bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality of the diagnostic process in patients presenting with symptoms suggestive of bladder or kidney cancer: a systematic review
Authors: Zhou Yin , van Melle Marije , Singh Hardeep , Hamilton Willie , Lyratzopoulos Georgios , Walter Fiona M
Published: October 2019

Objectives

In urological cancers, sex disparity exists for survival, with women doing worse than men. Suboptimal evaluation of presenting symptoms may contribute.

Design

We performed a systematic review examining factors affecting the quality of the diagnostic process of patients presenting with symptoms of bladder or kidney cancer.

Data sources

We searched Medline, Embase and the Cochrane Library from 1 January 2000 to 13 June 2019.

Eligible criteria

We focused on one of the six domains of quality of healthcare: timeliness, and examined the quality of the diagnostic process more broadly, by assessing whether guideline-concordant history, examination, tests and referrals were performed. Studies describing the factors that affect the timeliness or quality of the assessment of urinary tract infections, haematuria and lower urinary tract symptoms in the context of bladder or kidney cancer, were included.

Data extraction and synthesis

Data extraction and quality assessment were independently performed by two authors. Due to the heterogeneity of study design and outcomes, the results could not be pooled. A narrative synthesis was performed.

Results

28 studies met review criteria, representing 583 636 people from 9 high-income countries. Studies were based in primary care (n=8), specialty care (n=12), or both (n=8). Up to two-thirds of patients with haematuria received no further evaluation in the 6 months after their initial visit. Urinary tract infections, nephrolithiasis and benign prostatic conditions before cancer diagnosis were associated with diagnostic delay. Women were more likely to experience diagnostic delay than men. Patients who first saw a urologist were less likely to experience delayed evaluation and cancer diagnosis.

Conclusions

Women, and patients with non-cancerous urological diagnoses just prior to their cancer diagnosis, were more likely to experience lower quality diagnostic processes. Risk prediction tools, and improving guideline ambiguity, may improve outcomes and reduce sex disparity in survival for these cancers.
Management of erectile dysfunction after prostate cancer treatment: cross-sectional surveys of the perceptions and experiences of patients and healthcare professionals in the UK
Authors: Dyer Amy , Kirby Mike , White Isabel D , Cooper Alison Michelle
Published: October 2019

Objectives

Erectile dysfunction (ED) is known to be a common consequence of radical treatment for prostate cancer (PCa) but is often under-reported and undertreated. This study aimed to explore how ED in patients with PCa is managed in real-life clinical practice, from the perspective of patients and healthcare professionals (HCPs).

Design and setting

This is a UK-wide cross-sectional survey of men with ED after treatment for PCa which covered assessment and discussion of erectile function, provision of supportive care and satisfaction with management. Parallel surveys of primary and secondary HCPs were also conducted.

Results

Responses were received from 546 men with ED after PCa treatment, 167 primary (general practitioners and practice nurses) and 94 secondary care HCPs (urologists and urology clinical nurse specialists). Survey findings revealed inadequate management of ED in primary care, particularly underprescribing of effective management options. A fifth of men (21%) were not offered any ED management, and a similar proportion (23%) were not satisfied with the way HCPs addressed their ED concerns. There was poor communication between HCPs and men, including failure to initiate discussions about ED and/or involve partners, with 12% of men not told that ED was a risk factor of PCa treatment. These issues seemed to reflect poor access to effective ED management or services and lack of primary HCP confidence in managing ED, as well as confusion over the roles and responsibilities among both HCPs and men.

Conclusions

This study confirms the need for better support for men from HCPs and more tailored and timely access to effective ED management after treatment for PCa. A clearly defined pathway is required for the discussion and management of ED, starting from the planning stage of PCa treatment. Improved adherence to ED management guidelines and better education and training for primary care HCPs are areas of priority.
Predictors of return to work after kidney transplantation: a 12-month cohort of the Japan Academic Consortium of Kidney Transplantation study
Authors: Miyake Katsunori , Endo Motoki , Okumi Masayoshi , Unagami Kohei , Kakuta Yoichi , Furusawa Miyuki , Shimizu Tomokazu , Omoto Kazuya , Shirakawa Hiroki , Ishida Hideki , Tanabe Kazunari
Published: October 2019

Objectives

To investigate the cumulative return-to-work (RTW) rate and to identify predictors of employment after kidney transplantation (KT).

Design

Retrospective, outpatient-based cohort study.

Setting

This was a single-centre study of the largest Japanese kidney transplant centre.

Participants

We selected Japanese kidney transplant recipients aged 20–64 years who were employed in paid jobs at the time of transplantation and who visited an outpatient clinic from December 2017 to March 2018. From 797 patients, we evaluated 515 in this study.

Interventions

We interviewed patients at an outpatient clinic and investigated the timing and predictors of RTW using logistic regression models.

Primary and secondary outcome measures

The primary outcome was the cumulative RTW rate, and the secondary outcome was to investigate the predictors of RTW after KT.

Results

Among the 515 included recipients, the cumulative overall partial/full RTW rates at 2, 4, 6 and 12 months were 22.3%, 59.0%, 77.1% and 85.0%, respectively. The median duration from transplantation to RTW was 4 months. Regarding partial/full RTW, according to the multivariable analysis including all variables, male sex was a greater predictor for RTW than female sex (OR 2.05, 95% CI 1.32 to 3.20), and a managerial position was a greater predictor than a non-managerial position (OR 2.23, 95% CI 1.42 to 3.52). Regarding full RTW, male sex (OR 1.95, 95% CI 1.25 to 3.06) and managerial position (OR 1.95, 95% CI 1.25 to 3.06) were also good predictors.

Conclusions

The cumulative RTW rate was 85.0% 1-year post-transplantation. Given that cumulative RTW rates varied by sex and position, transplant and occupational physicians should support kidney transplant recipients in the aspect of returning to work.

Trial registration number

UMIN000033449
Diagnosing and treating haemothorax in dogs and cats
Authors: Allerton Fergus
Published: October 2019

Background: Cases of haemothorax are seen in primary practice. Given the range of potential aetiologies, a structured approach to diagnosis is important.

Aim of the article: This article reviews the causes of haemothorax and outlines the approach to diagnosing this condition in practice, as well as how to treat cases.
Effect of procedural refinement of transfemoral transcatheter aortic valve implantation on outcomes and costs: a single-centre retrospective study
Authors: Sangaraju Sivasankar , Cox Ian , Dalrymple-Hay Malcolm , Lloyd Clinton , Suresh Venkatesan , Riches Tania , Melhuish Samantha , Asopa Sanjay , Newcombe Samantha , Deutsch Cornelia , Bramlage Peter
Published: October 2019

Objectives

To determine the effect of introducing several procedural refinements of transfemoral transcatheter aortic valve implantation (TAVI) on clinical outcomes and costs.

Design

Retrospective analysis comparing two consecutive 1-year periods, before and after the introduction of procedural refinements.

Setting

Tertiary hospital aortic valve programme.

Participants

Consecutive patients undergoing transfemoral TAVI treated between April 2014 and August 2015 using the initial setup (n=70; control group) or between September 2015 and August 2016 after the introduction of procedural refinements (n=89).

Interventions

Introduction of conscious sedation, percutaneous access and closure, omission of transoesophageal echocardiography during the procedure, and an early discharge procedure.

Outcome measures

Procedural characteristics, complications and outcomes; length of stay in intensive care unit (ICU) and hospital; hospital-related direct costs associated with TAVI.

Results

There were no statistically significant differences in the incidence of complications or mortality between the two groups. The mean length of stay in the ICU was significantly shorter in the procedural-refinement group compared with the control group (5.1 vs 57.2 hours, p<0.001), as was the mean length of hospital stay (4.7 vs 6.6 days, p<0.001). The total cost per TAVI procedure was significantly lower, by £3580, in the procedural-refinement group (p<0.001). This was largely driven by lower ICU costs.

Conclusions

Among patients undergoing transfemoral TAVI, procedural refinement facilitated a shorter stay in ICU and earlier discharge from hospital and was cost saving compared with the previous setup.
Impact of pulmonary hypertension on outcome in patients with moderate or severe tricuspid regurgitation
Authors: Saeed Sahrai , Smith Jenna , Grigoryan Karine , Urheim Stig , Chambers John B , Rajani Ronak
Published: October 2019

Objectives

The true prevalence and disease burden of moderate or severe (significant) tricuspid regurgitation (TR) in patients undergoing routine echocardiography remains unknown. Our aim was to explore the prevalence of significant TR and the impact of pulmonary hypertension (PH) on outcome in a less selected cohort of patients referred to echocardiography.

Methods

From 12 791 echocardiograms performed between January and December 2010, a total of 209 (1.6%) patients (72±14 years, 56% men) were identified with significant TR; 123 (0.96%) with moderate and 86 (0.67%) with severe TR. Median follow-up time was 80 months (mean 70±33 months). Systolic pulmonary artery pressure was derived from peak velocity of tricuspid regurgitant jet plus the right atrial pressure and considered elevated if ≥40 mm Hg (PH).

Results

During follow-up there were 123 (59%) deaths with no difference in mortality between moderate and severe TR (p=0.456). The death rates were 93 (67%) in patients with PH versus 30 (42%) without PH (p<0.001). PH was associated with lower event-free survival in moderate (log-rank, p<0.001), but not in severe TR (log-rank, p=0.133). In a multivariate Cox regression analysis adjusted for age, smoking, coronary artery disease, reduced right ventricle S′, lower left ventricular ejection fraction at baseline, right atrium size and mitral valve replacement, PH remained a significant predictor of all-cause mortality (HR 2.22; 95% CI 1.41 to 3.47, p=0.001).

Conclusions

Moderate or severe TR was found in 1.6% of patients attending for routine echocardiograms. PH identified a high-risk subset of patients with moderate TR but not with severe TR.
Ferumoxytol-enhanced MRI in patients with prior cardiac transplantation
Authors: Stirrat Colin G , Alam Shirjel , MacGillivray Thomas J , Gray Calum , Dweck Marc Richard , Jones Victor , Wallace William , Payne John R , Prasad Sanjay K , Gardner Roy S , Petrie Mark C , Mirsadraee Saeed , Henriksen Peter , Newby David E , Semple Scott
Published: October 2019

Objectives

Ultra-small superparamagnetic particles of iron oxide (USPIO)-enhanced MRI can detect cellular inflammation within tissues and may help non-invasively identify cardiac transplant rejection. Here, we aimed to determine the normal reference values for USPIO-enhanced MRI in patients with a prior cardiac transplant and examine whether USPIO-enhanced MRI could detect myocardial inflammation in patients with transplant rejection.

Methods

Ten volunteers and 11 patients with cardiac transplant underwent T2, T2* and late gadolinium enhancement 1.5T MRI, with further T2* imaging at 24 hours after USPIO (ferumoxytol, 4 mg/kg) infusion, at baseline and 3 months.

Results

Ten patients with clinically stable cardiac transplantation were retained for analysis. Myocardial T2 values were higher in patients with cardiac transplant versus healthy volunteers (53.8±5.2 vs 48.6±1.9 ms, respectively; p=0.003). There were no differences in the magnitude of USPIO-induced change in R2* in patients with transplantation (change in R2*, 26.6±7.3 vs 22.0±10.4 s-1in healthy volunteers; p=0.28). After 3 months, patients with transplantation (n=5) had unaltered T2 values (52.7±2.8 vs 52.12±3.4 ms; p=0.80) and changes in R2* following USPIO (29.42±8.14 vs 25.8±7.8 s-1; p=0.43).

Conclusion

Stable patients with cardiac transplantation have increased myocardial T2 values, consistent with resting myocardial oedema or fibrosis. In contrast, USPIO-enhanced MRI is normal and stable over time suggesting the absence of chronic macrophage-driven cellular inflammation. It remains to be determined whether USPIO-enhanced MRI may be able to identify acute cardiac transplant rejection.

Trial registration number

NCT02319278349(https://clinicaltrials.gov/ct2/show/NCT02319278) Registered 03.12.2014 EUDraCT 2013-002336-24.
Retrospective study of the relative frequency of feline hepatobiliary disease in New Zealand based on 10 years of hepatic biopsy samples
Authors: Fluen Thomas , Hardcastle Michael , Smith Helen L , Gear Robyn N A
Published: October 2019

Aims

To retrospectively determine the relative frequency of feline hepatobiliary diseases from biopsy specimens submitted to a single laboratory across a 10‐year period and to establish whether age, sex or breed associations exist.

Methods

Histopathological data from 154 liver biopsies of New Zealand cats sampled between 2008 and 2018 were analysed. The samples were allocated to primary, secondary and tertiary disease categories using criteria established by the World Small Animal Veterinary Association. Breed associations were derived using ORs and 95% CIs. Gender and age associations were also evaluated.

Results

The most frequently diagnosed hepatobiliary diseases were lymphocytic cholangitis (20 per cent), hepatitis (16.9 per cent), reversible hepatocellular injury (16.4 per cent), neutrophilic cholangitis (9.7 per cent), haematopoietic neoplasia (9.7 per cent), hepatocellular neoplasia (5.6 per cent) and cholangiocellular neoplasia (4.1 per cent). Burmese cats were found to be at significantly increased risk of both biliary and parenchymal diseases and Birman cats to be at significantly increased risk of parenchymal disease. Domestic longhair cats were at significantly increased risk of hepatobiliary neoplasia. Birman cats were at significantly increased risk of hepatitis while domestic shorthair cats were at significantly decreased risk of neutrophilic cholangitis, reversible hepatocellular injury and hepatitis.

Conclusions

This study is the first retrospective examination of the relative frequency of hepatobiliary disease in biopsy specimens from New Zealand cats. Some breeds were associated with specific histopathology.
Predicting fish species richness and habitat relationships using Bayesian hierarchical multispecies occupancy models
Authors: White Shannon , Faulk Evan , Tzilkowski Caleb , Weber Andrew , Marshall Matthew , Wagner Tyler
Published: October 2019

Understanding how stream fishes respond to changes in habitat availability is complicated by low occurrence rates of many species, which in turn reduces the ability to quantify species–habitat relationships and account for imperfect detection in estimates of species richness. Multispecies occupancy models have been used sparingly in the analysis of fisheries data, but address the aforementioned deficiencies by allowing information to be shared among ecologically similar species, thereby enabling species–habitat relationships to be estimated for entire fish communities, including rare species. Here, we highlight the utility of hierarchical multispecies occupancy models for the analysis of fish community data and demonstrate the modeling framework on a stream fish community dataset collected in the Delaware Water Gap National Recreation Area, USA. In particular, we demonstrate the ability of the modeling framework to make inferences at the species-, guild-, and community-levels, thereby making it a powerful tool for understanding and predicting how environmental variables influence species occupancy probabilities and structure fish assemblages.
Resonance Analysis of Train–Track–Bridge Interaction Systems with Correlated Uncertainties
Authors: Xin Lifeng , Li Xiaozhen , Zhang Jiaxin , Zhu Yan , Xiao Lin
Published: October 2019

Over the last decades, the resonance-related dynamics for bridge systems subjected to a moving train has been researched and discussed from mechanics, physics and mathematics. In the current work, new perspectives of train-induced resonance analysis are investigated through introducing random propagation process into the train–bridge dynamic interactions. Besides, the Nataf-transformation-based point estimation method is applied to generate pseudorandom variables following arbitrarily correlated probability distributions. A three-dimensional (3D) nonlinear train-ballasted track–bridge interaction model founded on fundamental physical and mechanical principles is employed to convey and depict train–bridge interactions with random properties considered. After that, extensive applications are illustrated in detail for revealing the statistical characteristics of the so-called “random resonance”. Numerical results show that the critical train speeds associated with resonance and cancelation are random in essence owing to the variability of system parameters; the correlation between parameters exerts obvious influences on system dynamic behaviors; the last vehicle of a train will be in more violent vibrations compared to the front vehicles; the influences of track irregularities on the wheel–rail interactions are significantly greater than those of resonance.
S100A10 Is a Critical Mediator of GAS6/AXL–Induced Angiogenesis in Renal Cell Carcinoma
Authors: Xiao Yiren , Zhao Hongjuan , Tian Lei , Nolley Rosalie , Diep Anh N. , Ernst Anne , Fuh Katherine C. , Miao Yu Rebecca , von Eyben Rie , Leppert John T. , Brooks James D. , Peehl Donna M. , Giaccia Amato J. , Rankin Erinn B.
Published: October 2019

Angiogenesis is a hallmark of cancer that promotes tumor progression and metastasis. However, antiangiogenic agents have limited efficacy in cancer therapy due to the development of resistance. In clear cell renal cell carcinoma (ccRCC), AXL expression is associated with antiangiogenic resistance and poor survival. Here, we establish a role for GAS6/AXL signaling in promoting the angiogenic potential of ccRCC cells through the regulation of the plasminogen receptor S100A10. Genetic and therapeutic inhibition of AXL signaling in ccRCC tumor xenografts reduced tumor vessel density and growth under the renal capsule. GAS6/AXL signaling activated the expression of S100A10 through SRC to promote plasmin production, endothelial cell invasion, and angiogenesis. Importantly, treatment with the small molecule AXL inhibitor cabozantinib or an ultra-high affinity soluble AXL Fc fusion decoy receptor (sAXL) reduced the growth of a pazopanib-resistant ccRCC patient-derived xenograft. Moreover, the combination of sAXL synergized with pazopanib and axitinib to reduce ccRCC patient-derived xenograft growth and vessel density. These findings highlight a role for AXL/S100A10 signaling in mediating the angiogenic potential of ccRCC cells and support the combination of AXL inhibitors with antiangiogenic agents for advanced ccRCC.

Significance:

These findings show that angiogenesis in renal cell carcinoma (RCC) is regulated through AXL/S100A10 signaling and support the combination of AXL inhibitors with antiangiogenic agents for the treatment of RCC.
Ateminsuffizienz bei Motoneuronerkrankungen: Früh diagnostizieren und zeitnah therapieren
Authors: Knoch Johannes
Published: October 2019

Background: Motor neuron disease (MND) invariably impacts on inspiratory muscle strength leading to respiratory failure. Regular assessment of sniff nasal inspiratory pressure (SNIP) and/or maximal mouth inspiratory pressure (MIP) contributes to early detection of a requirement for ventilatory support. Objectives: The aim of this study was to compare the feasibility, agreement, and performance of both tests in MND. Methods: Patients with MND followed by a multidisciplinary consultation were prospectively included. Pulmonary follow-up included forced expiratory volumes, vital capacity (VC) seated and supine, MIP, SNIP, pulse oximetry, and daytime arterial blood gases. Results: A total of 61 patients were included. SNIP and MIP could not be performed in 14 (21%) subjects; 74% of the subjects showed a decrease in MIP or SNIP at inclusion versus 31% for VC. Correlation between MIP and SNIP (Pearson's rho: 0.68, p < 0.001) was moderate, with a non-significant bias in favor of SNIP (3.6 cm H2O) and wide limits of agreement (-34 to 41 cm H2O). Results were similar in «bulbar» versus «non-bulbar» patients. At different proposed cut-off values for identifying patients at risk of respiratory failure, the agreement between MIP and SNIP (64-79%) and kappa values (0.29-0.53) was moderate. Conclusions: MIP and SNIP were equally feasible. There was no significant bias in favor of either test, but a considerable disparity in results between tests, suggesting that use of both tests is warranted to screen for early detection of patients at risk of respiratory failure and avoid over diagnoses. SNIP, MIP, and VC all follow a relatively linear downhill course with a steeper slope for «bulbar» versus «non-bulbar» patients.
Clinical and Spectrophotometric Evaluation of Skin Photoadaptation in Vitiligo Patients after a Short Cycle of NB-UVB Phototherapy
Authors: Arisi Mariachiara , Rossi Maria Teresa , Fusano Marta , Gualini Alessandra , Tomasi Cesare , Moggio Erica , Caravello Simone , Calzavara-Pinton Piergiacomo , Venturini Marina
Published: October 2019

Background: The phenomenon of photoadaptation to narrow-band ultraviolet B (NB-UVB) radiation has been previously described in vitiligo and has usually been clinically measured by the assessment of the minimal erythema dose (MED) after phototesting. Objectives: To assess the photoadaptive response in vitiligo and healthy skin after NB-UVB phototherapy not only clinically, but also by spectrophotometry. Materials and Methods: Fourteen patients affected by generalized vitiligo underwent NB-UVB phototherapy twice weekly for 12 weeks. Before and after phototherapy, a phototesting procedure was administered on vitiligo patches and adjacent healthy skin with a solar simulated radiation (SSR). Visual assessment of the MED took place after 24 h. A spectrophotometer was used to assess the a* value and the melanin index (MI*), as signs of skin erythema and pigmentation. The photoadaptation factor (MED-PF) and the a* photoadaptation factor (a*-PF) were calculated. Results: After NB-UVB phototherapy, both vitiligo and healthy skin showed an increase in MED and MI* values and a reduction of skin erythema compared to baseline (p < 0.05). MED-PF data showed a photoadaptation in 10 (71.4%) vitiligo lesions and in 12 (85.7%) healthy skin areas. The assessment of the a*-PF showed a negative mean percentage value in all affected and unaffected skin areas. Conclusions: A short cycle of NB-UVB phototherapy can induce photoadaptation in vitiligo by increasing the MED and reducing skin erythema after stimulation with SSR. This is most likely due to the physical filter function induced by ultraviolet radiation.
Southeast Asian Pharmacogenomics Research Network (SEAPharm): Current Status and Perspectives
Authors: Chumnumwat Supatat , Lu Zen Huat , Sukasem Chonlaphat , Winther Michael David , Capule Francis R. , Abdul Hamid Asma A'tiyah , Bhandari Bibek , Chaikledkaew Usa , Chanhom Noppadol , Chantarangsu Soranun , Charoenyingwattana Angkana , Hang Tong Thi , Hlaing Tin Maung , Htun Kyaw Soe , Jittikoon Jiraphun , Le Ly , Mahasirimongkol Surakameth , Mohamed Noor Dzul Azri , Shrestha Jesus , Suwannoi Lakkana , Tragulpiankit Pramote , Turongkaravee Saowalak , Wattanapokayakit Sukanya , Xangsayarath Phonepadith , Yuliwulandari Rika , Zain Shamsul Mohd , Chantratita Wasun
Published: October 2019

Pharmacogenomics (PGx) is increasingly being recognized as a potential tool for improving the efficacy and safety of drug therapy. Therefore, several efforts have been undertaken globally to facilitate the implementation process of PGx into routine clinical practice. Part of these efforts include the formation of PGx working groups working on PGx research, synthesis, and dissemination of PGx data and creation of PGx implementation strategies. In Asia, the Southeast Asian Pharmacogenomics Research Network (SEAPharm) is established to enable and strengthen PGx research among the various PGx communities within but not limited to countries in SEA; with the ultimate goal to support PGx implementation in the region. From the perspective of SEAPharm member countries, there are several key elements essential for PGx implementation at the national level. They include pharmacovigilance database, PGx research, health economics research, dedicated laboratory to support PGx testing for both research and clinical use, structured PGx education, and supportive national health policy. The status of these essential elements is presented here to provide a broad picture of the readiness for PGx implementation among the SEAPharm member countries, and to strengthen the PGx research network and practice in this region.
Relationship between Plasma Endocan Level and Clinical Outcome of Chinese Peritoneal Dialysis Patients
Authors: Poon Peter Yam-Kau , Ng Jack Kit-Chung , Fung Winston Wing-Shing , Chow Kai-Ming , Kwan Bonnie Ching-Ha , Li Philip Kam-Tao , Szeto Cheuk-Chun
Published: October 2019

Background: Endocan is associated with endothelial dysfunction. In peritoneal dialysis (PD) patients, cardiovascular disease is a common cause of mortality. We examined the relationship between serum endocan level and clinical outcome of PD patients. Methods: We recruited 193 new PD patients (118 males, mean age 58.8 ± 11.6 years). Serum endocan levels were determined and stratified into tertile 1 (lowest) to 3 (highest). Nutritional status, arterial pulse wave velocity (PWV) and serum C-reactive protein (CRP) levels were measured. The patients were followed for at least 4 years for clinical outcomes. Results: For the whole cohort, patients with higher serum endocan levels had lower serum albumin and subjective global assessment score, higher carotid-femoral PWV, and higher serum CRP. For patients with suboptimal blood pressure (BP) control, cardiovascular event-free survival was 95.0, 95.5, and 78.5% for tertiles 1, 2, and 3 at 60 months respectively (p = 0.019). Multivariate Cox regression analysis showed that serum endocan level was an independent predictor of cardiovascular event-free survival. No association with cardiovascular event-free survival was found for patients with adequate BP control (95.0, 92.3, and 100% for tertile 1, 2, and 3 at 60 months, respectively, p = 0.6). Conclusions: Higher serum endocan level is associated with unfavourable nutritional, arterial and inflammatory conditions in PD patients. In patients with suboptimal BP control, higher serum endocan is also associated with worse cardiovascular outcome.
Prevalence of Skin Disease in Urban Haiti: A Cross-Sectional Study
Authors: Borda Luis J. , Louis Shesly J. , Fethiere Myriam , Dure Danie , Morrison Brian W.
Published: October 2019

The prevalence of skin disease varies with geographic location and may be affected by cultural factors. In Haiti, the combination of poor health care access, infrastructure lack, and natural disasters may affect the prevalence of skin conditions. Unfortunately, little epidemiological information has been obtained on the prevalence of skin diseases in Haiti. The objective of this study is to describe data on the prevalence of dermatological conditions in urban areas of Haiti. Univariate, bivariate, and χ2 analyses were used to evaluate associations. During February 2016, we documented 137 patients. The mean age was 27.7 years; most of the subjects were women (61.3%) in a cohort mostly adult (67.1%). The infectious and inflammatory dermatoses were the most prevalent (74.2%). Infectious skin diseases were more prevalent in men and in adults in general (p < 0.01). Inflammatory conditions were also more common in adults (p < 0.05). Additionally, alopecia and dyschromia were limited to women (p < 0.01). Infectious skin diseases, in particular fungal infections, were amongst the most common diagnoses in the urban area of Haiti. Therefore, improved access to antimicrobial and anti-inflammatory medications would likely benefit Haitian patients with dermatological conditions. These findings may help local public health officials and future dermatological expeditions better serve this population.
Disparities in Access and Mortality of Patients With ST‐Segment–Elevation Myocardial Infarction Using the Brazilian Public Healthcare System: VICTIM Register
Authors: Oliveira Jussiely Cunha , Almeida‐Santos Marcos Antonio , Cunha‐Oliveira Jeferson , Oliveira Laís Costa Souza , de Carvalho Barreto Ikaro Daniel , Clair RemacreMunareto Lima Ticiane , Andreline Maia Arcelino Larissa , Andrade Prado Luís Flávio , Serra Silveira Fábio , Augusto da Silva Nascimento Thiago , Pereira Ferreira Eduardo José , Vasconcelos Barreto Rafael , Vieira Moraes Enilson , Teles de Mendonça José , Sousa Antonio Carlos Sobral , Barreto‐Filho José Augusto ,   the VICTIM Register Investigators
Published: October 2019

Background

There is a scarcity of knowledge as to whether rates of myocardial reperfusion use and 30‐day mortality for patients with
ST
‐segment–elevation myocardial infarction are similar among patients using the Brazilian Public Health System (
SUS
) and those using the private healthcare system.

Methods and Results

A total of 707 patients were analyzed using the
VICTIM
(Via Crucis for the Treatment of Myocardial Infarction) register database; 589 patients from the
SUS
and 118 from the private network with
ST
‐segment–elevation myocardial infarction, who attended hospitals with the capacity to perform primary percutaneous coronary intervention (
PCI
) were investigated. The timeline, rates of use of
PCI
, and the 30‐day probability of death were investigated, comparing the
SUS
patients to those in the private system. The mean time between symptom onset and arrival at the
PCI
hospital was higher for
SUS
patients compared with users of the private system (25.4±36.5 versus 9.0±21 hours;
P
<0.001, respectively). Rates of primary
PCI
were low in both groups, but significantly lower for the
SUS
patients (45% versus 78%;
P
<0.001). The 30‐day mortality rate of
SUS
patients was 11.9% and of private patients was 5.9% (
P
=0.04). In the fully adjusted model, the odds ratio for 30‐day mortality for the
SUS
patients was higher (odds ratio, 2.96; 95%
CI
, 1.15–7.61;
P
=0.02).

Conclusions

The delay in reaching a
PCI
hospital was almost 3 times higher for the
SUS
patients. Primary
PCI
was underused in both groups, especially in the
SUS
patients. The
SUS
patients were more likely to die during the 30‐day follow‐up.
Biodegradable Flow Diverter for the Treatment of Intracranial Aneurysms: A Pilot Study Using a Rabbit Aneurysm Model
Authors: Nishi Hidehisa , Ishii Akira , Ono Isao , Abekura Yu , Ikeda Hiroyuki , Arai Daisuke , Yamao Yukihiro , Okawa Masakazu , Kikuchi Takayuki , Nakakura Akiyoshi , Miyamoto Susumu
Published: October 2019

Background

Herein, we report an in vivo study of a biodegradable flow diverter (
BDFD
) for aneurysm occlusion. Conceptually,
BDFD
s induce a temporal flow‐diverting effect and provide a vascular scaffold for neointimal formation at the neck of the aneurysm until occlusion. This offers several potential advantages, including a reduced risk of remote ischemic complications and more treatment options in case of device failure to occlude the aneurysm.

Methods and Results

A
BDFD
consisting of 48 poly‐
l
‐lactic acid wires with radiopaque markers at both ends was prepared. An in vitro degradation test of the
BDFD
was performed. Thirty‐six
BDFD
s were implanted in a rabbit aneurysm model. Digital angiography, optical coherence tomography, histopathology, and scanning electron microscopy were performed after 1, 3, and 6 months, and 1 year. The in vitro degradation test showed that the
BDFD
was almost degraded in 1.5 years. In the in vivo experiment, aneurysm occlusion rates were 0% at 1 month, 20% at 3 months, 50% at 6 months, and 33% at 1 year. Optical coherence tomography showed that luminal area stenosis was the highest at 3 months (16%) and decreased afterward. Immunohistochemical analysis showed that more than half of the luminal surface area was covered by endothelial cells at 1 month. Device fragmentation was not observed in any lesions.

Conclusions

This first in vivo study of a
BDFD
shows the feasibility of using
BDFDs
for treating aneurysms; however, a longer follow‐up is required for comprehensive evaluation of the biological and mechanical behavior peculiar to biodegradable devices.
Abelard’s Treatment of Logical Determinism in Its Twelfth-Century Context
Authors: Binini Irene
Published: October 2019

This article investigates Abelard’s defence of the compatibility between universal bivalence and the existence of future contingent events. It first considers the standard strategy put forward by twelfth-century commentators to solve Aristotle’s dilemma in De Interpretatione 9, which fundamentally relies on Boethius’ distinction between definite and indefinite truth values. Abelard’s own position on the dilemma is then introduced, focusing on a specific deterministic argument considered in his logical works that aims to demonstrate that, given the determinacy of present-tense propositions such as ‘“that Socrates will eat tomorrow” is true’, future contingent events such as that Socrates will eat tomorrow are determinate in advance. In addition to presenting Abelard’s reply to the argument, the article offers an analysis of his notions of contingency, determinacy, and future events, and a comparison between Abelard’s position and other twelfth-century discussions on future contingents.
Images of Wild Flowers in Israeli Visual Culture: Representations of a Troubled Land
Authors: Marnin-Distelfeld Shahar
Published: October 2019

This article examines images of wild flowers in Israeli visual culture from the period of pre-state Israel until the present day. These images have served as “cultural objects” that have helped construct a national identity. They have appeared in Hebrew publications, stamps, banknotes, and artworks. Arguing that the choice of botanical art is a political statement, this article shows the complex attitudes embodied in contemporary wild flower images—both thematic and stylistic—in which the artists negotiate their multifaceted relationship with the Land of Israel as a troubled territory. The images created by Israeli-Jewish artists share a twofold significance: they stand as naïve memories of Israel’s early years and, at the same time, they embody the reality of conflict implied in the idea of sharing the Land with the Israeli Arabs. The methodology of this article is interdisciplinary, as it integrates an analysis of visual images with the use of interviews and the explication of texts.
A Comparative Analysis of China’s Relations with Lebanon and Syria
Authors: Rosiers David Perez-Des
Published: October 2019

Since the establishment of the People’s Republic of China (prc), Beijing’s position in the Middle East has undergone important changes. Its influence in the region has grown in recent years in relation to its Belt-Road Initiative (bri). The instability of the region represents a constant challenge for China as some countries have to deal with sectarian divisions and complex political situations. Lebanon and Syria are also two countries constituted of complex domestic situations. This paper covers the evolution of China’s relations with both countries since 1949 with a comparative analysis. It demonstrates the similar approach of Beijing in its relations with Syria and Lebanon. Its relations with both countries have been punctuated by ups and downs, but mutual collaboration have increased recently due to their geostrategic position for the bri and their needs regarding infrastructures. The role of influential states in the region is taken into consideration for a better understanding of China’s position. It describes the non-intervention policy of Beijing. This paper analyzes that even if China’s relations and investments with Syria and Lebanon are set to increase in the upcoming years, Beijing will most likely remain patient and prudent regarding both countries.
Harvesting Energy of Body Motion Through Single Electrode Based Self-Powered Triboelectric Nanogenerator
Authors: Shamsuddin  , Khan Saeed Ahmed , Ali Ahmed , Rahimoon Abdul Qadir , Jalalzai Palwasha
Published: October 2019

A self-powered mechanical energy harvesting system consists of the storage system and the energy scavenging TENG. Triboelectric nanogenerator includes a system which integrates a self-powered sensor and the power generator, this triboelectric nanogenerator has the potential to be used
in a modern wearable electronic TENG. It has been reported that triboelectric nanogenerator working under complicated deformation like bending, stretching and twisting brings the main problem. Here we have fabricated the shape adaptive Triboelectric nanogenerator which solves all the deformation
issues and can harvest the mechanical energy through human body motion in any deformation, the fabricated TENG is a self-powered sensor which can sense the different human activities and can monitor the health issues, the TENG stores the energy directly to the capacitor for powering the wearable
electronics. A human skin based triboelectric nanogenerator was designed from the silicon rubber and the copper acetate-II used as the electrode, which makes the TENG flexible self-powered sensor, it can be stretched up to 200%. The stretchable nature and the flexibility of the human skin
based silicon rubber triboelectric nanogenerator makes it the promising flexible and shape-adaptive energy harvesting TENG. The fabricated TENG generated the open circuit voltage 70 V and the short circuit current 11 μA and delivered the power 55 μW at the load of 80 MΩ.
42 LEDs were powered directly from the TENG. The fabricated TENG has human skin tactile property which does not harm the human skin while using it multiple times. The layer of copper acetate is completely coated with silicone rubber. The fabricated TENG is flexible, biocompatible and cost
effective.
Hydrothermally Grown Copper-Doped ZnO Nanorods on Flexible Substrate
Authors: Ajmal Hafiz Muhammad Salman , Khan Waqar , Khan Fasihullah , Huda Noor-ul , Kim Sam-Dong
Published: October 2019

In this study, we observe the effect of Cu doping on the ZnO nanorod (NR) structure grown on a polyethylene terephthalate flexible substrates by hydrothermal growth of sol–gel method proceeded at 150 °C. Copper (II) nitrate trihydrate (Cu-nitrate) and copper (II) acetate monohydrate
(Cu-acetate) are employed as precursors for Cu dopants in aqueous growth solution to examine the evolutionary change of the growth morphology, optical characteristics, and chemical composition of as-grown ZnO NRs. A significant influence of dopant molarity on the morphology of wurtzite ZnO
nanocrystals is observed by field-emission scanning electron microscopy. X-ray diffraction analysis also reveals more enhanced crystalline quality from Cu-doped NR crystals prepared by Cu-acetates than that grown with Cu-nitrate precursor. Near band-edge emission of 2 mM Cu-acetate doped NRs
is greatly enhanced by 2.5 times compared to those grown with Cu-nitrate precursors. A great reduction in visible emissions is also realized, and this phenomenon is associated with overall improvement in NR crystalline quality by suppressing the oxygenated carbon groups or hydroxyl introduced
by the aqueous solution-based growth. X-ray photoelectron spectroscopy also shows that a very high O/Zn atomic ratio of 0.73 can be achieved in the case of NR crystals prepared by 2 mM Cu-acetate. Cu doped ZnO nanostructures of improved optical and structural properties achieved in this study
can be utilized in the wide emerging field of flexible device applications such as laser diodes, light-emitting diodes, piezoelectric transducers and generators, gas sensors, and ultraviolet detectors.
Effect of Metallic Electrodes Ensemble on Charge Transport Characteristics of Cytosine Based Molecular Devices
Authors: Vohra Rajan , Sawhney Ravinder Singh
Published: October 2019

The charge transport through molecular devices using an ensemble of metal electrodes having nucleobase cytosine as the central molecule has been envisaged using a combination of semi-empirical Extended Huckel Theory and Non Equilibrium Green Function (NEGF). FFT-2D computational approach
has been effectively applied to elucidate the electron transport characteristics of these molecular devices under both equilibrium as well as non-equilibrium states. The charge transport parameters viz. Device Density of States, Transmission Spectrum, I–V curve, G–V
curve and HOMO-LUMO Gap are measured to exhibit the charge transport properties. By comparing the obtained quantum transport properties, we observe that silver remains the best choice among the three electrode materials under study as the molecular device with the silver electrodes exhibits
the lower HOMO-LUMO Gap with increased current and conductance for the higher bias voltages in contrast to the other two configurations which show comparatively higher value of HOMO-LUMO Gap. Hence, the molecular device with the silver electrodes has greater possibility of getting utilized
as a switch in DNA based nano-electronics applications.
Carbon Nanotube Field Effect Transistor-Based Hybrid Full Adders Using Gate-Diffusion Input Structure
Authors: Hatefinasab Seyedehsomayeh
Published: October 2019

Scaling down the size of transistor in the nanoscale reduces the power supply voltage, as a result, the design of high-performance nano-circuit at low voltage has been considered. Most of digital circuits are composed of different components which determine the performance of the entire
digital circuits. With the improvement of these components, the digital circuits can be optimized. One of these components is full adder for which various structures have been proposed to improve its performance, among them the two novel full adder structures are based on Gate-Diffusion Input
(GDI) structure and half-classical XOR/XNOR logic (SEMI XOR/XNOR) modules. In this paper, Carbon Nanotube Field Effect Transistor (CNTFET)-based low power full adders by using SEMI XOR logic style and GDI structure are presented. Due to the incomparable thermal and mechanical properties of
the CNTFET, it can be the first alternative to substitute the metal oxide field effect transistors (MOSFET). The digital circuits have the better performance based on CNTFET. Therefore, the three proposed full adders in this paper are designed based on CNTFET technology with many merits, such
as low power dissipation, less energy delay product (EDP), and high speed at various supply voltages, frequencies, temperatures, load capacitors, and the number of tubes. Moreover, these proposed full adders occupy the minimum area consumption and have better performance in comparison with
previous standard full adders. All simulations are done by using the Synopsys HSPICE simulator in 32 nm-CNTFET technology and layout of all full adder circuits are presented on Electric.
Study on Thermal Shock Resistance of Nano-CeO2–Y2O3 Co-Stabilized ZrO2 (CYSZ) Ceramic Powders Thermal Barrier Coating of Aircraft Engine
Authors: Lyu Yang , Shao Xuan , Wang Wen-Xue , Tang Hui
Published: October 2019

In this paper, nano-CeO2–Y2O3 co-stabilized ZrO2 ceramic powders (CYSZ) were firstly prepared by co-precipitation method, and CYSZ powder was spray-granulated, followed by thermal plasma spraying of nano-CYSZ thermal barrier coating
on 35Cr2Ni4 MoA alloy matrix. After XRD and SEM analysis, the five CYSZ ceramic coatings (CeO2 content 0, 1, 5, 10, 15 mol%) prepared were tetragonal phase structures before and after the thermal shock experiment, and the thickness of CYSZ ceramic coating was
about 200 μm. Adding appropriate amount of nano CeO2 promoted the formation of micro-cracks in the coating, released the coating stress, slowed down the thermal shock damage process, and prevented the transformation from t-ZrO2 to m-ZrO2.
The AFM morphology showed that the coating surface grains grow vertically after thermal shock cycle, which indicated that the entry of Ce4+ into ZrO2 lattice resulted in lattice distortion and made the grains more stable. When the content of CeO2 is 1 mol%,
the thermal shock resistance excellent is 84 times. Therefore, the addition of CeO2 can effectively improve the thermal shock resistance performance of CYSZ thermal barrier coating, meeting the requirements of high temperature working conditions of aeroengine and hot-end components.
A New Variable-Threshold Persistent Anomaly Index: Northern Hemisphere Anomalies in the ERA-Interim Reanalysis
Authors: Miller Rebecca L. , Lackmann Gary M. , Robinson Walter A.
Published: October 2019

Persistent weather regimes characterized by anomalous temperature or precipitation are often associated with persistent anomalies (PAs) in the tropospheric geopotential height field. To identify PAs throughout the annual cycle, an earlier definition is modified to apply a seasonally varying magnitude threshold, based on a smoothed, daily varying climatological average of daily 500-hPa geopotential height variability. The modified index can be applied to a wide variety of analysis, reanalysis, or model-forecast gridded data. Here, the modified PA index is used to identify positive and negative Northern Hemisphere PAs in all seasons and to compute trends in PA frequency, strength, location, and duration, in the ECMWF ERA-Interim reanalysis dataset (1979–2016). Height data are detrended and anomalies are weighted with an inverse sine-of-latitude function. In addition to maxima in PA frequency identified previously (North Pacific, North Atlantic, and Russia), an additional summertime maximum appears in the Arctic; this feature has not been analyzed extensively. A composite of summertime positive Arctic PA events reveals an equivalent barotropic structure, similar to that documented for midlatitude PAs. Arctic PA frequency is greatest in summer; it exhibits no trend in frequency over the 38-yr ERA-Interim analysis period. In fact, no discernable trends in PA frequency, strength, or duration are evident in the analysis period for the primary PA regions, although there is a suggestion of a northward shift in positive PA activity in the North Pacific.