bluuebunny/crossref_metadata_2025 huggingface dataset:
Health systems changes after decentralisation: progress, challenges and dynamics in Pakistan
Authors: Zaidi Shehla Abbas , Bigdeli Maryam , Langlois Etienne V , Riaz Atif , Orr David W , Idrees Nasir , Bump Jesse B
Published: January 2019

Decentralisation is widely practised but its scrutiny tends to focus on structural and authority changes or outcomes. Politics and process of devolution implementation needs to be better understood to evaluate how national governments use the enhanced decision space for bringing improvements in the health system and the underlying challenges faced. We use the example of Pakistan’s radical, politically driven provincial devolution to analyse how national structures use decentralisation opportunities for improved health planning, spending and carrying out transformations to the health system. Our narrative draws on secondary data sources from the PRIMASYS study, supplemented with policy roundtable notes from Pakistan.

Our analysis shows that in decentralised Pakistan, health became prioritised for increased government resources and achieved good budgetary use, major strides were made contextualised sector-wide health planning and legislations, and a proliferation seen in governance measures to improve and regulate healthcare delivery. Despite a disadvantaged and abrupt start to devolution, high ownership by politicians and bureaucracy in provincial governments led to resourcing, planning and innovations. However, effective translation remained impeded by weak institutional capacity, feeble federal–provincial coordination and vulnerability to interference by local elites.

Building on this illustrative example, we propose (1) political management of decentralisation for effective national coordination, sustaining stable leadership and protecting from political interfere by local elites; (2) investment in stewardship capacity in the devolved structures as well as the central ministry to deliver on new roles.
Meta-analysis of the diagnostic value of Wisteria floribunda agglutinin-sialylated mucin1 and the prognostic role of mucin1 in human cholangiocarcinoma
Authors: Tang Zengwei , Yang Yuan , Wang Xiaolu , Meng Wenbo , Li Xun
Published: January 2019

Objective

Serum carbohydrate antigen 19–9 (CA19-9) is a widely used tumour marker for cholangiocarcinoma (CCA). However, it is not a necessarily good CCA marker in terms of diagnostic accuracy. The purpose of this study is to evaluate the diagnostic value ofWisteria floribundaagglutinin-sialylated Mucin1 (WFA-MUC1) and the prognostic role of Mucin1 (MUC1) in human CCA.

Design

Meta-analysis.

Data sources

Studies published in PubMed, Web of Science, The Cochrane Library and the China National Knowledge Infrastructure up to 11 October 2017.

Eligibility criteria

We included reports assessing the diagnostic capacity of WFA-MUC1 and the prognostic role of MUC1 in CCA. The receiver operating characteristic curve (ROC) of WFA-MUC1 and/or CA19-9 was described, and the HRs including 95% CI and the corresponding p value for MUC1 can be extracted.

Data extraction and synthesis

Two independent researchers extracted data and assessed risk of bias. The diagnostic sensitivity and specificity data of WFA-MUC1 were extracted and analysed as bivariate data. Pooled HRs and its 95% CI for MUC1 were calculated with a random-effects meta-analysis model on overall survival of resectable CCA.

Results

Sixteen reports were included in this study. The pooled sensitivity and specificity of WFA-MUC1 were 0.76 (95% CI 0.71 to 0.81) and 0.72 (95% CI 0.59 to 0.83) in serum, 0.85 (95% CI 0.81 to 0.89) and 0.72 (95% CI 0.64 to 0.80) in bile and 0.72 (95% CI 0.50 to 0.87) and 0.85 (95% CI 0.70 to 0.93) in tissue, respectively. The summary ROC (SROC) were 0.77 (95% CI 0.73 to 0.81) in serum, 0.88 (95% CI 0.85 to 0.90) in bile and 0.86 (95% CI 0.83 to 0.89) in tissue, respectively. Furthermore, the pooled sensitivity and specificity and the SROC of CA19-9 in serum were 0.67 (95% CI 0.61 to 0.72), 0.86 (95% CI 0.75 to 0.93) and 0.75 (95% CI 0.71 to 0.79), respectively. The pooled HRs for MUC1 was 2.20 (95% CI 1.57 to 3.01) in CCA and 4.17 (95% CI 1.71 to 10.17) in mass-forming intrahepatic CCA.

Conclusions

Compared with CA19-9, WFA-MUC1 was shown to possess stronger diagnostic capability. MUC1 could serve as a prognosis factor for poor outcomes of CCA, particularly, mass-forming intrahepatic CCA.
Reporting, presentation and wording of recommendations in clinical practice guideline for gout: a systematic analysis
Authors: Yang Nan , Yu Yang , Zhang Anqi , Estill Janne , Wang Xiaoqin , Zheng Mingfu , Zhou Qi , Zhang Jingyi , Luo Xufei , Qian Changli , Mao Yifang , Wang Qi , Yang Yantao , Chen Yaolong
Published: January 2019

Objectives

We systematically analysed recommendations from gout guidelines as an example, to provide a basis for developing a reporting standard of recommendations in clinical practice guidelines (CPGs).

Design

Systematic review without meta-analysis.

Methods

We systematically searched MEDLINE and all relevant guideline websites (National Institute for Health and Care Excellence, National Guideline Clearinghouse, Scottish Intercollegiate Guidelines Network, WHO, Guidelines International Network, DynaMed, UpTodate, Best Practice) from their inception to January 2017 to identify and select gout CPGs. We used search terms such as ‘gout’, ‘hyperuricemia’ and ‘guideline’. We included the eligible CPGs of gout according to the predefined inclusion and exclusion criteria after screening titles, abstracts and full texts. The characteristics of recommendations reported in the included guidelines were extracted and analysed.

Results

A total of 15 gout guidelines with a range of 5–80 recommendations were retrieved. Several indicators were used in the gout guidelines to facilitate identification of recommendations, including grouping all recommendations in a summary section, formatting recommendations in a particular or special way, using locating words for recommendations and indicating the strength of recommendation and quality of evidence. We found some components commonly used in the recommendations. The wording of recommendations varied across guidelines. Recommendations were detailed and explained in the section of rationale and explanation of recommendations. In some guidelines, recommendations were accompanied with other material to assist their reporting.

Conclusions

Variability and inconsistency were found on the reporting and presentation of recommendations in gout guidelines. Several points for reporting recommendation can be summarised. First, we suggested summarising and highlighting the core recommendations in a guideline. Second, guideline developers should try to structure and write recommendations reasonably. Third, it was necessary to detail and explain the recommendations and their rationale. Finally, describing and providing other potential useful contents was also a helpful way for clear reporting.
Twenty years of misdiagnosis of schizophrenia in a patient with Dandy-Walker variant syndrome
Authors: Gama Marques João
Published: January 2019

Various case reports of patients with Dandy-Walker variant syndrome mimicking schizophrenia have been published in the last 20 years, suggesting that this neurodevelopment disorder should be part of the differential diagnosis for every patient with a first episode of psychosis. In this report, it is presented that a patient who was diagnosed and treated as a paranoid schizophrenic for 20 years and had four bone fractures secondary to ataxic gait impairment, before performing a neuroimaging examination that revealed Dandy-Walker variant syndrome.
TERTgene: its function and dysregulation in cancer
Authors: Colebatch Andrew J , Dobrovic Alexander , Cooper Wendy A
Published: January 2019

In this review, we summarise the function and structure of telomerase reverse transcriptase (TERT) in humans, including its regulation. The dysregulation of telomerase throughTERTpromoter mutations across a range of cancers is discussed. The molecular mechanism activated byTERTpromoter mutations is outlined. Finally, the timing ofTERTpromoter mutations during carcinogenesis is reviewed in the context of their potential utility as clinical biomarkers of malignant transformation.
Association between allostatic load and health behaviours: a latent class approach
Authors: Forrester Sarah N , Leoutsakos Jeannie-Marie , Gallo Joseph J , Thorpe Roland J , Seeman Teresa E
Published: January 2019

Background

Allostatic load (AL) has been characterised in many ways throughout the literature; however, its relationship to health behaviours has only been studied in limited populations. We aimed to uncover qualitative patterns of biological indicators in AL and determine if those patterns were associated with certain health behaviours.

Methods

We conducted latent class analysis using biological indicators from a multiethnic population. We fit latent class regression of class on health behaviours (smoking, poor diet, physical activity and alcohol use) to measure the association between each latent class of AL and each health behaviour.

Results

Four classes, ‘Metabolic+Cholesterol, ‘Blood Pressure’, ‘Metabolic+Blood Pressure’ and ‘Low’, were found in the sample. Latent class regression showed that physical activity and alcohol use were significantly associated with the ‘Metabolic+Blood Pressure’ class.

Conclusion

Less physical activity was required to improve AL than was previously found. Low to moderate alcohol use was beneficial for lower AL. Implications of the amount of physical activity necessary to lower AL is discussed.
What’s in a smile? A review of the benefits of the clinician’s smile
Authors: Beamish Andrew James , Foster Jessica Jane , Edwards Harry , Olbers Torsten
Published: January 2019

For millennia, the smile has been recognised as a powerful communication device, offering benefits to both giver and receiver with few drawbacks. A sign of compassion, empathy and friendliness, smiling can benefit healthcare professionals and their patients, helping to build a relationship of trust. But beware the false smile, which is all too easily identified and may do more harm than good. In this review, we explore the literature surrounding smiling in healthcare and beyond, discussing the many reasons to be cheerful, from good health to a happy marriage, among aviators, table waiters, doctors, dentists and even dogs.
Associations between antenatal prednisone exposure and long-term cortisol and cortisone concentrations in children born to women with rheumatoid arthritis: results from a nationwide prospective cohort study
Authors: Ince-Askan Hilal , van den Akker Erica L T , de Rijke Yolanda B , van Rossum Elisabeth F C , Hazes Johanna M W , Dolhain Radboud J E M
Published: January 2019

Objectives

To identify whether children with antenatal prednisone exposure have chronically elevated cortisol and cortisone concentrations, an altered body composition or higher blood pressure. In addition, to identify whether maternal rheumatoid arthritis disease (RA) activity is associated with these alterations.

Methods

In this prospective study, 56 children (mean age=10.0 years) with and 61 children (mean age=9.6 years) without antenatal prednisone exposure, born to women with RA, were included. Hair cortisol and cortisone were analysed using liquid chromatography–tandem mass spectrometry. Linear regression models were built to analyse differences between the two groups, corrected for relevant covariates. Hair cortisol concentrations were also compared between the study population and an age-matched healthy reference group(n=150 children, mean age=9.8 years).

Results

Hair cortisol and cortisone concentrations were similar in children with and without antenatal prednisone exposure (median cortisol 1.14 pg/mg (IQR 0.67–1.75) and 1.15 pg/mg (IQR 0.65–2.21) and median cortisone 6.76 pg/mg (IQR 5.42–8.86) and 7.40 pg/mg (IQR 5.39–10.73), respectively). Antenatal prednisone exposure and maternal RA disease activity were also not associated with body composition or blood pressure. Hair cortisol concentrations were not different in children born to mothers with RA compared with children from the reference group.

Conclusion

This, in its kind, large and unique long-term prospective study demonstrates that low-dose antenatal prednisone exposure and maternal RA disease activity are not associated with negative consequences in prepubertal childhood. The findings of this study are reassuring and support the assumption that low-dose maternal prednisone use during pregnancy is safe for the offspring, at least until the age of approximately 10 years.
Treatment of cerebrospinal nematodiasis in a Boer Buck
Authors: Breuer Ryan , Merkatoris Paul , Tepley Samantha , Dierks Caitlyn , Klostermann Cassandra , Flaherty Heather , Smith Joseph
Published: January 2019

A nine‐month‐old Boer Buck presented for an acute onset of pelvic limb ataxia. Radiographs, complete blood count and serum biochemistry were within normal limits. A cerebrospinal fluid analysis yielded an eosinophilic pleocytosis, consistent with cerebrospinal nematodiasis. Treatment with ivermectin, non‐steroidal anti‐inflammatories, fenbendazole and range of motion exercises resulted in partial recovery of pelvic limb function within five days. Within five months post treatment the buck’s ambulation had returned to a normal gait.
Sequential drilling and drill angulation reduce the accuracy of drill hole start location in a synthetic bone model
Authors: Bishop Edith Sylvia , Hall Jon L , Handel Ian , Clements Dylan Neil , Ryan John
Published: January 2019

The accuracy of drill hole location is critical for implant placement in orthopaedic surgery. Increasing drill bit size sequentially has been suggested as a method for improving the accuracy of drill hole start location. The aim of this study was to determine whether sequential drilling or drill angulation would alter accuracy of drill hole start location. Three specialist veterinary surgeons drilled holes in synthetic bone models either directly, or with sequentially increasing drill bit sizes. Drilling was performed at 0o, 10o and 20o to perpendicular to the bone models. Three synthetic bone models were used to mimic canine cancellous and cortical bones. Sequential drilling resulted in greater inaccuracy in drill hole location when assessing all drilling angles together. There was no influence of surgeon or synthetic bone density on drilling accuracy. The combination of drill angulation and sequential drilling increased inaccuracy in drill hole start location. We conclude that sequential drilling decreased accuracy of drill hole location in the synthetic bone model when drilling was angled. Inaccuracy associated with the drill hole start location should be taken into account when performing surgery, although the magnitude of inaccuracy is low when compared with other sources of error such as angulation.
Why is the Supervet tour so popular?
Authors: Hobson‐West Pru
Published: January 2019

Pru Hobson‐West reflects on her experience of attending Noel Fitzpatrick's Supervet live tour and what she believes the general public may be gaining from the shows.
Christine Barbara Grinham
Authors: Heywood Emma , Newman Julia , Sidenius Katryn , Taylor Anne , Webber Sandra
Published: January 2019

A dedicated vet who, from graduation to retirement, had the best interests of her patients and staff at heart. She loved the countryside and being outdoors, especially with her husband and their dogs.
Numerical prediction of ice-jam profiles in lower Athabasca River
Authors: Beltaos Spyros
Published: January 2019

A recent study of dynamic ice breakup processes and their erosional potential in the Lower Athabasca River concluded that breakup can result in very large sediment loads, which cannot be predicted at present. As a first step towards building suitable modelling capability, a user-friendly, public-domain, ice jam model is calibrated and validated using 2013 and 2014 water level measurements as well as historical data sets by others. The calibrated model is shown to reliably compute the profiles of different ice jams occurring in a 60 km reach that extends both above and below Fort McMurray. The model also enabled development of an ice jam stage-flow relationship for the city of Fort McMurray, which can help assess present and future, climate-modified, flood risk.
Gauge and infrared properties of hadronic structure of nucleon in neutron beta decay to order O(α/π) in standard V − A effective theory with QED and linear sigma model of strong low-energy interactions
Authors: Ivanov A. N. , Höllwieser R. , Troitskaya N. I. , Wellenzohn M. , Berdnikov Ya. A.
Published: January 2019

Within the standard [Formula: see text] theory of weak interactions, Quantum Electrodynamics (QED) and the linear [Formula: see text]-model [Formula: see text] of strong low-energy hadronic interactions we analyze gauge and infrared properties of hadronic structure of the neutron and proton in the neutron [Formula: see text]-decay to leading order in the large nucleon mass expansion. We show that the complete set of Feynman diagrams describing radiative corrections of order [Formula: see text], induced by hadronic structure of the nucleon, to the rate of the neutron [Formula: see text]-decay is gauge noninvariant and unrenormalizable. We show that a gauge noninvariant contribution does not depend on the electron energy in agreement with Sirlin’s analysis of contributions of strong low-energy interactions (Phys. Rev. 164, 1767 (1967)). We show that infrared divergent and dependent on the electron energy contributions from the neutron radiative [Formula: see text]-decay and neutron [Formula: see text]-decay, caused by hadronic structure of the nucleon, are canceled in the neutron lifetime. Nevertheless, we find that divergent contributions of virtual photon exchanges to the neutron lifetime, induced by hadronic structure of the nucleon, are unrenormalizable even formally. Such an unrenormalizability can be explained by the fact that the effective [Formula: see text] vertex of hadron–lepton current–current interactions is not a vertex of the combined quantum field theory including QED and [Formula: see text], which are renormalizable theories. We assert that for a consistent gauge invariant and renormalizable analysis of contributions of hadronic structure of the nucleon to the radiative corrections of any order to the neutron decays one has to use a gauge invariant and fully renormalizable quantum field theory including the Standard Electroweak Model (SEM) and the [Formula: see text], where the effective [Formula: see text] vertex of hadron–lepton current–current interactions is caused by the [Formula: see text]-electroweak-boson exchange.
Bansara Eye Care: Growing Affordable Eye Care for the Rural Population
Authors: Lyngdoh Teidorlang , Sridhar G. , Mishra Prashant
Published: January 2019

Bansara eye care (BEC) is one of the first eye care providers in the state of Meghalaya, NE India and has brought many innovations in process and reduced cost of eye care treatment in the region. BEC has been trying to penetrate the rural markets, to educate and provide eye care services to the rural poor. The case deals with the challenges and poor acceptance of eye care services especially in the rural areas of the region. Lack of awareness and superstitious belief towards eye surgery was the main reason for poor penetration in the rural areas. The case highlights the key decisions that is required to be taken to be able to penetrate the rural markets and determine the expansion strategy.
iKure Techsoft: Providing Technology Enabled Affordable Health Care in Rural India
Authors: Chaudhuri Atanu , Saddikutti Venkatramanaiah , Prætorius Thim
Published: January 2019

iKure Techsoft was established in 2010 with the main objective to provide affordable and high quality primary health care to the rural population in India and to build a sustainable for-profit business model. To that end, iKure’s cloud based, and patent pending, Wireless Health Incident Monitoring System (WHIMS) technology along with their hub-and-spoke operating model are central, but also essential to exploit and explore further if iKure is to scale-up.

iKure provides primary health care services through three hub clinics and 28 rural health centres (RHCs). Each hub clinic employs between one and up to six medical teams (each consisting of 1 doctor, 1 nurse, 1 paramedic and 2 health workers stationed at the hub) & 1 mobile medical team (1 doctor, 1 paramedic, 2 health workers) for catering to the RHCs). Each medical team manages six RHCs.

Paramount in iKure’s health care delivery model is their self-developed software called WHIMS, which is a cloud-based award-winning application that runs on low internet bandwidths. WHIMS allow for (a) centralized monitoring of key metrics such as doctor’s attendance, treatment prescribed, patient record management, pharmacy stock management, and (b) supports effective communication, integration and contact that connects RHCs with hub clinics, but also city-based multi-specialty hospitals with whom iKure has formal tie-ups.

iKure, moreover, also works extensively with Non-Governmental Organizations (NGOs). Collaboration with local NGOs in the target areas helps to build trust with the rural villagers and their local knowledge and access helps to assess service demand. NGOs also provide the necessary local logistical support and basic infrastructure in the rural areas where iKure works. Moreover, collaboration, for example, with corporate organizations are central as they contribute with part of their corporate social responsibility (CSR) funds to support iKure initiatives.

At present, iKure is planning to add diagnostic services to its six hub clinics as well as expand its presence in other parts of West Bengal and other states across India. Expanding rural health care services even with the technology support of WHIMS is challenging because, for example, health is a very local issue (due to, among other things, local customs and languages) and it requires investing significant amount of time and resources to build relationship with the rural people as well as collaborators such as NGOs and corporates.

The accompanying case describes iKure’s journey so far in terms of understanding: (a) the state of health care and government health care services provided in rural India, (b) the establishment and evolution of the iKure business and health care model, (c) iKure’s operations and health care delivery model including the WHIMS technology solution and hub-and-spoke set-up of operations, (d) the collaborative model which relies on NGOs and private corporates, and (e) finally iKure’s challenges related to scaling-up.
CEO Compensation after Harvester Director Departure
Authors: Jarosiewicz Victor Esteban
Published: January 2019

I examine the effects of board member departures on CEO compensation using a sample of high-growth IPO firms. Agency theory predicts that a reduction in board monitoring by harvester directors (VCs and private equity investors) will result in an increase in CEO pay. I find that departures of the last harvester director on a board result in an immediate and lasting increase in CEO equity compensation, while prior departures by other harvester directors are not significant. The results hold even when controlling for other governance mechanisms, such as CEO wealth, CEO turnover, board composition, and external blockholder ownership.
Automated Segmentation of Colorectal Tumor in 3D MRI Using 3D Multiscale Densely Connected Convolutional Neural Network
Authors: Soomro Mumtaz Hussain , Coppotelli Matteo , Conforto Silvia , Schmid Maurizio , Giunta Gaetano , Del Secco Lorenzo , Neri Emanuele , Caruso Damiano , Rengo Marco , Laghi Andrea
Published: January 2019

The main goal of this work is to automatically segment colorectal tumors in 3D T2-weighted (T2w) MRI with reasonable accuracy. For such a purpose, a novel deep learning-based algorithm suited for volumetric colorectal tumor segmentation is proposed. The proposed CNN architecture, based on densely connected neural network, contains multiscale dense interconnectivity between layers of fine and coarse scales, thus leveraging multiscale contextual information in the network to get better flow of information throughout the network. Additionally, the 3D level-set algorithm was incorporated as a postprocessing task to refine contours of the network predicted segmentation. The method was assessed on T2-weighted 3D MRI of 43 patients diagnosed with locally advanced colorectal tumor (cT3/T4). Cross validation was performed in 100 rounds by partitioning the dataset into 30 volumes for training and 13 for testing. Three performance metrics were computed to assess the similarity between predicted segmentation and the ground truth (i.e., manual segmentation by an expert radiologist/oncologist), including Dice similarity coefficient (DSC), recall rate (RR), and average surface distance (ASD). The above performance metrics were computed in terms of mean and standard deviation (mean ± standard deviation). The DSC, RR, and ASD were 0.8406 ± 0.0191, 0.8513 ± 0.0201, and 2.6407 ± 2.7975 before postprocessing, and these performance metrics became 0.8585 ± 0.0184, 0.8719 ± 0.0195, and 2.5401 ± 2.402 after postprocessing, respectively. We compared our proposed method to other existing volumetric medical image segmentation baseline methods (particularly 3D U-net and DenseVoxNet) in our segmentation tasks. The experimental results reveal that the proposed method has achieved better performance in colorectal tumor segmentation in volumetric MRI than the other baseline techniques.
Evaluation of the Effects of Aedes Vector Indices and Climatic Factors on Dengue Incidence in Gampaha District, Sri Lanka
Authors: Wijegunawardana N. D. A. D. , Gunawardene Y. I. N. Silva , Chandrasena T. G. A. N. , Dassanayake R. S. , Udayanga N. W. B. A. L. , Abeyewickreme W.
Published: January 2019

Constant monitoring of Aedes vector indices such as Aedes mosquito abundance and ovitrap data is important for the control of dengue epidemics. Therefore, the current study attempted to evaluate the effect of larval and climatic factors on the incidence of dengue outbreaks in the Gampaha district. Based on the distribution of previously reported dengue cases, 34 households in Narangodapaluwa PHI area, Ragama, Sri Lanka, were selected randomly, and entomological surveillance was done fortnightly using adult mosquito catches and larval surveillance techniques for a period of two years. Further, weekly ovitrap surveillance was conducted for one year, by maintaining four ovitraps in a single house, two indoors and two outdoors at ground and at a height of 1.5–2 m. Based on the findings, larval indices, namely, Breteau index (BI), House index (HI), and Container index (CI), were calculated, along with the Ovitrap index (OI). The study area was positive for Ae. albopictus with an adult capturing range of 1~15/34 households. BI initially remained < 3%, which subsequently decreased up to 0. No significant difference in OI was found between the ovitraps placed at ground level and at a height of 1.5-2m (p>0.05), 95% level of confidence. The OI varied from 56.9% to 94.7% during the study period of 12 months, indicating two peaks at the monsoons. Statistics of one-way ANOVA revealed a significant difference in the monthly OI during the study period (p≤0.001) with two peaks representing the monsoonal rainfall patterns. Pearson’s correlation analysis revealed that the association between dengue cases and larval indices (BI, CI, HI, and OI) and meteorological parameters was not significant (p<0.05). Migration of mosquitoes and patients could be considered as possible factors affecting the absence of a significant relationship.
Optimal Observer Design of State Delay Systems
Authors: Chou Fu-I , Cheng Ming-Yang
Published: January 2019

This paper proposes a new method to design the observer for state delay systems such that (i) state estimation errors converge to zero quickly and (ii), at the same time, a quadratic performance measurement of the deviation of estimates from the actual states is minimized for reducing large error during the transient period of observation. The proposed new approach fuses the merits of both the orthogonal functions approach and evolutionary optimization. One illustrative example is given to verify the effectiveness and efficiency of the proposed new optimization method on performance improvement of state estimations. From the illustrative example, in addition to the asymptotical convergence of the estimated state errors, the performance index for the proposed optimal design approach is clearly much lower than that of the nonoptimal design method.
ДИНАМІКА ПІСЛЯІНФАРКТНОГО РЕМОДЕЛЮВАННЯ СЕРЦЯ ЗА ДАНИМИ ЕХОКАРДІОСКОПІЇ ПРИ ЗАСТОСУВАННІ РАМІПРИЛУ І ЗОФЕНОПРИЛУ
Authors: Bidovanets L. Yu.
Published: January 2019

Мета: оцінити динаміку післяінфарктного ремоделювання серця у хворих на гострий інфаркт міокарда на тлі приймання препаратів групи інгібіторів ангіотензинперетворювального ферменту раміприлу і зофеноприлу.

Матеріали і методи. Обстежено 54 хворих на гострий інфаркт міокарда, до складу комплексної терапії яких включено раміприл і зофеноприл. Оцінювали та порівнювали розміри серця за результатами ехокардіоскопії, рівень артеріального тиску, частоту серцевих скорочень та величину подвійного добутку.

Результати. Включення у комплексну терапію хворих на гострий інфаркт міокарда раміприлу і зофеноприлу супроводжується практично однаковим ефектом щодо зниження артеріального тиску та його стабільного утримання в межах фізіологічної норми протягом 3 місяців післяінфарктного періоду.

Застосування зофеноприлу, порівняно з раміприлом, у хворих, які перенесли гострий інфаркт міокарда, через 3 місяці супроводжується істотним зниженням частоти серцевих скорочень, подвійного добутку, кінцево-систолічного обʼєму (на 18,7 %), збільшенням фракції викиду (на 16,8 %), що свідчить про позитивний вплив препарату не тільки на величину артеріального тиску, але й на стан міокарда та його відновлення в післяінфарктний період.

Висновки. Включення у комплексну терапію хворих на гострий інфаркт міокарда раміприлу і зофеноприлу створює передумови для зниження тяжкості ушкодження міокарда та його відновлення в післяінфарктний період.
ОРГАНІЗАЦІЙНО-МЕТОДИЧНІ ВКАЗІВКИ ВЕДЕННЯ ПАЦІЄНТІВ З ВІРУСНИМ ГЕПАТИТОМ С
Authors: Komar O. M. , Kizlova N. M.
Published: January 2019

Мета: удосконалити організацію основних складових надання медичної допомоги пацієнтам з вірусним гепатитом С; зменшити ризик інфікування вірусом дорослого населення.

Матеріали і методи. Системному аналізу підлягали існуючі міжнародні й вітчизняні стандарти, протоколи і вказівки надання медичної допомоги хворим з вірусним гепатитом С. використання контент-аналізу дозволило вивчити нормативно-правове поле на теренах України організації системи охорони здоров’я за видами та рівнями надання медичної допомоги цій категорії пацієнтів, а бібліосемантичний метод дослідження окреслив коло невирішених питань щодо організаційно-методичного ведення пацієнтів з вірусним гепатитом С.

Результати. Запропоновано комплексний підхід до функціонально-структурної організації надання медичної допомоги пацієнтам з вірусним гепатитом С за рівнями (первинний, вторинний, третинний). Наведено методологію ранньої діагностики вірусного гепатиту С у вигляді алгоритму дій для лікаря первинної ланки та спеціаліста (інфекціоніста, гастроентеролога). Розкрито профілактичні технології попередження інфікування й розповсюдження вірусного гепатиту С.

Висновки. Виконання організаційно-методичних вказівок ведення пацієнтів з вірусним гепатитом С дасть змогу забезпечити проведення консультацій і тестування громадян за клінічними, епідеміологічними показниками та з профілактичною метою, а також з метою виявлення інфікованих вірусним гепатитом С.
Antithrombotic Agents
Authors: Chan Noel C. , Weitz Jeffrey I.
Published: January 2019

Recent advances in our understanding of the contribution of thrombin generation to arterial thrombosis and the role of platelets in venous thrombosis have prompted new treatment paradigms. Nonetheless, bleeding remains the major side effect of such treatments spurring the quest for new antithrombotic regimens with better benefit-risk profiles and for safer anticoagulants for existing and new indications. The aims of this article are to review the results of recent trials aimed at enhancing the benefit-risk profile of antithrombotic therapy and explain how these findings are changing our approach to the management of arterial and venous thrombosis. Focusing on these 2 aspects of thrombosis management, this article discusses 4 advances: (1) the observation that in some indications, lowering the dose of some direct oral anticoagulants reduces the risk of bleeding without compromising efficacy, (2) the recognition that aspirin is not only effective for secondary prevention of atherothrombosis but also for prevention of venous thromboembolism, (3) the finding that dual pathway inhibition with the combination of low-dose rivaroxaban to attenuate thrombin generation plus aspirin to reduce thromboxane A2-mediated platelet activation is superior to aspirin or rivaroxaban alone for prevention of atherothrombosis in patients with coronary or peripheral artery disease, and (4) the development of inhibitors of factor XI or XII as potentially safer anticoagulants.
SarcTrack
Authors: Toepfer Christopher N. , Sharma Arun , Cicconet Marcelo , Garfinkel Amanda C. , Mücke Michael , Neyazi Meraj , Willcox Jon A.L. , Agarwal Radhika , Schmid Manuel , Rao Jyoti , Ewoldt Jourdan , Pourquié Olivier , Chopra Anant , Chen Christopher S. , Seidman Jonathan G. , Seidman Christine E.
Published: January 2019

Rationale:

Human induced pluripotent stem cell–derived cardiomyocytes (hiPSC-CMs) in combination with CRISPR/Cas9 genome editing provide unparalleled opportunities to study cardiac biology and disease. However, sarcomeres, the fundamental units of myocyte contraction, are immature and nonlinear in hiPSC-CMs, which technically challenge accurate functional interrogation of contractile parameters in beating cells. Furthermore, existing analysis methods are relatively low-throughput, indirectly assess contractility, or only assess well-aligned sarcomeres found in mature cardiac tissues.

Objective:

We aimed to develop an analysis platform that directly, rapidly, and automatically tracks sarcomeres in beating cardiomyocytes. The platform should assess sarcomere content, contraction and relaxation parameters, and beat rate.

Methods and Results:

We developed SarcTrack, a MatLab software that monitors fluorescently tagged sarcomeres in hiPSC-CMs. The algorithm determines sarcomere content, sarcomere length, and returns rates of sarcomere contraction and relaxation. By rapid measurement of hundreds of sarcomeres in each hiPSC-CM, SarcTrack provides large data sets for robust statistical analyses of multiple contractile parameters. We validated SarcTrack by analyzing drug-treated hiPSC-CMs, confirming the contractility effects of compounds that directly activate (CK-1827452) or inhibit (MYK-461) myosin molecules or indirectly alter contractility (verapamil and propranolol). SarcTrack analysis of hiPSC-CMs carrying a heterozygous truncation variant in the myosin-binding protein C (
MYBPC3
) gene, which causes hypertrophic cardiomyopathy, recapitulated seminal disease phenotypes including cardiac hypercontractility and diminished relaxation, abnormalities that normalized with MYK-461 treatment.

Conclusions:

SarcTrack provides a direct and efficient method to quantitatively assess sarcomere function. By improving existing contractility analysis methods and overcoming technical challenges associated with functional evaluation of hiPSC-CMs, SarcTrack enhances translational prospects for sarcomere-regulating therapeutics and accelerates interrogation of human cardiac genetic variants.
Anthurium rosselianum (Araceae), a new species of Anthurium section Belolonchium from Colombia
Authors: CROAT THOMAS B.
Published: January 2019

A new species of Anthurium section Belolonchium from Colombia is described and justified by making comparisons with several other species in the section. The species is named in honor of the late, Allan Rossel, formerly a Volunteer Research Associate with the Missouri Botanical Garden.
Two new species of Ceropales (Ceropales) Latreille (Hymenoptera, Pompilidae), with a key to species from China
Authors: LU HAI-XIA , BASHIR NAWAZ HAIDER , LI QIANG , MA LI
Published: January 2019

Two new species in the Ceropales helvetica species-group are described: Ceropales (Ceropales) longisulcata Lu & Li, sp. nov. from Inner Mongolia, China and Ceropales (Ceropales) yunnanensis Lu & Li, sp. nov. from Yunnan, China. A key to the species of Ceropales (C.) from China is provided.
Morphological and molecular characterization of Lepidonema magnum Morffe & García, 2010 (Nematoda: Oxyuridomorpha: Hystrignathidae) from Passalus interstitialis Eschscholtz, 1829 (Coleoptera: Passalidae) from Cuba and new locality records for the species
Authors: MORFFE JANS , GARCÍA NAYLA , BREUGELMANS KARIN , HASEGAWA KOICHI , DAVIS ANDREW K.
Published: January 2019

Lepidonema magnum Morffe & García, 2010 (Nematoda: Oxyuridomorpha: Hystrignathidae) is redescribed and illustrated with the aid of SEM. New features of the cephalic end and genital tract of the females were observed. New locality records are given. The phylogenetic position of the species is inferred on the basis of the D2-D3 segment of the 28S LSU rDNA and 18S SSU rDNA. L. magnum forms a monophyletic clade formed by other hystrignathids: Coynema poeyi (Coy, García & Álvarez, 1993), two species of Longior Travassos & Kloss, 1958 and two Hystrignathus Leidy, 1850.
A new species of the genus Oxyporus Fabricius (Coleoptera: Staphylinidae: Oxyporinae) in Yunnan Province, China
Authors: LI GUO-FENG , WANG CHUN-MEI , LI HUA-FENG , LI ZHU-JIE , WU XING-XING
Published: January 2019

A new species of the genus Oxyporus Fabricius, 1775 is described based on specimens collected in Yunnan Province, China, namely Oxyporus (Oxyporus) tuantianius sp. nov. from Xinping County. The number of Oxyporus species worldwide is thus increased to 131. Color images of the habitus and aedeagus of the new species are included. A key to the Oxyporus species of Yunnan Province is provided.
Lipoprotein(a) in Patients Undergoing Transcatheter Aortic Valve Replacement
Authors: Ma Gary S. , Wilkinson Michael J. , Reeves Ryan R. , Yeang Calvin , DeMaria Anthony N. , Cotter Bruno , Patel Mitul , Mahmud Ehtisham , Tsimikas Sotirios
Published: January 2019

Lipoprotein(a) [Lp(a)] is a genetically determined risk factor for calcific aortic valve stenosis (CAVS) for which transcatheter aortic valve replacement (TAVR) is increasingly utilized as treatment. We evaluated the effect of a program to increase testing of and define the prevalence of elevated Lp(a) among patients undergoing TAVR. Educational efforts and incorporation of a “check-box” Lp(a) order to the preoperative TAVR order set were instituted. Retrospective chart review was performed in 229 patients requiring TAVR between May 2013 and September 2018. Of these patients, 57% had an Lp(a) level measured; testing rates increased from 0% in 2013 to 96% in 2018. Lipoprotein(a) testing occurred in 11% of patients before and in 80% of patients after the “check-box” order set ( P < .001). The prevalence of elevated Lp(a) (≥30 mg/dL) was 35%; these patients had a higher incidence of coronary artery disease requiring revascularization compared with patients with normal Lp(a) (65% vs 47%; P = .047). Patients with Lp(a) ≥30 mg/dL also had higher incidence of paravalvular leak compared with those with normal Lp(a) (13% vs 4%; P = .04). This study defines the prevalence of elevated Lp(a) in advanced stages of CAVS and provides a practice pathway to assess procedural complications and long-term outcomes of TAVR in patients with elevated Lp(a) levels.
Mouse Model of Tracheal Replacement With Electrospun Nanofiber Scaffolds
Authors: Dharmadhikari Sayali , Best Cameron A. , King Nakesha , Henderson Michaela , Johnson Jed , Breuer Christopher K. , Chiang Tendy
Published: January 2019

Objectives:

The clinical experience with tissue-engineered tracheal grafts (TETGs) has been fraught with graft stenosis and delayed epithelialization. A mouse model of orthotopic replacement that recapitulates the clinical findings would facilitate the study of the cellular and molecular mechanisms underlying graft stenosis.

Methods:

Electrospun nanofiber tracheal scaffolds were created using nonresorbable (polyethylene terephthalate + polyurethane) and co-electrospun resorbable (polylactide-co-caprolactone/polyglycolic acid) polymers (n = 10/group). Biomechanical testing was performed to compare load displacement of nanofiber scaffolds to native mouse tracheas. Mice underwent orthotopic tracheal replacement with syngeneic grafts (n = 5) and nonresorbable (n = 10) and resorbable (n = 10) scaffolds. Tissue at the anastomosis was evaluated using hematoxylin and eosin (H&E), K5+ basal cells were evaluated with the help of immunofluorescence testing, and cellular infiltration of the scaffold was quantified. Micro computed tomography was performed to assess graft patency and correlate radiographic and histologic findings with respiratory symptoms.

Results:

Synthetic scaffolds were supraphysiologic in compression tests compared to native mouse trachea ( P < .0001). Nonresorbable scaffolds were stiffer than resorbable scaffolds ( P = .0004). Eighty percent of syngeneic recipients survived to the study endpoint of 60 days postoperatively. Mean survival with nonresorbable scaffolds was 11.40 ± 7.31 days and 6.70 ± 3.95 days with resorbable scaffolds ( P = .095). Stenosis manifested with tissue overgrowth in nonresorbable scaffolds and malacia in resorbable scaffolds. Quantification of scaffold cellular infiltration correlated with length of survival in resorbable scaffolds (R2 = 0.95, P = .0051). Micro computed tomography demonstrated the development of graft stenosis at the distal anastomosis on day 5 and progressed until euthanasia was performed on day 11.

Conclusion:

Graft stenosis seen in orthotopic tracheal replacement with synthetic tracheal scaffolds can be modeled in mice. The wide array of lineage tracing and transgenic mouse models available will permit future investigation of the cellular and molecular mechanisms underlying TETG stenosis.
Quantitative Analysis of Carbon with Laser-Induced Breakdown Spectroscopy (LIBS) Using Genetic Algorithm and Back Propagation Neural Network Models
Authors: He Jiao , Pan Congyuan , Liu Yongbin , Du Xuewei
Published: January 2019

Carbon content detection is an essential component of the metal-smelting and classification processes. An obstacle in carbon content detection by laser-induced breakdown spectroscopy (LIBS) of steel is the interference of carbon lines by the adjacent Fe lines. The emission line of C(I) 247.86 nm generally has higher response and transmission efficiency than the emission line of C(I) 193.09 nm, but it blends with the Fe(II) 247.86 nm line. Therefore, this study proposes a method of back propagation (BP) neural network modeling, which incorporates a genetic algorithm (GA), evaluates the method of parameter modeling and prediction based on GA to optimize the BP neural network (GA–BP), and realizes a quantitative analysis of the C(I) 247.86 nm line. The achieved root mean square error for the GA–BP model is 0.0114. The obtained linear correlation coefficient shows a significant improvement after correction, indicating that the proposed method is effective. The method is concise, easy to implement, and can be applied in the carbon content detection of steels and iron-based alloys.
Self-Association of the Macromolecules of Aldrich Humic Acid in Aqueous Solutions Using Ultraviolet–Visible (UV–Vis) Absorption Spectroscopy
Authors: Lavrik Nikolay L. , Bazhin Nikolay M.
Published: January 2019

The ultraviolet–visible (UV–Vis) spectra of the aqueous solutions of humic acids (HA) Aldrich were obtained within the concentration range 1–20 mg/L (0.1–2ċ10–6 mol/L). A conclusion on the existence of the self-association (dimer formation) of HA macromolecules is based on the deviation of the concentration dependence of optical density (OD) from the linear one at [HA] > 10 mg/L (>10–6 mol/L). An original, mathematical algorithm is proposed to determine a dimerization constant K and a molar coefficient of dimer absorption [Formula: see text] The value of K was (2.56 ± 0.07) ċ 106 L/mol. The calculated molar coefficients of HA macromolecule dimer absorption, [Formula: see text], indicate an increase in the dimer extinction coefficient [Formula: see text] compared to the double value of the molar monomer absorption 2[Formula: see text]. It was established that the spectral dependence of the value β = [Formula: see text]/[Formula: see text] exhibits a minimum within a wavelength range of 300–450 nm, which is due to the difference in the efficiency of the interaction of various sites upon HA macromolecule dimerization. Thus, an approach of studying the processes of self-association is proposed using the method of UV–Vis absorption spectroscopy. This method is implemented for molecules that do not have characteristic absorption bands. The proposed method can also be successfully applied to molecules with characteristic absorption bands.
Indigenous students attendance at one Australian urban primary school (2005–2015): A case study
Authors: Baxter Lindy P , Meyers Noel M
Published: January 2019

Urban Indigenous students’ school attendance and factors contributing to annual attendance rates are relatively unknown, and yet almost 80% of the Indigenous population resides in non-remote regions. Our longitudinal study evaluated an urban primary school where Indigenous families preferentially enrolled their children because they recognised it supported their children in ways that celebrated Indigenous culture and ameliorated school-related symptoms of poverty. Indigenous students’ attendance influences appeared in phases: Indigenous status, poverty, and family characteristics, until significant influences for attendance were exhausted. While Indigenous students’ mean attendance rates were bounded between 80% and 90%, and below non-Indigenous peers’ attendance in each year, slight improvement occurred, even as poverty universally pervaded the Indigenous community. As poverty among non-Indigenous students increased, their mean attendance also declined below the 90% national benchmark.
Aspirational Talk in Strategy Texts: A Longitudinal Case Study of Strategic Episodes in Corporate Social Responsibility Communication
Authors: Penttilä Visa
Published: January 2019

This article examines the embeddedness of corporate social responsibility (CSR) communications in strategic planning. By drawing on the idea that talk and texts about CSR are an essential part of responsibility practices, I study how CSR aspirations—responsibility-related organizational self-descriptions, goals, and ideals that the organization cannot yet live up to or that the organizational constituents deem necessary to maintain—are intertwined with strategy texts and strategic episodes. Conducting a qualitative case study on a series of biennial strategy processes over a 20-year period, I show how CSR aspirations are established in authoritative strategy documents during stakeholder interactions, elaborated in consecutive strategic episodes, extended to new business areas, and evaluated in subsequent communications. These findings contribute to the CSR and strategy literature by showing how (a) aspirational talk can be established and perpetuated through recurrent communicative processes, (b) stakeholder engagement in CSR issues can influence strategy texts and how strategy texts become a part of intertextual organizational communications, and (c) strategic context can be conducive to progressive performativity.