bluuebunny/crossref_metadata_2025 huggingface dataset:
A new hoverfly genus and species from the middle Eocene Baltic amber (Diptera: Syrphidae)

Authors: NGÔ-MULLER VALÉRIE , NEL ANDRÉ
Published: February 2020

Syrphid flies are an important clade of pollinators, and predators on several insect groups. The oldest record of its stem lineage is late Cretaceous, but this family really diversified during the Eocene-Oligocene, with a rather sparse fossil record. Here we describe from the Baltic amber the new genus and species Eoxanthandrus garroustei gen. et sp. nov., the first fossil representative of the Syrphinae ‘group’ Bacchini and Melanostomini. Its closest extant relatives prey on caterpillars, while the other Syrphinae generally prey on Hemiptera. This specialized biology possibly dates back to the middle Eocene.
Type specimens of vascular plants in the herbarium of the National Institute of Biological Resources (KB) of the Republic of Korea

Authors: JANG HYUN-DO , PARK JEONG-MI , HYUN CHANG-WOO , LEE BYOUNG-YOON , NOH TAE-KWON
Published: February 2020

The article provides information on type specimens of 33 species (94 sheets) of vascular plants, kept in the herbarium of the National Institute of Biological Resources (KB) of the Republic of Korea. Most of the type specimens in KB were donated by the Herbaria of Ajou University (AJOU), Chonbuk National University (JNU), Chungbuk National University (CBU), Hallym University (HHU), Korea Plant Research Institute (KPRI), Seoul National University (SNU), and others in recent years. For all specimens, the type category is indicated. There were 15 sheets for holotypes, 57 sheets for isotypes, and 22 sheets for paratypes. There were seven species of Pteridophytes, 22 species of Dicotyledons, and four species of Monocotyledons. The most represented genera in the 33 species are Corydalis (seven species) and Isoetes (four species). The type specimens examined in this article belong to the taxa described by Korean botanists, Byoung-Un Oh, Byoung-Yoon Lee, Byung-Yun Sun, Chong-Wook Park, Hong-Keun Choi, Young-Dong Kim, and others.
A new species of Ukamenia from Vietnam (Lepidoptera: Tortricidae: Olethreutinae: Gatesclarkeanini)
Authors: HEPPNER JOHN B. , BAE YANG-SEOP
Published: February 2020

The genus Ukamenia Oku (1981) was proposed with Simaethis sapporensis Matsumura (1931) from Japan as its type species, which had been originally described in the family Choreutidae. Oku (1981) based the new genus on characters of S. sapporensis that were typical of Tortricidae rather than Choreutidae, notably the naked haustellum (scaled in Choreutidae), among many other characters differing between the two families, such as wing venation, head morphology, and genital form. Oku (1981) assigned his new genus to the tribe Olethreu­tini, but mentioned that it resembled the genus Gatesclarkeana Diakonoff, 1966. In her extensive study of Australian Olethreutinae, Horak (2006) briefly noted Ukamenia as being referable to Gateclark­eanini.
Larval morphology of Nicrophorus (Nicrophorus) nepalensis Hope (Coleoptera: Silphidae: Nicrophorinae)
Authors: ŠÍPKOVÁ HANA , RŮŽIČKA JAN
Published: February 2020

Larval morphology of all three instars of Nicrophorus (Nicrophorus) nepalensis Hope, 1831 (Coleoptera: Silphidae: Nicrophorinae) is described and illustrated, based on reared larvae. The eastern Palaearctic and Oriental N. (N.) nepalensis is similar to the western Palaearctic N. (N.) humator (Gleditsch, 1767) in a number of larval characters. This is congruent with recent classification of the genus Nicrophorus Fabricius, 1775 by Sikes, who suggested a close phylogenetic affinity of the N. nepalensis species group (with 16 species) with the N. humator species group (2 species). The generic description of larvae of Nicrophorus Fabricius, 1775 is expanded, based on detailed SEM observation.
A review of the pleasing lacewing genus Dilar Rambur (Neuroptera, Dilaridae) from South Asia
Authors: LI DI , ASPÖCK HORST , ASPÖCK ULRIKE , LIU XINGYUE
Published: February 2020

The pleasing lacewing genus Dilar Rambur, 1838, is poorly known from South Asia, previously only three species were accounted. Here, we present a revision of Dilar from South Asia, with descriptions of five new species, namely Dilar austroindicus sp. nov., Dilar biprojectus sp. nov., Dilar clavatus sp. nov., Dilar miralobatus sp. nov., and Dilar truncatus sp. nov. In addition, Dilar nietneri Hagen, 1858, from Sri Lanka is re-described. A key to males of Dilar from South Asia is provided.
Morphological and molecular characters reveal the status of Pedesta rubella (Devyatkin, 1996) stat. n. and P. similissima (Devyatkin, 2002) syn. n. (Lepidoptera, Hesperiidae)
Authors: LI MENG , MONASTYRKII ALEXANDER L. , KOLESNICHENKO KIRILL A. , LIU ZIHAO , XUE GUOXI , LONG JIFENG , TANG HUAXING
Published: February 2020

To clarify the relationships of Pedesta submacula (Leech, 1890), P. submacula rubella (Devyatkin, 1996) and P. similissima (Devyatkin, 2002), specimens from various localities in China and Vietnam, including the type materials of P. submacula rubella and P. similissima were examined. A neighbor-joining (NJ) tree was also reconstructed based upon partial COI sequences of 24 ingroup specimens and 4 outgroup species. The result shows that P. similissima is a synonym of P. submacula, and P. submacula rubella belongs to a separate species. The mean Kimura-2-Parameter genetic distance between P. submacula and P. rubella stat. n. is 4.4%. Wing patterns and genitalic structures of these taxa are illustrated and compared. A distribution map of both species is provided.
An Software Defined Network Based Secured Model for Malicious Virtual Machine Detection in Cloud Environment
Authors: Anitha H. M. , Jayarekha P.
Published: February 2020

Cloud computing is an emerging technology that offers the services to all the users as per their demand. Services are leveraged according to the Service level agreement (SLA). Service level agreement is monitored so that services are offered to the users without any problem and deprival.
Software Defined Network (SDN) is used in order to monitor the trust score of the deployed Virtual Machines (VM) and Quality of Service (QoS) parameters offered. Software Defined Network controller is used to compute the trust score of the Virtual Machines and find whether Virtual Machine
is malicious or trusted. Genetic algorithm is used to find the trusted Virtual Machine and release the resources allocated to the malicious Virtual Machine. This monitored information is intimated to cloud provider for further action. Security is enhanced by avoiding attacks from the malicious
Virtual Machine in the cloud environment. The main objective of the paper is to enhance the security in the system using Software Defined Network based secured model.
Enhancement of Organic Solar Cell Performance by Utilizing Cupper Phthalocyanine
Authors: Aldaghfag Shatha A.
Published: February 2020

An approach for improving the photoelectrical conversion efficiency of hetero-junction solar cells based on lead phthalocyanine, by incorporating cupper phthalocyanine with co-evaporation technique into the active layer has been reported in this work, the effect of adding cupper phthalocyanine
(CuPc) have been studied. The morphological, optical, and electrical properties of PbPc active layer and blend have been reported. Atomic force microscope study shows a change in the roughness, UV-VIS Spectroscopy revealed that the absorbance of PbPc films increases in the blend case and has
a main Q-band at wavelength 748 nm and the electrical study showed a change in (I–V) characteristics, the photoelectrical conversion efficiency (PCE) of solar cells increases. The photovoltaic parameters are discussed based on the morphology and optical variation of the active
layers.
Software-Defined Networking’s Traffic Engineering Benefits the Improvement of Network Performance
Authors: Naveen Chandar B. , Arivazhagan N. , Venkatesh K.
Published: February 2020

Quality of Service is considered as one of the important specifications in Software Defined Networking and we are focusing on Traffic Engineering which is capable of managing traffic characteristics like bandwidth for improving network performance. In this paper, performance evaluation
of Quality of Service parameters such as Packet Delivery Ratio, Packet Delay and Packet Loss are performed with Network simulator 2 for all types of Software Defined Networking topologies. To do such evaluation on these parameters we use Traffic Engineering, which helps on improving the network
performance, design mechanisms for routing to manage the traffic in network by improving the network resource usages and other major Quality of Service requisites. So in this proposed methodology, we use point-to-point topology related to traffic calculation which includes network parameters
like general calculation of a framework, analyzing the traffic and future indication. Also the work process relevant to traffic management includes bandwidth of the traffic, scheduling of Quality of Service-assurance, saving power and management of traffic in Software Defined Networking. Existing
technologies used for the above parameters are discussed below and our insights for future development on traffic engineering between the nodes in Software Defined Networking are offered.
Software Defined Networking Based Delay Sensitive Traffic Engineering of Critical Data in Internet of Things
Authors: Reddy Vaka Avinash , Venkatesh K. , Srinivas L. N. B.
Published: February 2020

The exponential growth of the number of devices that are connected to the internet is increasing. At present, there are more than 13 billion devices are connected and it was predicted that this number reaches up to 25 billion by 2020. In an Internet of Things ecosystem, these devices
are embedded to perform specific tasks in which they cannot take decisions. When there is an emergency state in any one of the nodes, the other nodes also produce the traffic simultaneously which makes the border router busy and creates a delay in message propagation and causes loss to the
productivity. In the proposed architecture, Software Defined Networking offers a solution to this problem by making wireless sensor network more intelligent and also makes network capable of making self-decision during emergency state. In the proposed architecture an Open vSwitch installed
on a Raspberry Pi as a Data Plane and Open Network Operating system, Mininet can be used as a Control Plane. The NodeMCU-ESP8266 wireless devices act as end nodes. A routing path with minimum latency during critical traffic can be implemented using Software Defined Networking.
Comparison of Proportional, Integral and Derivative and Adaptive Controller for Pitch and Roll Motion of Humanoid Arm
Authors: Rithu R. , Karthikeyan R.
Published: February 2020

A Comparison of Proportional, Integral and Derivative and Lypunov based Model Reference Adaptive Controller for Roll and Pitch Movement of Humanoid Arm in presence of perturbations is proposed in this paper. This controller ensures the dynamic stability of humanoid arm motions even
with the external disturbances. The Performance of controllers is evaluated based on the criterion: Integral Squared Error, Integral Absolute Error and Integral Time-weighted Absolute Error. It is observed that the system is able to track the inputs even in presence of disturbance without
any overshoot using Adaptive Controller.
Big Mac: A Distributed PaaS Framework for on Demand Big Data Processing Using Machine Learning Techniques
Authors: Jha Balanand , Abhishek Kumar , Deepak Akshay , Shrivastav Prakhar , Thakre Suraj , Karnatak Harshit
Published: February 2020

In the age of start-ups and technical research, the demand for high-end computing power and loads of space is ever increasing. Machine learning techniques have become an inseparable part of the big data analytics. Setting up one’s own infrastructure to deal with all this vastness
is usually not feasible due to high expenses and lack of desired expertise. As a solution to this problem, this paper proposes a system for Big-Data Analytics and Machine Learning based on Hadoop and Spark frameworks that also supports Operating System (OS) Rental Services. Machine Learning
(ML) services provide option to use both existing inbuilt popular models or create one’s own model. OS Rental services provide users with high end infrastructure on their low-end devices on rent. The entire implementation has been made open source for ease of access and facilitating
extensibility.
Query Expansion for Improving Web Search
Authors: Azad Hiteshwar Kumar , Deepak Akshay , Abhishek Kumar
Published: February 2020

The aim of this paper is to retrieve the most relevant expansion words for expanding the initial query of the user in order to enhance the outcomes of web search results. Query expansion plays a major role in reformulating a user’s initial query to a one more pertinent to the
user’s intended meaning. The reformulated query is then used to obtain more appropriate outcomes from a large amount of information on the web. The proposed semantic query expansion technique uses Wikipedia and WordNet as data sources. Wikipedia is taken as a base for all query expansions
because it is one of the most diversified and relevant databases available on the web. To further improve the proposed query expansion technique,WordNet—a lexical database—is used as the as another data source because the synonyms (synsets) of the query term provided by it can
be quite useful for query expansion. The proposed expansion technique successfully combines the two data sources to retrieve the most relevant expansion terms from the data sources in response to the user’s original query. The proposed work has been divided into four phases: (1) extraction
of relevant words from Wikipedia (2) extraction of relevant words from WordNet (3) merging of the expansion terms obtained from Wikipedia and WordNet, and (4) query formulation by combining the expansion terms using Boolean operators. This reformulated query is then fired on the web to find
the desired result. The Experimental result shows a significant improvement in information retrieval using query expansion.
Secure Multiparty Device Pairing Using Random Peephole Generations
Authors: Annadurai Soorya , Bhatkalkar Bhargav J.
Published: February 2020

A secure device pairing mechanism is used to establish a trusted communication channel between unassociated wireless devices. The broadcast nature of wireless communication opens the door for man-in-the-middle (MITM) attacks, and even other subtle forms of masquerader and misfeasor
attacks. This paper introduces a simple device pairing approach to tackle such attacks seamlessly. The algorithm is compatible with a multitude of devices, whereas a majority of existing algorithms are based on two devices exclusively. This approach utilizes a human visual channel as an Out-Of-Band
(OOB) channel to authenticate the public keys exchanged between the devices. The interactive nature of this approach forces user attention, hence improving the reliability and consistency of the device pairing process. To do so, we introduce the concept of ‘peepholes,’ and mathematically
define it before demonstrating the algorithm’s methodology. Subsequent sections also demonstrate its robustness against attacks via misfeasors, masqueraders, and men-in-the-middle.
An Effective Cardiac Care Recommender System
Authors: Christy A. Joy , Umamakeswari A. , Nivethidha R. , Monisha M. , Nair K. Kavya
Published: February 2020

Recommender systems are used now-a-days as information filtering tools for predicting user’s preferences, predominantly from big data and recommends things to their taste/choice. Recommender System for health domain provides a mean to assist users in categorizing users with similar
symptoms of diseases. Users often feel uncertain when investigating on their own about the medical information that is available on the various online sources. The primary objective is to suggest the preferred cardiologist to the users based on the symptom parameters they have given as input.
This information is analyzed and users with similar medical information are identified. Different users may have different expectations in the selection of doctors. So users are asked to prioritize their expectations. The proposed system is based on both collaborative and content filtering
approach that makes use of the information provided by users, analyzes them and identifies the similarity between users through the clusters created using K-Means algorithm. In K-Means clustering, the two types of clusters will be formed based on the health parameters given by
the users and the other one will be formed based on the users priority. The similar users that are available in both the clusters are identified and ratings of those similar users are taken into matrix. The doctor with the maximum average is recommended. Based on the ratings for the doctors
given by the similar users and priority of their expectations, doctors are recommended. We strongly believe that the idea of recommending the doctors based on the users similarity and priority can be adapted to cope with the special requirements of the health domain.
An Encapsulation of Vital Non-Linear Frequency Features for Various Speech Applications
Authors: Lalitha S. , Gupta Deepa
Published: February 2020

Mel Frequency Cepstral Coefficients (MFCCs) and Perceptual linear prediction coefficients (PLPCs) are widely casted nonlinear vocal parameters in majority of the speaker identification, speaker and speech recognition techniques as well in the field of emotion recognition. Post 1980s,
significant exertions are put forth on for the progress of these features. Considerations like the usage of appropriate frequency estimation approaches, proposal of appropriate filter banks, and selection of preferred features perform a vital part for the strength of models employing these
features. This article projects an overview of MFCC and PLPC features for different speech applications. The insights such as performance metrics of accuracy, background environment, type of data, and size of features are inspected and concise with the corresponding key references. Adding
more to this, the advantages and shortcomings of these features have been discussed. This background work will hopefully contribute to floating a heading step in the direction of the enhancement of MFCC and PLPC with respect to novelty, raised levels of accuracy, and lesser complexity.
Experimental Analysis on Intelligent Seed Sowing Mobile Robot Through Ant Colony Optimization
Authors: Mallikarjuna Rao A.
Published: February 2020

The world economy and culture are mapped with agriculture sector. Motivating the farmers from the conventional method of harvesting to innovative methods leads to better yield of products with less risk factor. Many inventors tried for better interaction between man and machine, found
improved results. In this work, Intelligent Seed Sowing Mobile Robot (ISSMR) designed, fabricated and programmed for automated seed sowing process in cultivation. In scrupulous, this Mobile Robot (MR) navigates in a straight line while sowing the seeds, at the end of each line MR takes either
right or left turn with a perpendicular angle, take an offset distance and navigate again in a straight line parallel to the previous line in the opposite direction. After reaching a length equal to first reference line MR takes a perpendicular left angle and continues the cycle. The ISSMR
is tested with two techniques; one intelligent navigation another Ant colony optimization. The machine is tested along with a number of iterations of the same process of seed sowing. There is flexibility in the program to change the line length and offset distance. The distribution of seeds
maintained uniformly along the length of the straight line. The ISSMR alerts the farmer for the presence of obstacle through buzzer, so that farmer removes the obstacle. The experimental results of the ISSMR in both the techniques are compared and found satisfactory. Hence, this intelligent
machine is recommended to farmers for improved cultivation.
Smart and Secure Home Automation Using Internet of Things Enabling Technologies
Authors: Bulusu Sowjanya , Krosuri Madhuri , Koripella Rishitha , Sampath Nalini
Published: February 2020

Many tools have been developed to control different devices from a remote location with the advancement in science and technology. These tools enable the control of the devices automatically without any physical contact with the switches. The purpose of the paper is to design Internet
of Things (IoT) based prototype and implement high security system with smart controlling of the appliances of the home in an automated way. For this we use fingerprint sensor for authentication, Voice controlled system and Light Dependent Resistor (LDR) sensor for controlling the home appliances
and a Global System for Mobile Communication (GSM) technology is used to alert the owner in case of authentication failure.
Hybrid Intrusion Detection System Security Enrichment Using Classifier Ensemble
Authors: Karthikeyan D. , Mohanraj V. , Suresh Y. , Senthilkumar J.
Published: February 2020

Intrusion Detection Systems (IDS) is a software or device used to monitor a system or network for malicious activity. Thus, effective intrusion detection of different attacks. Existing methods of studies prove value of data mining methods in Intrusion Detection Systems (IDS). We focus
on improving intrusion detection rate of IDS using Data Mining techniques. We implements a new classifier ensemble based intrusion detection systems (CEBIDS) using hybird detection approaches. CEBIDS combines feature level and data level techniques in WEKA tool with KDD cup’99 dataset
enhances detection rate in significant manner.
E-Textbook Enrichment Using Graph Based E-Content Recommendation
Authors: Kushwaha Rahul Chandra , Singhal Achintya , Biswas Anupam
Published: February 2020

This paper presents a novel computational technique for the enrichment of E-textbook using the recommendation of the open courseware, YouTube Videos, Wikipedia articles, Slideshare, Geogebra Applets and other relevant web contents. The research work is based on NCERT secondary class
mathematics E-Textbook to improve the learning deficiency by enrichment of the book using augmentation of the relevant web contents. The text mining tool is used for the enrichment of the E-textbook using the relevant E-resources available from the web. A phrase graph based algorithmic framework
has been developed to extract the mathematical concepts from the E-textbook and recommend the E-contents to the enrichment of the E-textbook. The proposed method provides more precise and relevant recommendations in comparison to the available methods.
Systematic Image Zooming and Panning of Graphical Images Using Fractional Replication
Authors: Shyamala Devi M. , Suguna R. , Lbungdim Paul K. , Kondapalli Sairam , Ambashta Satwat Kumar , Akhil Duggishetti
Published: February 2020

Scaling is the major operation performed in Transformation of images. The Scaling is an important operation for resizing and reshaping the images that are in digital form. Various operations can be performed with digital images out of which the shrinking and zooming are the most widely
operations by any type of users in the world. The other name for shrinking is sub sampling and the zooming operation is also named as Oversampling. The purpose of zooming operation is to extend or enlarge the image in order to have a clear and efficient view. Zooming operations are mostly
performed in our mobile for viewing the images in our gallery and this operation is the most frequently performed operation by the mobile users. By considering all these factors, graphical images are the most widely agent to convey any information to the transmitter in order to know the position,
size of an object. With this in concern, we try to focus on graphical image zooming as it is very important process in image processing. In this paper, we have used Fractional Replication for Image Zooming that is processed by copying and replicating the pixels from the base image based on
the inexact spatial correspondence between the base image and zoom image. And also, the pixel address of the zoom image is calculated fractionally from the pixel address of the base image. We have implemented all the zooming operations like Zoom out in subject of Y-Axis, Zoom out in
subject of X-Axis, Zoom in subject of Y Axis, Zoom in subject of X Axis, Left Side Panning, Right Side Panning, Top Zoom Panning and Bottom Zoom Panning for a graphical image using C programming language. Here we attempt to process the various Zooming operation analysis
of the graphical image.
A Prediction System for Diagnosis of Diabetes Mellitus
Authors: Franklin Ramya G. , Muthukumar B.
Published: February 2020

The growth of Science is a priceless asset to the human and society. The plethora of high-end machines has made life a sophistication which in turn is paid back as health issues. The health care data are complex and large. This heterogeneous data are used to diagnose patient’s
diseases. It is better to predict the diseases at an earlier stage that can save the life and also have an upper hand in controlling the diseases. Data mining approaches are very useful in analyzing the complex, heterogeneous and large data set. The mining algorithms extract the essential
data set from the raw data. This paper presents a survey on the various data mining algorithms used in predicting a very common disease in day a today life “Diabetics Mellitus.” Over 246 million people in the world are diabetic with a majority of them being women. The WHO reports
that by 2025 this number is expected to rise to over 380 million.
Detection of resistance genes from Pseudomonas aeruginosa using immunomagnetic isolation and chemiluminescence
Authors: Xu Fei , Chen Cheng , Li Xing , Zhang Bo
Published: February 2020

Pseudomonas aeruginosa (P. aeruginosa) is a common opportunistic and nosocomial bacterial pathogen. Various multi-resistance mechanisms present across numerous P. aeruginosa strains counteract conventional antimicrobial therapy, thereby becoming a great challenge. This study
aimed to establish the application of immunomagnetic isolation and chemiluminescence to detect the presence of extended spectra of β-lactamases encoding genes: blaTEM and blaVEB; metallo-beta-lactamases encoding gene: blaVIM; aminoglycoside modifying enzymes encoding gene: aac(6)II,
ant(3)I; and the specific gene for P. aeruginosa, gyrB. P. aeruginosa was specifically selected using the immunomagnetic nanoparticles (IMNPs) in the six parallel bacterial plates counting, proving that they are reliable. Then, the high efficiency of IMNPs@Probes in targeting the
resistance genes of P. aeruginosa was demonstrated using the results of chemiluminescent intensities of blaTEM, blaVEB, blaVIM aac(6)II, ant(3)I, and gyrB (more than 10 times higher than that of the control). Sixty-eight in situ clinical samples were tested for the presence
of these resistance genes, and one more blaTEM and three more blaVIM individuals were detected using this method compared to the traditional PCR. Thus, the application of our method in clinical screening is specific, accurate, and reliable, and it could be useful in the administration
of appropriate treatment.
Chronic Opioid Use after Laryngeal Cancer Treatment: A VA Study
Authors: Craker Nicole C. , Gal Thomas J. , Wells Lindsay , Schadler Aric , Pruden Samuel , Aouad Rony K.
Published: February 2020

Objective

To investigate opioid utilization in veterans undergoing laryngeal cancer treatment and describe the risk of chronic use after treatment cessation.

Study Design

A retrospective cohort study.

Setting

A single Veterans Health Administration site.

Subjects and Methods

Veterans with newly diagnosed and treated laryngeal cancer with attributable opioid use from 2005 to 2015. Milligram morphine equivalents (MMEs) were calculated from 90 days prior to diagnosis for up to 1 year. Adjuvant pain medications filled 30 days prior to and up to a year from the date of diagnosis were assessed.

Results

Of 74 veterans with biopsy‐proven laryngeal carcinoma, 73 (98.6%) were male and 71 (96%) were white. Forty‐three (58%) patients were stage 0/I/II; 31 (42%) were III/IV. Eleven (14.9%) were treated with surgery alone, 35 (47.3%) with radiation alone, and 28 (38%) with multimodal therapy. Twenty‐four (32.4%) patients had preexisting opioid use prior to cancer diagnosis. Patients who used opioids more than 30 days prior to date of diagnosis were found to be 10 times more likely to have persistent opioid use at 90 days (P =. 0024) and 8 times more likely to have chronic use at 360 days (P =. 0041). Maximum MMEs within 1 year of diagnosis were significantly associated with chronic use at 90 days (P =. 00045) and chronic use at 360 days (P =. 0006).

Conclusion

Preexisting opioid use and maximum MMEs are strongly associated with chronic opioid use among veterans treated for laryngeal carcinoma independent of stage and treatment type.
Complete versus Limited Endoscopic Sinus Surgery for Chronic Rhinosinusitis in Adults with Cystic Fibrosis
Authors: Lee Daniel J. , Yao Christopher M. K. L. , Sykes Jenna , Rizvi Leena , Tullis Elizabeth , Lee John M.
Published: February 2020

Objective

To examine the effects of the extent of endoscopic sinus surgery (ESS) on pulmonary health, including the pulmonary exacerbations and lung function in patients with cystic fibrosis (CF).

Study Design

Retrospective cohort study.

Setting

Tertiary health care center.

Subjects and Methods

A retrospective review of patients with CF who underwent ESS at St. Michael’s Hospital between 1999 and 2016 was performed. Two groups of patients were identified based on the surgical extent: (1) complete (maxillary antrostomy, complete ethmoidectomy, sphenoidotomy, and frontal sinusotomy) and (2) limited (any ESS that involved less than complete). Primary outcomes included the number of pulmonary exacerbations (the use of oral or intravenous [IV] antibiotics), number of hospital admissions and hospital days during a 2‐year pre‐ and postoperative period, and pulmonary function outcomes during a 1‐year pre‐ and postoperative period.

Results

There were 70 procedures (30 complete and 40 limited) among 57 patients. Baseline characteristics were similar between the groups. Complete ESS group had a significant reduction in the oral antibiotic use compared to the limited ESS group (median, –1.0 [interquartile range (IQR), –2 to 0] in complete vs 0 [IQR, –1 to 1] in limited, P =. 028). There was no difference in the use of IV antibiotics, number and duration of admissions, or rate of lung function change between the 2 groups.

Conclusion

Complete ESS may reduce mild forms of pulmonary exacerbations as shown in the decreased use of oral antibiotics. Overall, ESS does not significantly modify pulmonary outcomes in patients with CF.
Effects of Pregnancy on Otosclerosis
Authors: Qian Z. Jason , Alyono Jennifer C.
Published: February 2020

Objective

The effect of pregnancy on otosclerosis is controversial. If pregnancy physiologically increases the risk of progression, females with children would be expected to receive stapedectomy earlier than childless females and males. Here, we seek to determine whether sex moderates the relationship between number of children and age at stapedectomy.

Study Design

Retrospective observational study of national health care claims.

Setting

2003 to 2016 Optum Clinformatics Data Mart.

Subjects and Methods

In total, 6025 privately insured US adults (3553 females, 2472 males) who received stapedectomy for otosclerosis were queried for age and number of children at the time of initial surgery.

Results

The average age at stapedectomy was significantly lower in females than males (46.8 vs 48.1 years; t test, P <. 0001). Females with children had a significantly lower age at surgery compared to childless females (39.3 vs 49.9 years; t test, P <. 0001). Males with children similarly had a significantly lower age at surgery compared to childless males (40.5 vs 51.3 years; t test, P <. 0001). A higher number of children was correlated with lower age for both females (Pearson, r = −0.3817, P <. 0001) and males (Pearson, r = −0. 3675, P <. 0001). Linear regression showed that younger age of surgery could be predicted by female sex and number of children (F(3, 6021) = 336.93, P <. 001, R2 = 0.1437) with no significant interaction between sex and number of children (P =. 186).

Conclusion

Sex does not moderate the effect of increasing number of children on decreasing age at stapedectomy. Social, rather than biological, factors surrounding parenthood such as increased overall health care utilization may explain prior associations between pregnancy and otosclerosis.
Gender Differences in End-of-Life Care in Older Mexican American Adults
Authors: Ortiz-Dowling Evangeline M. , Crist Janice D. , Shea Kimberly , Phillips Linda R.
Published: February 2020

Mexican Americans (MAs), 1 of 10 subgroups of Latinos, are the largest and fastest growing Latino subgroup in the United States; yet, their access to end-of-life (EOL) care using hospice services is low. An investigation was needed into extant research-based knowledge about factors influencing EOL care decisions among MAs to guide health-care professionals in assisting MAs to make timely, acceptable, and satisfactory EOL care decisions. To determine whether gender was an influence on EOL decision-making among older MAs, CINAHL and PubMed were searched for articles published between 1994 and 2018. Relevant sources were also identified through the reference lists of review articles. Reports were included if they were written in English, involved participants aged 50 years and older who identified themselves as MA, and data derived directly from participants. Reports in which MAs were not equally represented in the sample, large databases, and instrumentation development and testing articles were excluded. Of the 345 unduplicated articles identified in our electronic search and the 47 identified through review articles, 22 met the inclusion criteria. Content analysis was conducted using a priori codes from the Ethno-Cultural Gerontological Nursing Model (ECGNM). Only 8 (36%) of the 22 articles reported on MA older adults’ gendered experiences related to EOL decision-making. Results indicate an association between gender and EOL decision-making. As the older MA population grows, tackling disparities in EOL services use requires attention to how culture and gender influence EOL decision-making and care.
A Physiological Analysis of Hyponatremia: Implications for Patients on Peritoneal Dialysis
Authors: Cherney David Z. , Zevallos Gonzalo , Oreopoulos Dimitrios , Halperin Mitchell L.
Published: February 2020

The basis for hyponatremia is a negative balance for sodium (Na+) plus potassium (K+) and/or a positive balance for water. In patients with normal renal function, vasopressin is needed to prevent the excretion of electrolyte-free water. Vasopressin is not important when there is little residual renal function. If hyponatremia is accompanied by a quantitatively appropriate gain in weight, this implies that a gain of electrolyte-free water was the basis for hyponatremia. In the absence of this weight gain, a loss of salts is to be suspected. If the extracellular fluid (ECF) volume is obviously low, hyponatremia is due to a deficit of NaCl, unless there is a deficit of K+. With a KCl deficit and a contracted ECF volume, there should also be a large shift of Na+ into cells, so metabolic alkalosis would not be an expected finding. In contrast, those patients with no change in weight who have a normal or expanded ECF volume are subdivided into those with a gain of solutes restricted to the ECF compartment (glucose, mannitol), or those with a deficit of solutes of intracellular fluid origin, which implies that a catabolic state (malnutrition) may be present.
Effect of Fluid Supplementation and Modality on Peritoneal Permeability Characteristics in a Rat Peritoneal Dialysis Model
Authors: Zweers Machteld M. , Splint Laura J. , Krediet Raymond T. , Struijk Dirk G.
Published: February 2020

Objective

Hemoconcentration may influence peritoneal permeability parameters in anesthetized animals without fluid supplementation. Therefore, the aim of this study was to investigate the effects of fluid supplementation on peritoneal permeability in an acute peritoneal dialysis model in anesthetized rats.

Design

To study the effect of fluid supplementation on peritoneal permeability characteristics, 24 anesthetized male Wistar rats were investigated in 3 groups during a 4-hour standardized peritoneal permeability analysis with a 3.86% glucose dialysis solution (SPARa). The groups included a control group with no fluid supplementation (None, n = 8), a group with continuous subcutaneous infusion of 0.9% NaCl 3 mL/hr (SC, n = 9), and a group with continuous intravenous infusion of 0.9% NaCl 3 mL/hr (IV, n = 7). Inflow, sampling, and outflow of the dialysate during the SPARa occurred via a cannula inserted intraperitoneally in the lower left quadrant of the abdomen. Blood was drawn at the end of the dwell. Baseline blood samples were obtained from six separate untreated rats.

Results

Plasma osmolality was significantly lower in the IV group (334 ± 1.4 mOsm/kg) compared to the None group (348 ± 0.7 mOsm/kg, p < 0.01), and not different from the SC group (335 ± 6.4 mOsm/kg), but higher than baseline (314 ± 5.3 mOsm/kg, p < 0.001). Urine production during the dwell was not different among the groups: None 10.6 ± 5.3 mL; SC 8.0 ± 6.0 mL; and IV 10.5 ± 5.6 mL. Transcapillary ultrafiltration after 4 hours was significantly higher in the IV group ( p < 0.05) compared to the other two groups. Net ultrafiltration and effective lymphatic absorption were similar in all groups. Mass transfer area coefficient of urea (MTACurea) was significantly greater in the IV group (155 ± 23.2 μL/minute, p < 0.003), but not different between the None (118 ± 16.2 μL/min) and SC (123 ± 25.9 μL/min) groups. Correcting these for the baseline plasma concentration resulted in higher values, but the IV data remained greater than the SC and None groups ( p < 0.01). The glucose absorption, albumin, and IgG clearances and the sieving of sodium were alike in all groups.

Conclusion

It can be concluded that IV fluid supplementation is more effective in preventing dehydration than SC supplementation, and it enhanced some peritoneal permeability characteristics in anesthetized rats during a 4-hour investigation. It is therefore important to standardize fluid supplementation in experiments with anesthetized animals.
Hyaluronan Preserves Peritoneal Membrane Transport Properties
Authors: Guo Qun-Ying , Peng Wen-Xing , Cheng Hui-Hong , Ye Ren-Gao , Lindholm Bengt , Wang Tao
Published: February 2020

Background

We have shown that intraperitoneal (IP) addition of hyaluronan (HA) in a single dwell study in rat could increase peritoneal fluid removal by decreasing the peritoneal fluid absorption rate. In this study, we investigated the impact of repeated use of HA on peritoneal membrane transport characteristics.

Methods

Twelve male Sprague–Dawley rats received a once-daily IP injection of 25 mL 4.25% glucose dialysis solution without (HP group, n = 6) or with 0.025% HA (HA group, n = 6) for 1 week. Forty-eight hours after the last injection, a 4 hour dwell using 25 mL 4.25% glucose dialysis solution with IP volume marker and frequent dialysate and blood samplings was performed in each rat as well as in rats that did not receive any injection (control group, n = 8).

Results

Although the IP volumes were significantly lower in the HP and HA groups compared to the control group, IP volume in the HA group was significantly higher than in the HP group. Net ultrafiltration at 4 hours was 5.6 ± 1.3 mL, 10.2 ± 1.8 mL, and 13.2 ± 0.6 mL for the H P, HA, and control group, respectively. The peritoneal fluid absorption rate decreased by 45% in the HA group compared to the HP group. There was no significant difference in peritoneal fluid absorption rate between the HA and the control group. No difference was found in the direct lymphatic absorption rate between the HP and HA groups [0.010 ± 0.003 mL/minute in the HP group and 0.011 ± 0.004 mL/min in the HA group] although they were both higher than that of the control group (0.004 ± 0.001 mL/min). The solute transport rates were in general significantly higher in the HP group compared to the HA and control groups, and there was no significant difference between the latter two groups, except that protein transport rate was significantly lower in the HA group compared to the control group.

Conclusions

The present study suggests that ( 1 ) repeated exposure to hypertonic glucose-based dialysis solution results in increased peritoneal solute transport rates, as well as increased peritoneal fluid absorption rates; and ( 2 ) these changes, reflecting a highly permeable peritoneal membrane, were ameliorated by repeated IP addition of hyaluronan. The similar changes in the direct lymphatic absorption rate in rats that received daily IP injection of dialysis solution suggest that direct peritoneal lymphatic absorption was not influenced by hyaluronan.
Acute Effects of Peritoneal Dialysis on Hemodynamics
Authors: Boon Diederik , Bos Willem Jan W. , Van Montfrans Gert A. , Krediet Raymond T.
Published: February 2020

Objectives

To investigate the acute hemodynamic effects of peritoneal dialysis (PD) using the noninvasive Portapres technique [TNO Biomedical Instrumentation (TNO BMI); Amsterdam, The Netherlands].

Design and Methods

Blood pressure was measured in 21 consecutive patients on continuous ambulatory PD during a standard peritoneal permeability analysis (SPA). Blood pressure, stroke volume, cardiac output, and total peripheral resistance were recorded and calculated using continuous finger pressure recordings with Portapres and Modelflow software (TNO BMI). The SPA consists of four phases: ( 1 ) drainage of night dwell dialysate, ( 2 ) instillation of a rinsing solution (1.36% glucose), ( 3 ) drainage of rinsing solution, and ( 4 ) instillation of the test solution (3.86% glucose to which dextran 70 has been added).

Results

Both systolic blood pressure (SBP) (7 ± 9 mmHg, p < 0.005) and diastolic blood pressure (DBP) (5 ± 6 mmHg, p < 0.01) increased during phase 2. Systolic BP and DBP increased further during phase 4 (SBP 8 ± 14 mmHg, p < 0.05; DBP 6 ± 8 mmHg, p < 0.005). These BP increases were caused by a rise in total peripheral resistance of 10% ± 18% ( p < 0.05) during phase 1, and 15% ± 21% ( p < 0.005) during phase 2.

Conclusions

Instillation and dwell of a dialysis solution during PD causes a rise in blood pressure. This is caused by an increase in total peripheral resistance. Factors influencing total peripheral resistance could be a direct mechanical effect of dialysate on mesenteric resistance vessels or a temperature-related effect.
Dissociation between Clearances of Small and Middle Molecules in Incremental Peritoneal Dialysis
Authors: Kim Dae Joong , Do Jung Ho , Huh Wooseong , Kim Yoon Goo , Oh Ha-Young
Published: February 2020

Objective

To evaluate the peritoneal clearance of middle molecules in comparison with the peritoneal clearance of small molecules in incremental peritoneal dialysis (PD).

Study Design

Peritoneal clearances of creatinine and b2-microgloblulin (B2M) were compared in 57 continuous ambulatory PD patients on full dose of 4 exchanges, and 54 incremental PD patients with 2 or 3 exchanges over 24 hours. Clearances were also compared when there were changes in the PD regimen, such as in the number of exchanges and the duration of the dwell time.

Setting

Tertiary-care university hospital.

Results

Peritoneal creatinine clearance increased almost linearly with the increase in the number of exchanges. In contrast, peritoneal clearance of B2M was 9.1 ± 3.6 L/week, 8.8 ± 4.4 L/week, and 7.9 ± 2.5 L/week with 2, 3, and 4 exchanges, respectively, per day, amounts that were not different from each other. Peritoneal clearance of B2M did not change when there was an increase in the number of dialysate exchanges from 2 to 3 and from 3 to 4 over a period of 24 hours; whereas the peritoneal clearance of creatinine increased. Peritoneal clearance of B2M almost doubled, from 5.4 ± 2.7 L/week with 2 exchanges over 12 hours per day, to 9.5 ± 4.4 L/week with the same 2 exchanges over 24 hours. The creatinine clearance did not change.

Conclusion

In contrast to peritoneal clearance of small molecules, such as creatinine, which was dependent on the number of dialysate exchanges, peritoneal clearance of middle molecules, such as B2M, depended mainly on the total dwell hours of PD and not on the number of exchanges of peritoneal dialysate in incremental PD. This might be another advantage of incremental PD, since peritoneal clearance of middle molecules in incremental PD over 24 hours can be comparable to that in full dose PD.
Effect of Preventing Staphylococcus Aureus Carriage on Rates of Peritoneal Catheter-Related Staphylococcal Infections. Literature Synthesis
Authors: Ritzau Jennifer , Hoffman Richard M. , Tzamaloukas Antonios H.
Published: February 2020

Objective

To determine whether specific preventive measures reduce the rate of peritoneal catheter-related infections and peritoneal catheter loss due to Staphylococcus aureus.

Design

Structured literature synthesis.

Methods

Relevant studies were identified by medline search, from personal files, and from the reference lists of retrieved articles. We analyzed English-language studies on treatment targeted at S. aureus, with at least 10 subjects and at least 3 months of follow-up, and data on staphylococcal peritoneal dialysis catheter infections. We excluded noncontrolled studies. Two investigators abstracted data using a structured form.

Results

W e evaluated six studies with concurrent controls and eight studies with historical controls. In one randomized, placebo-controlled, blinded study, periodic nasal mupirocin ointment reduced the rate of staphylococcal exit-site infection from 0.42 to 0.12 episodes/patient-year ( p = 0.006), but had no effect on the rates of staphylococcal tunnel infection, peritonitis, or catheter loss. In one randomized study without placebo control, periodic oral rifampin reduced the rate of staphylococcal exit-site infection from 0.65 to 0.22 epi/pt-yr ( p = 0.011), but had no effect on the rate of staphylococcal peritonitis. In another nonblinded, randomized, controlled study, the use of either rifampin or mupirocin was associated with low rates of staphylococcal catheter infections and catheter loss. In one study with historical controls, the rate of staphylococcal exit-site infection and peritonitis was lower after oral rifampin prophylaxis. In seven other studies comparing nasal or exit-site mupirocin to historical controls, the rate of staphylococcal exit-site infection decreased from 0.17 to 0.05 epi/pt-yr, the rate of staphylococcal peritonitis decreased from 0.18 to 0.06 epi/pt-yr, and the rate of catheter loss decreased from 0.09 to 0.05 epi/pt-yr during the mupirocin period.

Conclusion

The literature provides strong evidence that staphylococcal carriage prophylaxis using either oral rifampin or mupirocin ointment in the nares or exit site reduces significantly the rate of exit-site infection due to Staphylococcus aureus. Weaker evidence based on studies with historical controls suggests that rifampin or mupirocin prophylaxis also reduces the rate of staphylococcal peritonitis and peritoneal catheter loss. Studies with a stronger level of evidence are needed to verify this last point.