bluuebunny/crossref_metadata_2025 huggingface dataset:
Primary Amenorrhea, Aplastic Uterus, and a Functional Vagina: A Rare Case of Mayer-Rokitansky-Küster-Hauser Syndrome
Authors: Kirschen Gregory W. , Semenyuk Natalie
Published: May 2019

Background. Müllerian agenesis, also known as Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS), a failure of female urogenital development, typically results in a completely stenotic or rudimentary dimple vagina, both of which are generally nonfunctional in adulthood without mechanical dilation or surgical reconstruction. Case. A 20-year-old Tanner stage V heterosexual woman with normal sexual function since coitarche presented with a chief complaint of primary amenorrhea. She was found to have aplastic uterine buds, absent endometrium/cervix, normal ovaries, and an unusually well-developed lower vagina, a rare presentation of MRKHS. We discuss mechanisms by which the anomaly may have arisen. Summary & Conclusion. This case thus expands the clinical presentation of MRKHS to include a normal appearing vagina with intact sexual function from first sexual encounter, raising interesting questions about the basic underlying embryology.
Critical Velocity and Backlayering Conditions in Rail Tunnel Fires: State-of-the-Art Review
Authors: Haddad Razieh Khaksari , Maluk Cristian , Reda Eslam , Harun Zambri
Published: May 2019

The use of interurban and urban trains has become the preferred choice for millions of daily commuters around the world. Despite the huge public investment for train technology and mayor rail infrastructure (e.g., tunnels), train safety is still a subject of concern. The work described herein reviews the state of the art on research related to critical velocity and backlayering conditions in tunnel fires. The review on backlayering conditions includes the effect of blockages, inclination, and the location of the fire source. The review herein focuses on experimental and theoretical research, although it excludes research studies using numerical modeling. Many studies have used scaled tunnel structures for experimental testing; nevertheless, there are various scaling challenges associated with these studies. For example, very little work has been done on flame length, fire source location, and the effect of more than one blockage, and how results on scaled experiments represent the behaviour at real-scale. The review sheds light on the current hazards associated with fires in rail tunnels.
Prognostic Value of Serum Total Bilirubin after Percutaneous Coronary Intervention in Patients with Acute Coronary Syndrome
Authors: Tang Chengchun , Qian Hao , Wang Dong , Qiao Yong , Yan Gaoliang
Published: May 2019

Backgrounds. Previous studies have reported a relationship between serum total bilirubin (STB) and coronary artery disease (CAD). However, the relationship between STB and prognosis of patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI) remains inconclusive. The present study aimed to evaluate the relationship between STB level and prognosis of PCI in patients with ACS. Methods. In total, 2850 ACS patients who underwent PCI at the Affiliated Zhongda Hospital of Southeast University from June 2009 to Jan 2017 were included in the study. Twenty-four-hour STB, 30-day, and 1-year postoperative major adverse cardiovascular events (MACE) were recorded. Subjects were assigned to one of three groups based on STB: Group A (STB ≤ 9.6 μmol/L), Group B (9.7 μmol/L < STB ≤ 15.4 μmol/L), and Group C (STB ≥ 15.5 μmol/L). COX survival analysis was subsequently used to investigate the relationship between the incidence of MACE and STB in the three groups. Results. A total of 2770 subjects were successfully followed up; within 1 year after PCI, 115 (4.15%) subjects died and 191 (6.90%) subjects experienced MACE. One-year follow-up results showed that the incidence of MACE decreased significantly as STB increased; the risk of Group A was 2.002 times that of Group C (95% CI: 1.342-2.986). Cardiac mortality also decreased with increasing STB; the risk of Group A was 3.403 times that of Group C (95% CI: 1.319-8.785). Conclusion. Lower mortality and MACE incidence rates were found in patients with higher STB within 1 year. Therefore, STB is highly recommended as an independent long-term prognosis predictor of PCI in patients with ACS.
Smart Switching Bilateral Filter with Estimated Noise Characterization for Mixed Noise Removal
Authors: Langampol Kriengkri , Srisomboon Kanabadee , Patanavijit Vorapoj , Lee Wilaiporn
Published: May 2019

Traditionally, several existing filters are proposed for removing a specific type of noise. However, in practice, the image communicated through the communication channel may be contaminated with more than one type of noise. Switching bilateral filter (SBF) is proposed for removing mixed noise by detecting a contaminated noise at the concerned pixel and recalculates the filter parameters. Although the filter parameters of SBF are sensitive to type and strength of noise, the traditional SBF filter has not taken the strength into account. Therefore, the traditional SBF filter cannot remove the mixed noise efficiently. In this paper, we propose a smart switching bilateral filter (SSBF) to outperform a demerit of traditional SBF filter. In the first stage of SSBF, we propose a new scheme of noise estimation using domain weight (DW) pattern which characterizes the distribution of the different intensity between a considered pixel and its neighbors. By using this estimation, the types of mixed noises and their strength are estimated accurately. The filter parameters of SBF are selected from the table where the spatial weight and radiometric weight are already learned. As a result, SSBF can improve the performance of traditional SBF and can remove mixed noises efficiently without knowing the exact type of contaminated mixed noise. Moreover, the performance of SSBF is compared to the optimal SBF filter (OSBF) where OSBF sets the optimal value of filter parameters on the contaminated mixed noise and three new filters — block‐matching and 3D filtering (BM3D), nonlocal sparse representation (NCSR), and trilateral filter (TF). The simulation results showed that the performance of SSBF outperforms BM3D, NCSR, TF, and SBF and is near to optimal SBF filter, even if the SSBF does not know the type of mixed noise.
Standard Setting with Considerations of Energy Efficiency Evolution and Market Competition
Authors: Dai Rui , Zhang Jianxiong , Zhang Shichen
Published: May 2019

EE (energy efficiency) level, an indispensable index reflecting the environmental performance of products, can be improved by the EE innovating effort of the producer. Considering both the evolution of EE level and market differentiation, we develop a Stackelberg differential game between a policy maker who sets the EE standard and multiple competing producers with different initial EE levels who decide the EE innovation simultaneously. As there exist numerous possible reactions for each producer under a given EE standard about whether to meet the EE standard or not, whether there exists an equilibrium is what we pay special attention to. We find that, under a given EE standard, there indeed exists a unique optimal reaction for each producer, and there exists an equilibrium. Moreover, we find that as green awareness or initial EE level increases, both the EE standard and EE innovation increase. Additionally, if policy maker pays more attention to consumer welfare and environmental performance rather than profit of producer, a more strict EE standard would be set. Also, both less information about the initial EE level and more competition among producers induce lower EE standard and social welfare.
Effects of Tailings Gradation on Rheological Properties of Filling Slurry
Authors: Wang Bingwen , Xiong Tingyong , Gao Lijing , Chai Yuepeng , Cui Xiangyu , Ding Wei
Published: May 2019

The key technology in filling mining is the gravity transportation of high‐density slurries, and the filling system design is a significant part of this technology. The filling effect depends on the fluidity of the filling slurry. To investigate the influence of the gradation of tailings on the rheological properties of the filling slurry, this study uses particle size analysis to prepare three types of tailings: powder‐, relatively fine‐, and fine‐grained tailings, which are then mixed in different proportions. The rheological properties of the resulting filling slurries are tested; the viscosity coefficients and yield stresses of the slurries are obtained using the analysis software provided with the MCR102 advanced rheometer that is used to measure the rheological properties of the slurries. The experimental results demonstrate that there is no absolute relationship between the rheological properties of the slurry and the size of the tailings particles, but the rheological properties are related to the gradation of tailings. Lubricating effect is weakened with an insufficient content of powder‐grained particles in the tailings. On the contrary, when the content of powder‐grained particles in the tailings is too high, the viscous substances in the slurry increase. Both of these conditions can increase the friction loss of the slurry.
Research Methods and Applications of Gear Manufacturing Process Optimization
Authors: Li Qiang , Xie Liyang , Song Jiaxin , Li Haiyang , Xu Guoliang
Published: May 2019

This paper presents an optimization method for gear processes; through this method, the most worth optimized processes can be obtained and optimized, thus improving the reliability and supportability of gear products. Firstly, the POPN (Process Optimization Priority Number) analysis method considering the current process level and the process improvement cost is proposed with reference to the RPN (Risk Priority Number) analysis method to obtain the most worth optimized processes. Due to the fact that the unreasonable weight distribution of importance (I), changing difficulty (C), rationality (R), and detective difficulty (D) still exists in the POPN analysis, then combining the POPN analysis method and the AHP (Analytic Hierarchy Process)‐fuzzy comprehensive evaluation method to evaluate and rank the FPOPN (fuzzy POPN) level of each process, the higher the FPOPN level is, the more the process should be optimized. Finally, according to the evaluation results, some processes with high FPOPN level are optimized and the optimal parameters’ combination of these processes is obtained through the tests based on the Taguchi method. A detailed optimization example is also given from the beginning to end in accordance with the above methods, and compared with the original process gears, the optimized gears have a big increase in gear performance through the above optimization method.
Biomarkers of Inflammation in Obesity-Psoriatic Patients
Authors: Rodríguez-Cerdeira Carmen , Cordeiro-Rodríguez Mónica , Carnero-Gregorio Miguel , López-Barcenas Adriana , Martínez-Herrera Erick , Fabbrocini Gabriella , Sinani Ardiana , Arenas-Guzmán Roberto , González-Cespón José Luís
Published: May 2019

Psoriasis is a common chronic inflammatory multisystemic disease with a complex pathogenesis consisting of genetic, immunological, and environmental components. It is associated with a number of comorbidities, including diabetes, metabolic syndrome, obesity, and myocardial infarction. In addition, the severity of psoriasis seems to be related to the severity of obesity. Patients with higher levels of obesity show poorer response to systemic treatments of psoriasis. Several studies have demonstrated that white adipose tissue is a crucial site of the formation of proinflammatory adipokines such as leptin, adiponectin, and resistin and classical cytokines such as interleukin- (IL-) 6 and tumour necrosis factor-α. In psoriasis, due to the proliferation of Th1, Th17, and Th22 cells, IL-22, among others, is produced in addition to the abovementioned cytokines. With respect to leptin and resistin, both of these adipokines are present in high levels in obese persons with psoriasis. Further, the plasma levels of leptin and resistin are related to the severity of psoriasis. These results strongly suggest that obesity, through proinflammatory pathways, is a predisposing factor to the development of psoriasis and that obesity aggravates existing psoriasis. Different inflammatory biomarkers link psoriasis and obesity. In this paper, the most important ones are described.
Endoscopic Dilation of Refractory Postlaryngectomy Strictures: A Case Series and Literature Review
Authors: Stoner Patrick L. , Fullerton Amy L. , Freeman Alyssa M. , Chheda Neil N. , Estores David S.
Published: May 2019

Background. Endoscopic dilation of postlaryngectomy strictures (PLS) is safe and effective; however, PLS are often refractory and require serial dilations. Long-term outcomes of dilation in patients with refractory PLS are not well reported. Materials and Methods. Seven patients with dysphagia and refractory PLS underwent serial endoscopic dilation therapy during a 4.5-year period. Dilation characteristics, technical success, clinical success, and diet advancement (as assessed by Diet/GT scale) were measured. Results. All strictures were complex, and there were no reported complications. The median number of dilations per patient was 12 (range 7 to 48). The average interval in between dilations was six weeks. Technical success was achieved in 6/7 patients, and clinical success was achieved in 2/7 patients. 6/7 patients had advancements in Diet/GT scores. Conclusions. Dilation of refractory PLS is safe and effective and frequently requires the use of a retrograde approach, fluoroscopic guidance, and/or lumen patency strings. Serial dilations are required to maintain luminal patency, relieve dysphagia, and advance oral diet. The definition of clinical success of dilation in these patients should avoid the use of a specific time interval between dilations to characterize success.
Impedance Adaptive Controller for a Prototype of a Whiplash Syndrome Rehabilitation Device
Authors: Guzman-Victoria Isai , Salgado-Ramos Ivan , Mera-Hernandez Manuel , Chairez Isaac , Ahmed Hafiz
Published: May 2019

The objective of this study was to design of an output based impedance adaptive controller for a special class of cervical orthoses, a class of biomedical devices for the rehabilitation of neck illnesses. The controller used the adaptive sliding mode theory to enforce the tracking of the reference trajectory if the patient was not resistant to the therapy. If the patient rejects the orthosis activity, a second impedance‐based controller governs the orthosis movement allowing the patient to take the leading role in the orthosis sequence of movements. The proposed controller considers a weighted controller combining the tracking and the impedance controls in a single structure. The monitoring of the external force was evaluated on a novel weighting function defining on‐line the role of each controller. The proposed orthosis was motivated by the prevalence of whiplash, which is a syndrome that is produced by forced hyperextension and hyperflexion of the neck. This study included the development of a technological prototype of the orthotic type to support the recovery of patients diagnosed with whiplash. The sections that make up the orthotic device are two independent systems that move the patient’s head in the sagittal and frontal planes. For this purpose, the mechanical structure of the cervical orthosis was made up of 7 pieces printed in 3D with polylactic acid (PLA). The operation of the cervical orthosis was evaluated in two sections: (a) using a simulation system, which consists of a spring with an artificial head and the development of a graphic interface in Matlab, and (b) evaluating the controller on the proposed orthosis. With these elements, the follow‐up of the trajectory proposed by the actuators was evaluated, as well as its performance in the face of the opposition that a patient generates. The superiority of the proposed controller was confirmed by comparing the tracking efficiency with proportional‐integral‐derivative and first‐order sliding variants.
Safety, Efficacy, and Biomarker Analysis of Pyrotinib in Combination with Capecitabine in HER2-Positive Metastatic Breast Cancer Patients: A Phase I Clinical Trial
Authors: Li Qiao , Guan Xiuwen , Chen Shanshan , Yi Zongbi , Lan Bo , Xing Puyuan , Fan Ying , Wang Jiayu , Luo Yang , Yuan Peng , Cai Ruigang , Zhang Pin , Li Qing , Zhong Dafang , Zhang Yifan , Zou Jianjun , Zhu Xiaoyu , Ma Fei , Xu Binghe
Published: May 2019

Purpose:

This phase I study assessed the safety, tolerability, MTD, pharmacokinetics, antitumor activity, and predictive biomarkers of pyrotinib, an irreversible pan-ErbB inhibitor, in combination with capecitabine in patients with HER2-positive metastatic breast cancer (MBC).

Patients and Methods:

Patients received oral pyrotinib 160 mg, 240 mg, 320 mg, or 400 mg once daily continually plus capecitabine 1,000 mg/m2 twice daily on days 1 to 14 of a 21-day cycle. Pharmacokinetic blood samples were collected on days 1 and 14. Next-generation sequencing was performed on circulating tumor DNA to probe for predictive biomarkers.

Results:

A total of 28 patients were enrolled, 22 patients were treated at the two top-level doses. Among 17 (60.7%) trastuzumab-pretreated patients, 11 received trastuzumab for metastatic disease and 6 received adjuvant trastuzumab. No dose-limited toxicity was observed. Grade 3 treatment-related adverse events (AE) occurred in 12 (42.9%) patients; anemia (14.3%) and diarrhea (10.7%) were the most common grade 3 AEs. The overall response rate (ORR) was 78.6% [95% confidence interval (CI): 59.0%–91.7%], and the clinical benefit rate was 85.7% (95% CI: 67.3%–96.0%). The median progression-free survival (PFS) was 22.1 months (95% CI: 9.0–26.2 months). ORR was 70.6% (12/17) in trastuzumab-pretreated patients and 90.9% (10/11) in trastuzumab-naïve patients. Analysis of all genetic alterations in HER2-related signaling network in baseline blood samples suggested that multiple genetic alterations were significantly associated with poorer PFS compared with none or one genetic alteration (median, 16.8 vs. 29.9 months, P = 0.006).

Conclusions:

In a population largely naïve to HER2-targeted therapy, pyrotinib in combination with capecitabine was well-tolerated and demonstrates promising antitumor activity in patients with HER2-positive MBC.
Serine/Arginine–Rich Splicing Factor 3 Modulates the Alternative Splicing of Cytoplasmic Polyadenylation Element Binding Protein 2
Authors: DeLigio James T. , Stevens Shaun C. , Nazario-Muñoz Gina S. , MacKnight H. Patrick , Doe Keli K. , Chalfant Charles E. , Park Margaret A.
Published: May 2019

Triple negative breast cancer (TNBC) has an unusually low 5-year survival rate linked to higher metastatic rates. Our laboratory recently delineated a role for the alternative RNA splicing (AS) of cytoplasmic polyadenylation element binding protein 2 (CPEB2), via inclusion/exclusion of exon 4, in the metastasis of TNBC. In these studies, the mechanism governing the inclusion/exclusion of exon 4 was examined. Specifically, the RNA trans-factor, SRSF3, was found to be explicitly associated with CPEB2 exon 4. A SRSF3 consensus sequence was identified in exon 4, and mutation of this sequence abolished the association of SRSF3. The expression of SRSF3 was upregulated in TNBC cells upon the acquisition of anoikis resistance correlating with a reduction in the CPEB2A/B ratio. Importantly, downregulation of SRSF3 in these cells by siRNA induced the exclusion of exon 4 in cells increasing the ratio of CPEB2A (exon 4 excluded) to CPEB2B (exon 4 included). Downregulation of SRSF3 also reversed the CPEB2A/B ratio of a wild-type CPEB2 exon 4 minigene and endogenous CPEB2 pre-mRNA, but not a mutant CPEB2 minigene with the SRSF3 RNA cis-element ablated. SRSF3 downregulation ablated the anoikis resistance of TNBC cells, which was “rescued” by ectopic expression of CPEB2B. Finally, analysis of The Cancer Genome Atlas database showed a positive relationship between SRSF3 expression and lower CPEB2A/B ratios in aggressive breast cancers.

Implications:

These findings demonstrate that SRSF3 modulates CPEB2 AS to induce the expression of the CPEB2B isoform that drives TNBC phenotypes correlating with aggressive human breast cancer.

Visual Overview:

http://mcr.aacrjournals.org/content/molcanres/17/9/1920/F1.large.jpg.
Four-Dimensional Ultrasound for Evaluating Newborn Cardiac Output: A Pilot Study of Healthy Infants
Authors: Lobo Lisha , Stevenson Gordon , Alphonse Jennifer , Welsh Alec , Oei Ju Lee , Schindler Timothy
Published: May 2019

Background: There is currently no reliable non-invasive method of measuring cardiac output in neonatal intensive care. Spatiotemporal image correlation (STIC) is a novel four-dimensional (4D) ultrasound technique that was developed to assess the foetal heart, and it may be a useful way to assess neonatal haemodynamics. Objective: This study aimed to evaluate the feasibility and reproducibility of determining neonatal cardiac output using STIC ultrasound in newborn infants. Design: Infants were recruited opportunistically from a neonatal intensive care unit and then examined by 2 independent observers. STIC was used to obtain images of the heart. End-diastolic and end-systolic ventricular volumes were measured using virtual organ computer-aided analysis (VOCAL) and used to calculate cardiac output. Reproducibility was assessed with intraclass correlation coefficients (ICC) and agreement with Bland-Altman analysis. Results: Twenty-four clinically stable infants of 34–43 weeks corrected gestational age were assessed. Both observers successfully acquired 4D STIC volumes in all infants. Left ventricular output showed good reproducibility, with an intra-observer ICC of 0.86 (0.69–0.94) and inter-observer ICC of 0.87 (0.70–0.95). Right ventricular output also showed good reproducibility, with an intra-observer ICC of 0.88 (0.70–95) and inter-observer ICC of 0.84 (0.63–0.93). Conclusions: Determining cardiac output using 4D STIC ultrasound is feasible and reproducible in well newborn infants. With further evaluation, this technique may provide valuable information about haemodynamic status in newborn infants requiring intensive care.
Does Uterine Doppler Add Information to the Cerebroplacental Ratio for the Prediction of Adverse Perinatal Outcome at the End of Pregnancy?
Authors: Morales-Roselló José , Buongiorno Silvia , Loscalzo Gabriela , Abad García Cristina , Cañada Martínez Antonio José , Perales Marín Alfredo
Published: May 2019

Objective: To evaluate whether the addition of the mean uterine arteries pulsatility index (mUtA PI) to the cerebroplacental ratio (CPR) improves its ability to predict adverse perinatal outcome (APO) at the end of pregnancy. Methods: This was a prospective study of 891 fetuses that underwent an ultrasound examination at 34–41 weeks. The CPR and the mUtA PI were converted into multiples of the median (MoM) and the estimated fetal weight (EFW) into centiles according to local references. APO was defined as a composite of abnormal cardiotocogram, intrapartum pH requiring cesarean section, 5′ Apgar score <7, neonatal pH <7.10 and admission to pediatric care units. The accuracies of the different parameters were evaluated alone and in combination with gestational characteristics using univariate and multivariate analyses by means of the Akaike Information Criteria (AIC) and the area under the curve (AUC). Finally, a comparison was similarly performed between the CPR and the cerebro-placental-uterine ratio (CPUR; CPR/mUtA PI) for the prediction of APO. Results: The univariate analysis showed that CPR MoM was the best parameter predicting APO (AIC 615.71, AUC 0.675). The multivariate analysis including clinical data showed that the best prediction was also achieved with the CPR MoM (AIC 599.39, AUC 0.718). Moreover, when EFW centiles were considered, the addition of UtA PI MoM did not improve the prediction already obtained with CPR MoM (AIC 591.36, AUC 0.729 vs. AIC 589.86, AUC 0.731). Finally, the prediction by means of CPUR did not improve that of CPR alone (AIC 623.38, AUC 0.674 vs. AIC 623.27, AUC 0.66). Conclusion: The best prediction of APO at the end of pregnancy is obtained with CPR whatever is the combination of parameters. The addition of uterine Doppler to the information yielded by CPR does not result in any prediction improvement.
Single Nucleotide Polymorphisms in Chemosensory Pathway Genes GNB3, TAS2R19, and TAS2R38 Are Associated with Chronic Rhinosinusitis
Authors: Purnell Phillip R. , Addicks Benjamin L. , Zalzal Habib G. , Shapiro Scott , Wen Sijin , Ramadan Hassan H. , Setola Vincent , Siderovski David P.
Published: May 2019

Background: Chronic rhinosinusitis (CRS) is a multifaceted disease with a significant genetic component. The importance of taste receptor signaling has recently been highlighted in CRS; single nucleotide polymorphisms (SNPs) of bitter tastant-responsive G-protein-coupled receptors have been linked with CRS and with altered innate immune responses to multiple bacterially derived signals. Objective: To determine in CRS the frequency of six SNPs in genes with known bitter tastant signaling function. Methods: Genomic DNA was isolated from 74 CRS volunteers in West Virginia, and allele frequency was determined and compared with demographically matched data from the 1,000 Genomes database. Results: For two SNPs in a gene recently associated with bitterant signaling regulation, RGS21, there were no associations with CRS (although the frequency of the minor allele of RGS21, rs7528947, was seen to increase with increasing Lund-Mackay CT staging score). Two TAS2R bitter taste receptor gene variants (TAS2R19 rs10772420 and TAS2R38 rs713598), identified in prior CRS genetics studies, were found to have similar associations in this study. Conclusion: Unique to our study is the establishment of an association between CRS in this patient population and GNB3 SNP rs5443, a variation in an established G protein component downstream of bitterant receptor signal transduction.
Randomised Controlled Trials for Informing Perinatal Care
Authors: Gale Chris , McGuire William , Juszczak Edmund
Published: May 2019

Background: Randomised controlled trials provide the best evidence for the effects of interventions and are a key tool in the effort to improve the care and outcomes for newborn infants. Methods: We discuss the role of randomisation for minimising selection bias in clinical trials and describe examples of seminal trials that have shaped the development of modern perinatal care. We consider the challenges inherent in designing and delivering large, simple, and pragmatic trials, and the need for the development and adoption of core outcome sets to ensure that trials provide high-quality evidence of sufficient validity and applicability to guide policy and practice. Results: Since the earliest days of modern neonatology, the randomised controlled trial has been recognised as the best method for assessing treatments and practices. While many strategies that reduce mortality and morbidity have been introduced following randomised trials, there are, however, important examples of ineffective or potentially harmful practices that have been adopted in the absence of trial-based evidence. Typically, randomised controlled trials in perinatal care need to recruit several thousand participants to be able to detect modest but potentially important effects of new interventions on the most important but rare outcomes. Given the concerns about the financial burden and regulatory complexity of standard trial designs, innovative “efficient” trial designs are being evaluated to streamline processes while safeguarding participants. Conclusions: Well-conducted randomised controlled trials provide the most robust evaluation of interventions aimed at improving outcomes for newborn infants and their families. Increasingly, these trials will need to be large and multicentre (often international) and use a simple and pragmatic protocol, incorporating meticulous follow-up procedures and assessment of long-term outcomes.
Effect of Repetitive Transcranial Magnetic Stimulation on the Right Superior Temporal Gyrus for Severe Aphasia Caused by Damage to the Left Inferior Frontal Gyrus
Authors: Kawamura Mimpei , Takahashi Nobuhiro , Kobayashi Yasutaka
Published: May 2019

Several reports on repetitive transcranial magnetic stimulation (rTMS) for the treatment of aphasia caused by damage to the left inferior frontal gyrus state that low-frequency rTMS therapy for the right inferior frontal gyrus, which is contralateral to the focus area, is effective for improving verbal expression. However, most of these reports have studied the effects of rTMS therapy for comparatively mild aphasia. This study attempted to perform low-frequency rTMS on the right posterior superior temporal gyrus (BA22), which is the center for language reception for aphasia patients with a drastic decline in verbal expression due to damage to the left inferior frontal gyrus and a considerable decline in language perception. The participants performed a language task that was displayed on a computer monitor during rTMS. In addition, intensive speech-language and hearing therapy was performed by the therapist after rTMS. This study reports that a resultant improvement in language perception was observed in the activated brain regions based on neuropsychological tests and functional magnetic resonance imaging. This study is considered to be significant as it highlights a new method of rTMS treatment for severe aphasia.
Differential Clinical Profiles, Exercise Responses, and Outcomes Associated With Existing HFpEF Definitions
Authors: Ho Jennifer E. , Zern Emily K. , Wooster Luke , Bailey Cole S. , Cunningham Thomas , Eisman Aaron S. , Hardin Kathryn M. , Zampierollo Giovanna A. , Jarolim Petr , Pappagianopoulos Paul P. , Malhotra Rajeev , Nayor Matthew , Lewis Gregory D.
Published: May 2019

Background:

Heart failure with preserved ejection fraction (HFpEF) is common, yet there is currently no consensus on how to define HFpEF according to various society and clinical trial criteria. How clinical and hemodynamic profiles of patients vary across definitions is unclear. We sought to determine clinical characteristics, as well as physiologic and prognostic implications of applying various criteria to define HFpEF.

Methods:

We examined consecutive patients with chronic exertional dyspnea (New York Heart Association class II to IV) and ejection fraction ≥50% referred for comprehensive cardiopulmonary exercise testing with invasive hemodynamic monitoring. We applied societal and clinical trial HFpEF definitions and compared clinical profiles, exercise responses, and cardiovascular outcomes.

Results:

Of 461 patients (age 58±15 years, 62% women), 416 met American College of Cardiology/American Heart Association (ACC/AHA), 205 met European Society of Cardiology (ESC), and 55 met Heart Failure Society of America (HFSA) criteria for HFpEF. Clinical profiles and exercise capacity varied across definitions, with peak oxygen uptake of 16.2±5.2 (ACC/AHA), 14.1±4.2 (ESC), and 12.7±3.1 mL·kg
-1
·min
-1
(HFSA). A total of 243 patients had hemodynamic evidence of HFpEF (abnormal rest or exercise filling pressures), of whom 222 met ACC/AHA, 161 met ESC, and 41 met HFSA criteria. Over a mean follow-up of 3.8 years, the incidence of cardiovascular outcomes ranged from 75 (ACC/AHA) to 298 events per 1000 person-years (HFSA). Application of clinical trial definitions of HFpEF similarly resulted in distinct patient classification and prognostication.

Conclusions:

Use of different HFpEF classifications variably enriches for future cardiovascular events, but at the expense of not including up to 85% of individuals with physiologic evidence of HFpEF. Comprehensive phenotyping of patients with suspected heart failure highlights the limitations and heterogeneity of current HFpEF definitions and may help to refine HFpEF subgrouping to test therapeutic interventions.
Pulse Wave Velocities Derived From Cuff Ambulatory Pulse Wave Analysis
Authors: Schwartz Joseph E. , Feig Peter U. , Izzo Joseph L.
Published: May 2019

Pulse wave velocity (PWV), a measure of arterial stiffness, is an independent risk factor for cardiovascular morbidity and mortality. We investigated the relationship of ambulatory brachial cuff-based oscillometric PWV (oPWV) to 2 known correlates: age and brachial systolic blood pressure (SBP). In 234 participants in the Masked Hypertension Study, we analyzed 7284 validated hourly ambulatory SBP and oPWV readings using the Mobil-O-Graph monitor, which uses a proprietary pulse wave analysis algorithm to determine oPWV. Carotid-femoral PWV (cfPWV) was also measured. Mixed linear models were developed to estimate oPWV from age and ambulatory SBP. Participants were 34% male, with mean (SD) age 52.8 (9.9) years, SBP 123.8 (18.4) mm Hg, and oPWV 7.6 (1.3) m/s and cfPWV of 7.7 (1.7) m/s. The relationship of oPWV to age and SBP is given below:

Age uniquely accounted for an estimated 75% of the total variation of oPWV, whereas SBP uniquely accounted for 20%; these findings were confirmed in an external validation dataset. Together, age and SBP accounted for 99.1% of the total variance of oPWV but (only) 40.2% of the variance of cfPWV. The correlation between oPWV and cfPWV was 0.58 but was only 0.11 after controlling for age and SBP. We conclude that the Mobil-O-Graph’s oPWV is nearly completely explained by age and SBP and its relationship to cfPWV is because of their shared associations with age and SBP. Other hemodynamic variables derived from oscillometric pulse wave analysis may be useful and deserve additional scrutiny.
Noninvasive Estimation of Aortic Stiffness Through Different Approaches
Authors: Salvi Paolo , Scalise Filippo , Rovina Matteo , Moretti Francesco , Salvi Lucia , Grillo Andrea , Gao Lan , Baldi Corrado , Faini Andrea , Furlanis Giulia , Sorropago Antonio , Millasseau Sandrine C. , Sorropago Giovanni , Carretta Renzo , Avolio Alberto P. , Parati Gianfranco
Published: May 2019

Aortic pulse wave velocity is a worldwide accepted index to evaluate aortic stiffness and can be assessed noninvasively by several methods. This study sought to determine if commonly used noninvasive devices can all accurately estimate aortic pulse wave velocity. Pulse wave velocity was estimated in 102 patients (aged 65±13 years) undergoing diagnostic coronary angiography with 7 noninvasive devices and compared with invasive aortic pulse wave velocity. Devices evaluating carotid-femoral pulse wave velocity (Complior Analyse, PulsePen ET, PulsePen ETT, and SphygmoCor) showed a strong agreement between each other (
r
>0.83) and with invasive aortic pulse wave velocity. The mean difference ±SD with the invasive pulse wave velocity was −0.73±2.83 m/s (
r
=0.64) for Complior-Analyse: 0.20±2.54 m/s (
r
=0.71) for PulsePen-ETT: −0.04±2.33 m/s (
r
=0.78) for PulsePen ET; and −0.61±2.57 m/s (
r
=0.70) for SphygmoCor. The finger-toe pulse wave velocity, evaluated by pOpmètre, showed only a weak relationship with invasive aortic recording (mean difference ±SD =−0.44±4.44 m/s;
r
=0.41), and with noninvasive carotid-femoral pulse wave velocity measurements (
r
<0.33). Pulse wave velocity estimated through a proprietary algorithm by BPLab (v.5.03 and v.6.02) and Mobil-O-Graph showed a weaker agreement with invasive pulse wave velocity compared with carotid-femoral pulse wave velocity (mean difference ±SD =−0.71±3.55 m/s,
r
=0.23; 1.04±2.27 m/s,
r
=0.77; and −1.01±2.54 m/s,
r
=0.71, respectively), revealing a negative proportional bias at Bland-Altman plot. Aortic pulse wave velocity values provided by BPLab and Mobil-O-Graph were entirely dependent on age-squared and peripheral systolic blood pressure (cumulative
r
2
=0.98 and 0.99, respectively). Thus, among the methods evaluated, only those assessing carotid-femoral pulse wave velocity (Complior Analyse, PulsePen ETT, PulsePen ET, and SphygmoCor) appear to be reliable approaches for estimation of aortic stiffness.
Frequency and Prognosis of Treated Hypertensive Patients According to Prior and New Blood Pressure Goals
Authors: Ruilope Luis M. , Ruiz-Hurtado Gema , Barderas María G. , de la Cruz Juan J. , Lucia Alejandro , de la Sierra Alejandro , Gorostidi Manuel , Vinyoles Ernest , Segura Julián , Solís Jorge , Arribas Fernando , García-Puig Juan , Tamargo Juan , O’Brien Eoin , Volpe Massimo , Whelton Paul K. , Williams Bryan , Banegas José R.
Published: May 2019

United States and European guidelines have recommended new treatment goals for office blood pressure (BP). We examined 9784 hypertensives of the Spanish Ambulatory BP Monitoring (ABPM) registry with office BP treated to the prior goal (<140/90 mm Hg); and evaluated the frequency and all-cause mortality of 4 BP strata depending on whether or not they attained more conservative or new office BP goal (130–139/80–89 and <130/80 mm Hg, respectively) and whether or not BP was controlled according to ABPM criteria in the European and US guidelines (24-hour ambulatory BP <130/80 and <125/75 mm Hg, respectively). Whether achieving or not the new office BP goal, the total-mortality risk during a 5-year follow-up was only significantly higher than the reference (normal office BP and ABPM) when 24-hour ambulatory BP was above goal (hazard ratio from multivariable Cox models was in the range of 2.4–2.9;
P
<0.001). The frequency of patients achieving the new office BP goal was 34.4%, and the frequencies of those not achieving the ABPM goal were 31.6% and 53.7% using the 130/80 or the 125/75 ABPM goal, respectively. Mean office systolic BP was 129 mm Hg for patients not achieving the ABPM goal. In hypertensive patients controlled under prior office BP goal, the frequency of those achieving new office BP goal <130/80 was high, suggesting this goal can be attained. In addition, patients had a higher mortality risk only when ABPM was above goal despite having mean office systolic BP under control, a condition that was also common.
Antihomosexual Acts on Trial: The Poetics of Justice in Uganda
Authors: Edmondson Laura
Published: May 2019

Reading across artistic, political, and legal expressions of LGBT activism in and from Uganda reveals an aesthetics of silence. These moments of silence serve as a strategy of deferral that enables Ugandans on both sides of the Anti-Homosexuality Bill controversy to refuse humanitarian savior narratives, affirm the legitimacy of the postcolonial state, and point the way toward an East African grammar of justice.
Crude Optimism: Romanticizing Alberta’s Oil Frontier at the Calgary Stampede
Authors: Richards Kimberly Skye
Published: May 2019

Designed to preserve and promote western heritage and culture, the Calgary Exhibition and Stampede has become entwined with, and politically and economically expedient for, Alberta’s oil and gas industry. Performances at the Stampede relieve guilt about the expropriation of Indigenous territory and conquest of the natural world, and produce an affective climate of “crude optimism,” an optimistic attachment to fossil fuel production and consumption despite the brutal realities of extractivism.
Cossacks and Sturgeons: Fisheries, Colonization, and Science around the Aral Sea (1873-1906)
Authors: Pianciola Niccolò
Published: May 2019

The article addresses the managing of Aral Sea fisheries by the Tsarist administration, and the making of a colonial frontier inhabited by exiled Ural Cossack, Qaraqalpaq, Qazaq, Russian, and Ukrainian fishermen. By comparing the different power relations between Cossacks and the local population on the Ural River and in the Aral Sea region, it shows how they shaped fisheries management regulations and their effectiveness. It also investigates the conditions of production of scientific knowledge on the Aral Sea ecosystem and what role it played in governance decision-making. By drafting a series of fishing regulations and by examining the balance between humans and aquatic animals, scientists oriented the Tsarist government’s decisions on how to manage both the fisheries and the populations that exploited them. At the same time, members of a specific social group, the exiled Ural Cossacks, functioned as mediators between the imperial state and an ecosystem undergoing colonization.
The Grand Canal in Republican China
Authors: Ye Shirley
Published: May 2019

Since the late imperial era, Yellow River floods have endangered the environmental equilibrium of North China, including parts of the Grand Canal. The Republican government’s response to water disasters reflected the influence of global networks and institutions of expertise. By turning to an American company for infrastructure work on the Grand Canal, Chinese government officials placed their faith in global science and finance to renew a domestic symbol of state power. The project failed; nonetheless the efforts to restore the waterways and provide relief reveal the entangled humanitarian, corporate, and educational interests of modern China’s state building and environmental management.
On-Campus Animal-Assisted Therapy Events
Authors: McArthur Alisa D. , Syrnyk Corinne
Published: May 2019

Post-secondary students are experiencing more stress than ever before. In an attempt to help alleviate some of this stress, animal-assisted therapy (AAT) events were held on the campus of a small liberal arts institution just prior to final exams in the Fall and Winter terms. All students were invited to mingle with dogs and handlers from a local AAT advocacy group. In Study 1, students were surveyed following the events held in the Fall and Winter and self-reported an improved mood as a result of the events as well as being extremely satisfied with the experience. Similarly, Study 2, held in the subsequent Fall, replicated the findings from Study 1. In addition, the Brief Mood Inspection Scale, administered before and after the event, found students’ mood improved on all three subscales. The implications for future research to fully assess the impact of such events on students are discussed.
The “Supplementary” Historian? Li Zhao’s Guo shi bu as Mid-Tang Political and Social Critique
Authors: Shields Anna M.
Published: May 2019

This article examines the Tang dynasty anecdote collection Guo shi bu 國史補 (Supplement to the History of the State), compiled by Li Zhao 李肇 (?-after 827) in part as a critique of imperial government and elite social mores of the early decades of the ninth century. A quantitative analysis of topic frequency and distribution in the collection reveals Li Zhao’s techniques for depicting the corruption or political brilliance of the reigns of Tang emperors, as well as his admiration of powerful aristocratic clans, and his disdain for social climbing, perspectives that likely stemmed from his experiences as an official in Xianzong’s court and his elite family background. Understanding the organization, underlying themes, and structure of individual anecdotes of the Guo shi bu allows us to see the ways that anecdotes and “miscellaneous” histories ultimately shaped official accounts of the Tang dynasty. 

Cet article examine la collection d’anecdotes d’époque Tang Guo shi bu 國史補 (supplément à l’histoire de l’Etat) compilée par Li Zhao 李肇 (?-après 827), et la considère en partie comme une critique du gouvernement impérial et des mœurs des élites au début du ixe siècle. Une analyse quantitative des thèmes traités, dans leur fréquence et leur répartition au sein de l’ouvrage permet de révéler les techniques mises en œuvre par Li Zhao pour décrire la corruption ou le rayonnement politique des règnes des empereurs Tang successifs, son admiration pour les grands clans aristocratiques, et son dédain pour les parvenus et l’ascension sociale. Li hérite certainement cette vision de son expérience en tant que fonctionnaire à la cour de Xianzong ainsi que de son ascendance au sein des élites. Une telle compréhension de l’organisation du Guo shi bu, de ses thèmes sous-jacents et de la structure des anecdotes prises individuellement nous permet de mieux saisir comment les anecdotes et les miscellanées ont fini par déterminer le contenu des histoires officielles de la dynastie des Tang.
Reflections on Earth's Insights from an East Asianist
Authors: Tucker Mary Evelyn
Published: May 2019

Callicott's Earth's Insights is a remarkable survey of resources from the world's religions for formulating a global ethics. He mentions, in particular, the rich symbolic and conceptual resources available from East Asia. This paper supports such an assertion and develops more fully the teachings of Japanese Shingon Buddhism which helped to foster a deep identity with the natural world by means of ritual. Moreover, the paper suggests that the literary and artistic resources of Japanese culture are also important sources for further exploration.
Das Ungeschehene
Authors: Iyer Arun
Published: May 2019

This paper aims to explicate what Heidegger means by das Ungeschehene (the un-happened), revealing the significance of this concept in providing us with a novel way of understanding and relating to the historical past. Taking recourse to ga 38, it will show that this concept has to be understood in connection with Heidegger’s very specific way of understanding what was (das Gewesene) not as that which has simply elapsed and passed away (das Vergangene) but as that which continues to abide and bear upon the present. It will clarify that the un-happened is neither the same as that which did happen nor the same as that which did not happen. Through a concrete discussion of a specific period in India’s colonial history, it will establish how the un-happened occupies a unique place between what happened and what did not happen, making it very different from a counterfactual.
Heidegger’s Reassessment of Metaphysica Specialis and the Status of Metontological Inquiry in the Late Marburg Period
Authors: Reichl Pavel
Published: May 2019

This article examines the development of Heidegger’s thought directly following Being and Time, a period that is significant both in its own right and in its capacity to shed light on the problems driving Heidegger’s later works. I assess Crowell’s thesis that Heidegger’s aim was to develop a metontology along the lines of a pre-critical metaphysica specialis based on a reassessment of Kant’s transcendental dialectic. I show that such a reading misrepresents the nature of Heidegger’s project in this period and argue that Heidegger was instead attempting to develop a distinctively critical metaphysics in a post-Kantian vein.
The Spice Route between Africa and India
Authors: Sharma Dinesh
Published: May 2019

As an introduction to the special issue, this essay covers a range of topics – from Mazrui’s historic essay on Gandhi and Nehru to Rumi and Wordsworth’s universal optimism and the role of education and technology in globalization. The historic and cultural relationship between Africa and India is examined, where several important themes are discussed: 1) the emphasis on human rights and social justice; 2) building sustainable development through literacy, education, tech-transfer, and cultural exchange; 3) journeys of loss and redemption between Africa, India and the West; and 4) the historic India-Africa summits.