bluuebunny/crossref_metadata_2025 huggingface dataset:
Non-absorbable versus absorbable sutures for anterior colporrhaphy: study protocol for a randomised controlled trial in South Korea
Authors: Jeon Myung Jae , Suh Dong Hoon , Kim Chul Hong , Cho Hyun-Hee , Shin Jung-Ho , Lee Sa Ra , Jung Yong Wook , Kim Soo Rim , Kong Mi Kyung
Published: June 2020

Introduction

The anterior vaginal wall is the segment most commonly affected by prolapse. Traditionally, anterior vaginal wall prolapse is repaired via anterior colporrhaphy, which is known to have a high recurrence rate. Several factors might affect the outcome of anterior colporrhaphy, and the use of absorbable sutures might also be associated with the high recurrence rate because the sutures might not be able to retain adequate strength until the plicated pubocervical fascia remodels and regains maximum tensile strength. Nonetheless, no comparative data exist about the relative efficacy and safety of anterior colporrhaphy using non-absorbable versus absorbable sutures. The objective of this study is to compare the surgical outcomes of anterior colporrhaphy using non-absorbable sutures with those of anterior colporrhaphy using absorbable sutures.

Methods and analysis

This is a randomised, multicentre, superiority trial. Anterior colporrhaphy will be performed in a traditional manner with midline plication of the fibromuscular layer using either non-absorbable or absorbable sutures. The primary outcome is composite surgical success 1 year after surgery defined as the absence of all of the following: (1) anterior vaginal descent beyond the hymen, (2) the presence of vaginal bulge symptoms and (3) retreatment for recurrent anterior vaginal wall prolapse with either surgery or pessary. The secondary outcomes include the individual components of the composite primary end point, anatomical outcomes, condition-specific quality of life and adverse events related to anterior colporrhaphy. The planned number of participants is 192.

Ethics and dissemination

This study was approved by the Institutional Review Board of Seoul National University Hospital (H-1810-037-977). The results of the study will be published in peer-reviewed journals, and the findings will be presented at scientific meetings.

Trial registration number

NCT03736811
Effectiveness of cervical pessary compared to cervical cerclage with or without vaginal progesterone for the prevention of preterm birth in women with twin pregnancies and a short cervix: study protocol for a two-by-two factorial randomised clinical trial
Authors: Dang Vinh Q , He Yen TN , Pham Ha NH , Trieu Tuyen TT , Bui Trung Q , Vuong Nhu T , Nguyen Loc MT , Nguyen Diem TN , Le Thanh V , Li Wentao , Le Cam H , Mol Ben W , Vuong Lan N
Published: June 2020

Introduction

Women with twin pregnancies and a short cervix are at increased risk for preterm birth (PTB). Given the burden of prematurity and its attendant risks, the quest for effective interventions in twins has been an area of considerable research. Studies investigating the effectiveness of cervical cerclage, cervical pessary and vaginal progesterone in preventing PTB have yielded conflicting results. The aim of this study is to compare the effectiveness of cervical pessary and cervical cerclage with or without vaginal progesterone to prevent PTB in women with twin pregnancies and a cervical length (CL) ≤ 28 mm.

Methods and analysis

This multicentre, randomised clinical trial will be conducted at My Duc Hospital and My Duc Phu Nhuan Hospital, Vietnam. Asymptomatic women with twin pregnancies and a CL ≤28 mm, measured at 16–22 weeks’ gestation, will be randomised in a 1:1:1:1 ratio to receive a cerclage, pessary, cerclage plus progesterone or pessary plus progesterone. Primary outcome will be PTB <34 weeks. Secondary outcomes will be maternal and neonatal complications. We preplanned a subgroup analysis according to CL from all women after randomisation and divided into four quartiles. Analysis will be conducted on an intention-to-treat basis. The rate of PTB <34 weeks’ gestation in women with twin pregnancies and a cervix ≤28 mm and treated with pessary in our previous study at My Duc Hospital was 24.2%. A sample size of 340 women will be required to show or refute that cervical cerclage decreases the rate of PTB <34 weeks by 50% compared with pessary (from 24.2% to 12.1%, α level 0.05, power 80%, 5% lost to follow-up and protocol deviation). This study is not to be powered to assess interactions between interventions.

Ethics and dissemination

Ethical approval was obtained from the Institutional Ethics Committee of My Duc Hospital and informed patient consent was obtained before study enrolment. Results of the study will be submitted for publication in a peer-reviewed journal.

Trial registration number

NCT03863613 (date of registration: 4 March 2019).
Effects of ketamine in electroconvulsive therapy for major depressive disorder: meta-analysis of randomised controlled trials
Authors: Li Xiao-Mei , Shi Zhan-Ming , Wang Pei-Jia , Hu Hua
Published: June 2020

Background

The use of ketamine in electroconvulsive therapy (ECT) has been examined in the treatment of major depressive disorder (MDD); however, there has been no systematic review and meta-analysis of related randomised controlled trials (RCTs).

Aim

To examine the efficacy and safety of ketamine augmentation of ECT in MDD treatment.

Methods

Two reviewers searched Chinese (China National Knowledge Infrastructure and Wanfang) and English (PubMed, PsycINFO, Embase and Cochrane Library) databases from their inception to 23 July 2019. The included studies" bias risk was evaluated using the Cochrane risk of bias assessment tool. The primary outcome of this meta-analysis was improved depressive symptoms at day 1 after a single ECT treatment session. Data were pooled to calculate the standardised mean difference and risk ratio with their 95% CIs using RevMan V.5.3. We used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach to assess the whole quality of evidence.

Results

Four RCTs (n = 239) compared ketamine alone or ketamine plus propofol (n = 149) versus propofol alone (n = 90) in patients with MDD who underwent a single ECT session. Three RCTs were considered as unclear risk with respect to random sequence generation using the Cochrane risk of bias. Compared with propofol alone, ketamine alone and the combination of ketamine and propofol had greater efficacy in the treatment of depressive symptoms at days 1, 3 and 7 after a single ECT session. Moreover, compared with propofol alone, ketamine alone and the combination of ketamine and propofol were significantly associated with increased seizure duration and seizure energy index. Compared with propofol, ketamine alone was significantly associated with increased opening-eye time. Based on the GRADE approach, the evidence level of primary and secondary outcomes ranged from very low (26.7%, 4/15) to ‘low’ (73.3%, 11/15).

Conclusion

Compared with propofol, there were very low or low evidence levels showing that ketamine alone and the combination of ketamine and propofol appeared to rapidly improve depressive symptoms of patients with MDD undergoing a single ECT session. There is a need for high-quality RCTs.
Development of a psychological first-aid model in inpatients with COVID-19 in Wuhan, China
Authors: Cheng Wenhong , Zhang Fang , Hua Yingqi , Yang Zhi , Liu Jun
Published: June 2020

Background

Facing the social panic and substantial shortage of medical resources during the coronavirus disease 2019 (COVID-19) outbreak, providing psychological first-aid to inpatients is essential for their rehabilitation and the orderly operating of medical systems. However, the closed-ward environment and extreme shortage of onsite mental health workers have limited the use of traditional face-to-face diagnosis and psychological interventions.

Aim

To develop a mental health intervention model for inpatients that can be applied during a widespread epidemic, such as COVID-19.

Methods

In a medical team stationed in Leishenshan Hospital, Wuhan, China, we integrated onsite and online psychological support resources to implement a graded psychological intervention system. The onsite psychiatrist established trust with the patients and classified them into categories according to their symptom severity. While face-to-face evaluation and intervention are critical for effective online support, the online team effectively extended the scope of the ‘first-aid’ to all patients.

Conclusion

This integrated onsite and online approach was effective and efficient in providing psychological interventions for inpatients during the crisis. Our model provides a realistic scheme for healthcare systems in or after the COVID-19 epidemic and also could be adopted in areas of the world with insufficient mental healthcare resources.
Improvisation during a crisis: hidden innovation in healthcare systems
Authors: Wiedner Rene , Croft Charlotte , McGivern Gerry
Published: June 2020

Background

Crises, such as the COVID-19 pandemic, risk overwhelming health and social care systems. As part of their responses to a critical situation, healthcare professionals necessarily improvise. Some of these local improvisations have the potential to contribute to important innovations for health and social care systems with relevance beyond the particular service area and crisis in which they were developed.

Findings

This paper explores some key drivers of improvised innovation that may arise in response to a crisis. We highlight how services that are not considered immediate priorities may also emerge as especially fertile areas in this respect.

Conclusion

Health managers and policymakers should monitor crisis-induced improvisations to counteract the potential deterioration of non-prioritised services and to identify and share useful innovations. This will be crucial as health and social care systems around the world recover from the COVID-19 pandemic and head into another potential crisis: a global economic recession.
Associations between cigarette prices and consumption in Europe 2004–2014
Authors: Laverty Anthony A , Millett Christopher , Filippidis Filippos T
Published: June 2020

Introduction

Increases in tobacco price are known to reduce smoking prevalence, but these correlations may be blunted by the availability of budget cigarettes, promoted by the tobacco industry to maintain profits.

Objective

To investigate the effect of budget cigarettes on cigarette consumption using data from Europe 2004–2014.

Methods

Data on the annual population-weighted cigarette consumption per adult come from the International Cigarette Consumption Database. Data on the annual tobacco price come from Euromonitor International for 23 European countries. Median prices and price differentials (operationalised as percentages obtained by dividing the difference between median and minimum prices by the median price) were examined. A linear random-effects model was used to assess associations between median prices and price differentials with cigarette consumption within 1 year and with a 1-year time lag.

Results

Cigarette consumption per capita declined over the study period (−29.5 cigarettes per capita per year, 95% confidence interval −46.8 to −12.1). The analysis suggests that increases in cigarette price differentials, a marker of opportunities for smokers to switch to less expensive cigarettes, may be associated with greater consumption in the same year (6.4 for a 10% increase in differential, −40.0 to 52.6) and are associated with greater consumption in the following year (67.6, 25.8 to 109.5).

Conclusion

These analyses suggest that even in Europe, where tobacco taxes are relatively high compared with other regions, differential cigarette pricing strategies may undermine tobacco control. Further research is needed on links between tobacco price structures and consumption, and policy design to maximise the effectiveness of tobacco taxation.
A semi-infinite matrix analysis of the BFKL equation
Authors: de León N. Bethencourt , Chachamis G. , Romagnoni A. , Sabio Vera A.
Published: June 2020

The forward BFKL equation is discretised in virtuality space and it is shown that the diffusion into infrared and ultraviolet momenta can be understood in terms of a semi-infinite matrix. The square truncation of this matrix can be exponentiated leading to asymptotic eigenstates sharing many features with the BFKL gluon Green’s function in the limit of large matrix size. This truncation is closely related to a representation of the XXX Heisenberg spin $$= - \frac{1}{2}$$=-12 chain with SL(2) invariance where the Hamiltonian acts on a symmetric double copy of the harmonic oscillator. A simple modification of the BFKL matrix suppressing the infrared modes generates evolution more compatible with the Froissart bound.
Prospect of undoped inorganic crystals at 77 Kelvin for low-mass dark matter search at Spallation Neutron Source
Authors: Chernyak Dmitry , Pershey Daniel , Liu Jing , Ding Keyu , Saunders Nathan , Oli Tupendra
Published: June 2020

Investigated in this work were sensitivities of a prototype detector for the detection of low-mass dark matter particles produced at the Spallation Neutron Source at the Oak Ridge National Laboratory in 2 years of data taking. The presumed prototype consisted of 10 kg undoped CsI or NaI scintillation crystals directly coupled with SiPM arrays operated at 77 K. Compared to the COHERENT CsI(Na) detector, a much higher light yield was assumed for the prototype. An experiment with a cylindrical 1 kg undoped CsI crystal coupled directly to two photomultiplier tubes at about 77 K was conducted as the first step to verify the idea. A light yield of $$26.0 \pm 0.4$$26.0±0.4 photoelectrons per keV electron-equivalent was achieved. This eliminated the concern of self light absorption in large crystals raised in some of the early studies.
Modeling Dynamic Behavior of Stacked Sliding-Rocking Rigid Blocks Subjected to Base Excitation
Authors: Bao Yu
Published: June 2020

A system of stacked rigid blocks can be found in many applications of non-structural components: a statue resting on the top of a table is such an example. Previous studies usually assume that the friction at contact interface is so large that only rocking motion can be activated. However, this assumption may not be realistic when assessing the seismic response of unanchored non-structural components. Motivated from this constraint, this paper contributes to the state-of-the-art research of the classical rocking problem by presenting a numerical model within which sliding, rocking and sliding-rocking response of stacked rigid blocks can be computed by the time-history analysis. The exact fully nonlinear equations of motion, transition criteria for different response modes and treatment to handle the impact are presented in detail. The accuracy of the developed model is validated. A case study is also provided to investigate the overall failure probability of the stacked rigid blocks with realistic friction coefficient. In this particular case study, it is also shown that increasing the friction coefficient makes the stacked rigid blocks more susceptible to failure.
MULTISCALE ENTROPY AND MULTISCALE TIME IRREVERSIBILITY ANALYSIS OF RR TIME SERIES DEPENDING ON AMBIENT TEMPERATURE
Authors: ABELLÁN-AYNÉS ORIOL , NARANJO-ORELLANA JOSE , MANONELLES PEDRO , ALACID FERNANDO
Published: June 2020

Purpose: The main aim of this paper is to study the influence of temperature on multiscale entropy (MSE) and multiscale time irreversibility (MTI) through the use of short-term measurements. Methods: A total of 12 physically active, healthy, and nonsmoker individuals ([Formula: see text] years old; [Formula: see text][Formula: see text]cm of height; and [Formula: see text][Formula: see text]kg of body mass) voluntarily participated in this study. Two beat-to-beat recordings of 15[Formula: see text]min length were performed on every participant, one under hot conditions ([Formula: see text]C) and the other assessment under cool conditions ([Formula: see text]C). The order of these two assessments was randomly assigned. Multiscale sample entropy and MTI were assessed in every measurement through 10 scales. Results: Entropy was significantly higher under hot conditions ([Formula: see text]) from the fifth scale compared to cool conditions. On the contrary, MTI values were significantly lower under hotter conditions ([Formula: see text]). Conclusions: The study of MSE and time irreversibility of short RR measurements presents consistent and reliable data. Moreover, exposures to hot conditions provoke an increment of interbeat complexity throughout larger scales and a decrease in the MTI in a healthy population.
Functional Role of Fe, Cu-Doping in Ni-Based Perovskite Electrocatalysts for Oxygen Evolution Reaction
Authors: Hou Bingxue , Wang Cheng Cheng , Tang Rui , Zhang Qi , Tan Zanxiong , Fan Xincan , Cui Xumei
Published: June 2020

Water electrolysis is of vital importance to store renewable energy and the development of efficient, inexpensive and stable electrocatalysts for oxygen evolution reaction (OER) is essential, which requires much more understanding of the structural and the element classification. Here, a series of [Formula: see text]Fex[Formula: see text][Formula: see text] perovskites have been assessed as potential noble-metal-free OER electrocatalysts prepared by sol–gel method. Moreover, the functional role of Cu and Fe amount on the B-site of perovskites for OER electrocatalytic performance was evaluated. [Formula: see text][Formula: see text][Formula: see text] materials exhibited the highest intrinsic activities in 0.1[Formula: see text]M KOH for OER with an onset potential of 1.56[Formula: see text]V, a Tafel slope of 76[Formula: see text]mV[Formula: see text][Formula: see text], slightly lower than that of benchmark perovskite-type electrocatalyst [Formula: see text][Formula: see text]C[Formula: see text][Formula: see text]O3 (BSCF). The above results demonstrate that Cu element in the B-site of perovskites had little effect on the OER performance, and [Formula: see text][Formula: see text][Formula: see text] is a potential alternative electrocatalyst for OER application.
Modelling the Dependency between Inflation and Exchange Rate Using Copula
Authors: Kwofie Charles , Akoto Isaac , Opoku-Ameyaw Kwaku
Published: June 2020

In this paper, we propose a copula approach in measuring the dependency between inflation and exchange rate. In unveiling this dependency, we first estimated the best GARCH model for the two variables. Then, we derived the marginal distributions of the standardised residuals from the GARCH. The Laplace and generalised t distributions best modelled the residuals of the GARCH(1,1) models, respectively, for inflation and exchange rate. These marginals were then used to transform the standardised residuals into uniform random variables on a unit interval [0, 1] for estimating the copulas. Our results show that the dependency between inflation and exchange rate in Ghana is approximately 7%.
Localized Chronic Form of Langerhans Cell Histiocytosis in the Femur of a 16-Year-Old Male Successfully Treated with Radiofrequency Ablation
Authors: Papavasiliou Kyriakos , Bintoudi Antonia , Vlahodimos Apostolos , Tsiridis Eleftherios , Hytiroglou Prodromos , Tsitouridis Ioannis , Sayegh Fares
Published: June 2020

Only three cases of patients suffering from a localized chronic form of Langerhans cell histiocytosis (LCH) successfully treated with radiofrequency ablation (RFA) have been published so far. This is the first case report of a patient with a localized chronic form of LCH of the femur, which was successfully treated with percutaneous image-guided RFA, and who was evaluated pre-RFA and followed up post-RFA for a period of 48 months, in order to validate the safety and efficacy of this method and to obtain imaging studies depicting the actual in situ changes taking place post-RFA. RFA was proved to be a safe and efficient method when treating patients with a localized chronic form of LCH.
Risk Influencing Factor Analysis of Urban Express Logistics for Public Safety: A Chinese Perspective
Authors: Zhao Mingjing , Ji Shouwen , Zhao Qianru , Chen Cheng , Wei Zhen-Lin
Published: June 2020

Due to the uncertainty and complexity of multilinks and multifactors in urban express logistics system, it is very difficult to analyze the risk factors and the correlation among them for urban public security. In this paper, a method combining domain knowledge and data learning is proposed to construct Bayesian network, which can effectively deal with this problem. Based on the literature review and the investigation of transportation companies, this paper summarizes the risk factors to public safety caused by pick up, warehouse storage, transport, and the end distribution in the process of urban express logistics, which are divided into 5 dimensions: management, weather, human, transportation tools and facilities, and goods, including 11 risk factors. In this paper, Interpretative Structural Model is used to construct the initial hierarchical model to describe the complex relationship between factors, and then causal mapping method is used to improve the initial model to transform the structure into the final Bayesian network model. Finally, the sensitivity of one node to other nodes is analyzed based on the incident data. The results show that Bayesian network is effective in improving urban express logistics operation ability and avoiding public safety risks and has a strong generalization ability, which is simple and easy in practical application.
Preparation, Reliability, and Validity of a Japanese Version of the “Satisfaction of Treatment among Caregivers of Dependent Type 2 Diabetic Patients” Questionnaire
Authors: Ida Satoshi , Kaneko Ryutaro , Imataka Kanako , Okubo Kaoru , Shirakura Yoshitaka , Azuma Kentaro , Fujiwara Ryoko , Takahashi Hiroka , Murata Kazuya
Published: June 2020

The aim of this study was to prepare a Japanese version of the “Satisfaction of Treatment among Caregivers of Dependent Type 2 Diabetic Patients” (STCD2-J) questionnaire, which is used to assess the satisfaction of family caregivers with respect to the treatment for elderly patients with type 2 diabetes mellitus who require support. In addition, the reliability and validity of the STCD2-J questionnaire were analyzed. A Japanese version of the original STCD2 questionnaire was prepared, revised, and back-translated; the back-translated version was sent to the authors of the original version for confirmation. Family caregivers of patients with type 2 diabetes mellitus aged ≥65 years who regularly underwent medical examinations at the diabetes mellitus outpatient clinic of Ise Red Cross Hospital were included. Cronbach’s α coefficient was calculated to assess internal consistency. Exploratory factor analyses were performed to assess construct validity, and Pearson’s correlation coefficients between STCD2-J score and HbA1c as well as the degree of satisfaction with patients’ blood glucose levels, depression, and negative self-assessment of nursing care were calculated to assess criterion-related validity. This study included 208 individuals (55 males and 153 females). Cronbach’s α coefficient was 0.88. Factor analyses showed a single-factor structure both with and without rotation. The STCD2-J scores were significantly inversely correlated with HbA1c (r=−0.27, P<0.001). Significant correlations were observed between the STCD2-J scores and degree of satisfaction with patients’ blood glucose levels (r=0.43, P<0.001), depression (r=−0.20, P=0.003), and negative self-assessment of nursing care (r=−0.19, P=0.004). The reliability and validity of the STCD2-J questionnaire were confirmed. The STCD2-J questionnaire can be used in Japan as a tool to assess the satisfaction of family caregivers with the treatment of elderly patients with type 2 diabetes mellitus requiring support.
Three Growth Factors Induce Proliferation and Differentiation of Neural Precursor Cells In Vitro and Support Cell-Transplantation after Spinal Cord Injury In Vivo
Authors: Younsi Alexander , Zheng Guoli , Scherer Moritz , Riemann Lennart , Zhang Hao , Tail Mohamed , Hatami Maryam , Skutella Thomas , Unterberg Andreas , Zweckberger Klaus
Published: June 2020

Stem cell therapy with neural precursor cells (NPCs) has the potential to improve neuroregeneration after spinal cord injury (SCI). Unfortunately, survival and differentiation of transplanted NPCs in the injured spinal cord remains low. Growth factors have been successfully used to improve NPC transplantation in animal models, but their extensive application is associated with a relevant financial burden and might hinder translation of findings into the clinical practice. In our current study, we assessed the potential of a reduced number of growth factors in different combinations and concentrations to increase proliferation and differentiation of NPCs in vitro. After identifying a “cocktail” (EGF, bFGF, and PDGF-AA) that directed cell fate towards the oligodendroglial and neuronal lineage while reducing astrocytic differentiation, we translated our findings into an in vivo model of cervical clip contusion/compression SCI at the C6 level in immunosuppressed Wistar rats, combining NPC transplantation and intrathecal administration of the growth factors 10 days after injury. Eight weeks after SCI, we could observe surviving NPCs in the injured animals that had mostly differentiated into oligodendrocytes and oligodendrocytic precursors. Moreover, “Stride length” and “Average Speed” in the CatWalk gait analysis were significantly improved 8 weeks after SCI, representing beneficial effects on the functional recovery with NPC transplantation and the administration of the three growth factors. Nevertheless, no effects on the BBB scores could be observed over the course of the experiment and regeneration of descending tracts as well as posttraumatic myelination remained unchanged. However, reactive astrogliosis, as well as posttraumatic inflammation and apoptosis was significantly reduced after NPC transplantation and GF administration. Our data suggest that NPC transplantation is feasible with the use of only EGF, bFGF, and PDGF-AA as supporting growth factors.
Exponentially Fitted Numerical Method for Singularly Perturbed Differential-Difference Equations
Authors: Debela Habtamu Garoma , Kejela Solomon Bati , Negassa Ayana Deressa
Published: June 2020

This paper presents a numerical method to solve singularly perturbed differential-difference equations. The solution of this problem exhibits layer or oscillatory behavior depending on the sign of the sum of the coefficients in reaction terms. A fourth-order exponentially fitted numerical scheme on uniform mesh is developed. The stability and convergence of the proposed method have been established. The effect of delay parameter (small shift) on the boundary layer(s) has also been analyzed and depicted in graphs. The applicability of the proposed scheme is validated by implementing it on four model examples. Maximum absolute errors in comparison with the other numerical experiments are tabulated to illustrate the proposed method.
Comparison of Two Typical Professional Programs for Mechanical Analysis of Interlayer Bonding of Asphalt Pavement Structure
Authors: Li Shuangxi , Tang Liang , Yao Kang
Published: June 2020

The mechanical analysis of interlayer bonding problem of asphalt pavement is performed by the elastic layered system theory or finite element method (FEM); then, a lot of specialized programs based on the above theories emerged successively, of which BISAR3.0 and EverStressFE are quite representative. In order to further clarify the characteristics of BISAR3.0 and EverStressFE for investigating interlayer bonding problem of asphalt pavement, this paper will carry out a comprehensive comparison from the specific realization viewpoint, such as the principle of interlayer bonding, modeling, calculation processing, and result treatment, and a specific example will be given to compare and analyze their functions. The results indicate that the two programs have certain comparability in analyzing the interlayer bonding problem of asphalt pavement, which will contribute to the foundation for the rational selection of asphalt pavement structure mechanical analysis program.
Half-Logistic Xgamma Distribution: Properties and Estimation under Censored Samples
Authors: Bantan Rashad , Hassan Amal S. , Elsehetry Mahmoud , Kibria B. M. Golam
Published: June 2020

This paper proposed a new probability distribution, namely, the half-logistic xgamma (HLXG) distribution. Various statistical properties, such as, moments, incomplete moments, mean residual life, and stochastic ordering of the proposed distribution, are discussed. Parameter estimation of the half-logistic xgamma distribution is approached by the maximum likelihood method based on complete and censored samples. Asymptotic confidence intervals of model parameters are provided. A simulation study is conducted to illustrate the theoretical results. Moreover, the model parameters of the HLXG distribution are estimated by using the maximum likelihood, least square, maximum product spacing, percentile, and Cramer–von Mises (CVM) methods. Superiority of the new model over some existing distributions is illustrated through three real data sets.
¿Qué pueden hacer las AFPs para contribuir a mitigar la crisis económica que está causando el COVID-19?
Authors: Romero Rafael
Published: June 2020

Prácticamente todos los días surgen noticias relacionadas con las Administradoras de Fondos Previsionales (AFPs). ¿Qué hace que la institución de la administración de fondos para la jubilación genere tanto interés público? ¿Cuál es el tamaño agregado de los fondos administrados? ¿En qué invierten las AFPs? ¿Cómo podrían contribuir las AFPs a las empresas nacionales ante la crisis económica causada por el Covid-19?. Continuar leyendo...
New Delirium Severity Indicators: Generation and Internal Validation in the Better Assessment of Illness (BASIL) Study
Authors: Vasunilashorn Sarinnapha M. , Schulman-Green Dena , Tommet Douglas , Fong Tamara G. , Hshieh Tammy T. , Marcantonio Edward R. , Metzger Eran D. , Schmitt Eva M. , Tabloski Patricia A. , Travison Thomas G. , Gou Yun , Helfand Benjamin , Inouye Sharon K. , Jones Richard N. ,   the BASIL Study Team
Published: June 2020

Background: Delirium is a common and preventable geriatric syndrome. Moving beyond the binary classification of delirium present/absent, delirium severity represents a potentially important outcome for evaluating preventive and treatment interventions and tracking the course of patients. Although several delirium severity assessment tools currently exist, most have been developed in the absence of advanced measurement methodology and have not been evaluated with rigorous validation studies. Objective: We aimed to report our development of new delirium severity items and the results of item reduction and selection activities guided by psychometric analysis of data derived from a field study. Methods: Building on our literature review of delirium instruments and expert panel process to identify domains of delirium severity, we adapted items from existing delirium severity instruments and generated new items. We then fielded these items among a sample of 352 older hospitalized patients. Results: We used an expert panel process and psychometric data analysis techniques to narrow a set of 303 potential items to 17 items for use in a new delirium severity instrument. The 17-item set demonstrated good internal validity and favorable psychometric characteristics relative to comparator instruments, including the Confusion Assessment Method – Severity (CAM-S) score, the Delirium Rating Scale Revised 98, and the Memorial Delirium Assessment Scale. Conclusion: We more fully conceptualized delirium severity and identified characteristics of an ideal delirium severity instrument. These characteristics include an instrument that is relatively quick to administer, is easy to use by raters with minimal training, and provides a severity rating with good content validity, high internal consistency reliability, and broad domain coverage across delirium symptoms. We anticipate these characteristics to be represented in the subsequent development of our final delirium severity instrument.
Prognostic Effect of Preoperative Apolipoprotein B Level in Surgical Patients with Clear Cell Renal Cell Carcinoma
Authors: Wang Kun , Wu Tingchun , Chen Yiming , Song Guanglai , Chen Zhen
Published: June 2020

Background: The aim of this study was to assess the prognostic value of the preoperative apolipoprotein B (ApoB) level in surgical patients with clear cell renal cell carcinoma (ccRCC). Materials and Methods: The study included 307 ccRCC patients receiving radical or partial nephrectomy between 2003 and 2012 in our center. The correlations among the preoperative ApoB, clinicopathological parameters, and overall survival (OS) were evaluated. Results: A total of 193 males (62.9%) and 114 females (37.1%) with ccRCC who underwent radical or partial nephrectomy were enrolled in the present study. The OS at 5 years after the operation was 90.6% for all patients, 87.4% for the lower ApoB group, and 97.0% for the higher-ApoB group. The cause-specific survival (CSS) at 5 years after surgery was 90.2% for all patients, 86.7% for the lower-ApoB group, and 97.0% for the higher-ApoB group. A higher-ApoB level was related to a better OS and CSS in ccRCC patients (p = 0.001 and p < 0.001, respectively). In multivariate analysis, age >60 years (p = 0.008 and p = 0.023) and a lower Apo B level (p = 0.019 and p = 0.018) were independent prognostic factors for OS and CSS, respectively. Conclusions: In the Apo apolipoprotein family, the preoperative ApoB level had an important clinical significance for predicting the prognosis and survival rate of ccRCC patients.
Experiência e representação: por uma fenomenologia das imagens, em Noite e Neblina (1995) de Alain Resnais
Authors: Gomes Priscyla Freitas , Kaizer Felipe
Published: June 2020

O presente artigo parte do filme Nuit et broulliard (1955), produzido pelo cineasta francês Alain Resnais, para discutir a potência das imagens e os limites da representação de fatos históricos tidos como crimes à humanidade. Propõe-se uma leitura da abordagem de Resnais, considerando os princípios da fenomenologia e a crise da experiência no mundo moderno e suas implicações na contemporaneidade.
O artefato como dispositivo de profanação
Authors: Latorraca Giancarlo Salvador
Published: June 2020

O presente trabalho busca compreender aspectos ligados à profanação dos campos da arte e do design, expressos nos ideários do movimento Dadá e da obra de Lina Bo Bardi, a partir da apropriação simbólica de imagens e objetos do cotidiano, trazendo à luz novos procedimentos técnicos e plásticos que subverteram percepções pré-estabelecidas sobre a arte, os artefatos e os museus, como reação estética e política, vislumbrando uma revisão crítica da sociedade ocidental.
Contrapposto: a antítese como construção de significado
Authors: Mirocznik Betty
Published: June 2020

Problematiza-se aqui, a profusão das imagens que circulam pelas mídias na sociedade do hiperreal.  Essas imagens planas captadas nas telas de TV, computador e celulares, simulam a realidade, sendo denominadas por Baudrillard, como simulacro. Nesse contexto, é imperativo produzir-se uma imagem de resistência, que desperte o mistério e a experiência em cada um - imagem-enigma. Para essa discussão, elegeu-se a obra Contrapposto de Bruce Nauman.
Cartografias	do levante
Authors: Gregori Márcia Sandoval
Published: June 2020

O artigo tem como objetivo refletir sobre a prática cartográfica como possibilidade de ação política revolucionária e insurgente. Entende-se a cartografia tradicional e seus mapas como representações dominantes, dispositivos engendrados por relações de poder. A cartografia do levante, por sua vez, é compreendida como uma prática de desativação desses mecanismos de controle e captura para transformá-los em contra-dispositivos, em atuação transformadora, profanadora. A partir de imagens feitas pela pesquisadora busca-se analisar como essa fazer pode se inserir em cartografias do levante.
A Impermanência da imagem na obra de Lais Myrrha
Authors: Savastano Letícia Becker
Published: June 2020

Apostando na capacidade artística de alargar possibilidades de imaginação e narrativas, este ensaio discorre sobre uma série de obras da artista brasileira Lais Myrrha. As obras comentadas serão Mitos de Origem (2012), Teoria das Bordas (2007), o Passo da História (2014), Dicionário do Impossível (2005), Descontinuidade do Tempo (2017) e Cálculo das diferenças (2017). A seleção se da por serem expressões imagéticas que dialogam com a materialidade das coisas ao mesmo tempo que expõe a linha de raciocínio da artista com o objetivo de deslocar discursos e elementos conceituais aparentemente cristalizados enquanto narrativas incontestadas como, por exemplo, o tempo e o conceito de história.
A narrativa dos viajantes pelo Piauí
Authors: Teixeira Marina Lages Gonçalves
Published: June 2020

O presente artigo se utiliza da Teoria da Estética da Recepção, iniciada por Hans Robert Jauss, para discutir a narrativa dos viajantes que passaram pelo território do Piauí, utilizando como estudo de caso duas viagens chefiadas por Artur Neiva e Belisário Pena, por iniciativa das instituições IOCS e Fundação Oswaldo Cruz, em 1912; e a de Paulo Thedim Barreto, pelo SPHAN, em 1938. O estudo aqui proposto trata os viajantes como leitores de um espaço definido, Piauí,  por nós considerado a literatura, assim apresentamos três eixos de análise: o primeiro, o horizonte de expectativas – ou mundivivencial – dos viajantes; o segundo, acerca das implicações estéticas, onde se pretende iniciar a discussão do Brasil dos Sertões e a narrativa sem fronteiras; e, o último, aborda as implicações históricas e a cadeia de recepções envolvida, a partir do qual se trabalha a questão da narrativa histórica e literária sobre os sertões, abordando a construção dos elementos simbólicos e culturais sobre a temática.
Histone Deacetylase 9 Activates IKK to Regulate Atherosclerotic Plaque Vulnerability
Authors: Asare Yaw , Campbell-James Thomas A. , Bokov Yury , Yu Lydia Luya , Prestel Matthias , El Bounkari Omar , Roth Stefan , Megens Remco T.A. , Straub Tobias , Thomas Kyra , Yan Guangyao , Schneider Melanie , Ziesch Natalie , Tiedt Steffen , Silvestre-Roig Carlos , Braster Quinte , Huang Yishu , Schneider Manuela , Malik Rainer , Haffner Christof , Liesz Arthur , Soehnlein Oliver , Bernhagen Jürgen , Dichgans Martin
Published: June 2020

Rationale:

Arterial inflammation manifested as atherosclerosis is the leading cause of mortality worldwide. Genome-wide association studies have identified a prominent role of HDAC (histone deacetylase)-9 in atherosclerosis and its clinical complications including stroke and myocardial infarction.

Objective:

To determine the mechanisms linking HDAC9 to these vascular pathologies and explore its therapeutic potential for atheroprotection.

Methods and Results:

We studied the effects of
Hdac9
on features of plaque vulnerability using bone marrow reconstitution experiments and pharmacological targeting with a small molecule inhibitor in hyperlipidemic mice. We further used 2-photon and intravital microscopy to study endothelial activation and leukocyte-endothelial interactions. We show that hematopoietic
Hdac9
deficiency reduces lesional macrophage content while increasing fibrous cap thickness thus conferring plaque stability. We demonstrate that HDAC9 binds to IKK (inhibitory kappa B kinase)-α and β, resulting in their deacetylation and subsequent activation, which drives inflammatory responses in both macrophages and endothelial cells. Pharmacological inhibition of HDAC9 with the class IIa HDAC inhibitor TMP195 attenuates lesion formation by reducing endothelial activation and leukocyte recruitment along with limiting proinflammatory responses in macrophages. Transcriptional profiling using RNA sequencing revealed that TMP195 downregulates key inflammatory pathways consistent with inhibitory effects on IKKβ. TMP195 mitigates the progression of established lesions and inhibits the infiltration of inflammatory cells. Moreover, TMP195 diminishes features of plaque vulnerability and thereby enhances plaque stability in advanced lesions. Ex vivo treatment of monocytes from patients with established atherosclerosis reduced the production of inflammatory cytokines including IL (interleukin)-1β and IL-6.

Conclusions:

Our findings identify HDAC9 as a regulator of atherosclerotic plaque stability and IKK activation thus providing a mechanistic explanation for the prominence of HDAC9 as a vascular risk locus in genome-wide association studies. Its therapeutic inhibition may provide a potent lever to alleviate vascular inflammation.

Graphical Abstract:

A graphical abstract is available for this article.
Thrombolysis Outcomes in Acute Ischemic Stroke by Fluid-Attenuated Inversion Recovery Hyperintense Arteries
Authors: Zhou Zien , Yoshimura Sohei , Delcourt Candice , Lindley Richard I. , You Shoujiang , Malavera Alejandra , Torii-Yoshimura Takako , Carcel Cheryl , Wang Xia , Chen Xiaoying , Parsons Mark W. , Demchuk Andrew M. , Wardlaw Joanna M. , Mair Grant , Robinson Thompson G. , Chalmers John , Xu Jianrong , Anderson Craig S.
Published: June 2020

Background and Purpose:

To determine factors associated with fluid-attenuated inversion recovery (FLAIR) hyperintense arteries (FLAIR-HAs) on magnetic resonance imaging and their prognostic significance in thrombolysis-treated patients with acute ischemic stroke from the ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study) trial alteplase-dose arm.

Methods:

Patients with acute ischemic stroke (N=293) with brain magnetic resonance imaging (FLAIR and diffusion-weighted imaging sequences) scanned <4.5 hours of symptom onset were assessed for location and extent (score) of FLAIR-HAs, infarct volume, large vessel occlusion (LVO), and other ischemic signs. Logistic regression models were used to determine predictors of FLAIR-HAs and the association of FLAIR-HAs with 90-day outcomes: favorable functional outcome (primary; modified Rankin Scale scores, 0–1), other modified Rankin Scale scores, and intracerebral hemorrhage.

Results:

Prior atrial fibrillation, LVO, large infarct volume, and anterior circulation infarction were independently associated with FLAIR-HAs. The rate of modified Rankin Scale scores 0 to 1 was numerically lower in patients with FLAIR-HAs versus without (69/152 [45.4%] versus 75/131 [57.3%]), as was the subset of LVO (37/93 [39.8%] versus 9/16 [56.3%]), but not in those without LVO (25/36 [69.4%] versus 60/106 [56.6%]). After adjustment for covariables, FLAIR-HAs were independently associated with increased primary outcome (adjusted odds ratio [95% CI]: overall 4.14 [1.63–10.50]; with LVO 4.92 [0.87–27.86]; no LVO 6.16 [1.57–24.14]) despite an increased risk of hemorrhagic infarct (4.77 [1.12–20.26]).

Conclusions:

FLAIR-HAs are more frequent in acute ischemic stroke with cardioembolic features and indicate potential for a favorable prognosis in thrombolysis-treated patients possibly mediated by LVO.

Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01422616.
Routine Chest X-ray after Percutaneous Tracheostomy is Unnecessary
Authors: Hoehne Francesca , Ozaeta Maria , Chung Ray
Published: June 2020

Percutaneous tracheostomy (PT) is an increasingly common procedure in the management of critically ill patients. Current practice for both open and percutaneous tracheostomies is a post-procedure chest X-ray to rule out potentially life-threatening complications such as a pneumothorax or tube malposition. Our study evaluated the utility of chest X-ray after PT. A retrospective chart review was conducted for patients undergoing PT at Kern Medical Center between January 1999 and December 2003. Charts were reviewed for age, sex, and clinical outcome as well as the radiologist's interpretation of the postprocedure chest X-ray. A total of 73 procedures were completed in 47 men and 26 women. The majority of the tracheostomies were in trauma patients who needed prolonged ventilatory support. There were no complications identified on postprocedure chest X-ray. A single patient was converted to an open procedure secondary to bleeding. We conclude that routine chest X-ray after PT is unnecessary.
Herbal Product Use by Hispanic Surgical Patients
Authors: Rivera JosÉ O. , Chaudhuri Kallol , GonzÁlez-Stuart Armando , Tyroch Alan , Chaudhuri Swapna
Published: June 2020

We hypothesized that the use of herbal products is highly prevalent in Hispanic surgical patients on both sides of the U.S./México border. One hundred fifteen patients were interviewed in El Paso and 112 in Ciudad Juárez from December 2001 to June 2002. This prospective, randomized study evaluated patients aged 18 years or older that were scheduled for surgery. Sixty-two per cent of our sample in the United States and 81 per cent of patients in Mexico reported using herbal products in the past year. About 58 per cent of patients in the United States and 49 per cent in México rated the products as “excellent” in treating their conditions. Ninety-two percent of U.S, and 93 per cent of Mexican patients did not inform their physician of their herbal use. Preoperative assessment of patients did not include inquiries about herbal products in either hospital. With the growing use of herbal products and because most users do not inform their physician, there is increasing concern related to the possible occurrence of herbal-related adverse events during and after surgery. The fact that health care personnel did not inquire about herbal product use before surgery is an added concern.
TFC (Thoracic Fluid Content): A New Parameter for Assessment of Changes in Chest Fluid Volume
Authors: Van De Water Joseph M. , Mount Bruce E. , Chandra K.M. Dinesh , Mitchell B. Parrish , Woodruff Tajalyn A. , Dalton Martin L.
Published: June 2020

Clinical assessment of cardiac status can be difficult and incomplete without an assessment of fluid volume status, especially of the lungs. Now, a new parameter is available, thoracic fluid content (TFC). It is an indicator of total fluid volume, both intracellular and extracellular. Because it is measured noninvasively using impedance cardiography (ICG), it could be a welcome addition to the physician's assessment. An evaluation of TFC was performed beginning with 1) an examination of chest impedance (Z) as an accurate means of following fluid changes, 2) the relationship of TFC to Z using both loop and spot electrodes, and 3) clinical applications of TFC. In 1) 12 dogs, Z was superior (r = 0.935, P < 0.006) to 10 traditional hemodynamic and gas transfer parameters in trending a lactated Ringer's infusion; 2) a plastic model, changes in TFC values derived from Z measurements using both loop and spot electrodes were virtually identical and paralleled infused saline (r = 0.999, P < 0.001); 3) the clinical setting, TFC trended fluid changes well. From these results, we conclude that TFC is a reliable measurement of chest fluid status and of changes in that fluid. Along with cardiac index (CI), also provided by the ICG monitor, TFC can be very helpful to the clinician.