bluuebunny/crossref_metadata_2025 huggingface dataset:
Ripening Growth Kinetics of Cu6Sn5 Grains in Sn-3.0Ag-0.5Cu-xTiO2/Cu Solder Joints During the Reflow Process
Authors: Tang Y. , Luo S. M. , Li G. Y. , Yang Z. , Hou C. J.
Published: December 2017

The ripening growth kinetics of interfacial Cu6Sn5 grains between Cu substrates and Sn-3.0Ag-0.5Cu-xTiO2 (x = 0, 0.02, 0.05, 0.1, 0.3, and 0.6 wt %) (SAC305-xTiO2) solders were investigated. The results show that the Cu6Sn5 grain morphology is affected by the solder composition and the reflow time. The Cu6Sn5 grain size decreases upon addition of TiO2 and shows a significant decrease when the TiO2 nanoparticle fraction is increased to 0.1 wt %. At higher TiO2 nanoparticle fractions, the Cu6Sn5 grain size increases slightly. The growth of the Cu6Sn5 grains is mainly supplied by the flux of the interfacial reaction and the flux of ripening; the ripening flux plays a dominant role because it is approximately one order of magnitude greater than the interfacial reaction flux. The ripening growth of the Cu6Sn5 grains in the TiO2-containing solder joints is reduced more effectively than that of the Cu6Sn5 grains in the TiO2-free joint. For the SAC305/Cu and SAC305-0.6TiO2/Cu solder joints, the particle size distribution (PSD) of the Cu6Sn5 grains is well fit with the Marqusee and Ross (MR) model when the normalized size value of r/ is less than 1, and it is consistent with the flux-driven ripening (FDR) model when the value of r/ is greater than 1. On the other hand, for the SAC305-0.1TiO2/Cu solder joint, the Cu6Sn5 grains with a nearly hemispheric scallop shape and the PSD of the Cu6Sn5 grains show good agreement with the FDR model.
A Multi-Objective Optimization Approach on Spiral Grooves for Gas Mechanical Seals
Authors: Wang Xiuying , Shi Liping , Huang Wei , Wang Xiaolei
Published: December 2017

Spiral groove is one of the most common types of structures on gas mechanical seals. Numerical research demonstrated that the grooves designed for improving gas film lift or film stiffness often lead to the leakage increase. Hence, a multi-objective optimization approach specially for conflicting objectives is utilized to optimize the spiral grooves for a specific sample in this study. First, the objectives and independent variables in multi-objective optimization are determined by single objective analysis. Then, a set of optimal parameters, i.e., Pareto-optimal set, is obtained. Each solution in this set can get the highest dimensionless gas film lift under a specific requirement of the dimensionless leakage rate. Finally, the collinearity diagnostics is performed to evaluate the importance of different independent variables in the optimization.
A Detection Method for Friction Vibration Based on Harmonic Wavelet Packet Transform and Cross-Correlation Analysis
Authors: Xing Pengfei , Li Guobin , Liu Ting , Gao Hongtao , Wang Guoyou
Published: December 2017

Running-in wear experiments were conducted on a spherical-on-disk tester. The vibration signals collected in the experiments were detected by a combination of harmonic wavelet packet transform (HWPT) and cross-correlation analysis (CCA) methods. Experimental results show that the friction vibration signals detected in tangential and normal directions have the characteristics of no time delay and strong correlation. Their root-mean-square (RMS) values gradually reduce and enter a steady-state of fluctuation with the experiments time, which are consistent with the variation of friction coefficient and reflect the change of wear states from the running-in wear to the stable wear. Therefore, the detection of friction vibration can be realized by a combination of HWPT and CCA methods.
Research on the Turbine Blade Vibration Base on the Immersed Boundary Method
Authors: Liu Xiaolan , Yang Bo , Ji Chunning , Chen Qian , Song Moru
Published: December 2017

This paper is concerned with the study of a kind of discrete forcing immersed boundary method (IBM) by which the loosely aero-elasticity coupled method is developed to analyze turbine blade vibration. In order to reduce the spurious oscillations at steep gradients in the compressible viscous flowing field, a five orders weighted essentially nonoscillatory scheme (WENO) is introduced into the flow solver based on large eddy simulation (LES). The three-dimensional (3D) full-annulus domain of the last two stages of an industrial steam axial turbine is adopted to validate the developed method. By the method, the process of grid generation becomes very simple and the unsteady data transferring between stator and rotor is realized without the process of being averaged or weighted. Based on the analysis of some important aerodynamic parameters, it is believed that hypothesis of azimuthal periodicity is not reasonable in this case and full-annulus passages model is more feasible and suitable to the research of turbine blade vibration. Meanwhile, the blade vibration data are also discussed. It is at about 65% of rotor blade height of the last stage that an inflection point is observed and the midspan region of the blade is the vulnerable part damaged potentially by the blade vibration.
A New Structural Dynamic Model for Pump Mechanical Seals Vibration Analysis Incorporating Squeeze Motion of O-Ring Seals and General Dynamic Motion of the Pump Housing and the Pump Shaft
Authors: Childs Dara
Published: December 2017

New models are developed for flexibly mounted stator (FMS) and flexibly mounted rotor (FMR) mechanical seals that incorporate the radial reaction force components produced by supporting O-rings due to relative squeezing motion across the O-rings. Supporting data come from tests done in relation to O-ring supports for ball bearing races. The reaction-force model is linear but a nonlinear function of excitation frequency. The model accounts for the axial displacement doz of the O-ring from the mass center of the seal stator (FMS configuration) or seal rotor (FMR configuration), which couples the radial and pitch–yaw motion of the model's stiffness and damping matrices. Greens' coned-face-seal model is used to define the reaction moment arising across the seal faces via stiffness and damping matrices. The damping matrix does not coincide with Green's. His is constant; the matrix developed here contains terms that are harmonic at twice theprecession frequency. When averaged over one precession cycle, the new average damping matrix coincides with Green's result. When the averaged damping matrix is used, the resultant model is linear. However, because of the viscoelastic reaction-force and reaction-moment models used for the O-ring coefficients, most of the stiffness and damping matrices are strong functions of the assumed precession frequency. The new FMR model contains a skew-symmetric stiffness matrix due to the O-ring damping terms. In rotordynamics, skew symmetric stiffness matrices due to internal damping in the rotor can lead to rotordynamic instabilities.
Study protocol for a multicentre, randomised, controlled trial to assess the effectiveness of antimicrobial central venous catheters versus ordinary central venous catheters at reducing catheter related infections in critically ill Chinese patients
Authors: Wu Minming , Chen Yao , Du Bin , Kang Yan
Published: December 2017

Introduction

Catheter use is associated with many complications and is an iatrogenic source of morbidity and mortality in intensive care units (ICU). The catheter being studied (Certofix Protect) was developed to reduce the risk of catheter related infections. This clinical trial will compare the safety and efficiency of Certofix Protect with that of an ordinary Certofix catheter.

Methods and analysis

In this multicentre trial, we will randomly assigned dual lumen central venous catheterisation (≥5 ds) in patients in the adult ICU to the antimicrobial central venous catheter (CVC) group or the ordinary CVC group. We plan to recruit 12–16 medical centres in China. Our main objective is to assess the effectiveness of antimicrobial CVCs in reducing catheter related bloodstream infection (CRBSI), all cause mortality, catheter colonisation, catheter related thrombosis and other catheter related complications. The primary outcome is the incidence of CRBSI.

Ethics and dissemination

The ethics committee of West China Hospital of Sichuan University has granted ethics approval for this study (27 January 2015). The results will be published in peer reviewed journals and presented at conferences.

Trial registration number

NCT02645682.
Wait a minute? An observational cohort study comparing iron stores in healthy Swedish infants at 4 months of age after 10-, 60- and 180-second umbilical cord clamping
Authors: Askelöf Ulrica , Andersson Ola , Domellöf Magnus , Fasth Anders , Hallberg Boubou , Hellström-Westas Lena , Pettersson Karin , Westgren Magnus , Wiklund Ingela E , Götherström Cecilia
Published: December 2017

Background and objective

Umbilical cord blood (UCB) is a valuable stem cell source used for transplantation. Immediate umbilical cord (UC) clamping is widely practised, but delayed UC clamping is increasingly advocated to reduce possible infant anaemia. The aim of this study was to investigate an intermediate UC clamping time point and to evaluate iron status at the age of 4 months in infants who had the UC clamped after 60 s and compare the results with immediate and late UC clamping.

Design

Prospective observational study with two historical controls.

Setting

A university hospital in Stockholm, Sweden, and a county hospital in Halland, Sweden.

Methods

Iron status was assessed at 4 months in 200 prospectively recruited term infants whose UC was clamped 60 s after birth. The newborn baby was held below the uterine level for the first 30 s before placing the infant on the mother’s abdomen for additional 30 s. The results were compared with data from a previously conducted randomised controlled trial including infants subjected to UC clamping at ≤10 s (n=200) or ≥180 s (n=200) after delivery.

Results

After adjustment for age differences at the time of follow-up, serum ferritin concentrations were 77, 103 and 114 µg/L in the 10, 60 and 180 s groups, respectively. The adjusted ferritin concentration was significantly higher in the 60 s group compared with the 10 s group (P=0.002), while the difference between the 60 and 180 s groups was not significant (P=0.29).

Conclusion

In this study of healthy term infants, 60 s UC clamping with 30 s lowering of the baby below the uterine level resulted in higher serum ferritin concentrations at 4 months compared with 10 s UC clamping. The results suggest that delaying the UC clamping for 60 s reduces the risk for iron deficiency.

Trial registration number

NCT01245296.
Association between total dose of ritodrine hydrochloride and pulmonary oedema in twin pregnancy: a retrospective cohort study in Japan
Authors: Shinohara Satoshi , Sunami Rei , Uchida Yuzo , Hirata Shuji , Suzuki Kohta
Published: December 2017

Objective

Pulmonary oedema is recognised as a severe side effect of ritodrine hydrochloride. Recently, the number of twin pregnancies has been increasing. Few studies have reported the association between total dose of ritodrine hydrochloride prior to delivery and pulmonary oedema in twin pregnancy. We aimed to examine this association and determine the optimal cut-off threshold of total ritodrine hydrochloride dose to predict the incidence of pulmonary oedema in twin pregnancy based on obstetric records.

Design

Retrospective cohort study.

Setting

Yamanashi Prefectural Central Hospital, Japan.

Participants

Two hundred and twenty-six women with twin pregnancy who delivered at Yamanashi Prefectural Central Hospital between September 2009 and November 2016.

Methods

The obstetric records of the participants were analysed. We defined 1 unit of ritodrine hydrochloride as 72 mg per 24 hours continuous transfusion at 50 µg/min to calculate the dose of ritodrine used for tocolysis.

Outcome measures

Multivariable logistic regression analysis was performed to examine the association between total dose of ritodrine hydrochloride used for threatened preterm labour and pulmonary oedema, while controlling for potential confounding factors. Then, a receiver–operating characteristic curve was used to determine the optimal cut-off of total ritodrine dose to predict pulmonary oedema incidence.

Results

Mean maternal age was 32 (range, 18–46) years; 143 participants were nulliparous (63.3%), 109 had (48.2%) term deliveries and 194 (85.8%) had caesarean deliveries. The overall incidence of pulmonary oedema was 13.7% (31/226). Multivariable analysis showed that the total dose of ritodrine was significantly associated with pulmonary oedema (adjusted OR 1.02; 95% CI 1.004 to 1.03). The best cut-off point to predict the incidence of pulmonary oedema was 26 units (1872 mg) (sensitivity, 61.3%; specificity, 87.8%).

Conclusion

Our results suggest that consideration of the total dose of ritodrine hydrochloride is helpful in the management of patients with threatened preterm labour in twin pregnancy.
Development and validation of a priori risk model for extensive white matter lesions in people age 65 years or older: the Dijon MRI study
Authors: Tully Phillip J , Qchiqach Sarah , Pereira Edwige , Debette Stephanie , Mazoyer Bernard , Tzourio Christophe
Published: December 2017

Objectives

The objective was to develop and validate a risk model for the likelihood of extensive white matter lesions (extWML) to inform clinicians on whether to proceed with or forgo diagnostic MRI.

Design

Population-based cohort study and multivariable prediction model.

Setting

Two representative samples from France.

Participants

Persons aged 60–80 years without dementia or stroke. Derivation sample n=1714; validation sample n=789.

Primary and secondary outcome measures

Volume of extWML (log cm3) was obtained from T2-weighted images in a 1.5 T scanner. 20 candidate risk factors for extWML were evaluated with the C-statistic. Secondary outcomes in validation included incident stroke over 12 years follow-up.

Results

The multivariable prediction model included six clinical risk factors (C-statistic=0.61). A cut-off of 7 points on the multivariable prediction model yielded the optimum balance in sensitivity 63.7% and specificity 54.0% and the negative predictive value was high (81.8%), but the positive predictive value was low (31.5%). In further validation, incident stroke risk was associated with continuous scores on the multivariable prediction model (HR 1.02; 95% CI 1.01 to 1.04, P=0.02) and dichotomised scores from the multivariable prediction model (HR 1.28; 95% CI 1.02 to 1.60, P=0.03).

Conclusions

A simple clinical risk equation for WML constituted by six variables can inform decisions whether to proceed with or forgo brain MRI. The high-negative predictive value demonstrates potential to reduce unnecessary MRI in the population aged 60–80 years.
Effect of whole-body vibration exercise in preventing falls and fractures: a systematic review and meta-analysis
Authors: Jepsen Ditte Beck , Thomsen Katja , Hansen Stinus , Jørgensen Niklas Rye , Masud Tahir , Ryg Jesper
Published: December 2017

Objective

To investigate the effect of whole-body vibration exercise (WBV) on fracture risk in adults ≥50 years of age.

Design

A systematic review and meta-analysis calculating relative risk ratios, fall rate ratio and absolute weighted mean difference using random effects models. Heterogeneity was estimated using I2statistics, and the Cochrane Collaboration’s risk of bias tool and the GRADE approach were used to evaluate quality of evidence and summarise conclusions.

Data sources

The databases PubMed, Embase and the Cochrane Central Register from inception to April 2016 and reference lists of retrieved publications.

Eligibility criteria for selecting studies

Randomised controlled trials examining the effect of WBV on fracture risk in adults ≥50 years of age. The primary outcomes were fractures, fall rates and the proportion of participants who fell. Secondary outcomes were bone mineral density (BMD), bone microarchitecture, bone turnover markers and calcaneal broadband attenuation (BUA).

Results

15 papers (14 trials) met the inclusion criteria. Only one study had fracture data reporting a non-significant fracture reduction (risk ratio (RR)=0.47, 95% CI 0.14 to 1.57, P=0.22) (moderate quality of evidence). Four studies (n=746) showed that WBV reduced the rate of falls with a rate ratio of 0.67 (95% CI 0.50 to 0.89, P=0.0006; I2=19%) (moderate quality of evidence). Furthermore, data from three studies (n=805) found a trend towards falls reduction (RR=0.76, 95% CI 0.48 to 1.20, P=0.24; I2=24%) (low quality of evidence). Finally, moderate to low quality of evidence showed no overall effect on BMD and only sparse data were available regarding microarchitecture parameters, bone turnover markers and BUA.

Conclusions

WBV reduces fall rate but seems to have no overall effect on BMD or microarchitecture. The impact of WBV on fractures requires further larger adequately powered studies. This meta-analysis suggests that WBV may prevent fractures by reducing falls.

PROSPERO registration number

CRD42016036320; Pre-results.
Causal inference from experiment and observation
Authors: Zwahlen Marcel , Salanti Geogia
Published: December 2017

Results from well-conducted randomised controlled studies should ideally inform on the comparative merits of treatment choices for a health condition. In the absence of this, one attempts to use evidence from the impact of treatment when administered according to decisions of the physicians and the patients (observational evidence). Naïve comparisons between treatment options using observational evidence will lead to biased results. Under certain conditions, however, it is possible to obtain valid estimates of the comparative merits of different treatments from observational data. Causal inference can be conceptualised as a framework aiming to provide valid information about causal effects of treatments using observational evidence. It can be viewed as a missing data problem in which each patient has two outcomes: the observed outcome under the treatment actually received and a counterfactual (unobserved) outcome had the patient received a different treatment. Methodological developments over the last decades clarified the appropriate conditions and methods to obtain valid comparisons. This article provides an introduction to some of these methods.
Increased middle cerebral artery mean blood flow velocity index after stroke thrombectomy indicates increased risk for intracranial hemorrhage
Authors: Kneihsl Markus , Niederkorn Kurt , Deutschmann Hannes , Enzinger Christian , Poltrum Birgit , Fischer Renate , Thaler Daniela , Hermetter Christina , Wünsch Gerit , Fazekas Franz , Gattringer Thomas
Published: December 2017

Background and purpose

Cerebral hyperperfusion has been related to the risk of intracranial hemorrhage (ICH) in stroke patients after vessel recanalization therapy. We hypothesized that after successful mechanical thrombectomy for acute anterior circulation stroke, hemodynamics detectable by transcranial Duplex (TCD) sonography would vary, and that increased blood flow velocities would be associated with ICH.

Methods

We retrospectively identified all ischemic stroke patients with successful endovascular recanalization for anterior circulation vessel occlusion (Thrombolysis in Cerebral Infarction 2b–3) between 2010 and 2017. We reviewed their postinterventional TCD examinations for mean blood flow (MBF) velocities of the recanalized and contralateral middle cerebral artery (MCA) and searched for an association with postinterventional ICH and clinical outcome.

Results

123 stroke patients (mean age 63±14 years, 40% women) with successful anterior circulation thrombectomy were analyzed. Of those, 18 patients had postinterventional ICH. ICH patients had an increased MCA MBF velocity index (=MBF velocity of the recanalized divided by the contralateral MCA) compared with non-ICH patients (1.32±0.39 vs 1.02±0.32, P<0.001). In multivariate analysis, a higher MCA MBF velocity index was associated with postinterventional ICH and poor 90 day outcome.

Conclusions

A high MCA MBF velocity index on TCD after successful recanalization therapy for anterior circulation stroke indicates a risk for postinterventional ICH and worse prognosis.
Neurological complications of renal dialysis and transplantation
Authors: Karunaratne Kushan , Taube David , Khalil Nofal , Perry Richard , Malhotra Paresh A
Published: December 2017

Neurological complications from renal replacement therapy contribute significantly to morbidity and mortality in patients with renal failure. Such complications can affect either the central or peripheral nervous systems. Most neurological disturbances associated with the uraemic state do not respond fully to renal replacement therapy. There are also complications specifically associated with dialysis and transplantation. A multidisciplinary approach, involving both nephrologists and neurologists, is critical for the diagnosis and effective management of these disorders.
Cerebral arterial gas embolism from attempted mechanical thrombectomy: recovery following hyperbaric oxygen therapy
Authors: Segan Louise , Permezel Fiona , Ch’ng Wei , Millar Ian , Brooks Mark , Lee-Archer Matt , Cloud Geoffrey
Published: December 2017

Cerebral arterial gas embolism is a recognised complication of endovascular intervention with an estimated incidence of 0.08%. Its diagnosis is predominantly clinical, supported by neuroimaging. The treatment relies on alleviating mechanical obstruction and reversing the proinflammatory processes that contribute to tissue ischaemia. Hyperbaric oxygen therapy is an effective treatment and has multiple mechanisms to reverse the pathological processes involved in cerebral arterial gas embolism. Symptomatic cerebral arterial gas embolism is a rare complication of endovascular intervention for acute ischaemic stroke. Although there are no previous descriptions of its successful treatment with hyperbaric oxygen therapy following mechanical thrombectomy, this is likely to become more common as mechanical thrombectomy is increasingly used worldwide to treat acute ischaemic stroke.
Real-world burden of comorbidities in US patients with psoriatic arthritis
Authors: Shah Kamal , Paris Maria , Mellars Lillian , Changolkar Arun , Mease Philip J
Published: December 2017

Objectives

We assessed comorbidities associated with psoriatic arthritis in a broad cohort of US-insured adult patients using the Truven Health Analytics MarketScan Database.

Methods

Prevalence and incidence rates were assessed for 28 comorbid conditions among adult patients in the MarketScan database with a diagnosis of psoriatic arthritis and having two or more health claims for psoriatic arthritis between 1 July 2008 and 31 July 2015. Findings were compared with those of a similar, previously published analysis of patients with psoriasis.

Results

Among a total of 186 552 patients with a diagnosis of psoriatic arthritis, 94 302 had two or more health claims for psoriatic arthritis during the study period and were included in the comorbidity analysis. The prevalence and incidence rates of the most common comorbidities were 47.5% and 35.0% for hyperlipidaemia, respectively; 47.3% and 31.3% for hypertension; 21.2% and 15.4% for depression; 20.2% and 13.5% for type 2 diabetes mellitus; and 16.6% and 12.4% for fibromyalgia. Patients with psoriatic arthritis had notably higher incidence rates of uveitis, fibromyalgia, osteoporosis, Crohn’s disease and non-alcoholic liver disease than patients with psoriasis.

Conclusion

This observational retrospective analysis using the MarketScan database provides real-world health claims data on the prevalence and incidence of comorbidities in a large US patient population with psoriatic arthritis. The observed high cardiometabolic comorbidity rates align with those reported in the literature and may help healthcare providers in the comprehensive management of patients with psoriatic arthritis.
Secukinumab provides sustained improvements in the signs and symptoms of active ankylosing spondylitis with high retention rate: 3-year results from the phase III trial, MEASURE 2
Authors: Marzo-Ortega Helena , Sieper Joachim , Kivitz Alan , Blanco Ricardo , Cohen Martin , Delicha Evie-Maria , Rohrer Susanne , Richards Hanno
Published: December 2017

Background

Secukinumab treatment has previously been shown to significantly improve the signs and symptoms of active ankylosing spondylitis (AS), with responses sustained through 2 years. Here, we report the long-term (3 years) efficacy and safety of secukinumab in the MEASURE 2 study.

Methods

MEASURE 2 (NCT01649375) is a 5-year phase III, randomised, double-blind, double-dummy, parallel-group, placebo-controlled study to evaluate the efficacy, safety and tolerability of subcutaneous loading and maintenance dosing of secukinumab in adult subjects with active AS. Subjects were randomised to receive subcutaneous secukinumab 150 mg, 75 mg or placebo at baseline, weeks 1, 2 and 3 and every 4 weeks from week 4. At week 16, placebo-treated subjects were rerandomised to receive secukinumab 150/75 mg.

Results

Retention rates were high during weeks 16–156 and were 86% and 76% for secukinumab 150 and 75 mg, respectively. Secukinumab 150 mg provided sustained improvements in the Assessment of Spondyloarthritis International Society ASAS 20/40 response rates at week 156 (70.1%/60.9%) compared with week 52 (74.2%/57.0%); however, there was a slight decrease for secukinumab 75 mg (54.3%/37.0% vs 62.5%/43.2%, respectively). Sustained improvements were observed in all other end points, including Bath Ankylosing Spondylitis Disease Activity Index, AS Disease Activity Score with C reactive protein inactive disease, ASAS 5/6, Short Form-36 Physical Component Summary and ASAS partial remission. Clinical benefits were observed regardless of prior exposure to anti-tumour necrosis factor agents. The safety profile remained favourable and was consistent with previous reports.

Conclusions

This study showed sustained improvement through 3 years in signs, symptoms and physical function in subjects with AS. Retention rates were high and secukinumab was well tolerated, with a favourable safety profile.
Does access to pasture affect claw condition and health in dairy cows?
Authors: Armbrecht Linda , Lambertz Christian , Albers Dirk , Gauly Matthias
Published: December 2017

The aim of this study was to examine effects of pasturing in dairy cows on claw condition (claw length, hardness) and on the prevalence of claw diseases. At claw trimming, a total of 240 Holstein‐Friesian or Red‐Holstein cows from 20 German farms were examined twice, at the end of the pasture and barn season. Each individual claw was trimmed at both assessments. Farms were classified based on animals’ pasture access during pasture season into: group 1 (G1) >10 hours pasture access per day, group 2 (G2) 6–10 hours, group 3 (G3) <6 hours and group 4 (G4) without pasture access. Greater values for hardness were associated with lower scores (=prevalence×severity level) of sole ulcers, white line disease, sole haemorrhage, heel horn erosion and interdigital hyperplasia. In pasture groups, heel horn erosion showed lower frequencies in summer compared with winter, while it was vice versa in G4. In G1 and G3, lower frequencies of white line disease were found in summer compared with winter. Overall, pasture access had positive effects in particular for claw diseases that are related to moist environments. Nevertheless, appropriate free‐stall design and claw trimming routine might have a greater influence.
Late‐onset recurrence of neurological deficits after surgery for spinal arachnoid diverticula
Authors: Alcoverro Emili , McConnell James Fraser , Sanchez‐Masian Daniel , De Risio Luisa , De Decker Steven , Gonçalves Rita
Published: December 2017

Spinal cord dysfunction secondary to spinal arachnoid diverticula (SAD) has been widely reported in the veterinary literature and there is some suggestion that surgical treatment may provide better outcomes than medical treatment. Despite this, previous reports have mentioned cases with recurrence of clinical signs following surgical treatment but the cause for this has not been further investigated. The medical records of seven dogs and one cat which presented for investigation of recurrence of neurological deficits at least six months after surgery for SAD were retrospectively reviewed. Median time to relapse of the neurological deficits was 20.5 months after surgery. On repeated imaging, 3/8 cases showed clear regrowth of diverticulum, 2/8 cases showed dorsal compression at the previous laminectomy site (presumed to be the laminectomy membrane), and 3/8 cases showed herniation of the spinal cord through the laminectomy defect associated with a stellate appearance to the spinal cord with small multiloculated areas of dilation of the subarachnoid space. Repeat surgical intervention was most successful in the cases where SAD recurrence was identified while medical treatment resulted in either subtle improvement or stabilisation on the clinical signs, sometimes followed by slow deterioration.
Adverse Effects of Carbetocin versus Oxytocin in the Prevention of Postpartum Haemorrhage after Caesarean Section: A Randomized Controlled Trial
Authors: Mannaerts D. , Van der Veeken L. , Coppejans H. , Jacquemyn Y.
Published: January 2018

Purpose. To compare the incidence of nausea, vomiting, and arterial hypotension between carbetocin and oxytocin to prevent haemorrhage after caesarean section (CS).Methods. A randomized controlled trial in term pregnant women undergoing planned CS. Groups were randomized to carbetocin or oxytocin. Blood pressure (BP), heart rate, presence of nausea/vomitus, and need for vasopressors were evaluated throughout surgery. Preoperative and postoperative haemoglobin and haematocrit levels were compared.Results. Fifty-eight women were randomized (carbetocinn=32; oxytocinn=26). Both medications had hypotensive effect, difference in BP for carbetocin versus oxytocin: systolic (14.4 ± 2.4 mmHg versus 8.5 ± 1.8 mmHg); diastolic (7.8 ± 1.6 mmHg versus 8.9 ± 3.0 mmHg) without significant difference between the drugs (p=0.1andp=0.7). Both groups had similar needs for vasopressors. The presence of nausea was not rare, but the difference was not statistically significant (p=0.4). Average blood loss was slightly lower in the carbetocin group but not statistically significant (p=0.8).Conclusion. In planned CS, a possible clinical significant lower incidence of nausea after carbetocin was noted but this was not statistically significant. There were no differences regarding BP, heart rate, the need for vasopressor, and blood loss. The study was registered in the International Journal of Clinical Trials (ISRCTN95504420, 2/2017).
Linearization of Fifth-Order Ordinary Differential Equations by Generalized Sundman Transformations
Authors: Suksern Supaporn , Naboonmee Kwanpaka
Published: January 2018

In this article, the linearization problem of fifth-order ordinary differential equation is presented by using the generalized Sundman transformation. The necessary and sufficient conditions which allow the nonlinear fifth-order ordinary differential equation to be transformed to the simplest linear equation are found. There is only one case in the part of sufficient conditions which is surprisingly less than the number of cases in the same part for order 2, 3, and 4. Moreover, the derivations of the explicit forms for the linearizing transformation are exhibited. Examples for the main results are included.
Evidence for Mixed Rationalities in Preference Formation
Authors: Băbeanu Alexandru-Ionuț , Garlaschelli Diego
Published: January 2018

Understanding the mechanisms underlying the formation of cultural traits is an open challenge. This is intimately connected to cultural dynamics, which has been the focus of a variety of quantitative models. Recent studies have emphasized the importance of connecting those models to empirically accessible snapshots of cultural dynamics. In particular, it has been suggested that empirical cultural states, which differ systematically from randomized counterparts, exhibit properties that are universally present. Hence, a question about the mechanism responsible for the observed patterns naturally arises. This study proposes a stochastic structural model for generating cultural states that retain those robust empirical properties. One ingredient of the model assumes that every individual’s set of traits is partly dictated by one of several universal “rationalities,” informally postulated by several social science theories. The second, new ingredient assumes that, apart from a dominant rationality, each individual also has a certain exposure to the other rationalities. It is shown that both ingredients are required for reproducing the empirical regularities. This suggests that the effects of cultural dynamics in the real world can be described as an interplay of multiple, mixing rationalities, providing indirect evidence for the class of social science theories postulating such a mixing.
Predictors for Gingival Index in Middle-Aged Asian Indians with Type 2 Diabetes from South India: A Cross-Sectional Observational Study
Authors: Karthik S. Jai , Anoop Shajith , Kumar R. Suresh , Rani M. V. Usha
Published: January 2018

Asian Indians develop type 2 diabetes mellitus (T2DM) much earlier as compared to White Caucasians, due to unique phenotypic and genetic architecture. Periodontitis in T2DM patients is often a neglected clinical feature. This study was conducted to derive predictor variables for gingival index in middle-aged Asian Indians with T2DM in a semiurban population of Dravidian ethnicity from Tamil Nadu, India. T2DM patients (n=232, mean age:50.6±10.4years) with periodontitis (n=123, mean age:54.3±2.4years) and without periodontitis (n=109, mean age:55.2±3.1years) were recruited between 2014 and 2016 by purposive sampling method. Dental examinations for pocket depth (PD) and clinical attachment level (CAL) were performed and gingival index was calculated. Fasting venous blood samples were analysed for measures of glycaemia and cholesterol. Significant positive correlation (p<0.01) was observed for gingival index with glycosylated haemoglobin (HbA1c), pocket depth, presence of T2DM, and clinical attachment level. Stepwise multiple linear regression analysis derived increased pocket depth (p<0.01), elevated HbA1c (p<0.01), clinical attachment level (p<0.01), and presence of diabetes (p<0.01) as significant predictors (r2value = 0.67) for increased gingival index in middle aged patients with T2DM. These variables significantly (p<0.01) predispose middle-aged T2DM patients to increased gingival index, thus warranting appropriate intervention.
Sphingolipid Metabolic Pathway Impacts Thiazide Diuretics Blood Pressure Response: Insights From Genomics, Metabolomics, and Lipidomics
Authors: Shahin Mohamed H. , Gong Yan , Frye Reginald F. , Rotroff Daniel M. , Beitelshees Amber L. , Baillie Rebecca A. , Chapman Arlene B. , Gums John G. , Turner Stephen T. , Boerwinkle Eric , Motsinger‐Reif Alison , Fiehn Oliver , Cooper‐DeHoff Rhonda M. , Han Xianlin , Kaddurah‐Daouk Rima , Johnson Julie A.
Published: December 2017

Background

Although hydrochlorothiazide (
HCTZ
) is a well‐established first‐line antihypertensive in the United States, <50% of
HCTZ
treated patients achieve blood pressure (
BP
) control. Thus, identifying biomarkers that could predict the
BP
response to
HCTZ
is critically important. In this study, we utilized metabolomics, genomics, and lipidomics to identify novel pathways and biomarkers associated with
HCTZ BP
response.

Methods and Results

First, we conducted a pathway analysis for 13 metabolites we recently identified to be significantly associated with
HCTZ BP
response. From this analysis, we found the sphingolipid metabolic pathway as the most significant pathway (
P
=5.8E‐05). Testing 78 variants, within 14 genes involved in the sphingolipid metabolic canonical pathway, with the
BP
response to
HCTZ
identified variant rs6078905, within the

SPTLC
3

gene, as a novel biomarker significantly associated with the
BP
response to
HCTZ
in whites (n=228). We found that rs6078905 C‐allele carriers had a better
BP
response to
HCTZ
versus noncarriers (∆
SBP
/∆
DBP
: −11.4/−6.9 versus −6.8/−3.5 mm Hg; ∆
SBP
P
=6.7E‐04; ∆
DBP
P
=4.8E‐04). Additionally, in blacks (n=148), we found genetic signals in the

SPTLC
3

genomic region significantly associated with the
BP
response to
HCTZ
(
P
<0.05). Last, we observed that rs6078905 significantly affects the baseline level of 4 sphingomyelins (N24:2, N24:3, N16:1, and N22:1; false discovery rate <0.05), from which N24:2 sphingomyelin has a significant correlation with both
HCTZ DBP
‐response (
r
=−0.42;
P
=7E‐03) and
SBP
‐response (
r
=−0.36;
P
=2E‐02).

Conclusions

This study provides insight into potential pharmacometabolomic and genetic mechanisms underlying
HCTZ BP
response and suggests that

SPTLC
3

is a potential determinant of the
BP
response to
HCTZ
.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
00246519.
Interrelationships Among Flow‐Mediated Vasodilation, Nitroglycerine‐Induced Vasodilation, Baseline Brachial Artery Diameter, Hyperemic Shear Stress, and Cardiovascular Risk Factors
Authors: Maruhashi Tatsuya , Iwamoto Yumiko , Kajikawa Masato , Oda Nozomu , Kishimoto Shinji , Matsui Shogo , Hashimoto Haruki , Aibara Yoshiki , Yusoff Farina Mohamad , Hidaka Takayuki , Kihara Yasuki , Chayama Kazuaki , Noma Kensuke , Nakashima Ayumu , Goto Chikara , Hida Eisuke , Higashi Yukihito
Published: December 2017

Background

Flow‐mediated vasodilation (
FMD
) of the brachial artery has been used for the assessment of endothelial function. Considering the mechanism underlying the vasodilatory response of the brachial artery to reactive hyperemia, hyperemic shear stress (
HSS
), a stimulus for
FMD
; nitroglycerine‐induced vasodilation (
NID
), an index of endothelium‐independent vasodilation; and baseline brachial artery diameter (
BAD
) are also involved in vasodilatory response. The purpose of this study was to investigate the interrelationships among
FMD
,
HSS
,
NID
, baseline
BAD
, and cardiovascular risk factors.

Methods and Results

We measured
FMD
,
HSS
,
NID
, and baseline
BAD
simultaneously in 1033 participants (633 men and 400 women; mean age: 58.6±17.0 years). Framingham risk score was negatively correlated with
FMD
,
HSS,
and
NID
and was positively correlated with baseline
BAD
.
HSS
and
NID
were positively correlated with
FMD
, and baseline
BAD
was negatively correlated with
FMD
. In participants with normal
NID
,
FMD
was correlated with
HSS
,
NID
, and baseline
BAD
, all of which were independent variables of
FMD
in multivariate analysis. In participants with impaired
NID
,
FMD
was correlated with
NID
and baseline
BAD
, both of which were independent variables of
FMD
in multivariate analysis, but there was no association between
FMD
and
HSS
.

Conclusions

NID
and baseline
BAD
were independent variables of
FMD
regardless of the status of endothelium‐independent vasodilation, whereas there was a significant association between
FMD
and
HSS
in participants with normal
NID
but not in those with impaired
NID
. The influence of
HSS
on
FMD
seems to be dependent on the status of endothelium‐independent vasodilation.
Association Between Tetralogy of Fallot and Tracheobronchial Branching Abnormalities: A New Clue for Pathogenesis?
Authors: Chassagnon Guillaume , Lefort Bruno , Meot Mathilde , Carpentier Elodie , Sirinelli Dominique , Chantepie Alain , Morel Baptiste
Published: December 2017

Background

In our practice, we noticed an increased frequency of tracheobronchial branching abnormalities (
TBA
s) in patients with tetralogy of Fallot (ToF). This study aimed to determine whether an association exists between congenital
TBA
s and ToF with or without pulmonary atresia.

Methods and Results

The frequency of
TBA
s on chest computed tomography was assessed in 55 patients with ToF without pulmonary atresia, 34 patients with ToF with pulmonary arteria, and 100 control patients. We then looked for a possible association between
TBA
s and pulmonary artery branch hypoplasia, the presence of major aortopulmonary collateral arteries, and the presence of the chromosome 22q11 deletion.
TBA
s were significantly more frequent in patients with ToF with or without pulmonary atresia than in the control group (any
TBA
s, 21% versus 2% [
P
<0.001]; bronchial situs anomalies, 6% versus 0% [
P
=0.002]; right tracheal bronchus, 4% versus 0% [
P
=0.04]; left eparterial bronchus, 8% versus 0% [
P
=0.005]); and tended to be more frequent in those with ToF without pulmonary atresia than in those with ToF with pulmonary atresia (any
TBA
s, 27% versus 12% [
P
=0.11]; left eparterial bronchus, 13% versus 0% [
P
=0.04]).
TBA
s were readily multiple (8 patients of 19 with
TBA
) and concerned essentially the upper lobes.
TBA
s were not associated with pulmonary branch hypoplasia, major aortopulmonary collateral arteries, or the chromosome 22q11 deletion.

Conclusions

We demonstrated a significantly increased frequency of tracheobronchial abnormalities in patients with ToF with or without pulmonary atresia compared with a control group. These results suggest an interaction between abnormalities in conotruncal septation and tracheobronchial branching and may provide a new clue to the pathogenesis of conotruncal heart diseases.
Left Ventricular Torsion Shear Angle Volume Approach for Noninvasive Evaluation of Diastolic Dysfunction in Preserved Ejection Fraction
Authors: Sharifov Oleg F. , Schiros Chun G. , Aban Inmaculada , Perry Gilbert J. , Dell'italia Louis J. , Lloyd Steven G. , Denney Thomas S. , Gupta Himanshu
Published: December 2017

Background

Accurate noninvasive diagnostic tools for evaluating left ventricular (
LV
) diastolic dysfunction (
LVDD
) are limited in preserved
LV
ejection fraction. We previously proposed the relationship of normalized rate of change in
LV
torsion shear angle (φ′) to corresponding rate of change in
LV
volume (V′) during early diastole (represented as −dφ′/dV′) as a measure of
LV
diastolic function. We prospectively evaluated diagnostic accuracy of −dφ′/dV′ in respect to invasive
LV
parameters.

Methods and Results

Participants (n=36, age 61±7 years) with
LV
ejection fraction ≥50% and no acute myocardial infarction undergoing coronary angiography for chest pain and/or dyspnea evaluation were studied. High‐fidelity invasive
LV
pressure measurements and cardiac magnetic resonance imaging with tissue tagging were performed. τ, the time constant of
LV
diastolic relaxation, was 58±10 milliseconds (mean±
SD
), and
LV
end‐diastolic pressure was 14.5±5.5 mm Hg. Cardiac magnetic resonance imaging‐derived −dφ′/dV′ was 5.6±3.7. The value of −dφ′/dV′ correlated with both τ and
LV
end‐diastolic pressure (
r
=0.39 and 0.36, respectively,
P
<0.05).
LVDD
was defined as τ>48 milliseconds and
LV
end‐diastolic pressure >12 mm Hg (
LVDD
1), or, alternatively, τ>48 milliseconds and
LV
end‐diastolic pressure >16 mm Hg (
LVDD
2). Area under the curve (AUC) of −dφ′/dV′ for identifying
LVDD
1 was 0.83 (0.67‐0.98,
P
=0.001), with sensitivity/specificity of 72%/100% for −dφ′/dV′ ≥6.2.
AUC
of −dφ′/dV′ for identifying
LVDD
_2 was 0.82 (0.64‐1.00,
P
=0.006), with sensitivity/specificity of 76%/85% for −dφ′/dV′ ≥6.9. There were good limits of agreement between pre‐ and post‐nitroglycerin −dφ′/dV′.

Conclusions

The −dφ′/dV′ obtained from the
LV
torsion volume loop is a promising parameter for assessing global
LVDD
with preserved
LV
ejection fraction and requires further evaluation.
Trends and Predictors of Participation in Cardiac Rehabilitation Following Acute Myocardial Infarction: Data From the Behavioral Risk Factor Surveillance System
Authors: Peters Anthony E. , Keeley Ellen C.
Published: December 2017

Background

Participation in cardiac rehabilitation (
CR
) after acute myocardial infarction has been proven to significantly reduce morbidity and mortality. Historically, participation rates have been low, and although recent efforts have increased referral rates, current data on
CR
participation are limited.

Methods and Results

Utilizing data from the Behavioral Risk Factor Surveillance System conducted by Centers for Disease Control and Prevention, we performed a population‐based, cross‐sectional analysis of
CR
post‐acute myocardial infarction. Unadjusted participation from 2005 to 2015 was evaluated by univariable logistic regression. Multivariable logistic regression was performed with patient characteristic variables to determine adjusted trends and associations with participation in
CR
in more recent years from 2011 to 2015. Among the 32 792 survey respondents between 2005 and 2015, participation ranged from 35% in 2005 to 39% in 2009 (
P
=0.005) and from 38% in 2011 to 32% in 2015 (
P
=0.066). Between 2011 and 2015, participants were less likely to be female (odds ratio [
OR
] 0.763, 95% confidence interval [
CI
] 0.646‐0.903), black (
OR
0.700, 95%
CI
0.526‐0.931), uninsured (
OR
0.528, 95%
CI
0.372‐0.751), less educated (
OR
0.471, 95%
CI
0.367‐0.605), current smokers (
OR
0.758, 95%
CI
0.576‐0.999), and were more likely to be retired or self‐employed (
OR
1.393, 95%
CI
1.124‐1.726).

Conclusions

Only one third of patients participate in
CR
following acute myocardial infarction despite the known health benefits. Participants are less likely to be female, black, and uneducated. Future studies should focus on methods to maximize the proportion of
CR
referrals converted into
CR
participation.
Transfer of Audio-Visual Temporal Training to Temporal and Spatial Audio-Visual Tasks
Authors: Sürig Ralf , Bottari Davide , Röder Brigitte
Published: December 2017

Temporal and spatial characteristics of sensory inputs are fundamental to multisensory integration because they provide probabilistic information as to whether or not multiple sensory inputs belong to the same event. The multisensory temporal binding window defines the time range within which two stimuli of different sensory modalities are merged into one percept and has been shown to depend on training. The aim of the present study was to evaluate the role of the training procedure for improving multisensory temporal discrimination and to test for a possible transfer of training to other multisensory tasks. Participants were trained over five sessions in a two-alternative forced-choice simultaneity judgment task. The task difficulty of each trial was either at each participant’s threshold (adaptive group) or randomly chosen (control group). A possible transfer of improved multisensory temporal discrimination on multisensory binding was tested with a redundant signal paradigm in which the temporal alignment of auditory and visual stimuli was systematically varied. Moreover, the size of the spatial audio-visual ventriloquist effect was assessed. Adaptive training resulted in faster improvements compared to the control condition. Transfer effects were found for both tasks: The processing speed of auditory inputs and the size of the ventriloquist effect increased in the adaptive group following the training. We suggest that the relative precision of the temporal and spatial features of a cross-modal stimulus is weighted during multisensory integration. Thus, changes in the precision of temporal processing are expected to enhance the likelihood of multisensory integration for temporally aligned cross-modal stimuli.