bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical and economic benefits of de-escalating stress ulcer prophylaxis therapy in the intensive care unit: A quality improvement study
Authors: Anstey Matthew H , Litton Edward , Palmer Robert N , Neppalli Sneha , Tan Benedict J , Hawkins David J , Krishnamurthy Ravi B , Jacques Angela , Sonawane Ravikiran V , Chapman Andrew R , Norman Richard
Published: October 2019

Stress ulcer prophylaxis is commonly prescribed in the intensive care unit but can be inappropriately commenced or continued on discharge, exposing patients to potential harm. We aimed to evaluate whether a prescribing guideline, education program and pharmacist oversight would reduce inappropriate continuation of stress ulcer prophylaxis. This was a multicentre pre- (2014) and post- (2016) quality improvement study across five Australian intensive care units. Cost data were estimated using local information about prescribing patterns, and the relationship between long-term use and adverse events. A total of 531 patients were included in the pre- and 393 in the post-implementation periods. The proportion of hospital survivors inappropriately continued on stress ulcer prophylaxis reduced from 78/184 (42.4%) to 11/143 (7.7%) in the post-implementation period (odds ratio = 8.83; 95% confidence interval 4.47–17.45; P < 0.0001). Clostridium difficile–associated disease reduced from 10 patients to one in the pre- to post-implementation groups. The extrapolated direct savings to all Australian intensive care units from reduced proton pump inhibitor prescribing are relatively small (AUD$2.08 million/year), but the reduction in complications has both benefits for patients and indirect savings of AUD$16.59 million/year nationally. In patients admitted to the intensive care unit, the introduction of a simple, bundled intervention resulted in a significant decrease in inappropriate continuation of stress ulcer prophylaxis at hospital discharge and a reduction in recognised complications, and substantial cost savings.
Study of the structure and thermal characteristics of nanocomposites based on polyvinyl alcohol and intercalated montmorillonite
Authors: Krasinskyi Volodymyr , Gajdos Ivan , Suberlyak Oleh , Antoniuk Viktoria , Jachowicz Tomasz
Published: October 2019

The structure and thermal characteristics of nanocomposites based on polyvinyl alcohol (PVA) and montmorillonite (MMT) intercalated with polyvinylpyrrolidone were investigated by X-ray diffraction analysis and differential scanning calorimetry. The modification of PVA with intercalated MMT reduces the degree of crystallinity of the resulting nanocomposites but significantly increases their thermal stability. Under ultrasound, the intercalated MMT was completely distributed in a PVA solution and formed a monocrystalline structure. Films based on PVA with modified MMT were cross-linked at 110°C in the presence of 5 wt% acrylic acid and 0.5 wt% Ferrous(II) sulfate as an initiator. The formed films have a homogeneous cross-linked structure.
Investigation of the launch time of NH3-H2O absorption chiller under different working condition
Authors: Ebrahimnataj Tiji A , Ramiar A , Ebrahimnataj MR
Published: October 2019

This study deals with the launch time of main characteristic of NH3-H 2O absorption chiller under different working condition. The aim of this work was about to scrutinize a lumped-parameter dynamic simulation of aqua-ammonia absorption chiller in addition to investigating the effect of subcooled liquid at condenser/absorber outlet on absorption chiller’s key parameters launch time. Also, the effect of ambient temperature on absorption chiller’s key parameters’ launch time is studied. In order to determine the thermodynamic properties of the working fluid, the Engineering Equation Solver software is applied. By making a link between Engineering Equation Solver and MATLAB software, the differential equations are solved in the MATLAB software environment by fourth-order Rung–Kutta method. According to the result, increase of the sub-cool liquid temperature at condenser outlet has no effect on absorption chiller’s key parameters’ launch time. Besides, 10 ℃-increase in subcooled liquid temperature at the absorber outlet leads to decreasing the launch time of the coefficient of performance to 19.35%. The result shows that if cooling tower temperature goes from 22 ℃ to 30 ℃, launch time of the coefficient of performance rises by 10.43%, while evaporator heat transfer rate falls by 30%. To validate the dynamic model, the results deduced from numerical simulation are compared with peer steady–state results.
Fuel poverty and rebound effect in South Korea: An estimation for home appliances using the modified regression model
Authors: Jin Sang-Hyeon
Published: October 2019

Since the occurrence of oil shocks in the 1970s, a number of countries have introduced fuel poverty programs. However, rebound effects could be problematic even in these programs. In particular, there are two controversies surrounding rebound effects: the magnitude of rebound effects and the influence of income on these effects. This study attempts to resolve these issues by empirically estimating the rebound effects of individual home appliances for low-income households. Thereafter, it compares the rebound effects for low-income families with those for all-income families. Analyses results suggest that the magnitude of rebound effects highly depends on individual home appliances, and that these effects are usually larger for low-income households. Thus, the differences in rebound effects between all-income and low-income households also depend on individual appliances. Therefore, policy-makers should meticulously consider the rebound effects of individual home appliances when planning energy efficiency programs.
Antiphospholipid antibodies in patients with lupus nephritis: clinical correlations and associations with long-term outcomes
Authors: Yap D Y H , Thong K M , Yung S , Tang C , Ma B M Y , Chan T M
Published: October 2019

Whether the presence or absence of antiphospholipid antibodies (aPL) in patients with lupus nephritis (LN) is associated with differences in clinical outcomes remains unclear. We reviewed LN patients at a single centre during 2000–2017, and compared the clinical features and long-term outcomes between patients who were seropositive or seronegative for aPL. aPL was detected in 53/149 (35.6%) patients with biopsy-proven LN, and anticardiolipin IgM, anticardiolipin IgG, anti-β2 glycoprotein I and lupus anticoagulant was detected in 18.8%, 18.1%, 10.7% and 8.1%, respectively. Follow-up was 155.8 ± 61.0 months, and was similar between aPL-seropositive and -seronegative patients. aPL seropositivity persisted in 94.3% of patients during remission. aPL-seropositive patients showed inferior patient survival (91% and 85% at 10 and 15 years, respectively, compared to 99% and 95% in aPL-seronegative patients; p = 0.043). Nine (6.0%) patients died during follow-up, including six aPL-seropositive (four thrombotic events and two bleeding complications related to anticoagulation) and three aPL-seronegative patients. aPL seropositivity was associated with more rapid decline in estimated glomerular filtration rate (–1.44 mL/min/year compared to –0.38 mL/min/year in aPL-seronegative patients; p = 0.027) and inferior long-term renal survival (82% and 74% at 10 and 15 years, respectively, compared to 91% and 87% in aPL-seronegative patients; p = 0.034). aPL-seropositive patients also had a higher incidence of thrombotic events and miscarriage (32.1% and 13.2%, respectively, compared to 16.7% and 2.1% in the aPL-seronegative group; p = 0.030 and 0.006). We concluded that aPL seropositivity was associated with inferior long-term patient and renal survival and more frequent thrombotic events and miscarriage in LN patients.
Influence function-based empirical likelihood for inference of quantile medical costs with censored data
Authors: Jeyarajah Jenny , Wei Guanhao , Qin Gengsheng
Published: October 2019

In this paper, we propose empirical likelihood methods based on influence function and Jackknife techniques to construct confidence intervals for quantile medical costs with censored data. We show that the influence function-based empirical log-likelihood ratio statistic for the quantile medical cost has a standard Chi-square distribution as its asymptotic distribution. Simulation studies are conducted to compare coverage probabilities and interval lengths of the proposed empirical likelihood confidence intervals with the existing normal approximation-based confidence intervals for quantile medical costs. The proposed methods are observed to have better finite-sample performances than existing methods. The new methods are also illustrated through a real example.
Screening for obstructive sleep apnoea in an early psychosis cohort: a pilot study
Authors: Lane Abigail R , Myles Hannah , Foley Sharon , Siskind Dan
Published: October 2019

Objective:

Rates of obstructive sleep apnoea (OSA) appear to be lower in the youth population (< 4%) compared to the general population (6%–17%); rates in people with psychotic illness are estimated at 13.5%–57.1%. We hypothesised that this comorbidity extends to early psychosis (EP) populations, and used previously validated OSA questionnaires to screen for OSA in an EP cohort.

Method:

Fifty-three patients were screened using the OSA50 and STOP-Bang questionnaires with collection of anthropometric measures. Patients who screened positively were referred for polysomnography.

Results:

Fifteen per cent (8/53) screened positively; most frequently endorsed measures included BMI > 25, snoring, hypertension, neck circumference (> 40 cm) and male gender. Only 2/8 patients accepted polysomnography.

Conclusions:

Screening indicates OSA may be more prevalent in EP populations than age-equivalent cohorts, but ongoing research is required.
Teaching Students with Autism Spectrum Disorder: Strategies for the Music Classroom
Authors: Draper Ellary A.
Published: October 2019

The most recent Centers for Disease Control and Prevention report estimates that 1 in 59 children have autism spectrum disorder, and many of these children are receiving their education in their neighborhood schools, possibly participating in general music. Music teachers can make adaptations to their classroom environment and instructional strategies to support students with autism spectrum disorder, so they are able to participate in successful music-making experiences alongside their typical peers.
Comparison of drug-coated balloon angioplasty versus conventional angioplasty for arteriovenous fistula stenosis: Systematic review and meta-analysis
Authors: Abdul Salim Sohail , Tran Hong , Thongprayoon Charat , Fülöp Tibor , Cheungpasitporn Wisit
Published: October 2019

Background:

Arteriovenous fistula is the most preferred form of vascular access, but stenosis treated by balloon angioplasty is prone to restenosis. Multiple trials have been published with regard to the use of paclitaxel-coated balloon to prolong lesion patency compared to conventional balloon. Although paclitaxel-coated balloon has theoretical appeal, its use has not been widespread nationwide due to cost and lack of large-scale multicenter studies. We performed this meta-analysis to evaluate whether paclitaxel-coated balloon outperforms conventional balloon to prolong target lesion patency.

Methods:

PubMed/Medline, Clinical Trials.gov, EMBASE, Scopus, Web of Science, and Cochrane Central were searched from inception through April 2019 for studies that investigated the use of paclitaxel-coated balloon in arteriovenous fistula.

Results:

Ten studies were included in the final meta-analysis: six studies were randomized controlled trials and four studies were cohort studies. There were 911 participants with a mean age of 64.78 (±5.96) years, and 61.89% were male. Outcome of interest was target lesion primary patency, recorded at 1, 3, 6, 7, 12, and 24 months. Meta-analysis of randomized controlled trials shows that paclitaxel-coated balloons did not statistically improve target lesion primary patency compared to conventional balloons at months 1 (odds ratio = 1.54, p = 0.6373), 3 (odds ratio = 0.57, p = 0.0575), 6 (odds ratio = 0.65, p = 0.3644), 7 (odds ratio = 0.63, p = 0.0582), 12 (odds ratio = 0.64, p = 0.0612), and 24 (odds ratio = 0.43, p = 0.3452). Effect of paclitaxel-coated balloons was statistically significant for cohort studies at months 6 (odds ratio = 0.26, p = 0.0007), 12 (odds ratio = 0.21, p = 0.0001), and 24 (odds ratio = 0.23, p = 0.01).

Conclusion:

Paclitaxel-coated balloon showed no statistically significant improvement over conventional balloons in decreasing fistula stenosis in randomized controlled trial but were significant for cohort studies.
The Biopolitical Embodiment of Work in the Era of Human Enhancement
Authors: Le Dévédec Nicolas
Published: October 2019

Human enhancement or the use of technoscientific and biomedical advances to improve human performance is a social phenomenon that has become increasingly significant in Western societies over the last 15 years or so, notably in the workplace. By focusing on the non-medical use of psychostimulants, and from a perspective that is both critical and exploratory, this article aims to show that human enhancement practices prefigure new forms of embodiment and interiorization of work that are contributing to a significant reconfiguration of biopower. By allowing individuals to technically push back their physical and mental limits, beyond what is considered ‘normal’, human enhancement is enabling a form of biopower that is focused on the individual and on the possibility of reconfiguring biological norms in themselves. Far from participating in workers’ emancipation, this biopolitical model of enhancement markedly points to the issues of intensifying work conditions and increased employee self-discipline.
Determination of scattering frequencies for two-dimensional acoustic problems using boundary element method
Authors: Gao Haifeng , Zheng Changjun , Qiu Xiaolai , Xu Huidong , Matsumoto Toshiro
Published: October 2019

This paper presents a numerical approach for the determination of scattering frequencies of two-dimensional acoustic exterior resonance problems using boundary element method combined with a contour integral method. Since the solving range is surrounded by a Jordan curve in the complex plane, the complex eigenvalues can be acquired through evaluating the contour integral along the Jordan curve using the contour integral method. Complex scattering frequencies are directly extracted by the proposed approach, and their corresponding eigenmodes are also presented by evaluating the vibration amplitudes of internal points. The behaviors of the fictitious eigenfrequencies for unbounded domain are also studied. Numerical examples demonstrate the effectiveness of the approach for the resonance problems of unbounded domains.
Does education decrease Euroscepticism? A regression discontinuity design using compulsory schooling reforms in four European countries
Authors: Kunst Sander , Kuhn Theresa , van de Werfhorst Herman G
Published: October 2019

Previous research shows a strong and consistent relationship between educational attainment and Euroscepticism. As a result, education is considered to be a powerful predictor of attitudes towards European integration. However, these findings are predominantly found using cross-sectional research designs, therefore leaving open the possibility of strong selection effects due to pre-adult experiences and dispositions which both explain educational attainment and political attitudes. To test whether schooling causally reduces Euroscepticism, this article combines data on the compulsory schooling age with seven rounds of pooled European Social Survey data (2002–2014). Using compulsory schooling reforms within a ‘fuzzy’ regression discontinuity design, the results indicate no conclusive effect of education on Euroscepticism, questioning the impact of additional schooling. Consequently, this study provides a novel insight into the much-debated divide in support for European integration between lower and higher educated.
National British Orthodontic Society (BOS) Orthognathic Audit 2017–2018
Authors: Ireland Anthony J , Atack Nicola E , Cunningham Susan J , House Kate , Cobourne Martyn T , Hunt Nigel P , Sherriff Martyn , Sandy Jonathan R
Published: October 2019

Objective:

To carry out a UK national clinical audit of orthognathic acceptance criteria and information provided to orthognathic patients before treatment.

Design:

National clinical audit.

Setting:

Data collected using Bristol Online Surveys.

Participants:

Sixty-nine UK hospital orthodontic departments submitted data.

Methods:

Data were collected at two time points using Bristol Online Surveys over a period of 12 months. These were before treatment at the first multidisciplinary clinic (MDT) and immediately after surgery. The data collected included: Index of Orthognathic Functional Treatment Need (IOFTN); Index of Orthodontic Treatment Need (IOTN); age; previous orthodontic treatment; attendance at an MDT; treatment times; and information provision.

Results:

Eighty-five units agreed to take part in the audit with 69 submitting data, giving a response rate of 81%. The data from 3404 patients were uploaded, 2263 before treatment and 1141 immediately after surgery. Of patients, 91.07% had an IOFTN score of 4 or 5 and 88.73% had an IOTN score of 4 or 5. The mean age at the first MDT was 22 years in the first cohort and 21 years and 4 months in the second immediate post-surgery cohort. Of patients, 37.93% had undergone some form of previous orthodontic treatment, but only 0.28% had undergone previous orthognathic treatment; 96.93% had an MDT confirm that orthodontic treatment by itself was insufficient to adequately correct their functional symptoms. The average treatment time from bond up to surgery was 2 years and 6 months. With respect to information provision, patients received information from a number of sources, principally the British Orthodontic Society (BOS) patient information leaflets and the BOS website Your Jaw Surgery.

Conclusions:

In the UK, the majority of orthognathic cases fulfil the criteria for acceptance for NHS-funded orthognathic treatment, as outlined by the Chief Dental Officer’s interim guidance on orthognathic treatment. This suggests any prior approval process would not be a good use of NHS resources in the commissioning of orthognathic treatment.
First-Year College Students’ Behaviors and Characteristics of Those Who Stay and Those Who Go
Authors: Griffin Alice , Johnson Kelly V. , Jogan Kathi
Published: October 2019

This study examined the differences between first-year students who continued to Year 2 and first-year students who did not return to the second year at a mid-size, public, research university in the mid-south. The study utilized the National Survey of Student Engagement to compare the level of student–faculty interaction, experiences with the campus environment, and engagement in collaborative learning. Differences in the student engagement behaviors were examined by gender, race/ethnicity, and if the student was a first-generation college student. The participants included 1,402 first-year college students. Analysis revealed that those students who continued to Year 2 had significantly higher engagement in collaborative learning scores during their first year. However, female returners reported less faculty interaction than female nonreturners. Caucasian students who continued rated experiences with the campus environment and engagement in collaborative learning higher than those who did not continue to Year 2.
Use of Data Analytics in Supporting the Advising of Undecided Students
Authors: Wang Rong , Orr James E.
Published: October 2019

Higher education institutions have prioritized supporting undecided students with their major and career decisions for decades. This study used a U.S. public research-focused university’s large-scale institutional data set and undecided student’s retention and graduation rate predictors to demonstrate how to couple student and institutional data with predictive analytics to understand the different demographics, academic characteristics, and the number of major changes between undecided and decided students. This study helps practitioners take the first step in using data analytics to inform decision-making in academic advising and supporting undecided students’ academic success.
Investigating the electromagnetic wave-absorbing capacity and mechanical properties of flexible radar-absorbing knitted compound materials
Authors: Chen Niuniu , Wei Sainan , Shi Bao , Yan Ruosi , Li Xianghong , Zhan Tianhang
Published: October 2019

This study fabricated flexible radar-absorbing knitted compound materials by weft knitting and blending ferromagnetic nickel micron-fibers and cotton fiber into structures with a concave–convex surface, including rhombic, mat, wavy, and leno stitches. The electromagnetic wave-absorbing capability and mechanical properties of the flexible radar-absorbing knitted compound materials were evaluated. The results showed that the rhombic, mat, and wavy stitches displayed high mechanical properties with high bursting strength and there were no significant differences among them. The rhombic stitch flexible radar-absorbing knitted compound material with a ferromagnetic nickel micron-fiber content of 14% had a maximum bandwidth of 13 GHz and achieved a minimum reflectance of −20 dB at 7 GHz, which was 150% that of mat fabric, and 200% that of wavy fabric and leno fabric. This was ascribed to the fact that the concave–convex surface with regular diamond-shaped block improved the dispersion of the electromagnetic wave, weakened the wave strength, and increased the interference. Therefore, the rhombic stitch flexible radar-absorbing knitted compound material was the most suitable for flexible radar-absorbing material in this study. The development of flexible radar-absorbing materials, by combining aerospace technology, military technology and textile technology, is important for the application in stealth of aircraft and weapons.
The Possible Role of PD-1 Protein in Ganoderma lucidum–Mediated Immunomodulation and Cancer Treatment
Authors: Wang Gan , Wang Le , Zhou Jianlong , Xu Xiaoxin
Published: October 2019

Background: Ganoderma lucidum has been used in Chinese medicine for thousands years to improve health and to promote longevity. One important function of G lucidum is to modulate the immune system. However, the underlying mechanism is not well understood. Programmed cell death protein 1 (PD-1) is a cell surface protein present in certain immune cells ( eg, B- and Tcells) and plays an important role in modulating the immune response. The role of PD-1 protein in G lucidum–mediated immunomodulation is unknown. Methods: Cultured human Blymphocytes and extract prepared from G lucidum spores (GLE) were used to determine PD-1 protein in G lucidum–mediated immunomodulation. Both western blotting and immunofluorescence (IF) microscopy assays were used to determine the effect of GLE treatment on PD-1 protein expression. A reverse transcription-based quantitative polymerase chain reaction (real-time PCR) assay was used to determine the effect of GLE on transcription of pdcd-1 gene. Results: Both our western blotting and IF staining results demonstrated great reduction in PD-1 protein and in proportion of PD-1+ cells in these B-lymphocytes. Our real-time PCR results indicated that this PD-1 protein reduction was not caused by a transcriptional inhibition of the gene. In addition, our western blotting study further revealed that the GLE treatment caused an increase in expression of CCL5 chemokine in the cultured B-lymphocytes. Conclusions: PD-1 protein is an important target of G lucidum–mediated immunomodulation. G lucidum and its bioactive compounds can be developed into novel immunomodulators for prevention and treatment of cancer and many other diseases.
Two- to five-year follow-up of 78 patients after treatment with the Flow Redirection Endoluminal Device
Authors: Luecking Hannes , Doerfler Arnd , Goelitz Philipp , Hoelter Philip , Engelhorn Tobias , Lang Stefan
Published: October 2019

Background and purpose

Flow-diverter stents are well-established for the treatment of cerebral aneurysms. Flow Redirection Endoluminal Device differs from other flow-diverter stents by its dual-layer design and has proved equality to other devices in numerous short-term surveys. However, follow-up data covering substantially more than one year are still limited for this device. We present our long-term experience with Flow Redirection Endoluminal Device.

Materials and methods

Seventy-eight patients harboring distal internal carotid artery (91%) or vertebrobasilar (9%) cerebral aneurysms treated with Flow Redirection Endoluminal Device with or without adjunctive coiling met the inclusion criteria. All cases were evaluated for aneurysm occlusion (according to Modified Raymond Roy Classification, MRRC), for flow-diverter stents patency and configuration and for procedure- and device-related morbidity and mortality.

Results

Mean follow-up interval was 36.9 ± 9.5 months (<30 months: n = 18; 31–42 months: n = 31; >42 months: n = 24). Total and subtotal aneurysm occlusion after six months was assessed in 92.0% (MRRC1 = 77.3%, MRRC2 = 14.7%, MRRC3a =2.7%, MRRC3b = 4.1%) and increased to 95.9% (MRRC1 = 90.5%, MRRC2 = 5.4%, MRRC3a = 2.7%). There was one case of aneurysm growth requiring early re-treatment. Procedure-related morbidity was observed in three cases (3.8%; one transient hemiparesis, one suspected foreign-body reaction, and one micro-wire perforation). There was no procedure- or device-related mortality. In-stent stenosis due to intimal hyperplasia was observed in two cases and fish-mouthing in three cases.

Conclusions

Our long-term data covering two to five years after flow diversion confirm that Flow Redirection Endoluminal Device is a safe and effective device for the treatment of cerebral aneurysms with progressive high aneurysm occlusion rates; recurrence rates were very low. Overall device-related morbidity was low and was not observed later than six months after intervention.
Endovascular preoperative embolization for temporomandibular joint replacement surgery
Authors: Santillan Alejandro , Hee Sur Min , Schwarz Justin , Easthausen Imaani , Behrman David A , Patsalides Athos
Published: October 2019

Background and purpose

This retrospective study evaluates the safety and effectiveness of preoperative endovascular embolization in patients who underwent temporomandibular joint (TMJ) replacement surgery.

Material and methods

We included all patients treated with preoperative embolization of the internal maxillary artery (IMAX) between June 2016 and January 2019. All patients were treated by the same surgeon using standard surgical approaches and procedures. Periprocedural adverse events, blood loss during surgery and clinical follow-up are reported.

Results

Fourteen patients (12 females, median age 32.5) were treated with 21 embolizations of the IMAX (bilateral embolizations in seven patients) prior to TMJ replacement surgery with prosthetic joints (TMJ Concepts prostheses). Seven patients presented with TMJ ankylosis/degenerative joint disease/post-trauma deformity, four patients with Idiopathic Condylar Resorption and resultant mandibular displacement/hypoplasia, two patients with rheumatoid arthritis-associated condylar degeneration and resultant loss of mandibular position, and 1 patient being re-reconstructed following management of a prosthetic joint infection. Seven patients underwent bilateral prosthetic joint replacement. Four patients underwent additional facial skeletal surgery as part of their treatment. The mean blood volume loss during TMJ surgery was approximately 370 cc (range 100–800 cc). Joint space-specific blood loss was not recorded, but, as per the surgical team, was significantly decreased when compared to non-embolized patients. There were no intra-procedural complications. The median clinical follow-up was 3.5 months (range 1–24 months). The modified Rankin scale (mRS) was 0 before the procedure and at last clinical follow-up in all patients. After TMJ surgery, three patients reported paresthesia of the trigeminal nerve likely related to the residual condyle resection and two patients had mild facial nerve weakness (Temporal and/or Marginal Mandibular branch) related to the surgical exposures.

Conclusion

Endovascular preoperative embolization of the IMAX is feasible, safe and likely effective in reducing blood volume loss in complex TMJ replacement surgery.
Cyclophilin A and matrix metalloproteinase-9: Their relationship, association with, and diagnostic relevance in stable coronary artery disease
Authors: Ebrahim Hala F , Abdel Hamid Fatma F , Haykal Mohamed A , Soliman Ahmed F
Published: October 2019

Objectives

Data about the circulating levels of cyclophilin A and matrix metalloproteinase-9 in stable coronary artery disease are contradictory. Moreover, their relationship in this disease is not established yet. Thus, this study was designed to assess the relationship between the circulating levels of cyclophilin A and matrix metalloproteinase-9 in coronary artery disease patients with and without type 2 diabetes mellitus (T2DM).

Methods

Serum levels of cyclophilin A, matrix metalloproteinase-9, and high sensitive C-reactive protein (hsCRP) along with fasting blood glucose, glycated hemoglobin, serum lipids, and the anthropometric parameters were measured in 120 participants who were divided equally into four groups (i) normal controls, (ii) T2DM patients, (iii) stable coronary artery disease patients with T2DM, and (iv) stable coronary artery disease patients without T2DM.

Results

Levels of cyclophilin A and matrix metalloproteinase-9 were significantly elevated in sera of coronary artery disease patients with and without T2DM compared to normal controls and T2DM patients. In multiple linear regression models, only cyclophilin A was observed in the final model where it explained the 24.9% variability of matrix metalloproteinase-9. Additionally, high circulating levels of cyclophilin A and matrix metalloproteinase-9 were associated with an increased risk of developing stable coronary artery disease. Finally, the diagnostic efficacy of cyclophilin A and matrix metalloproteinase-9 to discriminate stable coronary artery disease patients with and without T2DM from subjects without coronary artery disease was found to be higher than that of hsCRP.

Conclusion

Serum level of cyclophilin A might be a determinant factor of matrix metalloproteinase-9 level; both may contribute to the pathogenesis of stable coronary artery disease and they appear to be valuable diagnostic biomarkers of stable coronary artery disease with and without T2DM.
Preferred options and evidence for upper limb surgery for spasticity in cerebral palsy, stroke, and brain injury
Authors: Tranchida Geneva V. , Van Heest Ann
Published: October 2019

Surgical interventions for the spastic upper extremity secondary to stroke, traumatic brain injury, and cerebral palsy aim to correct the common deformities of elbow flexion, forearm pronation, wrist and finger flexion, ulnar deviation, and thumb-in-palm deformity. After appropriate evaluation, as well as determining the goals of surgery, deformity correction can be achieved through single-event, multi-level surgery. Surgery includes a combination of soft tissue lengthening, tendon transfer, and joint stabilization procedures. Surgical treatment for shoulder adduction/internal rotation, elbow flexion, forearm pronation, wrist flexion, thumb-in-palm, and clenched fist deformities due to spasticity are discussed, and treatment outcomes are reviewed.
Restless legs syndrome
Authors: West Robert
Published: October 2019

Restless legs syndrome is a common, often debilitating disorder, which is under-recognised and under-diagnosed. Patients typically describe an uncomfortable urge to move their legs, this occurs mainly at night. It often has a significant impact on the quality of sleep, and hence, daily functioning. The pathophysiology of the disorder is well known, it relates to iron depletion and dopaminergic receptors in the brain, and this has aided the development of effective treatment. This article will cover the recognition, pathophysiology and management of the condition.
The impact of the Article 50 talks on the EU: Risk aversion and the prospects for further EU disintegration
Authors: Glencross Andrew
Published: October 2019

This article explores why there was no domino effect after Brexit and reflects on what this means for the health of European integration. It shows how the UK responded to the uncertainty surrounding the Article 50 talks by testing EU unity, prompting both sides to discuss a no-deal outcome. Evidence from Eurobarometer surveys demonstrates that attachment to the EU strengthened markedly during Brexit talks in the four countries considered most likely to flirt with leaving the EU. Hence Brexit changed the benchmarking process surrounding citizens’ evaluation of the prospects of getting a better deal outside the EU. Risk aversion thus explains the lack of a Brexit domino effect. However, the volatility of public opinion before and after the Article 50 talks, combined with the weaker increase in support over the EU as a whole, means there is no room for complacency over the future prospects of disintegration.
Effectiveness of a strategic energy reserve during the energy transition: The case of Switzerland
Authors: van Baal Paul Adrianus
Published: October 2019

Switzerland is considering implementing a strategic energy reserve, a novel policy instrument that remunerates power plant operators for storing a minimum amount of energy in reservoirs to convert into electricity when called upon. The policy is envisioned for the winter period, when the country’s large hydropower reservoirs tend to be nearly depleted. This study analyzes the impact of such a strategic energy reserve on security of supply, consumer costs, international trade, and sustainability. A hybrid simulation model is developed that combines agent-based modeling and system dynamics. The simulations show that the reserve can improve short-term security of supply but does not improve long-term security of supply as it does not impact domestic investments or reduce the import dependency in winter. The reserve leads to a slight increase in consumer costs, even when including the reduction in outage costs. A larger reserve is more effective at reducing the supply risk but is proportionally costly. Lastly, we find that the policy induces scarcity periods that would not have occurred otherwise, which means that the reserve should have a high strike price to ensure it is only called upon as a last resort. We conclude that there is no structural need for a strategic energy reserve, as it only increases short-term security of supply and does not contribute to solving the structural problem. Any implementation should be done on an ad hoc basis, conditional on a short-term generation adequacy assessment. This has the potential to minimize the associated costs while maximizing the benefits.
Antitumor Effects of MRS5698, a Cordycepin Derivative, on Endometrial Cancer Cells
Authors: Fong Pedro , Loi Cheng-I , U Wan-Fong , Choi Chou-I , Yi Tao , Meng Li-Rong
Published: October 2019

Endometrial cancer drug treatments often produce undesirable effects. Thus, discovering new drugs with fewer side effects is required. Cordycepin is a constituent of Cordyceps sinensis, which has been proven to inhibit tumor growth by stimulating the adenosine A3 receptor (A3R). However, cordycepin is rapidly degraded by adenosine deaminase (ADA) and has a clinically unacceptable short half-life. One of its derivatives, MRS5698, was predicted to exhibit antitumor effects with a poor affinity to ADA by our previous validated in silico experiments. The purpose of this study was to explore the possibilities of using MRS5698 as a novel antitumor agent through experiments on Ishikawa and HEC-1A cells. The detection of inhibition and apoptotic rate of MRS5698 and cisplatin, and their combination, on Ishikawa and HEC-1A cells were performed by MTT assays and flow cytometry, respectively. The inhibition rates of MRS5698 on Ishikawa and HEC-1A cells were both significantly higher than the control groups ( P < 0.05). MRS5698 produced a higher inhibitory effect on HEC-1A cells than on Ishikawa cells with IC50 values of 20.55 and 27.25 μg/mL, respectively. MRS5698 had a stronger inhibitory effect than cisplatin on HEC-1A cells. The Annexin V-FITC/propidium iodide assays demonstrated that the total rate of apoptosis of MRS5698 on HEC-1A cells was higher than that on Ishikawa cells. The results of MTT assay and cellular apoptosis showed that the combined use of MRS5698 and cisplatin produces dose-independent antagonistic effects. MRS5698 produced antitumor effects on both cell lines, which were better than that of cordycepin. However, the combined use of MRS5698 and cisplatin produced an antagonistic effect. A further in vivo study could be considered for investigating the antitumor effects of either MRS5698 monotherapy or MRS5698 in combination with other nonplatinum-based chemotherapeutic drugs in treating endometrial cancer.
Framework Decision 2008/909/JHA on the transfer of prisoners in the EU: Advances and challenges in light of the Italian experience
Authors: Montaldo Stefano
Published: October 2019

The article addresses the implementation of Framework Decision 2008/909/JHA on the transfer of prisoners in the European Union (EU) and discusses its advances and shortcomings from a twofold perspective: the general features and objectives underpinning the Framework Decision and how these theoretical premises have been put into practice by domestic authorities. First, the article discusses the state of the art of the implementation of this mechanism in Italy and provides relevant data. Second, it addresses the main strategies enacted in Italy by the judiciary, the legislature and the executive power to maximise the impact of the national implementing laws. The analysis demonstrates that these efforts are mainly intended to dispose of unwanted EU citizens and to cope with prison overcrowding, thereby marking a clear departure from the rationale of the Framework Decision. Third, the article focuses on the recurring challenges regarding horizontal cooperation between domestic judicial authorities, with a specific focus on the division of competences between the issuing and the executing authorities in light of the EU and the Italian case law. The article supports the view that the Italian case study can represent a test bed for future quantitative and qualitative improvements in the implementation of this Framework Decision at the EU level.
Deferasirox in thalassemia: a comparative study between an innovator drug and its copy among a sample of Iraqi patients
Authors: Daher Aqil M. , Al-Momen Hayder , Jasim Shaymaa Kadhim
Published: October 2019

Background:

The health care industry is witnessing an increasing trend in the use of generic medicines because of their presumed low cost compared with innovator medicines. The aim of this study was to determine and compare the performance of the copy drug Osveral® and its innovator drug deferasirox (Exjade®).

Methods:

A prospective observational study including 223 patients receiving the branded medicine Exjade® and 101 patients receiving the copy Osveral® was carried out. Data were assessed for a 1-year period and included clinical symptoms, serum ferritin (SF), serum creatinine (SC), and alanine aminotransferase (ALT). Data were analyzed with SPSS version 22 software (SPSS, Chicago, IL, USA).

Results:

The median age of the sample was 8 years. There was no significant difference in gender distribution between the two groups ( p = 0.625). Nausea was the most frequently reported adverse effect followed by diarrhea and abdominal pain in both groups. Patients receiving Exjade® had a higher relative reduction of SF at the end of the study compared with the Osveral® group (19.9% versus 9.93%, p = 0.028). SC was found to be significantly higher in the Osveral® group than in the Exjade® group throughout the study period. The mean platelet count was higher in the Exjade® group. ALT was significantly higher among patients receiving Osveral® over the last three months of the study.

Conclusions:

Exjade® showed a better ability to reduce SF, with less liver toxicity, and better hemostasis profile. No congenital anomalies associated with short-term use of both drugs during pregnancy were observed or reported.
Re-thinking Digital Health: Data, Appisation and the (im)possibility of ‘Opting out’
Authors: Kuntsman Adi , Miyake Esperanza , Martin Sam
Published: October 2019

Presented as providing cost-, time- and labour- effective tools for the (self)management of health, health apps are often celebrated as beneficial to all. However, their negative effects – commodification of user data and infringement on privacy – are rarely addressed. This article focuses on one particularly troubling aspect: the difficulty of opting out of data sharing and aggregation during app use or after unsubscribing/uninstalling the app. Working in the context of the new European General Data Protection Regulation and its implementation in the UK health services, our analysis reveals the discrepancy between the information presented to users, and the apps’ actual handling of user data. We also point to the fundamental tension in the digitisation of health, between the neoliberal model where both health and data concerns are viewed as an individual’s responsibility, and the digital-capitalist model, which puts forward, and capitalises on, collective (‘Big’) data. Pulled between the ‘biopolitics of the self’ and the ‘biopolitics of the population’ (concepts coined by Btihaj Ajana), opting out of health datafication therefore cannot be resolved as a matter of individual right alone. The article offers two contributions. Methodologically, we present a toolkit for a multi-level assessment of apps from the perspective of opting out, which can be adapted and used in future research. Conceptually, the article brings together critical digital health scholarship with the perspective of data justice, offering a new approach to health apps, which focuses on opt-out as a legal, social and technical possibility, and as a collective citizen and user right.
The nationalization process and formation of Shuitian Yi ethnicity during Ming and Qing: A case study of the Yi ethnic group in Bailu Ying, Mianning County, Sichuan
Authors: Long Sheng
Published: October 2019

This study explores the question of how ethnic groups were assimilated by the Imperial State to be placed under the administration of the central government and how their ethnicity changed during this process of nationalization. This paper studies the case of the Yi ethnic group in Bailu Ying of Mianning county, Sichuan Province in China. The ancestors of Yi people in Bailu Ying lived on Mount Daliang before the Wanli reign of the Ming Dynasty. In the early period of the Ming Dynasty, the government had set up Ningfan Garrison on the river valley on the west side of Mount Daliang. By the late Wanli Period, the garrison was consistently being attacked by the indigenous people in the area. In order to quell the resistance, the Imperial Court recruited Yi people as soldiers to guard the garrison. Afterwards, a new settlement of the Yi tribe in the Bailu Ying River valley emerged, and in the process the Yi people’s livelihood was transformed from herding and fishing to agriculture. In the early Qing, the Yi people in Bailu Ying were further integrated into the Imperial system with the inclusion of chieftains in the imperial governing body. However, up until the later years of the Qianlong reign, the Yi maintained relative autonomy in terms of its tribal settlement, power structure and cultural integrity. Later, with the arrival of new Han migrants, the introduction of the Baojia system, and the promotion of Han culture and education, the Yi group in Bailu Ying gradually lost its independence and began to be assimilated into the national identity, leading to the formation of Shuitian (rice field) Yi ethnicity.

The case of the Shuitian Yi shows that the survival strategy of tribal minorities from the mountains did not necessarily follow the pattern of ‘avoiding becoming part of empires’, as suggested by James C. Scott, nor were these ethnic people always slow and passive in integrating with empires. On the contrary, the acceptance of the imperial rule was a survival strategy that helped to creating new ethnic groups while also consolidating frontiers for the Ming and Qing Empires.
Prospective Evaluation of Range of Motion in Acute ACL Reconstruction Using Patellar Tendon Autograft
Authors: Harris Mitchell C. , Venrick Connor , Hines Adam C. , Cook Jay B. , Rowles Douglas J. , Tokish John M. , Bottoni Craig R.
Published: October 2019

Background:

Optimal timing of anterior cruciate ligament (ACL) reconstruction has been a topic of controversy. Reconstruction has historically been delayed for at least 3 weeks, given previous studies reporting a high risk of postoperative arthrofibrosis and suboptimal clinical results.

Purpose:

To prospectively evaluate postoperative range of motion following acutely reconstructed ACLs with patellar tendon autograft.

Study Design:

Case series; Level of evidence, 4.

Methods:

Patients (age >18 years) who had ACL reconstruction as soon as possible after injury, regardless of the condition or preoperative range of motion of the injured knee, underwent reconstruction with patellar tendon autograft. An identical standard surgical technique and postoperative rehabilitation were employed for all patients. Postoperative assessment included active range of motion measurements with a goniometer. Subjective outcomes were assessed with the Knee injury and Osteoarthritis Outcome Score (KOOS).

Results:

A total of 25 consecutive patients who met the inclusion criteria were enrolled. The mean age was 27.9 years (range, 20-48 years), and 19 were men. The time from injury to surgery was a mean 4.5 days (range, 1-9 days). The mean objective follow-up was 10.9 months (range, 3 days–19.4 months), and range of motion was regained at a mean 4.4 months (range, 1-9 months). Three meniscal repairs and 3 microfractures were performed concomitantly. There was 1 graft failure at 3 years postoperatively, noted at 50 months of subjective follow-up. There was no loss of extension >3° as compared with the contralateral knee in any patient. There was no loss of flexion >5° as compared with the contralateral knee in any patient who completed objective follow-up. The mean KOOS at final subjective follow-up was 82.8 (range, 57.7-98.8) at a mean 56.6 months postoperative (n = 14/24; range, 48-58 months).

Conclusion:

Excellent clinical results can be achieved following ACL reconstruction performed ≤9 days after injury with patellar tendon autograft. The authors found that early ACL reconstructions do not result in loss of motion or suboptimal clinical results as long as a rehabilitation protocol emphasizing extension and early range of motion is employed.