on role or screening test used. Results. Fifteen surveys/studies described burnout in anesthesiology, including different workers profiles (nurses, residents, consultants, and directors). All studies used the Maslach Burnout Inventory test but with significant differences for risk stratification. Burnout prevalence greatly varied across studies (10%–41% high risk, up to 59% at least moderate risk). Factors most consistently associated with burnout were strained working pattern, working as younger consultant, and having children. There was no consistent relationship between burnout and hospital characteristics, gender, or marital status. Conclusions. Burnout prevalence among anesthesiologists is relatively high across career stages, and some risk factors are reported frequently. However, the small number of studies as well as the large differences in their methodology and in reporting approach warrants further research in this field.
Can Early Dissection of Cervical Lymph Nodes Improve Prognosis in Squamous Cell Carcinomas of the Hard Palate
Authors: Deneuve Sophie , Bodard Anne-Gaelle , Delquignies Erica , Janot François , Zrounba Philippe , Julieron Morbize
Published: November 2017

Squamous cell carcinomas of the hard palate and maxillary alveolar ridge are rare tumours with a poor prognosis. Lymph node dissection is recommended for tumours with nodal involvement, and is rarely performed in the absence of adenopathy. We report a series of patients with squamous cell carcinomas and evaluate the rate of lymph node invasion and its impact on survival. This is a retrospective study of 72 patients treated for squamous cell carcinoma of the hard palate and maxillary alveolar ridge between January 1, 1998 and December 31, 2008 in two cancer centres. Using clinical and radiological assessment, tumours were classified as T1-T2 in 25 patients (34.7%) and T3-T4 in 47 patients (65.3%). At diagnosis, 16 (22.2%) patients had clinical and/or radiological nodal involvement and 7 patients (9.7%) distal metastasis. Among N0 patients, 13 (18%) experienced isolated lymph node recurrence. Two-year global survival was 60%; 5-year survival was 34%. The rate of lymph node invasion observed in squamous cell carcinoma of the hard palate and maxillary alveolar ridge does not differ from other oral cavity sites. Because nodal recurrence worsens the prognosis of such a patient, lymph node dissection should be considered at an early stage, even among N0 patients.
Differential Expression of the Aryl Hydrocarbon Receptor and Transforming Growth Factor Beta 1 in Chronic Rhinosinusitis with Nasal Polyps with Allergic Rhinitis
Authors: Chen Lu , Xiao Ling , Liu Jie , Shen Yang , Ke Xia , Huang Jiangju , Hu Guohua , Yang Yucheng
Published: November 2017

Objective: This study aimed to determine the aryl hydrocarbon receptor (AhR) and transforming growth factor beta 1 (TGF-β1) expression levels in chronic rhinosinusitis (CRS) and their possible correlation with allergic state and tissue remodeling. Methods: Patients were enrolled and divided into the following groups: CRS without nasal polyps (NP) without allergic rhinitis (AR) (CRSsNPsAR; n = 20), CRS with NP with AR (CRSwNPwAR; n = 20), CRS with NP without AR (CRSwNPsAR; n = 20), and controls (n = 15). Tissue samples were analyzed by Masson trichrome staining for collagen, while the location and expression of AhR and TGF-β1 were analyzed by immunohistochemistry, quantitative reverse transcription polymerase chain reaction (qRT-PCR), and Western blotting. Results: The collagen amounts as well as AhR and TGF-β1 mRNA and protein expression levels were significantly increased in the CRSsNPsAR group compared with the CRSwNP (CRSwNPsAR and CRSwNPwAR) samples (p < 0.01). However, higher collagen amounts (p < 0.05) and higher TGF-β1 (p < 0.05) but lower AhR expression levels (p < 0.05) were detected in the CRSwNPwAR versus the CRSwNPsAR patients. Both AhR and TGF-β1 expression were positively correlated with the collagen level in CRS samples (p < 0.01). Conclusions: Elevated AhR expression may be involved in the progression of tissue remodeling in CRSsNPsAR similar to TGF-β1 expression. Conversely, lower AhR expression may be involved in allergic reactions in CRSwNPwAR.
Mild-to-Moderate Chronic Kidney Disease and Geriatric Outcomes: Analysis of Cross-Sectional Data from the Berlin Aging Study II
Authors: König Maximilian , Gollasch Maik , Spira Dominik , Buchmann Nikolaus , Hopfenmüller Werner , Steinhagen-Thiessen Elisabeth , Demuth Ilja
Published: November 2017

Background: Mild-to-moderate chronic kidney disease (CKD G3a) is prevalent in older adults. Substantial evidence suggests that individuals with advanced CKD face a high risk for common geriatric conditions, like functional impairment and cognitive decline, whereas the relationships between mild-to-moderate CKD and functional impairment and cognitive decline, but also poor nutritional status and mood disorders, are still unclear. Objective: The aim of this study was to explore associations between mild-to-moderate CKD and impairments in the core domains of geriatric assessment (GA) in a large cohort of community-dwelling older adults. Methods: This was a cross-sectional analysis of 1,476 participants of the Berlin Aging Study II. Study participants were stratified as to presence or absence of CKD G3a (estimated glomerular filtration rate [eGFR] 45-59 mL/min/1.73 m2 vs. eGFR ≥60 mL/min/1.73 m2). GA comprised the following instruments: the Activities of Daily Living Scale (ADL), the Timed up and Go (TUG), the Tinetti test (Tinetti), the Mini-Mental-State Examination (MMSE), the Geriatric Depression Scale (GDS), and the Mini Nutritional Assessment (MNA). We used logistic regression models to estimate multivariable-adjusted associations between CKD G3a and impairments in the respective domains. Results: A total of 282 subjects with mild-to-moderate CKD (CKD G3a) were identified (19.1%). Overall, the prevalence of impairments identified was higher among subjects with compared to without CKD G3a (21 vs. 15.9%, p = 0.043). In multivariable-adjusted models, CKD G3a was consistently associated with increased odds of an impaired gait performance as to the TUG (adjusted odds ratio 2.06, 95% CI 1.04-4.09). In contrast, on average, individuals with and without CKD G3a did not differ as to their results in the MMSE, the ADL, the MNA, and the GDS. Conclusion: GA identified impairments in 21 versus 15.9% of older adults with and without mild-to-moderate CKD, respectively. However, except for an increased likelihood of impaired gait performance (TUG) with mild-to-moderate CKD, we did not find independent associations between mild-to-moderate CKD and geriatric conditions.
Proximal Deletion of 6q Overlapping with Toriello-Carey Facial Phenotype: Prenatal Findings, Clinical Course, Differential Diagnosis, and Review
Authors: Catena Sofía , Aracena Mariana , Pizarro Óscar , Espinoza Karena , Lay-Son Guillermo
Published: November 2017

Proximal deletion of 6q is a relatively rare chromosomal abnormality. Reported patients have deletions of different sizes but share partial overlap and present with similar clinical features, and some of them were described prior to the introduction of chromosome microarrays. We describe a male patient with prenatal sonographic findings of nuchal edema, intrauterine growth restriction, renal pelvis dilatation, and oligohydramnios. At birth, facial dysmorphism, retro/micrognathia, a short and wide neck as well as cardiovascular and renal anomalies were noted. His clinical evolution has been marked by failure to thrive, severe developmental delay, and cognitive impairment. The diagnosis of Toriello-Carey syndrome (TCS) was based on his “gestalt.” aCGH identified a de novo proximal deletion of 17 Mb in 6q (6q12q14.3). Deletion 6q13q14 seems to be responsible for the main facial features and should be considered within the differential diagnosis of TCS.
Evaluation of the Efficacy of Ultrasound-Guided Local Lauromacrogol Injection Combined with Aspiration for Cesarean Scar Pregnancy: A Novel Treatment
Authors: Chai Ze-Ying , Yu Li , Liu Man-Man , Zhu Tong-Wei , Qi Feng
Published: November 2017

Objectives: To evaluate the efficacy of ultrasound-guided local lauromacrogol injection combined with aspiration for treating cesarean scar pregnancy (CSP). Methods: From July 2016 to December 2016, 18 patients diagnosed with CSP were treated with ultrasound-guided local lauromacrogol injection combined with aspiration. Clinical data and outcome were analysed. Results: All patients were treated successfully. The amount of bleeding ranged between 10 and 50 mL. The duration of hospitalization ranged between 2 and 11 days. Serum β-human chorionic gonadotropin (β-hCG) decreased to the nondetectable level within 19–41 days. Menstruation recovery occurred after 10–24 days of normalization of serum β-hCG level. Reproductive functions were preserved, and there were no untoward effects or complications. Conclusions: Ultrasound-guided local lauromacrogol injection combined with aspiration is an effective CSP therapy, as it was associated with a high success rate, short hospitalization and fast recovery. However, its wider application and popularization have to be validated on a larger patient population affected by CSP.
Identification of Subpathway Signatures For Ovarian Cancer Prognosis by Integrated Analyses of High-Throughput miRNA and mRNA Expression
Authors: Tian Songyu , Tian Jiangtian , Chen Xiuwei , Li Lianwei , Liu Yunduo , Wang Yuping , Sun Yuqi , Zhang Chunlong , Lou Ge
Published: November 2017

Background/Aims: Ovarian cancer (OC) causes more death and serious conditions than any other female reproductive cancers, and many expression signatures have been identified for OC prognoses. However, no significant overlap is found among signatures from different studies, indicating the necessity of signature identifications at the functional level. Methods: We performed an integrated analyses of miRNA and gene expressions to identify OC prognostic subpathways (pathway regions). Using The Cancer Genome Atlas data set, we identified core prognostic subpathways, and calculated subpathway risk scores using both miRNA and gene components. Finally, we performed global risk impact analyses to optimize core subpathways using the random walk algorithm. Results: Subpathway-level analyses displayed more robust results than the gene- and miRNA-level analyses. Moreover, we verified the advantage of core subpathways over the entire pathway-based results and their prognostic performance in two independent validation data sets. Based on the global impact score, 13 subpathway signatures were selected and a combined subpathway-based risk score was further calculated for OC patient prognoses. Conclusions: Overall, it was possible to systematically perform integrated analyses of the expression levels of miRNAs and genes to identify prognostic subpathways and infer subpathway risk scores for use in OC clinical applications.
CEASING COPYCAT BEHAVIOUR: DEVELOPING PRODUCT-DESIGN IDENTITY THROUGH INDUSTRY AND HANDCRAFT INTERACTION
Authors: Braga Mariana Fonseca
Published: November 2017

A história do desenvolvimento industrial brasileiro e a educaçao em design nao contribuíram para a construçao de uma cultura de design e para a preservaçao da herança cultural, apesar da riqueza e variedade da cultura brasileira, e da reconhecida produçao dos designers brasileiros. A urgencia em transformar esse cenário caracterizado por uma cultura da cópia em direçao a contextos inovadores tem sido relatada em diversas publicaçoes. Este estudo visa contribuir para o entendimento da mudança do comportamento de cópia na indústria moveleira do Brasil partindo da análise de dois casos práticos. Os casos mostram a interaçao entre indústria e artesanato rumo a construçao de uma cultura de design e a preservaçao do patrimônio cultural regional. O primeiro caso (Pedra de Minas) usa observaçao participante como principal método, o segundo (poltrona Corn) usa entrevista semiestruturada direcionada ao proprietário da empresa, observaçao e análise de materiais de divulgaçao e website da empresa. Revisao de literatura interdisciplinar foi utilizada para auxiliar o entendimento dos casos empíricos e dos contextos de cópia no qual estao imersos, abordaram-se os seguintes tópicos: desencadeadores e barreiras para a integraçao do design nas Pequenas e Médias Empresas (PME); o comportamento da cópia (tópico pouco conhecido na área de pesquisa em design); identidade do produto; sistemas de produçao industrial e artesanal e suas relaçoes com o design. Os objetivos deste artigo sao: contribuir para a análise de casos práticos em uma economia emergente, investigar as relaçoes entre artesanato, indústria e design propondo possibilidades de projetos bidirecionais como potencial fonte de criaçao de valor na empresa e comunidade locais, começar a compreender o comportamento de cópia relacionado ao design de produto na indústria de móveis brasileira assim como sua mudança rumo a inovaçao orientada pelo design, entender melhor a importância da viabilidade para a manufatura e da prototipagem assim como suas fronteiras neste contexto. A discussao e a conclusao apontam os impulsionadores e as barreiras encontradas nos níveis micro (da empresa) e macro (do ambiente externo), enfatizando a necessidade de desenvolver políticas de design efetivas e infraestrutura adequada para apoiar a construçao de uma cultura de design e a preservaçao do patrimônio cultural.
O PROCESSO DE LICENCIAMENTO AMBIENTAL NO PROJETO DE EMPREENDIMENTOS INDUSTRIAIS DE MINERAÇÃO
Authors: Oliveira Priscilla Meireles de , Andery Paulo Roberto Pereira
Published: November 2017

Os projetos de mineraçao geralmente apresentam certa complexidade, e com frequencia tem problemas de desempenho associados ao aumento de prazos para entrada em operaçao. Nesse sentido, um dos grandes gargalos, considerados caminho crítico nos cronogramas de projetos de mineraçao, é o licenciamento ambiental. Os processos de licenciamento ambiental tem se tornado cada vez mais rigorosos, com órgaos responsáveis mais exigentes, o que tem demandado um prazo significativo nos cronogramas dos projetos, acarretando muitas vezes impactos consideráveis na implantaçao dos empreendimentos. Nesse contexto, este trabalho apresenta um estudo exploratório realizado no estado de Minas Gerais, com o objetivo de fazer um levantamento da dimensao dos atrasos em licenciamentos ambientais e das suas causas. Dessa forma, pode contribuir para que, em futuros trabalhos, sejam propostas diretrizes para modificaçao dos processos de licenciamento, no âmbito da concepçao e desenvolvimento dos empreendimentos. O estudo exploratório teve como base de análise os documentos constantes em 355 processos de licenciamento ambiental de quatorze empresas de mineraçao, formalizados no órgao licenciador mineiro. Foi constatado que um número substancial de empreendimentos tem prazos para a obtençao de licenças bem superiores aos previstos na legislaçao ambiental, impactando os cronogramas dos projetos. Constatouse, também, a alta incidencia de solicitaçao de informaçoes complementares por parte do órgao competente. Parte significativa dessas solicitaçoes é decorrente de falhas na caracterizaçao dos empreendimentos e das soluçoes de engenharia, bem como da falta de maturidade na análise do impacto ambiental e suas medidas mitigadoras. O trabalho é relevante na medida em que o conhecimento dos prazos praticados e das causas de atraso na obtençao de licenças ambientais permite aos empreendedores o estabelecimento de cronogramas mais realistas para a concessao das licenças, bem como o direcionamento de açoes no sentido de evitar que estas solicitaçoes ocorram, antevendo riscos e contribuindo para agilizar a análise dos processos de licenciamento.
PROJETAR-COM: O ARQUITETO COMO “AUTOR-REDE” EM MOVIMENTO
Authors: Costa Rodrigo Neves , Azevedo Giselle Arteiro Nielsen , Pedro Rosa Maria Leite
Published: November 2017

A Teoria Ator-Rede (TAR) foi gerada nos estudos de sociologia da ciencia e da tecnologia e tem sido usada em outros campos, como a arquitetura. Porém, ainda existem dificuldades de compreensao e transposiçao dos conceitos propostos, principalmente pelo seu caráter inovador. Assim, este artigo discute o projeto de arquitetura, especialmente o processo de concepçao, propondo uma abordagem a partir das noçoes da teoria. Considerando características do processo de concepçao extraídas da literatura arquitetônica, propomos considerar o projeto como uma construçao coletiva, em que humanos e nao humanos se articulam ativamente, sustentando problema e soluçao. Neste caso, tratamos arquiteto como um “autor-rede”, pois a autoria do projeto está mais ligada a capacidade de traduçao – as associaçoes realizadas – do arquiteto do que a concepçao do objeto em si, reconhecendo a agencia de outros atores. Sobre o processo, a proposta é estar atento as açoes que ocorrem na prática, observando as estratégias utilizadas para incorporaçao de requisitos ao projeto, as traduçoes realizadas pelo arquiteto. Nao é tanto olhar para o produto, mas para sua construçao. Isso diz respeito também a considerar a edificaçao como um projeto em movimento, um fluxo contínuo de transformaçoes.
Phyllanthus racemosus (Phyllanthaceae), a misinterpreted name, replaces P. polyphyllus
Authors: CHAKRABARTY TAPAS , BALAKRISHNAN NAMBIYATH P.
Published: November 2017

Phyllanthus polyphyllus Willdenow (1805: 586) is at present considered to be an accepted name applied for a species distributed in the peninsular India and Sri Lanka (e.g. Wight 1852, Thwaites 1861, Müller 1866, Hooker 1887, Trimen 1898, Gamble 1925, Webster 1997, Gangopadhyay et al. 2007, Chakrabarty et al. 2012). As regards Phyllanthus racemosus Linnaeus f. (1782: 415), it is at present considered to be a synonym of Synostemon bacciformis (L.) Webster (1960: 26), based on Phyllanthus bacciformis Linnaeus (1771: 294), according to the recent treatment by Van Welzen et al. (2014). However, it may be mentioned that it was Willdenow (1805: 582) who first misinterpreted P. racemosus by referring it to an Indian specimen (“Habitat in India orientali” – Klein s.n., B–W17973–010 [digital image!]), which is identifiable as Synostemon bacciformis. Later, Müller (1863) while describing Agyneia bacciformis (L.) Jussieu (1824: 24, t. 6) var. angustifolia cited P. racemosus as its synonym. Subsequently, Hooker (1887) and Pax & Hoffmann (1922) cited P. racemosus as a synonym of Agyneia bacciformis, while Van Welzen (2003) placed it as a synonym of Sauropus bacciformis (L.) Airy Shaw (1980: 685).