bluuebunny/crossref_metadata_2025 huggingface dataset:
Michigan Appropriate Perioperative (MAP) criteria for urinary catheter use in common general and orthopaedic surgeries: results obtained using the RAND/UCLA Appropriateness Method
Authors: Meddings Jennifer , Skolarus Ted A , Fowler Karen E , Bernstein Steven J , Dimick Justin B , Mann Jason D , Saint Sanjay
Published: August 2018

Background

Indwelling urinary catheters are commonly used for patients undergoing general and orthopaedic surgery. Despite infectious and non-infectious harms of urinary catheters, there is limited guidance available to surgery teams regarding appropriate perioperative catheter use.

Objective

Using the RAND Corporation/University of California Los Angeles (RAND/UCLA) Appropriateness Method, we assessed the appropriateness of indwelling urinary catheter placement and different timings of catheter removal for routine general and orthopaedic surgery procedures.

Methods

Two multidisciplinary panels consisting of 13 and 11 members (physicians and nurses) for general and orthopaedic surgery, respectively, reviewed the available literature regarding the impact of different perioperative catheter use strategies. Using a standardised, multiround rating process, the panels independently rated clinical scenarios (91 general surgery, 36 orthopaedic surgery) for urinary catheter placement and postoperative duration of use as appropriate (ie, benefits outweigh risks), inappropriate or of uncertain appropriateness.

Results

Appropriateness of catheter use varied by procedure, accounting for procedure-specific risks as well as expected procedure time and intravenous fluids. Procedural appropriateness ratings for catheters were summarised for clinical use into three groups: (1) can perform surgery without catheter; (2) use intraoperatively only, ideally remove before leaving the operating room; and (3) use intraoperatively and keep catheter until postoperative days 1–4. Specific recommendations were provided by procedure, with postoperative day 1 being appropriate for catheter removal for first voiding trial for many procedures.

Conclusion

We defined the appropriateness of indwelling urinary catheter use during and after common general and orthopaedic surgical procedures. These ratings may help reduce catheter-associated complications for patients undergoing these procedures.
Facilitators of interdepartmental quality improvement: a mixed-methods analysis of a collaborative to improve pediatric community-acquired pneumonia management
Authors: Leyenaar JoAnna K , Andrews Christine B , Tyksinski Emily R , Biondi Eric , Parikh Kavita , Ralston Shawn
Published: August 2018

Background

Emergency medicine and paediatric hospital medicine physicians each provide a portion of the initial clinical care for the majority of hospitalised children in the USA. While these disciplines share goals to increase quality of care, there are scant data describing their collaboration. Our national, multihospital learning collaborative, which aimed to increase narrow-spectrum antibiotic prescribing for paediatric community-acquired pneumonia, provided an opportunity to examine factors influencing the success of quality improvement efforts across these two clinical departments.

Objective

To identify barriers to and facilitators of interdepartmental quality improvement implementation, with a particular focus on increasing narrow-spectrum antibiotic use in the emergency department and inpatient settings for children hospitalised with pneumonia.

Methods

We used a mixed-methods design, analysing interviews, written reports and quality measures. To describe hospital characteristics and quality measures, we calculated medians/IQRs for continuous variables, frequencies for categorical variables and Pearson correlation coefficients. We conducted in-depth, semistructured interviews by phone with collaborative site leaders; interviews were transcribed verbatim and, with progress reports, analysed using a general inductive approach.

Results

47 US-based hospitals were included in this analysis. Qualitative analysis of 35 interview transcripts and 142 written reports yielded eight inter-related domains that facilitated successful interdepartmental quality improvement: (1) hospital leadership and support, (2) quality improvement champions, (3) evidence supporting the intervention, (4) national health system influences, (5) collaborative culture, (6) departments’ structure and resources, (7) quality improvement implementation strategies and (8) interdepartmental relationships.

Conclusions

The conceptual framework presented here may be used to identify hospitals’ strengths and potential barriers to successful implementation of quality improvement efforts across clinical departments.
Autoimmune hepatitis and complexities in management
Authors: Janmohamed Ashnila , Hirschfield Gideon M
Published: August 2018

Autoimmune hepatitis (AIH) is a rare heterogenous immune-mediated liver disease that for the majority has effective therapy, usually resulting in excellent prognosis. Treatment is based on immunosuppression using standard therapy with corticosteroids and azathioprine. Second-line therapeutic options exist for those who are non-responders (‘difficult to treat AIH’) or intolerant to standard therapy; however, their use is not standardised, and in addition, there is vast variation in practice and efficacy. Given the rarity of AIH, expertise in its management can be limited to large referral programmes. In this case-based review, we aim to discuss common clinical dilemmas encountered by clinicians managing adult patients with AIH and address the related competencies in the 2010 Gastroenterology curriculum.
Paternal age and the risk of low birth weight and preterm delivery: a Finnish register-based study
Authors: Goisis Alice , Remes Hanna , Barclay Kieron , Martikainen Pekka , Myrskylä Mikko
Published: August 2018

Background

Based on existing studies, there is no conclusive evidence as to whether and why paternal age matters for birth outcomes.

Methods

We used Finnish population registers on 106 652 children born 1987–2000. We first document the unadjusted association between paternal age and the risk of low birth weight (LBW; <2500 g) and preterm birth (<37 weeks’ gestation). Second, we investigate whether the unadjusted association is attenuated on adjustment for child’s, maternal and parental socioeconomic characteristics. Third, by adopting a within-family design which involves comparing children born to the same father at different ages, we additionally adjust for unobserved parental characteristics shared between siblings.

Results

The unadjusted results show that being born to a father aged 40+, as opposed to a father aged 30–34, is associated with an increased risk of LBW of 0.96% (95% CI 0.5% to 1.3%) and to a younger father (<25) with a 1% (95% CI 0.6% to 1.3%) increased risk. The increased risk at younger paternal ages is halved on adjustment for the child’s characteristics and fully attenuated on adjustment for child/parental characteristics. The increased risk at paternal ages 40+ is partially attenuated on adjustment for maternal characteristics (β=0.62%; 95% CI 0.13% to 1.1%). Adjustment for unobserved parental characteristics shared by siblings further attenuates the 40+ coefficient (β=0.4%; 95% CI −0.5% to −1.2%). Results for preterm delivery are similar.

Conclusions

The results underscore the importance of considering paternal age as a potential risk factor for adverse birth outcomes and of expanding research on its role and the mechanisms linking it to birth outcomes.
Surgery in patients with childhood-onset epilepsy: analysis of complications and predictive risk factors for a severely complicated course
Authors: d'Orio Piergiorgio , Rizzi Michele , Mariani Valeria , Pelliccia Veronica , Lo Russo Giorgio , Cardinale Francesco , Nichelatti Michele , Nobili Lino , Cossu Massimo
Published: August 2018

Object

To compare the occurrence of surgery-related complications in patients with childhood-onset focal epilepsy operated on in the paediatric or in the adult age. To investigate risk factors for surgery-related complications in the whole cohort, with special attention to age at surgery and severe morbidity.

Methods

A cohort of 1282 patients operated on for childhood-onset focal epilepsy was retrospectively analysed. Occurrence of surgery-related complications, including a severely complicated course (SCC: surgical complication requiring reoperation and/or permanent neurological deficit and/or death), was compared between patients operated on in the paediatric age (<16 year-old; 452 cases) and, respectively, in adulthood (≥16 year-old; 830 cases). The whole cohort of patients was also evaluated for risk factors for a SCC.

Results

At last contact (median follow-up 98 months), 74.5% of patients were in Engel’s class I (78.0% of children and 73.0% of adults). One hundred patients (7.8%) presented a SCC (6.4% for children and 8.6% for adult patients). Postoperative intracranial haemorrhages occurred more frequently in adult cases. At multivariate analysis, increasing age at operation, multilobar surgery, resections in the rolandic/perirolandic and in insulo-opercular regions were independent risk factors for a SCC.

Conclusions

Surgery for childhood-onset focal epilepsy provides excellent results on seizures and an acceptable safety profile at any age. Nevertheless, our results suggest that increasing age at surgery is associated with an increase in odds of developing severe surgery-related complications. These findings support the recommendation that children with drug-resistant, symptomatic (or presumed symptomatic) focal epilepsy should be referred for a surgical evaluation as early as possible after seizure onset.
The safety of triple antiplatelet therapy under thromboelastography guidance in patients undergoing stenting for ischemic cerebrovascular disease
Authors: Wu Zhonghua , Liu Ao-Fei , Zhou Ji , Zhang Yiqun , Wang Kai , Li Chen , Qiu Hancheng , Jiang Wei-Jian
Published: August 2018

Objective

To investigate the safety of triple antiplatelet therapy (TAT) with cilostazol in patients undergoing stenting for extracranial and/or intracranial artery stenosis.

Methods

A prospectively collected database was reviewed to identify patients who underwent stenting for extracranial and/or intracranial artery stenosis and showed resistance to aspirin and/or clopidogrel as assessed by pre-stenting thromboelastography (TEG) testing. Patients were assigned to a TAT group and a dual antiplatelet therapy (DAT) group. Major complications were defined as thromboembolic events (transient ischemic attack (TIA), ischemic stroke, and stent thrombosis) or major bleeding events within 30 days, and minor complications were defined as extracranial bleeding that did not require vascular surgery or transfusion within 30 days.

Results

A total of 183 patients were identified. The incidence of major complications was significantly lower in the TAT group than in the DAT group (TAT group vs. DAT group, 1/110 vs. 6/73; P=0.017). TIAs occurred in four patients, with one in the TAT group and three in the DAT group (1/110 vs. 3/73; P=0.303). Ischemic strokes occurred in three patients in the DAT group (TAT group vs. DAT group, P=0.062). No major bleeding events or stent thrombosis was recorded in either group. Two patients (one in each group) experienced minor complications that resolved without additional treatment (1/110 vs. 1/73; P>0.999).

Conclusions

TAT under TEG guidance appears to be a safe antiplatelet strategy in patients undergoing stenting for extracranial and/or intracranial artery stenosis. By employing TAT under TEG guidance, favorable outcomes can be achieved in these patients.
Treatment of pediatric intracranial aneurysms: case series and meta-analysis
Authors: Yasin Junaid T , Wallace Adam N , Madaelil Thomas P , Osbun Joshua W , Moran Christopher J , Cross Dewitte T , Limbrick David D , Zipfel Gregory J , Dacey Ralph G , Kansagra Akash P
Published: August 2018

Background

There are limited outcome data to guide the choice of treatment in pediatric patients with cerebral aneurysms.

Objective

To describe our institutional experience treating pediatric patients with cerebral aneurysms and to conduct a meta-analysis of available studies to provide the best current evidence on treatment related outcomes.

Methods

We identified pediatric patients with cerebral aneurysms evaluated or treated at our institution using a comprehensive case log. We also identified studies to include in a meta-analysis through a systematic search of Pubmed, SCOPUS, EMBASE, and the Cochrane Database of Systematic Reviews. As part of both the local analysis and meta-analysis, we recorded patient characteristics, aneurysm characteristics, management, and outcomes. Statistical analysis was performed using Fisher’s exact test and the two tailed Student’s t test, as appropriate.

Results

42 pediatric patients with 57 aneurysms were evaluated at our institution, and treatment specific outcome data were available in 560 patients as part of our meta-analysis. Endovascular and surgical treatments yielded comparable rates of favorable outcome in all children (88.3% vs 82.7%, respectively, P=0.097), in children with ruptured aneurysms (75% vs 83%, respectively, P=0.357), and in children with unruptured aneurysms (96% vs 97%, respectively, P=1.000).

Conclusion

Endovascular and surgical treatment yield comparable long term clinical outcomes in pediatric patients with cerebral aneurysms.
Cingulate gyrus epilepsy
Authors: Powell Rob , Elwes Robert , Hamandi Khalid , Mullatti Nandini
Published: August 2018

The cingulate gyrus is located above the corpus callosum and forms part of the limbic system. Cingulate gyrus epilepsy poses a diagnostic challenge, given its diverse and variable seizure semiology. We present two patients with seizures arising in the cingulate gyrus that highlight the electroclinical and imaging features of this rare form of epilepsy. Cingulate seizures can give a wide range of clinical manifestations, which relate to the underlying neuroanatomy and subdivisions of the cingulate cortex. Here, we review the semiology of cingulate epilepsy and how this relates to the location of seizure onset and patterns of propagation.
CT-derived muscle remodelling after bronchoscopic lung volume reduction in advanced emphysema
Authors: Sanders Karin J C , Klooster Karin , Vanfleteren Lowie E G W , Slebos Dirk-Jan , Schols Annemie M W J
Published: August 2018

Muscle wasting frequently occurs in severe emphysema. Improving respiratory mechanics by bronchoscopic lung volume reduction using endobronchial valves (EBV) might prevent further loss or even increase in muscle mass. CT-derived skeletal muscle mass gain was observed in 39/49 patients 6 months after EBV. Multiple linear regression showed that gain in muscle (β=2.4; 95% CI 0.2 to 4.6; p=0.036) and intramuscular fat (β=3.1; 95% CI 0.2 to 5.9; p=0.035) is associated with improved 6 min walk distance independent of the change in residual volume. Skeletal muscle remodelling associates with improved exercise capacity after EBV, independent of hyperinflation reduction.

Trial registration number

Clinical trial registered with the Dutch trial register www.trialregister.nl (NTR2876), Results.
A perspective on the magnetism of alkanethiol-coated gold thin films
Authors: Dong Pengcheng , Trudel Simon
Published: August 2018

Intriguing ferromagnetic behaviour has been reported in gold thin films — a diamagnetic material in the bulk — wherein large magnetic moments and uncommon anisotropy are often hallmark features. The tuning of the electronic and magnetic properties by the presence of molecular self-assembled monolayers has been proposed. In this work, we present the study of the magnetism of a wide collection of alkanethiols of differing chain lengths coated on Au. We find no or only very weak magnetism, casting doubt on the universality and reproducibility of this phenomenon.
Vibration Modes and Parameter Analysis of V‐Shaped Electrothermal Microactuators
Authors: Zhang Zhuo , Yu Yueqing , Zhang Xuping
Published: August 2018

Comprehensive analysis on the modal characteristics of V‐shaped electrothermal microactuators is presented in this paper for the first time. Considering the unique geometric characteristics of the V‐shaped beam, that is, two inclined beams supporting a movable shuttle, both the lateral and longitudinal deflections are taken into account in the modal analysis. Boundary and continuity conditions are employed to obtain the frequency equation. Natural frequencies are then obtained by solving the frequency equation. Mode shapes corresponding to their natural frequencies are also calculated analytically. The theoretical modal analysis is verified with the finite element analysis using ANSYS software. Based on the model analysis, this paper further investigates the relationship between natural frequencies and the volume scaling of the V‐shaped beam. Finally, comprehensive parametric studies in terms of material properties and structural dimensions are conducted to provide insights and guidance in designing the V‐shaped beam electrothermal microactuators.
Epidemiology and Etiology of Acute Pancreatitis in Urban and Suburban Areas in Shanghai: A Retrospective Study
Authors: Fan Junjie , Ding Ling , Lu Yingying , Zheng Junyuan , Zeng Yue , Huang Chunlan
Published: August 2018

Aim. To investigate the epidemiology, etiology, and severity of acute pancreatitis (AP) in urban and suburban areas of Shanghai in 2011 and 2016. Methods. A retrospective study of patients admitted to Shanghai General Hospital (urban and suburban campuses) with AP in 2011 and 2016 was undertaken. Patients were divided into acute biliary pancreatitis (ABP), hypertriglyceridemic pancreatitis (HTGP), alcoholic pancreatitis, and pancreatitis of other causes according to etiology. Severity of AP was divided into mild AP (MAP), moderately severe AP (MSAP), and severe AP (SAP). Results. AP patients in the suburban area increased more rapidly than those in the urban area. The mean onset age of AP in the urban area in 2016 was older than that in the suburban area (p<0.05). The suburban patients in 2016 have significantly younger mean onset age than those in 2011 (p<0.05). HTGP incidence in suburban patients increased from 2011 to 2016, which changed little in the urban area. Urban females were more likely to develop HTGP than suburban ones in 2011, which reversed in 2016. As to the male patients, the incidence of HTGP increased in both urban and suburban areas. Nonelderly (<60 years old) patients had higher HTGP incidence than elderly ones in both 2011 and 2016. The descending trend of SAP in the suburban area was more obvious than that in the urban area. The length of hospitalization decreased from 2011 to 2016, especially in SAP patients. Conclusions. AP patients increased more rapidly in the suburban area of Shanghai with younger onset age. The incidence of HTGP increased significantly in the suburban area, reminding of the prevention and screening of HTG.
Characteristics and Determinants of Patients Discontinuation of Breast Cancer Follow-Up Care at the Radiation Oncology Department, University College Hospital, Ibadan, Nigeria
Authors: Dairo M. D. , Adamu D. B. , Onimode Y. A. , Ntekim A. , Ayeni O.
Published: August 2018

Objectives. The aim of this study is to describe the characteristics and predictors of discontinuation during follow-up care among breast cancer patients at the Radiation Oncology Department, University College Hospital (UCH), Ibadan, Nigeria.Methodology. This is a retrospective cross-sectional study of 504 patients with histological diagnosis of breast cancer referred for radiotherapy to the breast or chest wall. Data extraction form was used to obtain information on sociodemographic and disease related variables and time to discontinuation of care. Discontinuation rates and its predictors were estimated using Kaplan-Meier, Log rank test, and Cox’s regression method of analyses.Results. Five hundred and four breast cancer patients were studied. The mean age was 47.7years, 58.2% presented late with advanced stage disease, and 40% and 39% had metastasis and anaemia, respectively. Seventy-seven percent of patients discontinued follow-up care before completion of ten-year period. The 5-year and 10-year discontinuation rates were 69.8% and 92.6%, respectively. The median discontinuation time was 44 months. Discontinuers were more likely to be older than the age of 45yearsHR=1.415; 95% CI= 1.044 - 1.917, have metastasisHR=1.793; 95% CI=1.396 - 2.302, be anaemicHR=1.404; 95% CI = 1.120 - 1.760), and have late-stage diseaseHR=1.310; 95% CI = 1.407-1.639).Conclusion. Breast cancer care discontinuation is associated with late presentation and advanced stage of disease. Therefore a system of community follow-up care and public awareness about breast cancer symptoms is recommended to reduce late presentation and discontinuity of care.
A Rare Case of Spontaneous Cardiac Tamponade Induced by Concomitant Use of Rivaroxaban and Amiodarone
Authors: Oladiran Oreoluwa , Segal Jared , Nwosu Ifeanyi , Nazir Salik
Published: August 2018

Rivaroxaban is a direct oral anticoagulant (DOAC) approved as an important alternative to warfarin in patients with nonvalvular atrial fibrillation. We report the case of an 87-year-old man with past medical history of nonvalvular atrial fibrillation on rivaroxaban and recently started amiodarone for pulseless ventricular tachycardia who presented to our hospital with intermittent chest pain and was diagnosed with spontaneous hemopericardium causing cardiac tamponade. The culprit drugs were discontinued, and the patient was treated with emergent pericardiocentesis. Both rivaroxaban and amiodarone are substrates for the CYP3A4 hepatic pathway, and concomitant use can result in increased plasma rivaroxaban levels causing an increased propensity to bleeding. While most physicians are cognizant of the need for renal dosing of rivaroxaban, this article aims to increase awareness of its interactions with drugs that are also metabolized through the same hepatic CYP450 pathway.
Effect of Freezing on the Shelf Life of Salmon
Authors: Dawson Paul , Al-Jeddawi Wesam , Remington Nanne
Published: August 2018

Food shelf-life extension is important not only to food manufacturers, but also to home refrigeration/freezing appliance companies, whose products affect food quality and food waste. While freezing and refrigerating both extend the shelf life of foods, food quality deterioration continues regardless of the preservation method. This review article discusses the global fish market, the composition of fish meat, and the effects of freezing and thawing on salmon quality.
Diabetic Myonecrosis: A Diagnostic and Treatment Challenge in Longstanding Diabetes
Authors: Lawrence Lima , Tovar-Camargo Oscar , Lansang M. Cecilia , Makin Vinni
Published: August 2018

Objective. Diabetes mellitus is associated with microvascular and macrovascular complications; the most commonly recognized ones include diabetic nephropathy, retinopathy, and neuropathy. Less well-known complications are equally important, as timely recognition and treatment are essential to decrease short- and long-term morbidity. Methods. Herein, we describe a case of a 41-year-old female with longstanding, uncontrolled type 2 diabetes, who presented with classical findings of diabetic myonecrosis. Results. Our patient underwent extensive laboratory and imaging studies prior to diagnosis due to its rarity and similarity in presentation with other commonly noted musculoskeletal conditions. We emphasize the clinical presentation, laboratory and imaging findings, treatment regimen, and prognosis associated with diabetic myonecrosis. Conclusion. Diabetic myonecrosis is a rare complication of longstanding, poorly controlled diabetes mellitus. The diagnosis requires a high index of suspicion in the right clinical setting: acute onset nontraumatic muscular pain with associated findings on clinical exam, laboratory studies, and imaging. While the short-term prognosis is good, the recurrence rate remains high and long-term prognosis is poor given underlying uncontrolled diabetes and associated sequelae.
Type I/II Interferon in HIV-1-Infected Patients: Expression in Gut Mucosa and in Peripheral Blood Mononuclear Cells and Its Modification upon Probiotic Supplementation
Authors: Pinacchio Claudia , Scheri Giuseppe Corano , Statzu Maura , Santinelli Letizia , Ceccarelli Giancarlo , Innocenti Giuseppe Pietro , Vullo Vincenzo , Antonelli Guido , Brenchley Jason M. , d’Ettorre Gabriella , Scagnolari Carolina
Published: August 2018

Expression of type I and II interferon (IFN) was evaluated in gut-associated lymphoid tissue (GALT) and peripheral blood mononuclear cells (PBMCs) of HIV-1-positive patients on long-term, suppressive, antiretroviral therapy before and after probiotic supplementation. IFNα subtypes and IFNβ were expressed at higher levels in GALT compared to PBMC, whereas an opposite trend of expression was recorded for IFNγ. An increase of IFNα6, IFNα10, IFNα14, IFNα17, and IFNα21 and a decrease of IFNγ were observed in both anatomical sites after probiotic supplementation.
Smart Care Beds for Elderly Patients with Impaired Mobility
Authors: Hong Youn-Sik
Published: August 2018

Most accidents occurring at medical institutions treating elderly patients with mobility impairment are bedsores and fall accidents. One of the reasons for this high rate of accidents is the lack of nursing personnel. In order to aid caregivers in nursing elderly patients who are not able to move about freely, in this paper, we propose a design and implementation of a smart bed. In this bed, several pressure sensors are deployed underneath the mattress cover to consider both peoples’ standard physical characteristics and the specific body parts where bedsores commonly occur. To manage the pressure ulcer area and to prevent falls, the body area is divided into three vertical areas and three horizontal areas. Each microcontroller unit manages pressure‐sensing information in one of the body regions divided horizontally. In this study, a real‐time pressure‐sensing algorithm is presented that is capable of deciding on the possibilities of bedsores and falling accidents by considering both the intensity and the duration of pressure of specific body parts. Our experimental results demonstrate that a prototype smart bed works well for several human models of various heights and weights.
Fractal Method for Modeling the Peculiar Dynamics of Transient Carbon Plasma Generated by Excimer Laser Ablation in Vacuum
Authors: Ursu C. , Nica P. , Focsa C. , Agop M.
Published: August 2018

Carbon plasmas generated by excimer laser ablation are often applied for deposition (in vacuum or under controlled atmosphere) of high‐technological interest nanostructures and thin films. For specific excimer irradiation conditions, these transient plasmas can exhibit peculiar behaviors when probed by fast time‐ and space‐resolved optical and electrical methods. We propose here a fractal approach to simulate this peculiar dynamics. In our model, the complexity of the interactions between the transient plasma particles (in the Euclidean space) is substituted by the nondifferentiability (fractality) of the motion curves of the same particles, but in a fractal space. For plane symmetry and particular boundary conditions, stationary geodesic equations at a fractal scale resolution give a fractal velocity field with components expressed by means of nonlinear solutions (soliton type, kink type, etc.). The theoretical model successfully reproduces the (surprising) formation of V‐like radiating plasma structures (consisting of two lateral arms of high optical emissivity and a fast‐expanding central part of low emissivity) experimentally observed.
Programmed Cell Death-1/Programmed Death-Ligand 1 Blockade Improves Survival of Animals with Sepsis: A Systematic Review and Meta-Analysis
Authors: Zhang Qiang , Qi Zhijiang , Bo-Liu  , Li Chun-Sheng
Published: August 2018

Object. To investigate effects of programmed cell death-1 (PD-1) related blockade in sepsis animals. Methods. Two reviewers independently searched electronic databases including PubMed, EMBASE, and the Cochrane Library up to February 2017. Strict literature retrieval and data extraction were performed to extract relevant data. Data analysis was conducted using RevMan 5.3 software and Stata version 12.0. And relative risks (RRs) for survival rate were calculated. A fixed-effect model was selected to pool and a forest plot was used to display RRs. Results. Four studies involving 394 animals were finally included. Nine control groups are used to pool. A fixed-effect model was applied to estimate a pooled RR of 2.19 (95% CI: 1.74–2.76), indicating that PD-1 related blockade increased survival rate in sepsis animals. Conclusion. We concluded that PD-1 related blockade can improve survival of animals with sepsis. But robust standardized clinical experiments for sepsis patients are highly desirable.
Coexistent Breast Cancer and Essential Thrombocythemia: How We Addressed the Therapeutic Challenges
Authors: Seegobin Karan , Gharia Bharatsinh , Maharaj Satish , Zuberi Lara
Published: August 2018

Essential thrombocythemia (ET) occurring with breast cancer is uncommon; the therapeutic approach varies and poses a challenge. A 65-year-old female presented to us after being diagnosed with hormone positive, HER2-negative infiltrating ductal carcinoma. She had a platelet count of 600 thou/cu mm. Her JAK2 mutation was positive. Bone marrow biopsy showed increased megakaryocytes. She was diagnosed with ET in the setting of breast cancer. She underwent breast conservation surgery after which aspirin was resumed. Anticipating thrombocytopenia during chemotherapy and given the absence of data combining hydroxyurea with standard chemotherapy used for breast cancer, we felt it prudent to delay cytoreductive therapy for her ET until after completion of breast cancer treatment. Her average platelet count during chemotherapy was 480 thou/cu mm with the lowest being 377 thou/cu mm. Her platelet count remained at goal between 300 and 350 thou/cu mm after four months of hydroxyurea.
HPLC Method for Quantification of Caffeine and Its Three Major Metabolites in Human Plasma Using Fetal Bovine Serum Matrix to Evaluate Prenatal Drug Exposure
Authors: Lopez-Sanchez Rosa del Carmen , Lara-Diaz Victor Javier , Aranda-Gutierrez Alejandro , Martinez-Cardona Jorge A. , Hernandez Jose A.
Published: August 2018

Caffeine is recognized as the first-line therapeutic agent for apnea of prematurity. The dosage regimen is 10 mg/kg loading dose and 2.5 mg/kg maintenance dose. However, the plasma concentration achieved, not always, is therapeutically useful. It makes necessary to increase the doses to reach plasma concentration up to 30 or 35 μg/mL or even higher to attain therapeutic effect. To study why neonates have these differences, and whether these effects are linked to prenatal caffeine exposure, we had to develop an analytical method for an accurate measurement of caffeine and metabolites concentration. The analysis was carried out using fetal bovine serum (FBS) as biological matrix in a high-performance liquid chromatography with an ultraviolet detector method. This method allows acceptable chromatographic resolution between analytes in 15 minutes. It was validated and proved to be linear in the 0.1–40 µg/mL range for caffeine, paraxanthine, theobromine, and theophylline in the same chromatographic analysis. Accuracy for quality control samples for intra- and interday assays was ranged from 96.5 to 105.2% and 97.1 to 106.2%. Precision had CV no more than 10% in all concentration levels for all analytes. No differences were observed between quantification in human and FBS. This method was applied to quantify plasma drug concentration in mothers and their newborns in a Mexican northeast population. In our study, we confirmed self-reported caffeine maternal intake in 85.2% (n=23); meanwhile, in their newborn’s plasma, it was detected only in 78% (n=21). Caffeine plasma concentrations in mother and newborn had a linear relationship, and no differences were observed between groups (mothers versus children). These results suggest that our analytical method and substitution of biological matrix was linear, precise, and accurate for caffeine quantification and could be used for measuring prenatal exposure and let us to study, in the future, concentration differences observed during apnea clinical treatment.
Interleukin-34 Synovial Fluid Was Associated with Knee Osteoarthritis Severity: A Cross-Sectional Study in Knee Osteoarthritis Patients in Different Radiographic Stages
Authors: Wang Shuang-Lei , Zhang Rui , Hu Kong-Zu , Li Mao-Qiang , Li Zhan-Chun
Published: August 2018

Background. Inflammation might play a crucial role in the pathogenesis of osteoarthritis (OA). Interleukin-34 (IL-34) is a well-known proinflammatory cytokine. Objective. The objective of this study was to detect IL-34 levels in serum and synovial fluid (SF) of patients with OA and to investigate their correlation with radiographic and symptomatic severity. Methods. One hundred and eighty-two OA patients and 69 controls were recruited. IL-34 levels were measured by enzyme-linked immunosorbent assay (ELISA). Radiographic and symptomatic severity of OA was reflected by Kellgren-Lawrence (KL) grades and Western Ontario McMaster University Osteoarthritis Index (WOMAC) scores, respectively. Results. SF IL-34 levels were independently associated with the KL grade (B=0.273, 95% CI: 0.150–0.395; P<0.001). SF IL-34 levels were significantly correlated with WOMAC scores (r=0.265, 95% CI: 0.123–0.399; P<0.001). The correlation between SF IL-34 levels and WOMAC scores was still significant after adjusting for confounding factors (B=0.020, 95% CI: 0.001–0.038; P=0.035) in OA patients. Conclusions. We found that IL-34 levels in SF were significantly associated with the radiographic and symptomatic severity of knee OA.
The Eigenvalue Problem for Caputo Type Fractional Differential Equation with Riemann-Stieltjes Integral Boundary Conditions
Authors: Ma Wenjie , Cui Yujun
Published: August 2018

In this paper, we investigate the eigenvalue problem for Caputo fractional differential equation with Riemann-Stieltjes integral boundary conditionsDc0+θp(y)+μf(t,p(y))=0,y∈[0,1],p(0)=p′′(0)=0,p(1)=∫01p(y)dA(y), whereDc0+θis Caputo fractional derivative,θ∈(2,3], andf:[0,1]×[0,+∞)→[0,+∞)is continuous. By using the Guo-Krasnoselskii’s fixed point theorem on cone and the properties of the Green’s function, some new results on the existence and nonexistence of positive solutions for the fractional differential equation are obtained.
Cabbage (Brassica oleracea var. capitata) Protects against H2O2‐Induced Oxidative Stress by Preventing Mitochondrial Dysfunction in H9c2 Cardiomyoblasts
Authors: Yang Dong Kwon
Published: August 2018

Oxidative stress plays an important role in the progression of cardiac diseases, including ischemia/reperfusion injury, myocardial infarction, and heart failure. Growing evidence indicates that cabbage has various pharmacological properties against a wide range of diseases, such as cardiovascular diseases, hepatic diseases, and cancer. However, little is known about its effects on oxidative stress in cardiomyocytes or the underlying mechanisms. Therefore, the present study examined the effects of cabbage extract on oxidative stress in H9c2 cardiomyoblasts. Cell viability, reactive oxygen species (ROS) production, apoptosis, mitochondrial functions, and expression levels of mitogen‐activated protein kinase (MAPK) proteins were analyzed to elucidate the antioxidant effects of this extract. Cabbage extract protected against H2O2‐induced cell death and did not elicit any cytotoxic effects. In addition, cabbage extract suppressed ROS production and increased expression of antioxidant proteins (SOD‐1, catalase, and GPx). Cabbage extract also inhibited apoptotic responses and activation of MAPK proteins (ERK1/2, JNK, and p‐38) in oxidative stress‐exposed H9c2 cells. Notably, cabbage extract preserved mitochondrial functions upon oxidative stress. These findings reveal that cabbage extract protects against oxidative stress and suggest that it can be used as an alternative therapeutic strategy to prevent the oxidative stress in the heart.
Gingival Reactive Lesions in Orally Rehabilitated Patients by Free Revascularized Flap
Authors: Tenore Gianluca , Mohsen Ahmed , Pompa Giorgio , Brauner Edoardo , Cassoni Andrea , Valentini Valentino , Polimeni Antonella , Romeo Umberto
Published: August 2018

The aim is to discuss four cases of gingival reactive hyperplastic lesions in patients with a history of excision of oral neoplastic lesions and rehabilitation by a free revascularized flap of the iliac crest. One female and 3 male patients were referred due to the presence of exophytic lesions at the rehabilitated sites. The clinical examination revealed that the poor oral hygiene was the common trigger factor in all the cases, in addition to trauma from the upper left second molar in the first case, pericoronitis related to a partially erupted lower right third molar in the third case, and poor stability of an upper removable partial denture in the fourth case. All the cases were subjected to elimination of these suspected triggering factors, exclusion of dysplasia, excisional biopsy by CO2 laser, and five follow-up visits. The histological examination of all the cases confirmed the diagnosis of pyogenic granuloma. These presented cases suggest that the limitations in oral functions and maintaining the oral hygiene measures following the free revascularized flap reconstruction surgery probably played a role in the development of gingival reactive hyperplastic lesions with presence of trigger factors such as local trauma, chronic infection, or inadequate prosthesis.
Innate and Adaptive Cell Populations Driving Inflammation in Dry Eye Disease
Authors: Reyes José L. , Vannan Danielle T. , Eksteen Bertus , Avelar Imelda Juárez , Rodríguez Tonathiu , González Marisol Ibet , Mendoza Alicia Vázquez
Published: August 2018

Dry eye disease (DED) is the most common ocular disease and affects millions of individuals worldwide. DED encompasses a heterogeneous group of diseases that can be generally divided into two forms including aqueous-deficient and evaporative DED. Evidence suggests that these conditions arise from either failure of lacrimal gland secretion or low tear film quality. In its secondary form, DED is often associated with autoimmune diseases such as Sjögren’s syndrome and rheumatoid arthritis. Current treatment strategies for DED are limited to anti-inflammatory medications that target the immune system as the source of deleterious inflammation and tissue injury. However, there is a lack of understanding of the underlying pathogenesis of DED, and subsequently, there are very few effective treatment strategies. The gap in our knowledge of the etiology of primary DED is in part because the majority of research in DED focused on secondary autoimmune causes. This review focuses on what is currently understood about the contribution of innate and adaptive immune cell populations in the pathogenesis of DED and highlights the need to continue investigating the central role of immunity driving DED.
Periprosthetic Joint Infection Does Not Preclude Good Outcomes after a Revision Total Knee Arthroplasty: A 7-Year Follow-Up Study of 144 Retrospective Cases
Authors: Ro Du Hyun , Kim Jong-Keun , Kim Sunghwan , Han Hyuk-Soo , Lee Myung Chul
Published: August 2018

Background and Purpose. Debate exists on whether septic revision total knee arthroplasty (TKA) results in inferior clinical outcomes, and limited information is available regarding the factors associated with such outcomes. This study aimed to (1) compare clinical outcomes and characteristics of aseptic versus septic revision TKA and (2) identify the risk factors associated with inferior clinical outcomes. Methods. We retrospectively reviewed 144 revision TKAs (90 aseptic and 54 septic revisions) that were followed for a minimum of 3 years (mean = 7 years). Clinical outcome data, namely, Knee Society knee and function scores and the Hospital for Special Surgery knee score, were collected. We reviewed 13 pre- and intraoperative variables. Results. Postoperative clinical outcomes were inferior in septic revision surgeries (p<0.05). In regression analyses, however, septic revision was not an independent risk factor for poor clinical outcomes. The independent risk factors for poor outcome were identified where Anderson Orthopedic Research Institute grade 3 femoral and tibial bone defects, more than three surgeries, and treatment for persistent infection were associated with inferior clinical outcomes (all p<0.05). Standard two-stage septic revision without grade 3 bone defects or additional surgeries showed comparable outcomes to aseptic revision. Interpretation. Clinical outcomes of septic revision were inferior to those of aseptic revision. However, poor outcomes were mainly associated with large bone defects and an increased number of surgeries. The outcomes of aseptic and septic revision surgery were similar when patients with larger bone defects and more than three surgeries were excluded.
Time Course of Changes in Simulated Keratometry and Total Corneal Refractive Power after Corneal Collagen Cross-Linking for Progressive Keratoconus
Authors: Takahashi Masahide , Kamiya Kazutaka , Kono Yusuke , Shoji Nobuyuki
Published: August 2018

Purpose. To assess the simulated keratometry (Sim K) and the total corneal refractive power (TCRP) in eyes undergoing conventional corneal cross-linking (CXL). Methods. This study comprised 20 eyes of 20 keratoconic patients (14 men and 6 women; median age (25th and 75th percentile), 26.5 (21.8, 38.0) years) who underwent CXL. The Sim K and TCRP were measured with a rotating Scheimpflug system (Pentacam HR, Oculus), preoperatively and 1, 3, 6, and 12 months postoperatively. Results. The values of Sim K were 52.65 (46.00, 55.70), 52.45 (45.85, 56.88), 51.70 (45.78, 55.83), 51.40 (45.68, 56.80), and 51.25 (46.08, 56.15) D preoperatively and 1, 3, 6, and 12 months postoperatively, respectively. The corresponding figures of TCRP were 52.10 (45.48, 55.08), 51.30 (45.18, 55.20), 50.95 (45.15, 54.50), 50.00 (45.18, 55.08), and 49.80 (45.48, 54.15) D, respectively. The variances of the Sim K and TCRP data were not statistically significant (p=0.994 and p=0.970, respectively, Kruskal–Wallis test). The Sim K was significantly larger than the TCRP before CXL and at 1, 3, 6, and 12 months after CXL (p<0.001, Wilcoxon signed-rank test). Conclusions. Not only the Sim K but also TCRP was decreased by approximately 1 D after CXL. The Sim K readings may overestimate the TCRP, even after CXL for progressive keratoconus.
Synchronization of Different Uncertain Fractional-Order Chaotic Systems with External Disturbances via T-S Fuzzy Model
Authors: Wang Lin , Ni Jinbo , Yang Chunzhi
Published: August 2018

This paper presents an adaptive fuzzy synchronization control strategy for a class of different uncertain fractional-order chaotic/hyperchaotic systems with unknown external disturbances via T-S fuzzy systems, where the parallel distributed compensation technology is provided to design adaptive controller with fractional adaptation laws. T-S fuzzy models are employed to approximate the unknown nonlinear systems and tracking error signals are used to update the parametric estimates. The asymptotic stability of the closed-loop system and the boundedness of the states and parameters are guaranteed by fractional Lyapunov theory. This approach is also valid for synchronization of fractional-order chaotic systems with the same system structure. One constructive example is given to verify the feasibility and superiority of the proposed method.
A New Calibration Method for the Real-Time Calculation of Dynamic Safety Following Distance under Railway Moving Block System
Authors: Pan Deng , Luo Qing , Zhao Liting , Zhang Chuansheng , Chen Zejun
Published: August 2018

Only the actual following distance that is a little greater than the optimum safety following distance at any time can make the following train move in safety and efficiency. For this purpose, a new calibration method is studied for the real-time calculation of the dynamically optimum safety following distance. To cope with the complex situations of train following operation, the mathematic model of train deceleration operation based on the hyperbolic function with a variable acceleration control strategy is established to simulate the speed-changing behavior of high-speed train steered by the well-experienced driver. Using the evaluation of train behavior adjustment quality and the numerical analysis theory, we build the fitting function of the optimum absolute safety following distance changing with the following train’s velocity for the real-time calibration of safe following distance under absolute braking mode. And then, we discussed the real-time calculation of the optimum safety following distance under relative braking mode (i.e., the relative safety following distance). The study results will help a high-speed train to evaluate and optimize its own following behavior according to the current operation states of train following system, the actual following distance, and the absolute or relative safety following distance. The actual following distance is rationally controlled by the scientific adjustment of the following train’s behavior so that train following movement can be always safe, efficient, and smooth (comfortable).
The Study of Viral RNA Diversity in Bird Samples Using De Novo Designed Multiplex Genus-Specific Primer Panels
Authors: Ayginin Andrey A. , Pimkina Ekaterina V. , Matsvay Alina D. , Speranskaya Anna S. , Safonova Marina V. , Blinova Ekaterina A. , Artyushin Ilya V. , Dedkov Vladimir G. , Shipulin German A. , Khafizov Kamil
Published: August 2018

Advances in the next generation sequencing (NGS) technologies have significantly increased our ability to detect new viral pathogens and systematically determine the spectrum of viruses prevalent in various biological samples. In addition, this approach has also helped in establishing the associations of viromes with many diseases. However, unlike the metagenomic studies using16SrRNA for the detection of bacteria, it is impossible to create universal oligonucleotides to target all known and novel viruses, owing to their genomic diversity and variability. On the other hand, sequencing the entire genome is still expensive and has relatively low sensitivity for such applications. The existing approaches for the design of oligonucleotides for targeted enrichment are usually involved in the development of primers for the PCR-based detection of particular viral species or genera, but not for families or higher taxonomic orders. In this study, we have developed a computational pipeline for designing the oligonucleotides capable of covering a significant number of known viruses within various taxonomic orders, as well as their novel variants. We have subsequently designed a genus-specific oligonucleotide panel for targeted enrichment of viral nucleic acids in biological material and demonstrated the possibility of its application for virus detection in bird samples. We have tested our panel using a number of collected samples and have observed superior efficiency in the detection and identification of viral pathogens. Since a reliable, bioinformatics-based analytical method for the rapid identification of the sequences was crucial, an NGS-based data analysis module was developed in this study, and its functionality in the detection of novel viruses and analysis of virome diversity was demonstrated.