bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Diluent Volume of a Single Dose of Epidural Bupivacaine in Parturients During the First Stage of Labor
Authors: Christiaens Frank , Verborgh Christian , Dierick Ann , Camu Frédéric
Published: March 2019

Background and Objectives

0.1% bupivacaine for obstetric epidural analgesia is given by infusion, using a loading dose of a higher concentration alone or in combination with opioid analgesics. A single dose of 0.1% without any additive for relief of first-stage labor pain has not yet been documented.

Methods

Fifty-eight primiparae in active labor and with less than 5 cm cervical dilatation received 20 mg epidural bupivacaine diluted in 4 mL [group 1: 0.5% (I)], 10 mL [group 2: 0.2% (II)], or 20 mL [group 3: 0.1% (III)]. Pain relief, dermatomal spread, and motor block were assessed.

Results

Visual analog pain scale (VAS) was significantly lower in group 2 (0.88 ± 1.34) and group 3 (0.25 ± 0.61) than in group 1 (4.37 ± 2.57). Onset and time to maximum analgesia was significantly shorter in group 2 than in group 3. Mean duration of analgesia was 120 ± 21 minutes in group 3, 100 ± 26 in group 2, and 43 ± 21 in group 1. The mean numbers and upper limits of dermatomes blocked did not differ between groups 2 and 3, but were higher than in group 1. Motor blocks in groups 2 and 3 were more extensive than in group 1 with no difference between groups 2 and 3. Ten mL 0.2% or 20 mL 0.1% epidural bupivacaine results in a similar degree of pain relief, superior to that following 4 mL 0.5%, while duration was longest after 20 mL 0.1%.

Conclusions

Analgesia lasts significantly longer following 20 mL 0.1% bupivacaine than following 10 mL 0.2% bupivacaine when given for first-stage labor pain. Four milliliters 0.5% bupivacaine results in inadequate pain relief.
Spinal Anesthesia With Tetracaine in 0.75% Glucose: Influence of the Vertebral Interspace Used for Injection
Authors: Sakura Shinichi , Sumi Mariko , Morimoto Noriko , Yamamori Yuji , Saito Yoji
Published: March 2019

Background and Objectives

The anesthetic behavior and hemodynamic consequences of spinal anesthesia with marginally hyperbaric tetracaine containing a low concentration of glucose injected at two different interspaces were examined and compared with those of conventionally hyperbaric solution.

Methods

One-hundred twenty ASA Physical Status I or II patients scheduled for elective surgery to the lower limb were sequentially assigned to one of three equal groups to receive spinal anesthesia: Group 1 received 0.5% tetracaine in 0.75% glucose with 0.125% phenylephrine at the L2-L3 interspace; group 2 0.5% tetracaine in 0.75% glucose with 0.125% phenylephrine at the L3-L4 interspace; group 3 0.5% tetracaine in 7.5% glucose with 0.125% phenylephrine at the L3-L4 interspace. Neural block was assessed in a double-blinded manner by cold, pinprick, and touch sensation, and a modified Bromage scale after the injection of the study drug.

Results

Injection at the L2-L3 interspace produced significantly higher spread of analgesia [median T7 (10th, 90th percentiles T10, T4)] than injection at L3-L4 interspace [T10 (L1, T5)] when using the solution in 0.75% glucose. There were no significant differences in peak dermatomal levels between groups 1 and 3, but the number of patients who required ephedrine for the treatment of hypotension was larger in group 3.

Conclusions

A marginally hyperbaric tetracaine solution injected at the L2-L3 interspace with the patient in the lateral position produced greater extent of cephalad spread than that at the L3-L4 interspace. When compared to a conventionally hyperbaric tetracaine solution injected at the L3-L4 interspace, the marginally hyperbaric solution injected at the L2-L3 interspace caused less hemodynamic variability despite similar levels of maximum sensory block.
Alkalinizing Water-Soluble Local Anesthetic Solutions by Addition of Cyclodextrin
Authors: Miyoshi Michio , Imoto Toshiaki , Hiji Yasutake
Published: March 2019

Background and objectives

The use of sodium bicarbonate for alkalinization of local anesthetics to improve their efficacy has some disadvantages including decreased stability of the solutions. The present study was performed to evaluate usefulness of cyclodextrins (CDs) in improving the solubility and stability of local anesthetic solutions at near physiologic pH without precipitation.

Methods

Solubility of local anesthetics with or without CDs in physiologic saline was investigated by monitoring cloudiness or precipitate formation visually and by recording absorbance at 620 nm. Interaction of anesthetic and CD was also studied spectrophotometrically using spectral change of the drugs associated with the inclusion complex formation.

Results

Cyclodextrins improved the solubility and stability of the four local anesthetics studied (dibucaine, tetracaine, bupivacaine, and lidocaine). In the neutral pH region, the effects of the CDs were more significant with dibucaine and tetracaine, which are more hydrophobic than the other two. A type of effective CD was different for each anesthetic depending partly on the tendency to form inclusion complex with local anesthetic. The local anesthetic solutions solubilized by CDs were found to remain clear for more than 72 hours without any visible precipitation or turbidity at neutral pHs.

Conclusions

The improved solubility of local anesthetics by adding CD may be caused by inclusion complex formation of CD with local anesthetics. This new preparation for the alkalinized water-soluble anesthetic solutions may be useful for practical application in the clinical setting, although this awaits further study.
Addition of Bupivacaine to Sufentanil in Patient-Controlled Epidural Analgesia After Lower Limb Surgery in Young Adults
Authors: Vercauteren Marcel P. , Van Den Bergh Lieve , Kartawiadi Sri L. , Van Boxem Koen , Hoffmann Vincent L.H.
Published: March 2019

Background and Objectives

The usefulness of adding bupivacaine to an opioid administered by the epidural route is controversial. This study examines both the quality of pain relief and side effects, in particular urinary retention, during patient-controlled epidural analgesia (PCEA) with sufentanil alone or in combination with two different concentrations of bupivacaine.

Methods

In a double-blind randomized study, 60 healthy young adults undergoing open knee or ankle surgery with combined spinal-epidural anesthesia received postoperative analgesia via PCEA with sufentanil alone or with 0.06% or 0.12% bupivacaine. In addition to pain scores at rest and during mobilization, bladder function was evaluated. Strict criteria were respected in scoring the occurrence of problems suggestive of urinary retention. The 24-hour analgesic consumption and the incidence of other side effects were also recorded.

Results

Patients receiving bupivacaine had better pain relief than those receiving only the opioid, but this difference was more pronounced when measuring dynamic pain scores. The consumption of sufentanil was significantly higher in the group receiving the opioid alone than in the group receiving 0.06% bupivacaine. The bupivacaine dose requirements were twice as high with the 0.12% concentration. Bladder problems occurred significantly more frequently in patients treated with the highest bupivacaine concentration. Motor impairment was not a major problem.

Conclusions

A 0.06% bupivacaine-sufentanil combination offered the best results in terms of analgesic quality and lower side effects, mainly micturition problems, which may be explained by the higher consumption of local anesthetic at the higher bupivacaine concentration. Analgesic quality could not be improved by increasing the bupivacaine concentration.
Sympathetic Hyperactivity, Respiratory Failure, Pruritus, and Anesthesia After Unintentional Epidural Injection of Potassium Chloride: Case Report
Authors: do Nascimento Paulo , Módolo Norma Sueli Pinheiro , do Amaral Meletti José Fernando , Braz José Reinaldo Cerqueira
Published: March 2019

Background and Objectives

A combination of epidural and general anesthesia has been widely used to attenuate the surgical stress response and to provide postoperative analgesia. This case report illustrates the use of this anesthetic technique. Analgesia was induced with local anesthetic in the immediate postoperative period using unintentional 19.1% potassium chloride (KCI) as diluent.

Methods

An ASA I male patient was scheduled for surgical correction of idiopathic megaesophagus under continuous epidural anesthesia combined with general anesthesia. In the postoperative period, while preparing 10 mL 0.125% bupivacaine to be administered through the epidural catheter for pain control, 5 mL 19.1% KCI was unintentionally used as diluent, resulting in a 9.55% potassium solution concentration.

Results

The patient developed warmness of the lower limbs, tachycardia, hypertension, intense pruritus on the chest, agitation, exacerbation of sensory and motor blocks, and respiratory failure secondary to pulmonary edema, requiring ventilatory support. Total recovery was observed after 24 hours.

Conclusions

Epidurally injected potassium leads to severe clinical manifestations caused by autonomic dysfunction, spinal cord irritation, and possible release of histamine. Despite continuous recommendations, ampule misidentification still happens in hospitals, frequently leading to serious accidents.
Ultrasound-guided subomohyoid suprascapular nerve block and phrenic nerve involvement: a cadaveric dye study
Authors: Sehmbi Herman , Johnson Marjorie , Dhir Shalini
Published: March 2019

Backgrounds and objectives

The anterior approach to the subomohyoid suprascapular (SOS) nerve is a new, technically easy and reliable regional anesthesia technique for postoperative shoulder analgesia. However, due to its proximity, the injectate may spread to the brachial plexus and phrenic nerve. The goal of this anatomic study with dye injection in the subomohyoid space and subsequent cadaver dissection was to establish the likely spread of local anesthesia and the extent of brachial plexus and phrenic nerve involvement resulting from ultrasound-guided SOS nerve block.

Methods

The suprascapular nerve (SSN) under the inferior belly of omohyoid muscle in the posterior triangle of the neck was identified. Using a contrast dye, 10 ultrasound-guided SOS nerve injections of 5 mL were done bilaterally, in five fresh cadavers. The area was then dissected to evaluate the spread of the contrast dye in the immediate proximity of the brachial plexus, phrenic and SSN.

Results

The SSN and omohyoid muscle were easily identified on each cadaver. SOS nerve staining with contrast dye was seen in 90% of dissections. The superior trunk was stained in 90% and the middle trunk was stained in 80% of dissections. The inferior trunk was stained in 20% of dissections. A spread of dye around the SSN was observed in 90% and the phrenic nerve was mildly stained in 20% of the dissections.

Conclusion

In-plane ultrasound-guided needle injection with a 5 mL volume for SOS block was sufficient to stain the SSN. This conservative volume involved other parts of the brachial plexus and may potentially spread to the phrenic nerve. Further clinical studies are required for confirmation.
Feasibility of lung cancer prediction from low-dose CT scan and smoking factors using causal models
Authors: Raghu Vineet K , Zhao Wei , Pu Jiantao , Leader Joseph K , Wang Renwei , Herman James , Yuan Jian-Min , Benos Panayiotis V , Wilson David O
Published: March 2019

Introduction

Low-dose CT (LDCT) is currently used in lung cancer screening of high-risk populations for early lung cancer diagnosis. However, 96% of individuals with detected nodules are false positives.

Methods

In order to develop an efficient early lung cancer predictor from clinical, demographic and LDCT features, we studied a total of 218 subjects with lung cancer or benign nodules. Probabilistic graphical models (PGMs) were used to integrate demographics, clinical data and LDCT features from 92 subjects (training cohort) from the Pittsburgh Lung Screening Study cohort.

Results

Learnt PGMs identified three variables directly (causally) linked to malignant nodules and the largest benign nodule and used them to build the Lung Cancer Causal Model (LCCM), which was validated in a separate cohort of 126 subjects. Nodule and vessel numbers and years since the subject quit smoking were sufficient to discriminate malignant from benign nodules. Comparison with existing predictors in the training and validation cohorts showed that (1) incorporating LDCT scan features greatly enhances predictive accuracy; and (2) LCCM improves cancer detection over existing methods, including the Brock parsimonious model (p<0.001). Notably, the number of surrounding vessels, a feature not previously used in predictive models, significantly improves predictive efficiency. Based on the validation cohort results, LCCM is able to identify 30% of the benign nodules without risk of misclassifying cancer nodules.

Discussion

LCCM shows promise as a lung cancer predictor as it is significantly improved over existing models. Validated in a larger, prospective study, it may help reduce unnecessary follow-up visits and procedures.
Seasonal and annual variations in egg mass and clutch size for Loggerhead Sea Turtles (Caretta caretta): experienced females lay heavier eggs
Authors: Hatase Hideo , Omuta Kazuyoshi
Published: March 2019

Organisms modify reproductive traits adaptively or non-adaptively in response to temporal environmental variation. Long-lived iteroparous sea turtles are ideal animals to examine such temporal shifts in resource allocation. We analyzed seasonal shifts in egg mass and clutch size for Loggerhead Sea Turtles (Caretta caretta (Linnaeus, 1758)) nesting at a temperate rookery (Yakushima Island, Japan) over a 2-year period, as well as annual variation in egg mass and clutch size over a 5-year period. Egg mass and clutch size, adjusted for female body size, did not vary seasonally at both the population and individual levels. Adjusted egg mass showed significant annual variation, despite a lack of annual variation in adjusted clutch size. Thus, Loggerhead Sea Turtles are unlikely to exhibit adaptive seasonal variation in reproductive traits, whereas they vary egg size non-adaptively in response to annual environmental conditions. Although experienced Loggerhead Sea Turtles laid heavier eggs, the annual variation in egg mass was not attributable either to breeding experience of the sampled females or to ambient temperature during follicular development, implying that other factors are involved, such as resource availability. Our data show that egg size is a more plastic reproductive trait than clutch size for Loggerhead Sea Turtles inhabiting the North Pacific.
Prediction of wake structure and aerodynamic characteristics of flow around square cylinders at different arrangements
Authors: Fezai Salwa , Oueslati Fakher , Ben-Cheikh Nader , Ben-Beya Brahim
Published: March 2019

Two-dimensional incompressible fluid flows around square cylinders at different arrangements have been numerically analyzed in the present work. The calculations are carried out for several values of Reynolds number (Re) ranging from 20 to 180. The results are presented in the form of vorticity contours and temporal histories of drag and lift coefficients. Besides, the physical parameters, namely, the average drag and lift coefficients and Strouhal number, are evaluated as a function of Re. Two different states of flow are predicted in the current investigation by systematically varying Re for steady and unsteady regimes. Vortex shedding is studied at different arrangements of the square cylinders allowing the investigation of three possible configurations. Special attention is paid to compute the drag and lift forces acting on the different obstacles, which allowed determining the optimal configuration in terms of both drags and lifts. The unsteady periodic wake is characterized by the Strouhal number, which varies with the Reynolds number and the obstacle geometry. The values of vortex shedding frequencies are consequently calculated in this study.
Automatic Plaque Segmentation in Coronary Optical Coherence Tomography Images
Authors: Zhang Huaqi , Wang Guanglei , Li Yan , Lin Feng , Han Yechen , Wang Hongrui
Published: March 2019

Coronary optical coherence tomography (OCT) is a new high-resolution intravascular imaging technology that clearly depicts coronary artery stenosis and plaque information. Study of coronary OCT images is of significance in the diagnosis of coronary atherosclerotic heart disease (CAD). We introduce a new method based on the convolutional neural network (CNN) and an improved random walk (RW) algorithm for the recognition and segmentation of calcified, lipid and fibrotic plaque in coronary OCT images. First, we design CNN with three different depths (2, 4 or 6 convolutional layers) to perform the automatic recognition and select the optimal CNN model. Then, we device an improved RW algorithm. According to the gray-level distribution characteristics of coronary OCT images, the weights of intensity and texture term in the weight function of RW algorithm are adjusted by an adaptive weight. Finally, we apply mathematical morphology in combination with two RWs to accurately segment the plaque area. Compared with the ground truth of clinical segmentation results, the Jaccard similarity coefficient (JSC) of calcified and lipid plaque segmentation results is 0.864, the average symmetric contour distance (ASCD) is 0.375[Formula: see text]mm, the JSC and ASCD reliabilities are 88.33% and 92.50% respectively. The JSC of fibrotic plaque is 0.876, the ASCD is 0.349[Formula: see text]mm, the JSC and ASCD reliabilities are 90.83% and 95.83% respectively. In addition, the average segmentation time (AST) does not exceed 5 s. Reliable and significantly improved results have been achieved in this study. Compared with the CNN, traditional RW algorithm and other methods. The proposed method has the advantages of fast segmentation, high accuracy and reliability, and holds promise as an aid to doctors in the diagnosis of CAD.
Robust Multibit Image Watermarking Based on Contrast Modulation and Affine Rectification
Authors: Zhong Xin , Shih Frank Y.
Published: March 2019

In this paper, we present a robust multibit image watermarking scheme to undertake the common image-processing attacks as well as affine distortions. This scheme combines contrast modulation and effective synchronization for large payload and high robustness. We analyze the robustness, payload, and the lower bound of fidelity. Regarding watermark resynchronization under affine distortions, we develop a self-referencing rectification method to detect the distortion parameters for reconstruction by the center of mass in affine covariant regions. The effectiveness and advantages of the proposed scheme are confirmed by experimental results, which show the superior performance as comparing against several state-of-the-art watermarking methods.
Does the Current State of Environmental Impact Assessment in Armenia Pose a Challenge for the Future?
Authors: Geghamyan Sophya , Pavlickova Katarina
Published: March 2019

Many post-Soviet countries are still improving their Environmental Impact Assessment (EIA) systems, and Armenia is no exception. In recent years, approximation to and harmonisation with the laws of the European Union has seen Armenia increasingly adopt and apply EU regulations and directives, and this process was supported by adoption of the new law on EIA and Expertise in 2014. The main objectives of this study are to review and analyse the current state of the Armenian EIA system and to assess its legal framework. We applied a method divided into two parts: review and analysis of the legislative aspects of the EIA system in Armenia and the circulation of a survey-questionnaire to EIA experts to establish current practices. The findings of this research provided positive and negative factors which can both be used to improve the assessment system in Armenia. While the most significant EIA strength combines the existence of a systematic law and public involvement in this process, the law has weaknesses in its monitoring, informative and quality control provisions. Moreover, public participation has many weaknesses in practice, including the definition of stakeholders and the lack of guidelines and manuals which challenges expert action. Finally, this paper has explored the major positives and negatives of the Armenian EIA system in practice, and we consider that this should help other Former Soviet Union (FSU) countries define and combat the challenges of their EIA systems.
Effect of Un-Balanced Water Supply and Nonuniform Pressure Distribution on the Performance of an Adsorption Cooling System
Authors: Cao Ngoc Vi , Duong Xuan Quang , Lee Woo Su , Chung Jae Dong
Published: March 2019

A three-dimensional numerical analysis was conducted to examine the effect on performance of un-balanced heating/cooling water supply and nonuniform pressure distribution in the beds, issues observed in an experiment by our colleague during the development of a 35[Formula: see text]kW prototype finned-tube type adsorption chiller. Case studies were conducted with reference values of [Formula: see text][Formula: see text]m/s, [Formula: see text][Formula: see text]Pa and [Formula: see text][Formula: see text]Pa, and the differences in [Formula: see text][Formula: see text]m/s, [Formula: see text][Formula: see text]Pa and [Formula: see text][Formula: see text]Pa. A remarkable increase in COP was found for the cases of un-balanced heating water supply and nonuniform pressure distribution when the bed was connected to the evaporator. However, after integration of multi-modules, the effect was smoothed out, which removed the worry about the degradation in the overall COP. The effect of un-balanced cooling water supply and nonuniform pressure distribution when the bed was connected to the condenser was not discernible. In all cases, the change in SCP was negligible.
Endothelial to Mesenchymal Transition: Role in Physiology and in the Pathogenesis of Human Diseases
Authors: Piera-Velazquez Sonsoles , Jimenez Sergio A.
Published: March 2019

Numerous studies have demonstrated that endothelial cells are capable of undergoing endothelial to mesenchymal transition (EndMT), a newly recognized type of cellular transdifferentiation. EndMT is a complex biological process in which endothelial cells adopt a mesenchymal phenotype displaying typical mesenchymal cell morphology and functions, including the acquisition of cellular motility and contractile properties. Endothelial cells undergoing EndMT lose the expression of endothelial cell-specific proteins such as CD31/platelet-endothelial cell adhesion molecule, von Willebrand factor, and vascular-endothelial cadherin and initiate the expression of mesenchymal cell-specific genes and the production of their encoded proteins including α-smooth muscle actin, extra domain A fibronectin, N-cadherin, vimentin, fibroblast specific protein-1, also known as S100A4 protein, and fibrillar type I and type III collagens. Transforming growth factor-β1 is considered the main EndMT inducer. However, EndMT involves numerous molecular and signaling pathways that are triggered and modulated by multiple and often redundant mechanisms depending on the specific cellular context and on the physiological or pathological status of the cells. EndMT participates in highly important embryonic development processes, as well as in the pathogenesis of numerous genetically determined and acquired human diseases including malignant, vascular, inflammatory, and fibrotic disorders. Despite intensive investigation, many aspects of EndMT remain to be elucidated. The identification of molecules and regulatory pathways involved in EndMT and the discovery of specific EndMT inhibitors should provide novel therapeutic approaches for various human disorders mediated by EndMT.
Resistance of Synthetic and Biologic Surgical Meshes to Methicillin-ResistantStaphylococcus aureusBiofilm: AnIn VitroInvestigation
Authors: Kallick Ethan , Nistico Laura , Longwell Mark , Byers Barbara , Cartieri Frank , Kreft Rachael , Edington Howard
Published: March 2019

Surgical meshes have become the standard procedure for a variety of surgical applications with 20 million meshes being implanted each year. The popularity of mesh usage among surgeons is backed by the multiple studies that support its functionality as a tool for improving surgical outcomes. However, their use has also been associated with infectious surgical complications and many surgeons have turned to biologic meshes. While there have been several studies investigating synthetic meshes, there is limited data comparing synthetic and biologic meshesin vitroin an infection model. This study evaluates thein vitrosusceptibility of both synthetic and biologic meshes to single-species methicillin-resistantStaphylococcus aureus(MRSA) biofilms. This research compares biofilm biomass, average thickness, and coverage between the three meshes throughflorescent in situ hybridization(FISH), confocal scanning microscopy (CSLM), and image analysis. We also report the varying levels of planktonic and attached bacteria through sonication and cfu counts. While the data illustrates increased biofilm formation on biologic meshin vitro, the study must further be investigatedin vivoto confirm the study observations.
Continuous Use of Combined Hormonal Contraceptive and the Effect on Blood Coagulation Factors in Female Capuchin Monkeys (Sapajus libidinosus)
Authors: Rodrigues Rosângela C. , Belham Flávia Schechtman , Garcia Ana , Satler Corina , Tomaz Carlos , Tavares Maria Clotilde H.
Published: March 2019

This study aimed at evaluating the availability of the primate Sapajus libidinosus as an animal model for research assessing the physiological effects of the continuous use of combined hormonal contraceptives. In order to do this, six reproductively active female S. libidinosus from the Primate Research Center of the University of Brasília were selected to take part in this experiment. Every 21 days or so, each female received a single dose of combined hormonal contraceptive (algestone acetophenide and 17-enanthate estradiol) in a total of five doses throughout the experiment. The physiological parameters were accessed by means of 13 blood samples from each female, whereas three were gathered during the baseline and 10 samples were collected during the treatment phase. The results showed that the contraceptive use provoked changes in hematological coagulation factors such as an increase in the amount of platelets (p=0.039) and a reduction in both prothrombin (p<0.001) and thromboplastin coagulation time (p<0.001). These results are similar to what has been observed in human patients; thus, it is concluded that S. libidinosus can be successfully used in studies about the physiological impact of hormonal contraceptives.
Stress Fracture of the Hamate Hook in a Water Polo Player
Authors: Ueda Hana , Hama Shunpei , Yasuda Masataka , Minato Kenta , Miyashita Masahiro , Shin Kishik
Published: March 2019

Hamate hook fractures are usually caused by direct trauma while using a tennis racket or a baseball bat. We report stress fracture of the hamate hook in a water polo player without any specific trauma. We consider that the stress fracture occurred via indirect mechanisms through the flexor tendons. Strong ulnar deviation of the wrist during ball release and strong grip on a ball with outstretched fingers, which are unique to water polo, were the likely causes of the stress fracture of the hamate hook.
Energy Integration in Wastewater Treatment Plants by Anaerobic Digestion of Urban Waste: A Process Design and Simulation Study
Authors: Vicentin Rocio , Fdz-Polanco Fernando , Fdz-Polanco Maria
Published: March 2019

The process simulation performed in the present study aimed at investigating energetically self-sufficient wastewater treatment plant of 500,000 population equivalents. To implement this, three different scenarios were evaluated using computational tools named GPS-X® and SuperPro®. They were designed based on municipal wastes recovery to energy generation and its utilisation within the facility. An anaerobic/anoxic/oxic process for biological treatment of wastewater was considered and mesophilic anaerobic digestion at different scenarios (1) primary sludge (PS) with waste activated sludge (WAS), (2) PS with thermally hydrolysed WAS, and (3) PS with WAS and organic fractions derived from municipal solid waste. The results from scenario 1 and scenario 2 showed only enough thermal energy to meet their demand (they reach only 44 and 52% of electrical self-sufficiency, respectively), while positive net thermal and electrical energy result in scenario 3 from codigestion of sewage sludge and the organic fraction of municipal solid waste. The main limitation of tools used is their lack of sensitivity to economies of scale and their dependence on real data used for process design to obtain more accurate results.
Evaluation of Yield, Reaction to Diseases, and Grain Physical Attributes of Some Introduced Rice Hybrids in Ghana
Authors: Abebrese Samuel Oppong , Yeboah Alex , Dogbe Wilson , Dartey Paul Kofi Ayirebi , Akromah Richard , Gracen Vernon Edward , Offei Samuel Kwame , Danquah Eric Yirenkyi
Published: March 2019

Hybrid rice technology is one of the promising, sustainable, and proven technologies for increasing rice production and productivity with a yield advantage of 15–30% over modern inbred varieties. The potential of hybrid rice has so far not been exploited in Ghana. This study was undertaken to evaluate the yield potential, reaction to diseases, and physical grain attributes of some introduced hybrids. The trials were laid out in a randomized complete block design (RCBD) with three replicates across three locations. Data were taken on grain yield, yield components, reaction to diseases, and grain physical characteristics. Four promising hybrids (SWARNA 2, ARGH 1501, ARGH 1502, and ARGH 1503) with a mean yield advantage of 15–20.8% over the best inbred check “AgraRice” were identified. With few exceptions, the hybrids were broadly adapted and had adequate resistance to blast and bacterial leaf blight. Most of the test hybrids had long slender grains which make them acceptable to the Ghanaian market but lacked aroma.
A Deep Evolutionary Approach to Bioinspired Classifier Optimisation for Brain‐Machine Interaction
Authors: Bird Jordan J. , Faria Diego R. , Manso Luis J. , Ekárt Anikó , Buckingham Christopher D.
Published: March 2019

This study suggests a new approach to EEG data classification by exploring the idea of using evolutionary computation to both select useful discriminative EEG features and optimise the topology of Artificial Neural Networks. An evolutionary algorithm is applied to select the most informative features from an initial set of 2550 EEG statistical features. Optimisation of a Multilayer Perceptron (MLP) is performed with an evolutionary approach before classification to estimate the best hyperparameters of the network. Deep learning and tuning with Long Short‐Term Memory (LSTM) are also explored, and Adaptive Boosting of the two types of models is tested for each problem. Three experiments are provided for comparison using different classifiers: one for attention state classification, one for emotional sentiment classification, and a third experiment in which the goal is to guess the number a subject is thinking of. The obtained results show that an Adaptive Boosted LSTM can achieve an accuracy of 84.44%, 97.06%, and 9.94% on the attentional, emotional, and number datasets, respectively. An evolutionary‐optimised MLP achieves results close to the Adaptive Boosted LSTM for the two first experiments and significantly higher for the number‐guessing experiment with an Adaptive Boosted DEvo MLP reaching 31.35%, while being significantly quicker to train and classify. In particular, the accuracy of the nonboosted DEvo MLP was of 79.81%, 96.11%, and 27.07% in the same benchmarks. Two datasets for the experiments were gathered using a Muse EEG headband with four electrodes corresponding to TP9, AF7, AF8, and TP10 locations of the international EEG placement standard. The EEG MindBigData digits dataset was gathered from the TP9, FP1, FP2, and TP10 locations.
Orthopedic Manifestations of Bruck Syndrome: A Case Series with Intermediate to Long-term Follow-Up
Authors: Santana Adolfredo , Oleas-Santillán Geovanny , Franzone Jeanne M. , Nichols L. Reid , Bowen J. Richard , Kruse Richard W.
Published: March 2019

The aim of this study was to evaluate the association of contractures, fractures, and deformities in four patients with Bruck syndrome treated in our facility. Data were collected from medical records, radiographs, dual-energy X-ray absorptiometry (DEXA) scans, genetic tests, and gait analysis. All had contractures at birth and genotypic findings including mutations in PLOD2 or FPKB10. Three cases were treated with bisphosphonates with improvement in bone density verified by DEXA. In Bruck syndrome, orthopedic deformities include the following sequential aspects: contractures, characterized by upper and lower extremity contractures such as clubfeet; fractures, characterized by multiple diaphyseal fractures in the long bones of the extremities; and deformities, characterized by malalignment of extremities and the spine. Physical therapy and bracing proved helpful for the contractures to try to stop progression. Bone fragility needs to be considered when deciding to attempt cast correction. Surgeries in the soft tissues can be performed to retain joint movement. In fractures with angulation, intramedullary nail fixation was useful, and in cases without deformity, casting alone was successful. We suggest monitoring the bone density with DEXA, nutrition support with vitamin D and calcium, and treatment with bisphosphonates. Spine deformities were successfully treated by spinal fusion and instrumentation.
Prevalence of Cognitive Impairment and Its Predictors among HIV/AIDS Patients on Antiretroviral Therapy in Jimma University Medical Center, Southwest Ethiopia
Authors: Yideg Yitbarek Getachew , Mossie Ayana Andualem , Bariso Gare Moyeta , Garedew Woldeamanuel Gashaw
Published: March 2019

Background. Cognitive impairment among human immunodeficiency virus (HIV) infected patients can lead to treatment nonadherence, faster progression of the illness, disability, and bed ridden state if we fail to detect it early. However, there is scarcity of previous published studies in Ethiopia on the assessment of cognitive impairment among HIV-positive patients. Hence, this study aimed to determine the prevalence and associated factors of cognitive impairment among HIV-positive patients receiving antiretroviral therapy (ART) at Jimma University Medical Center, Ethiopia. Methods. Hospital-based cross-sectional study was conducted among 328 HIV-positive patients attending Jimma University Medical Center, Ethiopia. Data were collected from a face-to-face interview and review of medical records using semistructured questionnaire. Validated International HIV Dementia Scale (IHDS) was used to screen for cognitive impairment. Data was analyzed using SPSS version 20. Results. A total of 328 (191 females and 137 males) HIV-positive patients were included in the study with a response rate of 97.04%. The prevalence of cognitive impairment among HIV-positive patients was 35.7%. Factors significantly associated with cognitive impairment were age group of 41−64 years (adjusted odds ratio [AOR] = 3.1, 95% confidence interval [CI] (1.3, 7.4)], plasma HIV-1 RNA load between 1.7log10 and 3log10 copies/ml [AOR = 2.2, 95% CI (1.1,4.3)] and ≥ 3log10 copies/ml [AOR = 7.5, 95% CI (2.6, 21.5)], khat chewing [AOR = 4.4, 95% CI (2.3, 8.3)], and clinical stage III of the disease [AOR = 5.6, 95% CI (1.7, 19.2)]. Conclusion. Despite the use of ART, the burden of cognitive impairment among HIV patients was high. Older age, khat chewing, advanced stage of the disease, and higher viral load were the independent factors associated with cognitive impairment. Thus, continuous screening of cognitive impairment, identification of the possible risk factors, and proper management strategy should be designed.
Frontal Anatomical Correlates of Cognitive and Speech Motor Deficits in Amyotrophic Lateral Sclerosis
Authors: Yunusova Yana , Ansari Jamal , Ramirez Joel , Shellikeri Sanjana , Stanisz Greg J. , Black Sandra E. , Gillingham Susan M. , Kiss Alex , Stuss Donald T. , Zinman Lorne
Published: March 2019

The goal of this study was to identify neurostructural frontal lobe correlates of cognitive and speaking rate changes in amyotrophic lateral sclerosis (ALS). 17 patients diagnosed with ALS and 12 matched controls underwent clinical, bulbar, and neuropsychological assessment and structural neuroimaging. Neuropsychological testing was performed via a novel computerized frontal battery (ALS-CFB), based on a validated theoretical model of frontal lobe functions, and focused on testing energization, executive function, emotion processing, theory of mind, and behavioral inhibition via antisaccades. The measure of speaking rate represented bulbar motor changes. Neuroanatomical assessment was performed using volumetric analyses focused on frontal lobe regions, postcentral gyrus, and occipital lobes as controls. Partial least square regressions (PLS) were used to predict behavioral (cognitive and speech rate) outcomes using volumetric measures. The data supported the overall hypothesis that distinct behavioral changes in cognition and speaking rate in ALS were related to specific regional neurostructural brain changes. These changes did not support a notion of a general dysexecutive syndrome in ALS. The observed specificity of behavior-brain changes can begin to provide a framework for subtyping of ALS. The data also support a more integrative framework for clinical assessment of frontal lobe functioning in ALS, which requires both behavioral testing and neuroimaging.
Adsorption Studies of Textile Dye (Chrysoidine) from Aqueous Solutions Using Activated Sawdust
Authors: Ashraf Muhammad Waqar , Abulibdeh Nidal , Salam Abdus
Published: March 2019

Chrysoidine is a type of industrial azo dye and a well-known toxicant. Due to its good dyeing characteristics, it is widely used for dyeing leather, paper, feather, grass, wood, bamboo, etc. Hence, it is very important to remove or reduce its concentration below the contamination level in the waste line by using low-cost technologies. Sawdust is a plentiful material available very cheaply from sawmills and woodworks. Therefore, the present work was conducted to study sorption ability of both raw sawdust and chemically activated sawdust carbon on the removal of chrysoidine from the aqueous solutions. Adsorption isotherms of the dye on sawdust were determined and correlated with usual isotherm equations like Freundlich and Langmuir. Experimental results have shown that sawdust has a high adsorption efficiency, and the adsorption of chrysoidine followed Freundlich’s isotherm. Although raw sawdust proved to be slightly less efficient in comparison to chemically treated sawdust but in economic terms, raw sawdust is more cost-effective as the difference in the percent dye removal is less than the difference in the manufacturing costs. The influence of several parameters such as effect of temperature, adsorbent dose, adsorption time, etc., on the adsorption process was studied along with thermodynamic parameters such as enthalpy (ΔH°) and entropy (ΔS°).
Challenges for the Clinical Development of PI3K Inhibitors: Strategies to Improve Their Impact in Solid Tumors
Authors: Hanker Ariella B. , Kaklamani Virginia , Arteaga Carlos L.
Published: March 2019

The PI3K pathway is mutated and aberrantly activated in many cancers and plays a central role in tumor cell proliferation and survival, making it a rational therapeutic target. Until recently, however, results from clinical trials with PI3K inhibitors in solid tumors have been largely disappointing. Here, we describe several factors that have limited the success of these agents, including the weak driver oncogenic activity of mutant PI3K, suboptimal patient selection in trials, drug-related toxicities, feedback upregulation of compensatory mechanisms when PI3K is blocked, increased insulin production upon PI3Kα inhibition, lack of mutant-specific inhibitors, and a relative scarcity of studies using combinations with PI3K antagonists. We also suggest strategies to improve the impact of these agents in solid tumors. Despite these challenges, we are optimistic that isoform-specific PI3K inhibitors, particularly in combination with other agents, may be valuable in treating appropriately selected patients with PI3K-dependent tumors.

Significance:

Despite the modest clinical activity of PI3K inhibitors in solid tumors, there is an increasing understanding of the factors that may have limited their success. Strategies to ameliorate drug-related toxicities, use of rational combinations with PI3K antagonists, development of mutant-selective PI3K inhibitors, and better patient selection should improve the success of these targeted agents against solid tumors.
Water Intake from the Points of View of Rhazes and Avicenna
Authors: Jafari Parisa , Mojahedi Morteza , Zareiyan Armin , Mokaberinejad Roshanak , Chaichi Raghimi Mahshid , Hakimi Fatemeh , Parsa Elham
Published: March 2019

Owing to the effect of acute and chronic hypohydration on health and the lethal effects of hyperhydration, an appropriate amount of water intake is important for each individual. Traditional Iranian medicine (TIM) is a holistic system one of whose important parts deals with lifestyles and how to maintain health, including the amount of water intake for every person and the appropriate principles of drinking water. In this study, Avicenna’s Canon of Medicine, Rhazes’ Benefits of Food and Its Harmfulness, and conventional medical articles were reviewed to evaluate the amount of water intake for each person and the principles of drinking water. TIM has expressed an individualized difference in the amount of water intake in the form of temperament and the relationship between the appropriate time of drinking water with other daily activities. In this view, drinking water at the inappropriate time causes liver and gastrointestinal diseases; it can create the foundation for conducting new studies in the field of appropriate water intake and lifestyle changes to reduce malnutrition complications.
Location and Frequency of Residual Breast Tissue after Mastectomy
Authors: Ustun Ibrahim , Beksac Kemal , Kandemir Olcay , Berberoglu Ugur
Published: March 2019

Introduction: Residual breast tissue after mastectomy is a problem since breast cancer can arise from it. The aim of this study was to investigate the incidence and location of residual breast tissue following modified radical mastectomy. Methods: 111 consecutive breast cancer patients who underwent mastectomy were enrolled in this study. During surgery, after removal of the breast tissue and before skin closure, a 1-cm2 tissue sample was obtained from each quadrant under the skin flaps. These samples were evaluated histopathologically for the presence of any residual breast tissue. Results: Residual breast tissue was detected in the tissue samples of 12/111 (10.8%) patients. 4 of these patients had residual breast tissue in all 4 quadrants. 6 patients had residual tissue in a single quadrant. With 9 positive biopsy results, the upper medial quadrant was the most frequently involved location. The other quadrants had 6 positive biopsy results each. At the end of a median of 20 months of follow-up, none of these patients developed breast cancer recurrences. Conclusion: Mastectomy has a high probability of residual breast tissue being left behind. Physicians should be aware of this and act accordingly when planning surgical or follow-up treatment.
Subjective Cognitive Decline in the Community Is Affected at Multiple Aspects of Mental Health and Life Quality: A Cross-Sectional Study of the Community Medicine of Keelung Chang Gung Memorial Hospital
Authors: Wei Yi-Chia , Huang Li-Yuan , Chen Chih-Ken , Lin Chemin , Shyu Yu-Chiau , Chen Yao-Liang , Huang Wen-Yi , Lin Ching-Po
Published: March 2019

Background: Subjective cognitive decline (SCD) is one of the early warning signs of objective cognition impairment and dementia. Methods: This cross-sectional study screened SCD and studied multiple domains of mental health, lifestyle, and life quality of the community-dwelling people in the northern coastal region of Taiwan. Results: Among 426 valid AD8 questionnaires, a cutoff of score 2 divided subjects into 115 with SCD (SCD+) and 311 without SCD (SCD–). Analysis of age, sex, body compositions, and blood tests revealed an older age (60.7 ± 10.9 years) of the SCD+ group than the SCD– group (57.6 ± 12.0 years, p < 0.05). Further exclusion of subjects younger than 50 years eliminated age differences and left 100 with SCD (SCD+_50) and 229 without (SCD–_50). Multidomain comparisons of the SCD+_50 group over the SCD–_50 group were made: the Taiwanese Depression Questionnaire found a higher likelihood of depression; the Pittsburgh Sleep Quality Index revealed suboptimal sleep quality; the SF-36 showed inferior function of all 8 aspects of quality of life; the Health-Promoting Lifestyle Profile documented a less health-seeking lifestyle of nutrition, self-actualization, and stress management. Conclusions: Aging increased the SCD risk. People with SCD had suboptimal performance in mental health and life quality in addition to subjective cognition problems.
Effect of Obesity on Cognitive Function among School Adolescents: A Cross-Sectional Study
Authors: Meo Sultan Ayoub , Altuwaym Abdulrahman Abdulaziz , Alfallaj Rayan Mohammed , Alduraibi Khalid Abdulaziz , Alhamoudi Abdullah Mohammed , Alghamdi Saud Mohammed , Akram Ashfaq
Published: March 2019

Objectives: Childhood obesity contributes to the risk of numerous health problems and has become a major global health concern. This study aimed to establish the association between obesity and cognitive function among healthy school adolescents. Methods: This study was carried out by taking school adolescents (n = 400) from June 2016 to December 2017. The mean age of the participants was 13.93 ± 0.81 years. The students were divided into group A (obese, n = 223) and B (non-obese, n = 177). Cognitive functions were recorded as per study tool of the Cambridge Neuropsychological Test Automated Battery (CANTAB). Results: Severely obese students showed a significant delay in cognitive functions as compared to students with normal BMI. Attention Switching Task (AST)-Latency among students with normal BMI was 647.88 ± 137.59 compared to the students with high BMI (685.08 ± 115.92, p = 0.05), AST-Incongruent was 680.78 ± 142.07 versus 726.76 ± 122.31 (p = 0.02), AST-Percent correct trials was 84.31 ± 10.45 versus 78.09 ± 14.87 (p = 0.001), and Intra-Extra Dimensional Set Shift (IED) Total errors among students with normal BMI was 33.93 ± 21.53 compared to the students with high BMI (42.86 ± 37.27, p = 0.03). Conclusion: Cognitive functions including AST-Latency, AST-Incongruent, AST-Percent correct trials, and IED Total errors were significantly weakened in markedly obese students. Significant impairments in their cognitive functions, especially attention, retention, intelligence, and cognitive flexibility, were observed. The findings of this study emphasize the need to involve school adolescents in physical activities to reduce body weight in order to have cognitive functions within normal range and also to minimize obesity-associated complications.