bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving PICC use and outcomes in hospitalised patients: an interrupted time series study using MAGIC criteria
Authors: Swaminathan Lakshmi , Flanders Scott , Rogers Mary , Calleja Yvonne , Snyder Ashley , Thyagarajan Rama , Bercea Priscila , Chopra Vineet
Published: November 2017

Background

Although important in clinical care, reports of inappropriate peripherally inserted central catheter (PICC) use are growing.

Objective

To test whether implementation of the Michigan Appropriateness Guide for Intravenous Catheters (MAGIC) can improve PICC use and patient outcomes.

Design

Quasi-experimental, interrupted time series design at one study site with nine contemporaneous external controls.

Setting

Ten hospitals participating in a state-wide quality collaborative from 1 August 2014 to 31 July 2016.

Patients

963 hospitalised patients who received a PICC at the study site vs 6613 patients at nine control sites.

Intervention

A multimodal intervention (tool, training, electronic changes, education) derived from MAGIC.

Measurements

Appropriateness of PICC use and rates of PICC-associated complications. Segmented Poisson regression was used for analyses.

Results

Absolute rates of inappropriate PICC use decreased substantially at the study site versus controls (91.3% to 65.3% (−26.0%) vs 72.2% to 69.6% (−2.6%); P<0.001). After adjusting for underlying trends and patient characteristics, however, a marginally significant 13.8% decrease in inappropriate PICC use occurred at the study site (incidence rate ratio 0.86 (95% CI 0.74 to 0.99; P=0.048)); no change was observed at control sites. While the incidence of all PICC complications decreased to a greater extent at the study site, the absolute difference between controls and intervention was small (33.9% to 26.7% (−7.2%) vs 22.4% to 20.8% (−1.6%); P=0.036).

Limitations

Non-randomised design limits inference; the most effective component of the multimodal intervention is unknown; effects following implementation were modest.

Conclusions

In a multihospital quality improvement project, implementation of MAGIC improved PICC appropriateness and reduced complications to a modest extent. Given the size and resources required for this study, future work should consider cost-to-benefit ratio of similar approaches.
Exposure to ambient fine particulate matter and semen quality in Taiwan
Authors: Lao Xiang Qian , Zhang Zilong , Lau Alexis K H , Chan Ta-Chien , Chuang Yuan Chieh , Chan Jimmy , Lin Changqing , Guo Cui , Jiang Wun Kai , Tam Tony , Hoek Gerard , Kan Haidong , Yeoh Eng-kiong , Chang Ly-yun
Published: November 2017

Objectives

Environmental exposure to chemicals has been considered a potential factor contributing to deteriorated semen quality. However, previous literature on exposure to air pollution and semen quality is inconsistent. We therefore investigated the health effects of short-term and long-term exposure to fine particulate matter (PM2.5) on semen quality in Taiwanese men from the general population.

Methods

A cross-sectional study was conducted among 6475 male participants aged 15–49 years who participated in a standard medical examination programme in Taiwan between 2001 and 2014. Semen quality was assessed according to the WHO 1999 guidelines, including sperm concentration, total motility, progressive motility and morphology. Three-month and 2-year average PM2.5concentrations were estimated at each participant’s address using a spatiotemporal model based on satellite-derived aerosol optical depth data. Multivariable linear and logistic regressions were used to examine the associations between PM2.5and semen quality.

Results

A robust association was observed between exposure to PM2.5and decreased normal morphology. Every increment of 5 µg/m3in 2-year average PM2.5was significantly associated with a decrease of 1.29% in sperm normal morphology and a 26% increased risk of having the bottom 10% of sperm normal morphology, after adjusting for a wide range of potential confounders (p<0.001). On the other hand, an increment of 5 µg/m3in 2-year average PM2.5was associated with an increase of 1.03×106/mL in sperm concentration and a 10% decreased risk of being the bottom 10% of sperm concentration (both p<0.001). Similar results were found for 3-month PM2.5.

Conclusions

Exposure to ambient PM2.5air pollution is associated with a lower level of sperm normal morphology and a higher level of sperm concentration.
Occupational exposure to asbestos and risk of cholangiocarcinoma: a population-based case–control study in four Nordic countries
Authors: Farioli Andrea , Straif Kurt , Brandi Giovanni , Curti Stefania , Kjaerheim Kristina , Martinsen Jan Ivar , Sparen Pär , Tryggvadottir Laufey , Weiderpass Elisabete , Biasco Guido , Violante Francesco Saverio , Mattioli Stefano , Pukkala Eero
Published: November 2017

Objectives

To assess the association between occupational exposure to asbestos and the risk of cholangiocarcinoma (CC).

Methods

We conducted a case–control study nested in the Nordic Occupational Cancer (NOCCA) cohort. We studied 1458 intrahepatic CC (ICC) and 3972 extrahepatic CC (ECC) cases occurring among subjects born in 1920 or later in Finland, Iceland, Norway and Sweden. Each case was individually matched by birth year, gender and country to five population controls. The cumulative exposure to asbestos (measured in fibres (f)/ml × years) was assessed by applying the NOCCA job-exposure matrix to data on occupations collected during national population censuses (conducted in 1960, 1970, 1980/81 and 1990). Odds ratios (OR) and 95% CI were estimated using conditional logistic regression models adjusted by printing industry work.

Results

We observed an increasing risk of ICC with cumulative exposure to asbestos: never exposed, OR 1.0 (reference category); 0.1–4.9 f/mL × years, OR 1.1 (95% CI 0.9 to 1.3); 5.0–9.9 f/mL × years, OR 1.3 (95% CI 0.9 to 2.1); 10.0–14.9 f/mL × years, OR 1.6 (95% CI 1.0 to 2.5); ≥15.0 f/mL × years, OR 1.7 (95% CI 1.1 to 2.6). We did not observe an association between cumulative asbestos exposure and ECC.

Conclusions

Our study provides evidence that exposure to asbestos might be a risk factor for ICC. Our findings also suggest that the association between ECC and asbestos is null or weaker than that observed for ICC. Further studies based on large industrial cohorts of asbestos workers and possibly accounting for personal characteristics and clinical history are needed.
Information provided by diagnostic and screening tests: improving probabilities
Authors: Weatherall Mark
Published: November 2017

Uncertainty in clinical encounters is inevitable and despite this uncertainty clinicians must still work with patients to make diagnostic and treatment decisions. Explicit diagnostic reasoning based on probabilities will optimise information in relation to uncertainty. In clinical diagnostic encounters, there is often pre-existing information that reflects the probability any particular patient has a disease. Diagnostic testing provides extra information that refines diagnostic probabilities. However, in general diagnostic tests will be positive in most, but not all cases of disease (sensitivity) and may not be negative in all cases of disease absence (specificity). Bayes rule is an arithmetic method of using diagnostic testing information to refine diagnostic probabilities. In this method, when probabilities are converted to odds, multiplication of the odds of disease before diagnostic testing, by the positive likelihood ratio (LR+), the sensitivity of a test divided by 1 minus the specificity refines the probability of a particular diagnosis. Similar arithmetic applies to the probability of not having a disease, where the negative likelihood ratio is the specificity divided by 1 minus the sensitivity. A useful diagnostic test is one where the LR+ is greater than 5–10. This can be clarified by creating a contingency table for hypothetical groups of patients in relation to true disease prevalence and test performance predicted by sensitivity and specificity. Most screening tests in populations with a low prevalence of disease have a very high ratio of false positive results to true positive results, which can also be illustrated by contingency tables.
Efficacy and safety outcomes of recanalisation procedures in patients with acute symptomatic pulmonary embolism: systematic review and network meta-analysis
Authors: Jimenez David , Martin-Saborido Carlos , Muriel Alfonso , Zamora Javier , Morillo Raquel , Barrios Deisy , Klok Frederikus A , Huisman Menno V , Tapson Victor , Yusen Roger D
Published: November 2017

Background

We aimed to review the efficacy and safety of recanalisation procedures for the treatment of PE.

Methods

We searched PubMed, the Cochrane Library, EMBASE, EBSCO, Web of Science and CINAHL databases from inception through 31 July 2015 and included randomised clinical trials that compared the effect of a recanalisation procedure versus each other or anticoagulant therapy in patients diagnosed with PE. We used network meta-analysis and multivariate random-effects meta-regression to estimate pooled differences between each intervention and meta-regression to assess the association between trial characteristics and the reported effects of recanalisation procedures versus anticoagulation.

Results

For all-cause mortality, there were no significant differences in event rates between any of the recanalisation procedures and anticoagulant treatment (full-dose thrombolysis: OR 0.60; 95% CI0.36 to 1.01; low-dose thrombolysis: 0.47; 95% CI 0.14 to 1.59; and catheter-associated thrombolysis: 0.31; 95% CI 0.01 to 7.96). Full-dose thrombolysis increased the risk of major bleeding (2.00; 95% CI 1.06 to 3.78) compared with anticoagulation. Catheter-directed thrombolysis was associated with the lowest probability of dying (surface under the cumulative ranking curve (SUCRA), 0.67), followed by low-dose thrombolysis (SUCRA, 0.66) and full-dose thrombolysis (SUCRA, 0.55). Similarly, low-dose thrombolysis was associated with the lowest probability of major bleeding (SUCRA, 0.61), followed by catheter-directed thrombolysis (SUCRA, 0.54) and full-dose thrombolysis (SUCRA, 0.17). The results were similar in sensitivity analyses based on restricting only to studies in haemodynamically stable patients with PE.

Conclusions

In the treatment of PE, recanalisation procedures do not seem to offer a clear advantage compared with standard anticoagulation. Low-dose thrombolysis was associated with the lowest probability of dying and bleeding.

Trial registration number

PROSPERO CRD42015024670.
Activation of the central melanocortin system in rats persistently reduces body and fat mass independently of caloric reduction
Authors: Côté Isabelle , Green Sara M. , Morgan Drake , Carter Christy S. , Tümer Nihal , Scarpace Philip J.
Published: November 2017

Recent evidence indicate that melanotan II (MTII) reduces body mass independently of caloric reduction. Because MTII induces a transient hypophagia, caloric reduction is still considered a primary mechanism for MTII-mediated body mass loss. To examine the contribution of caloric reduction to long-term body mass loss in response to MTII, we centrally infused MTII or vehicle in ad libitum fed (MTII and Control) animals in comparison with a group of animals that were pair-fed (PF) to the MTII group. Food intake and body mass were recorded daily, and body composition was assessed biweekly. The present study demonstrates that central MTII-mediated body mass loss is only partially mediated by caloric restriction, and the long-term body mass loss is independent of the initial hypophagia. More importantly, central MTII administration induced a rapid but sustained fat mass loss, independently of caloric reduction. MTII-treated animals preserved their lean/fat mass ratio throughout the study, whereas PF animals underwent a transient reduction of lean/fat mass ratio that was only normalized when food intake returned to Control level. In summary, it can be concluded that activation of the central melanocortin system in rats persistently reduces body and fat mass independently of caloric reduction.
INTERNATIONAL MIGRATION, HUMAN CAPITAL COMPOSITION AND MIDDLE-INCOME TRAPS
Authors: FAN ZHAOBIN , LI HUI
Published: November 2017

One of the most interesting and debateable topics in China’s economic growth is whether China’s economy would be hindered by a middle-income trap. This paper addresses this topic by analyzing the link between international skilled migration and the middle-income trap. Our study has extended the model proposed by [De la Croix, D. and Docquier F. (2012). Do Brain Drain and Poverty Result from Coordination Failures? Journal of Economic Growth, 17(1) 1–26.] and accounted for the importance of heterogeneity of human capital emphasized by [Jones, F. (2008). The Knowledge Trap: Human Capital and Development Reconsidered. NBER Working Paper No. 14138, Northwestern University.] Results have demonstrated that in the presence of externalities in the formation of human capital, there possibly exist four steady-state development paths in the dynamic system due to coordination failures. These four paths include: (i) the unskilled labor equilibrium which is characterized by low-income and significant loss of skilled labor, (ii) the generalist equilibrium with lower-middle income and significant loss of specialists, (iii) the specialist equilibrium with the characteristics of upper-middle income and significant loss of generalists; and (iv) the skilled equilibrium with high income and insignificant loss of skilled workers. Amongst them, the generalist equilibrium and specialist equilibrium represent two types of middle-income trap.
Atomistic full-quantum transport model for zigzag graphene nanoribbon-based structures: Complex energy-band method
Authors: Chen Chun-Nan , Luo Win-Jet , Shyu Feng-Lin , Chung Hsien-Ching , Lin Chiun-Yan , Wu Jhao-Ying
Published: November 2017

Using a non-equilibrium Green’s function framework in combination with the complex energy-band method, an atomistic full-quantum model for solving quantum transport problems for a zigzag-edge graphene nanoribbon (zGNR) structure is proposed. For transport calculations, the mathematical expressions from the theory for zGNR-based device structures are derived in detail. The transport properties of zGNR-based devices are calculated and studied in detail using the proposed method.
From Patterns to Function in Living Systems: Dryland Ecosystems as a Case Study
Authors: Meron Ehud
Published: November 2017

Spatial patterns are ubiquitous in animate matter. Besides their intricate structure and beauty they generally play functional roles. The capacity of living systems to remain functional in changing environments is a question of utmost importance, but its intimate relationship to pattern formation is largely unexplored. Here, we address this relationship using dryland vegetation as a case study. Following a brief introduction to pattern-formation theory, we describe a mathematical model that captures several mechanisms of vegetation pattern formation and discuss ecological contexts that showcase different mechanisms. Using this model, we unravel the different vegetation patterns that keep dryland ecosystems viable along the rainfall gradient, identify multistability ranges where fronts separating domains of alternative stable states exist, and highlight the roles of front dynamics in mitigating or reversing desertification. The utility of satellite images in testing model predictions is discussed. An outlook on outstanding open problems concludes this paper.
Organizational Citizenship Behavior: Recent Trends and Developments
Authors: Organ Dennis W.
Published: November 2017

For decades, the accepted view in organizational psychology was that job satisfaction and job performance were unrelated. However, recent years have found increasing evidence that satisfaction, while not strongly related to task productivity by individuals, is more closely related to a different kind of contribution, which is referred to as organizational citizenship behavior (OCB). Furthermore, research in the past two decades has enriched the theoretical and empirical knowledge base of OCB, examining its relationship to culture, attitudes, personality, mood state, stress, and organizational performance.
Issues and Challenges in Census Taking
Authors: Skinner Chris
Published: November 2017

In recent decades, census taking around the world has faced major challenges, including cost pressures, concerns about intrusiveness, privacy and response burden, reduced cooperation, difficulties in accessing secure apartments and enumerating unsafe areas, more complex living arrangements, and timeliness concerns. National statistical offices have responded to these concerns with various methodological developments. These include the use of new technologies and sampling in traditional census taking. There has also been a shift from traditional census methods to greater use of registers, as pioneered in the Nordic countries, and to the combined use of registers and sample surveys. In addition to reviewing such developments, this article reviews developments in associated statistical methodology, including record linkage and coverage adjustment methods. The article concludes by discussing possible future developments in census taking around the world.
On Stability of Periodic Solutions of Lienard Type Equations
Authors: Yin Zijian , Chen Hongbin
Published: November 2017

We use the Floquet theory to analyze the stability of periodic solutions of Lienard type equations under the asymptotic linear growth of restoring force in this paper. We find that the existence and the stability of periodic solutions are determined primarily by asymptotic behavior of damping term. For special type of Lienard equation, the uniqueness and stability of periodic solutions are obtained. Furthermore, the sharp rate of exponential decay of the stable periodic solutions is determined under suitable conditions imposed on restoring force.
Potential Role of MicroRNA-375 as Biomarker in Human Cancers Detection: A Meta-Analysis
Authors: Yan Jin , She Qiang , Shen Xiaoran , Zhang Yifeng , Liu Bingtuan , Zhang Guoxin
Published: November 2017

The association between circulating microRNA-375 (miR-375) expression and cancers has been studied; however, the results are inconsistent. We searched PubMed, Embase, and Web of Science for studies concerning the diagnostic value of miR-375 for cancer. The bivariate meta-analysis model was employed to summarize sensitivity, specificity, and diagnostic odds ratio (DOR) for miR-375 in the diagnosis of cancer. Summary receiver operating characteristic (SROC) curve analysis and the area under the curve (AUC) were also used to check the overall test performance. A total of 645 cancer patients and 421 cancer-free individuals from 12 studies were contained in this meta-analysis. The summary estimates revealed that the pooled sensitivity was 78% (95% confidence interval (CI): 64%–87%), the specificity was 74% (95% CI: 62%–84%), the DOR was 10.04 (95% CI: 6.01–16.77), and the AUC was 0.82 (95% CI: 0.79–0.85). In addition, we found that the diagnostic effect of miR-375 varies according to the race and cancer type. Our data suggest that miR-375 profiling has a potential to be used as a screening test for cancers but the specific race and cancer should be considered. More studies on the diagnostic value of miR-375 for cancer are needed in the future.
Rapid Convergence for Telegraph Systems with Periodic Boundary Conditions
Authors: Wang Peiguang , Liu Xiang
Published: November 2017

The generalized quasilinearization method is applied in this paper to a telegraph system with periodic boundary conditions. We consider the case in which the forcing function F(t,x,U) satisfies the following condition: ∂n-1F(t,x,U)/∂Un-1 exists and is quasimonotone nondecreasing or nonincreasing. We develop nonlinear iterates of order n-1 which will be different with n being even or odd. Finally, we develop two sequences which converge to the solution of the telegraph system and the convergence is of order n.
Ethnopharmacological Evaluation of Breu Essential Oils from Protium Species Administered by Inhalation
Authors: da Silva Eduardo Rodrigues , Oliveira Danilo Ribeiro de , Fernandes Patrícia Dias , Bizzo Humberto Ribeiro , Leitão Suzana Guimarães
Published: November 2017

Background. Breu is an aromatic oleoresin which has been used by Amazonian traditional communities as a remedy for headaches and migraines by burning and inhaling the smoke produced during its combustion. This study evaluated the antinociceptive and sedative activities of formulations containing breu essential oils administered by inhalation. Methods. Five different formulations (A–E) containing breu essential oils were evaluated for their sedative and antinociceptive activities in mice. They were delivered for 20 minutes using an inhalation chamber coupled with a nebulizer and the air inside was collected by static headspace and analyzed by GC‐FID. Results. All nebulized formulations had similar chemical compositions and major compounds as the original essential oils. None of them resulted in significant increase in response time during the hot plate test. In the formalin test, Formulation E showed a significant inhibition of licking responses in the early (46.8%) and late (60.2%) phases. Formulation B was effective (36.9%) in the first phase and Formulation D (37.9%) in the second. None of the formulations presented sedative effects. Conclusion. Breu essential oils, when inhaled, may present antinociceptive and anti‐inflammatory properties without sedation. Additionally, nebulization proved to be an efficient method for administration of formulations containing these essential oils.
Dropping Shock Characteristics of the Suspension Cushioning System with Critical Components
Authors: Li Hui , Chen Anjun , Duan Ningning
Published: November 2017

Dimensionless dropping shock dynamic equations of suspension nonlinear packaging system with critical components were obtained. The numerical results of shock response were gained using Runge-Kutta method. To evaluate the dropping shock characteristics of critical components, the dropping damage boundary curve was established, where the system parameter and the dimensionless shock velocity were selected as two coordinate parameters. Then, the frequency ratio and the system damping ratio were taken as third basic parameters of the dropping damage boundary surface, respectively. To study dynamic properties of the suspension system with critical components, the shock response acceleration, shock response displacements, and dropping damage boundary were analyzed. Based on the numerical results, the effects of the relevant parameters on dropping shock response and damage boundary of critical component were investigated. It is demonstrated that both a higher frequency ratio and a system damping ratio in the specific range can exert a positive effect on the product protection and should be selected in design process of the suspension system. Furthermore, with the decrease of suspension angle, the acceleration response peak decreases, the displacement response peak increases, and the safety zone enlarges.
Privacy-Preserving k-Means Clustering under Multiowner Setting in Distributed Cloud Environments
Authors: Rong Hong , Wang Huimei , Liu Jian , Hao Jialu , Xian Ming
Published: November 2017

With the advent of big data era, clients who lack computational and storage resources tend to outsource data mining tasks to cloud service providers in order to improve efficiency and reduce costs. It is also increasingly common for clients to perform collaborative mining to maximize profits. However, due to the rise of privacy leakage issues, the data contributed by clients should be encrypted using their own keys. This paper focuses on privacy-preserving k-means clustering over the joint datasets encrypted under multiple keys. Unfortunately, existing outsourcing k-means protocols are impractical because not only are they restricted to a single key setting, but also they are inefficient and nonscalable for distributed cloud computing. To address these issues, we propose a set of privacy-preserving building blocks and outsourced k-means clustering protocol under Spark framework. Theoretical analysis shows that our scheme protects the confidentiality of the joint database and mining results, as well as access patterns under the standard semihonest model with relatively small computational overhead. Experimental evaluations on real datasets also demonstrate its efficiency improvements compared with existing approaches.
Sedimentary Record of Polycyclic Aromatic Hydrocarbons from the Shuanglong Catchment, Southwest China
Authors: Liu Yu-ping , Wang Yan-hua , Ye Chun , Xie Biao , Yang Hao
Published: November 2017

Polycyclic aromatic hydrocarbons (PAHs) in the dated sediments from the Shuanglong catchment in the southwest of China were measured to characterize source inputs. The PAHs concentrations in the priority controlling list of US EPA (∑PAHs) ranged within 102.47~563.24 ng g−1, with an average value of 207.18 ng g−1. The 2-3 rings PAHs were predominant, accounting for 73.77% of ∑PAH. According to the classification of pollution levels, ∑PAHs concentrations in the sediments are within the range of moderate pollution level. Both the total and individual PAH concentrations changed with the depth. The profile distribution of PAHs concentration in the sediments suggested that PAHs acted as an effective way to reconstruct the historical trends of socioeconomic changes in the study areas. Results of Ant/(Ant + Phe), Fla/(Fla + Pyr), and BaA/(BaA + Chry) show that petroleum and petrogenic matter are attributed to the potential pollution source in the Shuanglong catchment. The coal combustion and incomplete combustion of gasoline and fossil fuel are dominant. TOC contents had positive correlation with ∑PAHs (R2=0.72, P<0.001), 2-3 rings (R2=0.44, P<0.001), 4-ring (R2=0.78, P<0.001), and 5-6 rings (R2=0.62, P<0.001).
Stability Analysis of Analytical and Numerical Solutions to Nonlinear Delay Differential Equations with Variable Impulses
Authors: Liu X. , Zeng Y. M.
Published: November 2017

A stability theory of nonlinear impulsive delay differential equations (IDDEs) is established. Existing algorithm may not converge when the impulses are variable. A convergent numerical scheme is established for nonlinear delay differential equations with variable impulses. Some stability conditions of analytical and numerical solutions to IDDEs are given by the properties of delay differential equations without impulsive perturbations.
mTOR-Dependent Cell Proliferation in the Brain
Authors: Ryskalin Larisa , Lazzeri Gloria , Flaibani Marina , Biagioni Francesca , Gambardella Stefano , Frati Alessandro , Fornai Francesco
Published: November 2017

The mammalian Target of Rapamycin (mTOR) is a molecular complex equipped with kinase activity which controls cell viability being key in the PI3K/PTEN/Akt pathway. mTOR acts by integrating a number of environmental stimuli to regulate cell growth, proliferation, autophagy, and protein synthesis. These effects are based on the modulation of different metabolic pathways. Upregulation of mTOR associates with various pathological conditions, such as obesity, neurodegeneration, and brain tumors. This is the case of high-grade gliomas with a high propensity to proliferation and tissue invasion. Glioblastoma Multiforme (GBM) is a WHO grade IV malignant, aggressive, and lethal glioma. To date, a few treatments are available although the outcome of GBM patients remains poor. Experimental and pathological findings suggest that mTOR upregulation plays a major role in determining an aggressive phenotype, thus determining relapse and chemoresistance. Among several activities, mTOR-induced autophagy suppression is key in GBM malignancy. In this article, we discuss recent evidence about mTOR signaling and its role in normal brain development and pathological conditions, with a special emphasis on its role in GBM.
Effects of Electrostatic Field on Osteoblast Cells for Bone Regeneration Applications
Authors: Su Chen-Ying , Fang Tzan , Fang Hsu-Wei
Published: November 2017

Many external stimulations have been shown to promote bone regeneration. The effects of an alternating current (AC) electrostatic field, one of external stimulations, generated from a device with high voltage and low current output on human osteoblastic cell line have been investigated in this study. We investigated how human osteoblasts responded to an AC electrostatic field, and the output parameters were set as 1 kV and 160 μA. Our results showed that, under such condition, the AC electrostatic field had a downregulation effect on the production ability of alkaline phosphatase and type 1 collagen expression. However, the expression of osteocalcin gene was elevated on the end of EFID treatment suggesting that AC electrostatic field might be a potential stimulation for accelerating the differentiation of osteoblastic cells.
Decision of Lead-Time Compression and Stable Operation of Supply Chain
Authors: Zhang Songtao , Li Shuangshuang , Zhang Siqi , Zhang Min
Published: November 2017

A cost optimization strategy and a robust control strategy were studied to realize the low-cost robust operation of the supply chain with lead times. Firstly, for the multiple production lead times which existed in the supply chain, a corresponding inventory state model and a supply chain cost model were constructed based on the Takagi-Sugeno fuzzy control system. Then, by considering the actual inventory level, the lead-time compression cost, and the stock-out cost, a cost optimization strategy was proposed. Furthermore, a fuzzy robust control strategy was proposed to realize the flexible switching among the models. Finally, the simulation results show that the total cost of the supply chain could be reduced effectively by the cost optimization strategy, and the stable operation of the supply chain could be realized by the proposed fuzzy robust control strategy.
Increased Circulating Th17 but Decreased CD4+Foxp3+ Treg and CD19+CD1dhiCD5+ Breg Subsets in New-Onset Graves’ Disease
Authors: Qin Jing , Zhou Jin , Fan Chenling , Zhao Na , Liu Yongping , Wang Shuo , Cui Xuejiao , Huang Mingshi , Guan Haixia , Li Yushu , Shan Zhongyan , Teng Weiping
Published: November 2017

Th17 and regulatory lymphocyte subsets such as Tregs and Bregs have been reported to play important roles in autoimmune diseases. The aim of this work was to perform quantitative studies of circulating Th17, Tregs, and Bregs in patients with new-onset Graves’ disease (GD). Twenty GD patients and 20 healthy controls were involved in this study. Blood samples were taken for flow cytometry detection of CD4+IL-17+ Th17, CD4+Foxp3+ Tregs, and CD19+CD1dhiCD5+ Bregs and meanwhile, for real-time PCR measurement of gene expressions of RORγt, IL-17 and IL-10. The proportions of Tregs and Bregs as well as the Foxp3 gene expression but not IL-10 were significantly decreased in GD group compared with the healthy controls. The frequency of Th17 together with the gene expressions of RORγt and IL-17 were significantly increased in the GD group. Furthermore, the Th17/Treg ratio was also significantly higher in GD group. A significant positive correlation between Th17 and TSAb (r=0.656, p<0.001) but significant negative correlations between Treg/Breg and TSAb (r=-0.339, p=0.032; r=-0.759, p<0.001) were identified among the participants. This study indicated that increased Th17 and impaired Treg responses, along with a decreased number of CD19+CD1dhiCD5+ Breg cells, were involved in GD pathogenesis.
Arthroscopic Management for the Unstable Inferior Leaf of the Lateral Meniscus Anterior Horn and Associated Cysts through a Direct Inframeniscal Portal: A Retrospective Study
Authors: Chen Dongyang , Li Qiangqiang , Sun Ye , Qin Jianghui , Yao Yao , Jiang Qing
Published: November 2017

Introduction. To investigate the clinical results of arthroscopic management for the unstable inferior leaf of the lateral meniscus anterior horn and associated cysts through an inframeniscal portal. Methods. From March 2005 to October 2014, 64 patients with an unstable inferior leaf of the lateral meniscus anterior horn and associated cysts underwent arthroscopic management with an inframeniscal portal. The mean age of the patients was 36.9 years (range, 18 to 49 years). The mean follow-up period was 28 months (range, 24 to 44 months). Clinical results were assessed using physical examination, the Lysholm knee score, and postoperative magnetic resonance scanning. Results. The median Lysholm score improved significantly at 1 year after surgery and at final follow-up. Magnetic resonance scanning at least one year after the operation revealed no recurrent meniscal tears or cysts. No reoperations were required after an average follow-up of 28 months. All patients reported significant symptomatic relief after the operation. They had full range of motion at three months and returned to normal activities and sports one year after surgery. Conclusion. The direct inframeniscal portal can provide an effective approach to manage lesions in the anterior horn of the lateral meniscus with predictable clinical outcomes.
A Study on Cytotoxic and Apoptotic Potential of a Triterpenoid Saponin (3-O-α-L-Arabinosyl Oleanolic Acid) Isolated fromSchumacheria castaneifoliaVahl in Human Non-Small-Cell Lung Cancer (NCI-H292) Cells
Authors: Samarakoon Sameera R. , Ediriweera Meran K. , Nwokwu Chukwumaobim Daniel Uzochukwuwulu , Bandara Chamara Janaka , Tennekoon Kamani H. , Piyathilaka Poorna , Karunaratne D. Nedra , Karunaratne Veranja
Published: November 2017

Lung cancer is the major cause of cancer death among men. A number of natural compounds have proven to be useful in the treatmet of lung cancer. This study was aimed to determine cytotoxic and apoptotoic effects of a natural compound 3-O-α-L-arabinosyl oleanolic acid (3-O-L-AO) isolated fromSchumacheria castaneifoliain non-small-cell lung cancer (NCI-H292) cells. Cytotoxic effects of 3-O-L-AO were determined by Sulforhodamine B (SRB) assay and apoptotic effects were tested by evaluating (a) apoptotsis related morphological changes, (b) caspase 3/7 activity, and (c) expression ofBax, p53, and survivingenes. Oxidative stress markers (reactive oxygen species (ROS), glutathione-S-transferase (GST), and glutathione (GSH)) were also analysed in 3-O-L-AO treated NCI-H292 cells. 3-O-L-AO exerted potent cytotoxic effects in NCI-H292 cells while being less cytotoxic to normal lung (MRC-5) cells. Exposure to 3-O-L-AO caused upregulation ofBaxandp53and downregulation ofsurvivinin NCI-H292 cells. Activation of caspase 3/7 and morphological features related to apoptosis further confirmed 3-O-L-AO induced apoptosis. Furthermore, elevated ROS and GST levels and decreased GSH levels suggested 3-O-L-AO can induce apoptosis, possibly causing oxidative stress in NCI-H292 cells. Overall results suggest that 3-O-L-AO can be considered as an effective anticancer agent for the treatment of lung cancer.
Intracranial Internal Carotid Artery Wall Calcification in Ischemic Strokes Treated with Thrombolysis
Authors: Tábuas-Pereira Miguel , Sargento-Freitas João , Silva Fernando , Parra Joana , Mendes Patrícia , Seara Vera , Mesquita Miguel , Baptista Mariana , Cordeiro Gustavo , Cunha Luis
Published: November 2017

Background: Calcifications are an important element of atherosclerotic plaques and have been used as a marker of atherosclerosis and clinical outcome predictor in different vascular territories. CT-scan, performed in the acute ischemic stroke setting, can reliably detect intracranial arterial calcifications. Objectives: To investigate the association between intracranial internal carotid artery calcification and functional outcome, symptomatic intracerebral hemorrhage (sICH), recanalization, and death. Methods: We included 396 consecutive ischemic stroke patients submitted to recombinant tissue plasminogen activator treatment between January 2011 and September 2014. Admission CT-scans were reviewed to calculate the Total Carotid Syphon Calcification score. Patients were followed for up to at least 6 months post-stroke or until death. Outcome measures included evaluation of recanalization on the first 24 h (transcranial color coded Doppler or angio-CT), sICH, and assessment of functional outcome at 3 months after stroke (using modified Rankin scale). Results: Carotid artery wall calcification did not predict sICH, recanalization or any good outcome. However, it was a statistically significant predictor of death (OR 1.102, 95% CI [1.004–1.211], p = 0.042). Discussion: Intracranial carotid artery calcification does not increase the risk of thrombolysis-induced sICH. Patients with higher grade of carotid artery wall calcification may have a higher mortality rate.
Dizziness and the Acute Vestibular Syndrome at the Emergency Department: A Population-Based Descriptive Study
Authors: Ljunggren Micaela , Persson Julia , Salzer Jonatan
Published: November 2017

Background: Dizziness is a common occurrence witnessed at emergency departments (EDs). This study aims to describe the epidemiology and management of dizzy patients with and without an acute vestibular syndrome (AVS) in the ED at Umeå University Hospital. Methods: A total of n = 2,126 ED dizziness visits during 3 years were identified. Data were obtained through retrospective review of medical records. Cases were stratified based on presentation, including AVS and neurological deficits. The outcomes analyzed included cerebrovascular causes of dizziness. A Poisson distribution was assumed when calculating incidence CIs. Results: Dizziness accounted for 2.1% of all ED visits, incidence 477/100,000 inhabitants (95% CI 457–498). Among dizzy patients, 19.2% had an AVS, incidence 92/100,000 inhabitants (95% CI 74–113). Top medical diagnostic groups were otovestibular (15.1%), cardiovascular (8.7%) and neurological diseases (7.7%), including stroke and transitory ischemic attack (4.8%). Cerebrovascular causes of dizziness were more common among those with an AVS (10.0%) vs. those without (3.6%), p < 0.01. Conclusion: The risk for cerebrovascular causes of dizziness, although low in an unselected cohort, increases with the presence of neurological signs and an AVS. These population-based data may be useful when planning and implementing dizziness and AVS management algorithms at EDs.
Increased Th1/Th17 Responses Contribute to Low-Grade Inflammation in Age-Related Macular Degeneration
Authors: Chen Jiajia , Wang Wenzhan , Li Qiuming
Published: November 2017

Background/Aims: Age-related macular degeneration (AMD) is the primary cause of senior blindness in developed countries. Mechanisms underlying initiation and development of AMD remained known. Methods: We examined the CD4+ T cell compartments and their functions in AMD patients. Results: AMD patients presented significantly higher frequencies of interferon (IFN)-γ-expressing and interleukin (IL)-17-expressing CD4+ T cells than healthy controls. The levels of IFN-γ and IL-17 expression by CD4+ T cells were significantly higher in AMD patients. These IFN-γ-expressing Th1 cells and IL-17-expressing Th17 cells could be selectively enriched by surface CCR3+ and CCR4+CCR6+ expression, respectively. Th1 and Th17 cells from AMD patients promoted the differentiation of monocytes toward M1 macrophages, which were previously associated with retinal damage. Th1 and Th17 cells also increased the level of MHC class I expression in human retinal pigment epithelial (RPE)-1 cells, while Th1 cells increased the frequency of MHC class II-expressing RPE-1 cells. These proinflammatory effects were partly, but not entirely, induced by the secretion of IFN-γ and IL-17. Conclusions: This study demonstrated an enrichment of Th1 cells and Th17 cells in AMD patients. These Th1 and Th17 cells possessed proinflammatory roles in an IFN-γ- and IL-17-dependent fashion, and could potentially serve as therapeutic targets.
Administration of Curcumin Protects Kidney Tubules Against Renal Ischemia-Reperfusion Injury (RIRI) by Modulating Nitric Oxide (NO) Signaling Pathway
Authors: Liu Fuhe , Ni Wenjuan , Zhang Jiajia , Wang Guokang , Li Fanzhu , Ren Wenxia
Published: November 2017

Background/Aims: To explore the protective effect of curcumin on renal ischemia-reperfusion injury (RIRI) in rats, and its influence on nephridial tissue’s NO and cGMP levels as well as downstream signaling pathway, to elucidate the possible mechanism of curcumin on RIRI. Methods: 36 Sprague Dawley rats (SD rats) were randomly divided into Sham group, Model group, curcumin (CUR +) Model group, 12 rats per group. They were all given RIRI model preparation by unilateral artery occlusion method. All groups’ β2-MG in urine in 24h, serum Cr and BUN were compared, and UAER were calculated. Nitric oxide synthase (NOS), cGMP-dependent protein kinase (PKG), Caspase-3 expression were all determined by western blot. Nitric oxide (NO), NOS and cGMP levels were also examined by using ELISA. All groups’ nephridial histomorphology and kidney tubules score were evaluated and compared. Results: β2-MG and UAER in urine, serum Cr and BUN, in renal tissue were all elevated in Model of RIRI, indicating the success of animal model of RIRI establishment, and above index in CUR + Model group were all lower than those in Model group. Furthermore, iNOS, NO, cGMP, PKG and Caspase-3 in renal tissue were all increased in Model of RIRI, indicating the NO signaling pathway was activated, which is one of the pathogenesis of RIRI, and above index in CUR + Model group were all lower than those in Model group, suggesting that inactivation of iNOS/NO/cGMP/PKG signaling pathway is one of the reasons that explain the protective effect of curcumin in RIRI. Conclusion: The activation of iNOS/NO/cGMP/PKG signaling pathway and the consequent promoted apoptosis of renal tubules are significantly involved in the pathogenesis of development of RIRI, and curcumin treatment could protect renal tubules against RIRI, at least partially, by suppressing the activated iNOS/NO/cGMP/PKG signaling pathway.
Day-by-Day Variability of Home Blood Pressure and Incident Cardiovascular Disease in Clinical Practice
Authors: Hoshide Satoshi , Yano Yuichiro , Mizuno Hiroyuki , Kanegae Hiroshi , Kario Kazuomi
Published: November 2017

We assessed the relationship between day-by-day home blood pressure (BP) variability and incident cardiovascular disease (CVD) in clinical practice. J-HOP study (Japan Morning Surge-Home Blood Pressure) participants underwent home BP monitoring in the morning and evening for a 14-day period, and their BP levels and BP variability independent of the mean (VIM) were assessed. Incident CVD events included coronary heart disease and stroke. Cox models were fitted to assess the home BP variability–CVD risk association. Among 4231 participants (mean±SD age, 64.9±10.9 years; 53.3% women; 79.1% taking antihypertensive medication), mean (SD) home systolic BP (SBP) levels over time and VIM
SBP
were 134.2 (14.3) and 6.8 (2.5) mm Hg, respectively. During a 4-year follow-up period (16 750.3 person-years), 148 CVD events occurred. VIM
SBP
was associated with CVD risk (hazard ratio per 1-SD increase, 1.32; 95% confidence interval [CI], 1.15–1.52), independently of mean home SBP levels over time and circulating B-type natriuretic peptide levels or urine albumin-to-creatinine ratio. Adding VIM
SBP
to the CVD prediction model improved the discrimination (C statistic, 0.785 versus 0.770; C statistic difference, 0.015; 95% CI, 0.003–0.028). Changes in continuous net reclassification improvement (0.259; 95% CI, 0.052–0.537), absolute integrated discrimination improvement (0.010; 95% CI, 0.003–0.016), and relative integrated discrimination improvement (0.104; 95% CI, 0.037–0.166) were also observed with the addition of VIM
SBP
to the CVD prediction models. In addition to the assessments of mean home SBP levels and cardiovascular end-organ damage, home BP variability measurements may provide a clinically useful distinction between high- and low-risk groups among Japanese outpatients.
Not Doomed to Repeat: Enhanced Medial Prefrontal Cortex Tracking of Errors Promotes Adaptive Behavior during Adolescence
Authors: McCormick Ethan M. , Telzer Eva H.
Published: November 2017

Feedback information is one of the most powerful forces that promotes learning, providing guidance for changes to ongoing behavioral patterns. Previous examinations of feedback learning have largely relied on explicit feedback based on task performance. However, learning is not restricted to explicit feedback and likely involves other forms of more subtle feedback cues. One potential form of this kind of learning may involve internally generated feedback in response to error commission. Whether this error-related response prompts neural and behavioral adaptation that overlaps with, or is distinct from, those evoked by external feedback is largely unknown. To explore this gap, 55 adolescents completed a difficult behavioral inhibition task designed to elicit relatively high rates of error commission during an fMRI session. We examined neural adaptation after accumulating errors (i.e., internally generated negative feedback events) at the group level, as well as the impact of individual differences in error tracking on overall task performance. Group effects show that medial PFC (mPFC) activation tracks accumulating errors; however, reduced tracking of errors is associated with greater total false alarms. These findings suggest that increased mPFC integration of error-related feedback is beneficial for task performance and, in concert with previous findings, suggests a domain-general role for mPFC integration of negative feedback.
Project Amoreiras (Mulberry Trees): Autonomy and Artificial Learning in an Urban Environment
Authors: Prado Gilbertto
Published: November 2017

This artist’s writing discusses Project Amoreiras, developed by the Poéticas Digitais Group. The proposal is an urban intervention involving art, technology and environment, configured as an interactive installation of mulberry trees on the Paulista Avenue (São Paulo, Brazil). The article highlights its poetic and technological elements as critical positioning on pollution in the metropolitan environment, the processes of autonomy and artificial learning, the emergent behavior of the trees, the application of John Conway’s neighborhood principles to the project as well as the positive reception of the proposal by the pedestrians during the exhibition.