bluuebunny/crossref_metadata_2025 huggingface dataset:
Antiplatelet therapy in elderly patients with acute coronary syndrome: Between scientific evidence and future perspectives
Authors: BarillÃ  Francesco , Torromeo Concetta , Iorio Riccardo , Porco Luigina , Paravati Vincenzo , Gaudio Carlo
Published: June 2018

Dual antiplatelet therapy (DAPT) is an important strategy for reducing cardiovascular events (CV) after an acute coronary syndrome (ACS). Elderly patients undergoing DAPT have a higher risk of bleeding than younger patients for a variety of reasons. Stratification of thrombotic/hemorrhagic risk is mandatory in order to decide on the type and duration of DAPT. The percentage of patients â‰¥ 75 years represented in clinical trials is not large, so very often elderly people are prescribed treatment protocols only experimented on younger patients with a lower hemorrhagic risk. However, even in patients aged â‰¥ 75 treated with invasive or conservative therapy, after an ACS, a DAPT with aspirin 80-100 mg/day plus a P2Y12 receptor inhibitor for 12 months is recommended. In elderly patients, DAPT should be considered a dynamic process that can be modified over time based on the patient's clinical conditions, or any other necessities (non-procrastinating surgical interventions, comorbid-like effects that can increase hemorrhagic risk). In patients with moderate-high or very high hemorrhagic risk, DAPT treatment should last less than 12 months. A prolongation of DAPT beyond 12 months in this setting is limited to a very low percentage of patients, after careful assessment of ischemic/hemorrhagic profile.
DAPT plus anticoagulant therapy: The difficult coexistence post-ACS in older patients with atrial fibrillation
Authors: Di Bari Mauro , Pratesi Alessandra , Nigro Francesca M. , Marozzi Irene , Fumagalli Stefano
Published: June 2018

Atrial fibrillation (AF) and coronary artery disease requiring percutaneous coronary intervention (PCI) and stenting often coexist in older patients. This poses the difficult problem of concurrent anticoagulant and double antiplatelet therapy (triple therapy). Current treatment guidelines do recommend triple therapy, especially in the course of acute coronary syndrome (ACS), with limitations due to an excessive risk of bleeding associated with this therapeutic regimen. This review summarizes randomized clinical trials and observational studies that compared triple therapy with a variety of different therapeutic options. Although the available evidence is not completely satisfactory and other studies are urgently needed, alternative regimens to triple therapy in AF patients undergoing PCI and stenting are promising, at least in terms of safety.
Efficacy and safety of oral anticoagulant therapy in frail patients with atrial fibrillation
Authors: Patti Giuseppe , Mantione Ludmilla , Bressi Edoardo , Bisignani Antonio
Published: June 2018

Antithrombotic treatment of frail patients with AF presents various challenges. The fear of bleeding often leds to a large underuse of anticoagulant agents in these patients, although more recent data indicate that oral anticoagulation Â (especially with the newer, direct anticoagulants) is increasingly used. While there is a need for more real world data, available evidence suggests that non-vitamin K antagonist oral anticoagulants (NOACs) are an effective alternative to warfarin in frail patients with AF for preventing thromboembolic events, with a better safety profile. Logical considerations and evidence-base data related to the reduced bleeding risk (also including major bleeding and intracranial bleeding) of NOACs make these drugs the anticoagulant agents of choice in frail patients; however, in this setting an individualised approach should be taken, taking into consideration the risk of thromboembolic and bleeding events, other comorbidities and patient-related factors, rather than a generalised â€œone drug fits allâ€ approach.
Management of hypertension in the elderly: Looking for a trade-off between cardiovascular prevention and serious adverse events
Authors: Buonacera Agata , Stancanelli Benedetta , Malatino Lorenzo
Published: June 2018

Despite the effectiveness of anti-hypertensive therapy is well recognized, the most adequate target to achieve in the management of hypertension in the elderly is still under debate. Indeed, looking at the balance between benefits and risks, accumulating evidence has recently specifically addressed this issue, focusing on controversies. Evidence surrounding a more aggressive treatment may lead to a turnaround in the clinical care of older adult hypertensives, but a balanced trade-off between benefits and risks needs to be programmed and achieved, particularly in this clinical setting. We argue whether and how the results from recent trials could influence the management of hypertension in older people.
Effect of sodium metabisulfite gel on the bond strength of dentin of bleached teeth
Authors: Vieira Henrique Heringer , Toledo Josè Carlos , Catelan Anderson , Gouveia Thayla Hellen Nunes , Aguiar Flávio Henrique Baggio , Lovadino Josè Roberto , Lima Dèbora Alves Nunes Leite
Published: June 2018

Objective: This study aimed to evaluate the effect of the application of sodium metabisulfite (SMB) on the bond strength of bleached teeth. Materials and Methods: The study was divided into two parts. The first part evaluated the application of various concentrations of SMB for 1 h prior to the completion of bonding procedures. Fifty blocks were divided into five groups (n = 10): control; bleaching with 35% hydrogen peroxide (HP); HP + 5% SMB; HP + 12.5% SMB; and HP + 25% SMB. The second part evaluated the application of 25% gel SMB to either enamel or dentin, including the application time. Sixty blocks were divided into six groups (n = 10): control; bleaching with 35% HP; HP + 25% SMB for 1 h in enamel; HP + 25% SMB for 1 h in dentin; HP + 25% SMB for 10 min in enamel; and HP + 25% SMB for 10 min in dentin. Statistical Analysis: Following the completion of microshear bond testing, data were analyzed using one-way analysis of variance as well as Tukey's and Dunnett's tests. Results: In part 1, data analysis revealed statistical differences (P < 0.0001) between HP and HP + 5% SMB. No statistical differences were found between the control and both HP + 12.5% SMB and HP + 25% SMB. Part 2 revealed a statistical difference (P = 0.001359) only between the bleached group and others. Conclusions: The use of 25% SMB gel immediately after bleaching was able to reverse the deleterious effect of bleaching on the bond strength of dental composites to dentin.
Comparative evaluation of apical constriction position in incisor and molar teeth: An in vitro study
Authors: Mousavi Seyed Amir , Farhad Alireza , Shahnaseri Shirin , Basiri Abbas , Kolahdouzan Erfan
Published: June 2018

Objective: The apical constriction (AC) and the apical foramen (AF) are the principal reference points used to determine the apical limit for instrumentation and root canal filling. AC varies in different races, and the aim of the current study was to measure and compare the distances from AC to AF and the anatomical apex (AA) in incisor and molar teeth in the Iranian population. Materials and Methods: Forty-five roots of incisor teeth and 45 roots of molar teeth were selected randomly in Isfahan Province, Iran. If the foramen was located toward the mesial or distal side of the apex, the cut was made mesiodistally, and if it was toward the buccal or lingual side, the section was made accordingly. Roots were examined under a microscope at ×25 magnification. The distances from AC to AF and AA were then estimated using a Motic camera. Descriptive statistics were used. The independent t-test was also used to compare distances in incisors and molars, and P = 0.05 was deemed to indicate statistical significance. Results: The mean distances between AC and AF were 0.847 ± 0.33 mm in incisors and 0.709 ± 0.27 mm in molars. The mean distances between AC and AA were 1.23 ± 0.39 mm in incisors and 1.01 ± 0.38 mm in molars. In an independent t-test, the distances between AC and AF differed significantly in incisors and molars (P = 0.035), but the distances between AC and AA did not (P = 0.172). Conclusion: The end points for root canal therapy should be 0.85 mm in incisors and 0.70 mm in molars.
A national survey of tooth wear on facial and oral surfaces and risk factors in young Nigerian adults
Authors: Olaide Savage Kofoworola , Oderinu Olabisi Hajarat , Adegbulugbe Ilemobade Cyril , Uti Omolara Gbonjubola , Dosumu Oluwole Oyekunle , Olusile Adeyemi Oluniyi
Published: June 2018

Objective: The objective of this study is to assess the prevalence of tooth wear and to identify risk factors in a sample of young Nigerian adults. Materials and Methods: Participants were individuals aged 18–35 years, attending dental clinics located in eight centers representing the six geopolitical zones of the country. Calibrated examiners measured tooth wear using basic erosive wear examination (BEWE) index. Individuals were characterized by the highest BEWE score recorded for any facial/oral tooth surface. Previously validated questionnaire was used to gather information on demographics and risk factors. Results: A total of 1349 participants were examined. The prevalence of tooth wear was 60.2%. Bivariate analysis showed significant differences in the prevalence of tooth wear with age, educational level, and occupation (P ≤ 0.05). There were significant differences in tooth wear among the participants from the different states. Tooth wear was found to increase with smoking. Tooth wear was associated with brushing frequency, use of chewing stick, and other local cleaning agents. Multiple regression analysis showed that age, brushing frequency, brushing after breakfast added statistically significantly to the prediction of tooth wear (P < 0.05). Conclusion: Tooth wear was common in the population. The frequency of tooth brushing, use of chewing sticks and other local tooth cleaning agents may be contributory.
Solute transport with periodic input point source in one-dimensional heterogeneous porous media
Authors: Yadav R.R. , Roy J.
Published: June 2018

In the present study, we presented analytical solutions for solute transport  in a semi-infinite heterogeneous adsorbing porous media with time-varying boundary condition. Initially, solute concentration in the domain is function of the space variable. Continuous periodic point source is injected in the domain through left boundary, i.e. x = 0. Due to heterogeneity of the medium, dispersion parameter is considered proportional to (z +1) th power of linear function of space variable. The groundwater flow velocity is considered proportional to multiple of temporal function and z th power of linear function of space. First-order decay and zero-order production are also considered space as well as time dependent while retardation factor is a space dependent function. Laplace Transformation Technique is employed to get the solution of the proposed problem. Certain new transformations are introduced to convert the variable coefficient into constant coefficient. Comparison with analytical and pdepe MATLAB solution of the transport equation are illustrated graphically and found to be in excellent agreement.Keywords: Advection; Dispersion; Aquifer; Porous Medium ; Retardation; Laplace Transformation.
Snow-darkening versus direct radiative effects of mineral dust
aerosol on the Indian summer monsoon: role of the Tibetan Plateau
Authors: Shi Zhengguo , Xie Xiaoning , Li Xinzhou , Yang Liu , Xie Xiaoxun , Lei Jing , Sha Yingying , Liu Xiaodong
Published: June 2018

Abstract. Mineral dust aerosol exerts complicated effects on the climate system and two of which are through their direct radiative forcing and snow-darkening forcing. Especially, the snow-darkening effect of dust on climate have been scarcely explored till now. When depositing in snow, dust can reduce the albedo of snow by darkening it and increase the snow melt. In this study, the snow-darkening effect of dust, as well as the direct radiative effect, on the Indian summer monsoon are evaluated by atmospheric general circulation model experiments, with a special focus on the role of Tibetan Plateau. The results show that, the snow-darkening and direct radiative forcing of dust have both significant impacts on the onset of Indian monsoon but they are distinctly opposite. The snow-darkening effect weakens the Indian monsoon precipitation during May and June while the direct radiative forcing intensifies it. The surface temperature over western Tibetan Plateau and Central Asia becomes warmer due to the dust-induced decrease in snow cover, which leads to a local low-level cyclonic anomaly as well as an anticyclonic anomaly over Indian subcontinent and Arabian Sea. This circulation pattern allows air current penetrating into Indian subcontinent more from Central Asia but less from Indian Ocean. In contrast, the direct radiative forcing of dust cools Tibetan Plateau and adjacent areas but warms Arabian Peninsular, which intensifies the moisture convergence and upward motion over Indian monsoon region. The upper tropospheric atmospheric circulation over Asia is also sensitive to both effects. Our results highlight a potential role of snow-albedo feedback in the effects of dust, which significantly amplifies the response of temperature over Tibetan Plateau. Thus, links between the climatic impact of dust, Tibetan Plateau thermal condition and surface snow cover are of importance and require to be clarified accurately.
A Neural Network Aerosol Typing Algorithm Based on Lidar Data
Authors: Nicolae Doina , Vasilescu Jeni , Talianu Camelia , Binietoglou Ioannis , Nicolae Victor , Andrei Simona , Antonescu Bogdan
Published: June 2018

Abstract. Atmospheric aerosols play a crucial role in the earth system, but their role is not completely understood, partly because of the large variability in their properties resulting from a large number of possible aerosol sources. Recently developed techniques were able to retrieve the height distributions of optical and microphysical properties of fine-mode and coarse-mode particles, providing the types of the aerosols depicted. One such technique for aerosol typing is based on artificial neural networks (ANNs). In this article, a Neural Network Aerosol Typing Algorithm Based on Lidar Data (NATALI) was developed to estimate the most probable aerosol type from a set of multispectral data. The algorithm has been adjusted for running on the EARLINET 3ß + 2a (+1d) profiles. The NATALI algorithm is based on the ability of specialized ANNs to resolve the overlapping values of the intensive optical parameters calculated for each identified layer in the multiwavelength Raman lidar profiles. The ANNs were trained using synthetic data, for which a new aerosol model was developed. Two parallel typing schemes were implemented in order to accommodate datasets containing or not the measured linear particle depolarization ratios (LPDR): a) identification of mixtures from 14 aerosol mixtures (high-resolution typing) if the LPDR is available in the input data files, and b) identification of 5 predominant aerosol types (low-resolution typing) if the LPDR is not provided. For each scheme, three ANNs were run simultaneously, and a voting procedure selects the most probable answer. The whole algorithm has been integrated into a Python code. The main issue with the approached used in NATALI is that the results are strongly dependent on the input data, and thus the outputs should be understood accordingly. The algorithm has side-applications, for example, to test the quality of the optical data and identify incorrect calibration or incorrect cloud screening. Blind tests on EARLINET data samples showed the capability of this tool to retrieve the aerosol type from a large variety of data, with different quality and physical content.
A theoretical approach to assess soil moisture–climate coupling
across CMIP5 and GLACE-CMIP5 experiments
Authors: Schwingshackl Clemens , Hirschi Martin , Seneviratne Sonia I.
Published: June 2018

Abstract. Terrestrial climate is influenced by various land–atmosphere interactions that involve numerous land surface state variables. In several regions on Earth, soil moisture plays an important role for climate through its control on the partitioning of net radiation into sensible and latent heat fluxes and, consequently, its impact on temperature and precipitation. The Global Land-Atmosphere Climate Experiment–Coupled Model Intercomparison Project phase 5 (GLACE-CMIP5) aims to quantify the impact of soil moisture on these important climate variables and to trace the individual coupling mechanisms. GLACE-CMIP5 provides experiments with different soil moisture prescriptions that can be used to isolate the effect of soil moisture on climate. Using a theoretical approach that relies on the distinct relation of soil moisture with evaporative fraction (the ratio of latent heat flux over net radiation) and daily maximum near-surface air temperature in different soil moisture regimes, the climate impact of the soil moisture prescriptions in the GLACE-CMIP5 experiments can be emulated and quantified. The theoretical estimation of the soil moisture effect on evaporative fraction agrees very well with estimations obtained directly from the GLACE-CMIP5 experiments (pattern correlation of 0.85). Moreover, the soil moisture effect on daily maximum temperature is well captured in those regions where soil moisture exerts a strong control on latent heat fluxes. The theoretical approach is further applied to quantify the soil moisture contribution to the projected change of the temperature on the hottest day of the year, confirming recent estimations by other studies. Finally, GLACE-style soil moisture prescriptions are emulated in an extended set of CMIP5 models. The results indicate consistency between the soil moisture–climate coupling strength estimated with GLACE-CMIP5 and CMIP5 models. Although the theoretical approach is designed to capture only the local soil moisture–climate coupling strength, it can also help to distinguish non-local from local soil moisture–atmosphere feedbacks where sensitivity experiments (such as GLACE-CMIP5) are available. Overall, the presented theoretical approach constitutes a simple and powerful tool to quantify local soil moisture–climate coupling in both GLACE-CMIP5 and CMIP5 models that can be applied in the absence of dedicated sensitivity experiments.
Evaluating four gap-filling methods for eddy covariance measurements of evapotranspiration over hilly crop fields
Authors: Boudhina Nissaf , Zitouna-Chebbi Rim , Mekki Insaf , Jacob Frédéric , Ben Mechlia Nétij , Masmoudi Moncef , Prévot Laurent
Published: June 2018

Abstract. Estimating evapotranspiration in hilly watersheds is paramount for managing water resources, especially in semiarid/subhumid regions. The eddy covariance (EC) technique allows continuous measurements of latent heat flux (LE). However, time series of EC measurements often experience large portions of missing data because of instrumental malfunctions or quality filtering. Existing gap-filling methods are questionable over hilly crop fields because of changes in airflow inclination and subsequent aerodynamic properties. We evaluated the performances of different gap-filling methods before and after tailoring to conditions of hilly crop fields. The tailoring consisted of splitting the LE time series beforehand on the basis of upslope and downslope winds. The experiment was setup within an agricultural hilly watershed in northeastern Tunisia. EC measurements were collected throughout the growth cycle of three wheat crops, two of them located in adjacent fields on opposite hillslopes, and the third one located in a flat field. We considered four gap-filling methods: the REddyProc method, the linear regression between LE and net radiation (Rn), the multi-linear regression of LE against the other energy fluxes, and the use of evaporative fraction (EF). Regardless of the method, the splitting of the LE time series did not impact the gap-filling rate, and it might improve the accuracies on LE retrievals in some cases. Regardless of the method, the obtained accuracies on LE estimates after gap filling were close to instrumental accuracies, and they were comparable to those reported in previous studies over flat and mountainous terrains. Overall, REddyProc was the most appropriate method, for both gap-filling rate and retrieval accuracy. Thus, it seems possible to conduct gap filling for LE time series collected over hilly crop fields, provided the LE time series are split beforehand on the basis of upslope–downslope winds. Future works should address consecutive vegetation growth cycles for a larger panel of conditions in terms of climate, vegetation, and water status.
#anawarrior identities and the stigmatization process: An ethnography in Italian networked publics
Authors: Vellar Agnese
Published: June 2018

Received opinion holds that pro-ana are “sites that promote anorexia”. In this paper, I will describe the stigmatization process operating in digital environments and the evolution of pro-ana identities in the light of the theories that view eating disorders (EDs) as culture-bound syndromes. I will then illustrate the findings of an ethnographic study of the ana-mia (from the contraction of anorexia and bulimia) culture that has emerged on Italian social media (blogs and visual SNSs such as Instagram). Analyzing the forms of self-representation drew back the curtains on the “popular discourse” of the ana-mias, whose digital bodies express the need for self-discipline typical of post-feminist identity in neoliberal societies. Ana-mias represent themselves as #anawarriors: their life is an ongoing battle against their illness and to defend themselves from outsiders, but is some cases also to gain visibility and reach the status of microcelebrities.
International comparison of active citizenship by using Twitter data, the case of England and the Netherlands
Authors: Rosales Sánchez Cristina
Published: June 2018

Can social media become the new data source for certain social indicators? What does social media offer in comparison with classical sources for official statistics? This research analyzes the potential of Twitter data to obtain indicators of active citizenship. We use a methodology developed for a case study in Spain and test its replicability by applying it to England and the Netherlands. Twitter data offers an advantage to assess change in active citizenship over time and at high spatial resolution, while survey data — traditional sources for official statistics — are more authoritative and robust. Collecting and analyzing Twitter data is also faster than traditional survey processes. However, we found that Twitter usage specificities in each country ease or hinder the process, affecting the time to secure an indicator. Whilst future research will focus on other social indicators and sources of data, this research is an important step in developing an evidence-based understanding of the strengths and weakness of social media to inform policies.
Thinking relationally about digital inequality in rural regions of the U.S.
Authors: Burrell Jenna
Published: June 2018

This article reconsiders the concept of digital inequality drawing from recent developments in science and technology studies, including evolving theories of materiality (Barad, 2003; Bennett, 2010; Ingold, 2012), work on critical media infrastructures (Parks and Starosielski, 2015), and on maintenance and repair (Jackson, 2014; Edgerton, 2007). New ways of thinking about the material world move away from an examination of the cultural significance of ‘objects’ to consider the relationality, vibrancy, and continual “becoming” of materials that we live amidst and interact through. These innovative theoretical developments offer new ways of framing present-day problems and consequences of disparate connectivity by drawing attention to connecting infrastructures instead of the end points of access. I draw from ethnographic fieldwork on Internet access and use in a rural and remote part of northern California to show how the uneven and patchy deployment of the Internet and its physical infrastructures across space shapes rural experiences of the Internet.
Determinants of farmer participation in direct marketing channels: A case study for cassava in the Oyo State of Nigeria
Authors: Donkor Emmanuel , Onakuse Stephen , Bogue Joe , De los Rios-Carmenado Ignacio
Published: June 2018

Improving rural farmers’ access to direct agricultural markets is required to ensure sustainable supply of food. Rural farmers in the developing world account for the largest share of food supply including cassava. Globally, cassava (Manihot esculenta Crantz) is recognised as an important source of valuable semi-processed industrial raw materials such as ethanol, high-quality cassava flour and starch. However, there is less empirical research on rural farmers’ participation in direct marketing channels in the cassava sector. This study focused on analysing the determinants of farmer participation in direct marketing channels using the case of the cassava sector in the Oyo State of Nigeria. The Bivariate Tobit model was applied in the empirical analysis, based on a primary dataset generated from 400 rural cassava farmers from the Oyo State of Nigeria. The result showed that, in general, farmers sold a higher percentage of their cassava output to processors. The Bivariate Tobit results showed that human capital, physical capital, social capital, and market conditions had significant effects on farmers’ decisions on whether to sell their cassava output directly to processors or middlemen. On the contrary, natural and financial capitals did not significantly affect farmers’ marketing channel decision. The study recommends that policy instruments should target improving road networks in rural areas, enhancing farmers’ access to market information, and increasing membership of farmer association to ensure an active participation of farmers in the direct marketing channels.
Comprehensive Review of Current Constraining Devices in Total Hip Arthroplasty
Authors: Van der Merwe Johannes Michiel
Published: June 2018

Hip instability after total joint arthroplasty is a devastating complication. Appropriate management of instability is a challenge. Three components that are commonly used in these challenging scenarios are constrained liners, constrained tripolar components, and nonconstrained tripolar components. The biomaterials and biomechanics of these devices vary. Surgeons must take into account the risks associated with each of these components and some surgical pearls for their use. A thorough review of the recent literature allows comparison of results addressing the short-, medium-, and long-term survival of each component. Constraining devices are a good option when used in salvage procedures in elderly and/or low-demand patients with hip instability. However, constraining devices should not be used to correct deficiencies in surgical technique or implant placement.
Images: Ruptured intratesticular arteriovenous malformation
Authors: Capitano Mario , Schieda Nicola , Robertson Susan J. , Morash Chris , Breau Rodney H. , Maciejewski Conrad , Flood Trevor A.
Published: June 2018

N/A
Prevalence estimates for lower urinary tract symptom severity among men in Uganda and sub-Saharan Africa based on regional prevalence data
Authors: Bajunirwe Francis , Stothers Lynn , Berkowitz Jonathan , Macnab Andrew J.
Published: June 2018

Introduction: In the absence of specific regional data, the prevalence of urinary symptoms in the developing world is currently estimated. Regional prevalence data and estimates based on them have relevance for accurate planning/provision of future healthcare. We sought to extrapolate prevalence estimates for lower urinary tract symptom (LUTS) severity and associated sexual dysfunction for Uganda as a whole and sub-Saharan Africa (SSA) using newly available regional data from a community-based cohort of men in Uganda.Methods: Global Burden of Disease Study (GBDS) population statistics were applied to a regional dataset to provide prevalence estimates for Uganda and SSA; 415 men >55 years from five rural Ugandan communities had completed the International Prostate Symptom Scale (IPSS) and Epstein inventory to grade their LUTS severity and satisfaction with sexual function.Results: Prevalence rates for moderate and severe LUTS were 40.5% and 20%, respectively, in men >55 in the Ugandan regional data; associated scores for all four Epstein sexual satisfaction measures were low. GBDS population figures (2016) for men >55 years are 942 115 (Uganda) and 33.9 million (SSA); hence, scaling up from regional prevalence data suggests 381 557 and 188 423 men >55 years in Uganda, and 13 729 500 and 6 780 000 in SSA have moderate and severe LUTS, respectively, and the majority will have compromise of elements of their sexual function.Conclusions: Extrapolation from a small regional dataset (for which we have no guarantee of national or SSA representability) provides the first prevalence estimates for LUTS severity based on African data, and suggests a large proportion of men >55 years are troubled with LUTS and associated sexual dysfunction.
Overnight continuous saline irrigation after transurethral resection for non-muscle-invasive bladder cancer is helpful in prevention of early recurrence
Authors: Do Jungmo , Lee Sin Woo , Jeh Seong Uk , Hwa Jeong Seok , Hyun Jae Seog , Choi See Min
Published: June 2018

Introduction: It has been reported that many methods prevent recurrence after transurethral resection of bladder tumour (TURBT) for non-muscle-invasive bladder cancer (NMIBC), but it has rarely been reported that overnight continuous saline irrigation is effective in preventing recurrence. The purpose of this study was to evaluate the efficacy of overnight continuous saline irrigation in preventing recurrence after TURBT.Methods: We retrospectively studied patients with NMIBC who underwent TURBT from January 2010 to May 2015 at our institution. Patients who underwent cystoscopy every 12 weeks during the first year after surgery were included. Patients with cancer stage ≥pT2, lymph node metastasis, or distant metastasis were excluded. The overnight continuous saline irrigation (OCSI) group and the no irrigation group were compared and analyzed.Results: A total of 332 patients were included in the study. There were no differences in the basic characteristics of the patients between the two groups. In the OCSI group, the recurrence-free survival rate was higher than that in the no irrigation group, indicating that there was a significant difference between the two groups (p=0.032).Conclusions: After TURBT surgery, OCSI may help prevent early recurrence of NMIBC.
Bladder neck placement of a synthetic polypropylene sling for the treatment of stress urinary incontinence
Authors: McLoughlin Louise C. , Gleeson Mari , Francis Sami , O’Rourke Colin , Flood Hugh D.
Published: June 2018

Introduction: Pubo-vaginal sling placed at the bladder neck is the gold standard treatment for stress urinary incontinence (SUI). The synthetic mid-urethral sling (MUS) is now widely used, as morbidity rates with this technique are substantially reduced. This is an initial report on long-term outcomes of a polypropylene sling (PPS) placed in the traditional bladder neck location.Methods: A retrospective analysis of all patients who underwent PPS insertion at our institution between 2006 and 2014 was conducted. Patient and urodynamic demographics were recorded. Subjective and objective measures of success were determined by postoperative pad usage and validated incontinence questionnaires. Results: A total of 170 patients were followed for a median of four years (range 1–8). The mean age was 51 years (±10). Subjective response was assessed in 57% of patients; the overall subjective cure rate was 85.3% (n=145), subjective improvement rate was 4.1% (n=7), and the subjective failure rate was 10.6% (n=18). The mean Urogenital Distress Inventory (UDI)-6 score was 6.5 (±5.6) out of a maximum score of 24 and the Incontinence Impact Questionnaire (IIQ)-7 score was 5.5 (±6.3) out of a maximum score of 28. There was no significant difference in objective outcome measures in those with an abdominal leak-point pressure (ALPP) < or >60 cmH2O.Conclusions: Bladder neck placement of a PPS resulted in cure rates of 85% in this series. SUI secondary to intrinsic sphincter deficiency (ISD) and urethral hypermobility were treated with equal success. Bladder neck PPS placement has a role in the treatment of SUI. Our data may well reassure rectus fascia sling (RFS) surgeons who wish to take advantage of faster postoperative recovery using the less invasive PPS placed at the bladder neck.
Phasmomantella gen. nov., a spectacular new genus of praying mantis from southern Central Vietnam (Mantodea, Mantidae, Deroplatyinae, Euchomenellini)
Authors: Vermeersch Xavier H.C.
Published: June 2018

The new genus Phasmomantella gen. nov. is created to accommodate the new species P. nuichuana gen. et sp. nov. described from five adult females from Núi Chúa National Park in southern Central Vietnam. A second species, Phasmomantella pallida (Roy, 2001) gen. et comb. nov., is transferred from Euchomenella where it was originally described based on a single male specimen from the Nha Trang region in the Khánh Hòa Province. Phasmomantella gen. nov. is placed in the tribe Euchomenellini of the subfamily Deroplatyinae. A comprehensive diagnosis and detailed descriptions are presented along with high-resolution photographs, measurements and a distribution map. The standardised measurements are illustrated and a new key is proposed for the tribe Euchomenellini. The unique biogeography and habitats of the collection site within Núi Chúa National Park are discussed in the light of possible endemism and importance for nature conservation.
Re-thinking ‘normal’ development in the early learning of number
Authors: Coles Alf , Sinclair Nathalie
Published: June 2018

In this article we suggest that, notwithstanding noted differences, one unmarked similarity across psychology and mathematics education is the continued dominance of the view that there is a ‘normal’ path of development. We focus particularly on the case of the early learning of number and point to evidence that puts into question the dominant narrative of how number sense develops through the concrete and the cardinal. Recent neuroscience findings have raised the potential significance of ordinal approaches to learning number, which in privileging the symbolic—and hence the abstract—reverse one aspect of the ‘normal’ development order. We draw on empirical evidence to suggest that what children can do, and in what order, is sensitive to, among other things, the curriculum approach—and also the tools they have at their disposition. We draw out implications from our work for curriculum organisation in the early years of schooling, to disrupt taken-for-granted paths.
Subtraction by addition strategy use in children of varying mathematical achievement level: A choice/no-choice study
Authors: Torbeyns Joke , Peters Greet , De Smedt Bert , Ghesquière Pol , Verschaffel Lieven
Published: June 2018

We investigated the use of the subtraction by addition strategy, an important mental calculation strategy in children with different levels of mathematics achievement. In doing so we relied on Siegler’s cognitive psychological model of strategy change (Lemaire & Siegler, 1995), which defines strategy competencies in terms of four parameters (strategy repertoire, distribution, efficiency and selection), and the choice/no-choice method (Siegler & Lemaire, 1997), which is essentially characterized by offering items in two types of conditions (choice and no-choice). Participants were 63 11-12-year-olds with varied mathematics achievement levels. They solved multi-digit subtraction problems in the number domain up to 1,000 in one choice condition (choice between direct subtraction or subtraction by addition on each item) and two no-choice conditions (obligatory use of either direct subtraction or subtraction by addition on all items). We distinguished between two types of subtraction problems: problems with a small versus large difference between minuend and subtrahend. Although mathematics instruction only focused on applying direct subtraction, most children reported using subtraction by addition in the choice condition. Subtraction by addition was applied frequently and efficiently, particularly on small-difference problems. Children flexibly fitted their strategy choices to both numerical item characteristics and individual strategy speed characteristics. There were no differences in strategy use between the different mathematical achievement groups. These findings add to our theoretical understanding of children’s strategy acquisition and challenge current mathematics instruction practices that focus on direct subtraction for children of all levels of mathematics achievement.
Time as a measure: Elementary students positioning the hands of an analog clock
Authors: Earnest Darrell , Gonzales Alicia C. , Plant Anna M.
Published: June 2018

Elementary students have difficulty with the topic of time. The present study investigated students’ actions to position hour and minute hands on an analog clock to indicate particular times of the day. Using one-on-one interviews with students in Grades 2 and 4 (n = 48), we analyzed whether students were more accurate for one hand indicator (hour or minute) versus the other as well as their solution approaches as they positioned each hand. We first present a quantitative analysis of student performance to document whether hour and minute hands posed differential challenges for students as they positioned hands to indicate particular times. Results indicate the hour hand is significantly more challenging to position accurately than the minute hand. Students’ solutions reflected varied approaches, including consideration of the quantitative hour-minute multiplicative relationship, attention to part-whole relations, and matching numbers from the provided time to numerals on the clock. We discuss implications for theory and instruction, including the relationship of time to length measure learning trajectories and the current treatment of time in K-12 mathematics standards for the United States.
Fotografi som visuel metode i ernærings- og sundhedsfaglige studier
Authors: Justesen Lise , Laub Maria Therese , Rostgaard Poulsen Birthe
Published: June 2018

Denne artikel er en praktisk indføring i, hvad det vil sige at arbejde med fotografi som metode til indsamling af empiri. Artiklen introducerer en række fotografiske metoder, der kan anvendes i observations- og interviewstrategier. Gennem case-eksempler, med udgangspunkt i metoderne Participant Driven Photo Elicitation, Research Driven Photo Elicitation samt Kollaborativ Fotografisk Metode, sætter vi fokus på praktiske greb for studerende såvel praktikere, der selv vil i gang med studier inden for det ernæringsfaglige og sundhedsfaglige felt. Artiklen behandler, hvordan man skaber og håndterer fotografisk empiri i konkrete ernærings- og sundhedsrelaterede studier samt beskriver, hvad fotografisk empiri kan i sammenligning med andre empiriske metoder baseret på mundtligt og skriftligt materiale alene. Desuden gennemgås etiske og juridiske aspekter ved brug af fotografi i empiriske studier og til sidst beskrives en række fototekniske overvejelser, der kan kvalificere fotografiernes tekniske kvaliteter.
Dynamic action of the Sec machinery during initiation, protein translocation and termination
Authors: Fessl Tomas , Watkins Daniel , Oatley Peter , Allen William John , Corey Robin Adam , Horne Jim , Baldwin Steve A , Radford Sheena E , Collinson Ian , Tuma Roman
Published: June 2018

Protein translocation across cell membranes is a ubiquitous process required for protein secretion and membrane protein insertion. In bacteria, this is mostly mediated by the conserved SecYEG complex, driven through rounds of ATP hydrolysis by the cytoplasmic SecA, and the trans-membrane proton motive force. We have used single molecule techniques to explore SecY pore dynamics on multiple timescales in order to dissect the complex reaction pathway. The results show that SecA, both the signal sequence and mature components of the pre-protein, and ATP hydrolysis each have important and specific roles in channel unlocking, opening and priming for transport. After channel opening, translocation proceeds in two phases: a slow phase independent of substrate length, and a length-dependent transport phase with an intrinsic translocation rate of ~40 amino acids per second for the proOmpA substrate. Broad translocation rate distributions reflect the stochastic nature of polypeptide transport.
Structures of two aptamers with differing ligand specificity reveal ruggedness in the functional landscape of RNA
Authors: Knappenberger Andrew John , Reiss Caroline Wetherington , Strobel Scott A
Published: June 2018

Two classes of riboswitches related to the ykkC guanidine-I riboswitch bind phosphoribosyl pyrophosphate (PRPP) and guanosine tetraphosphate (ppGpp). Here we report the co-crystal structure of the PRPP aptamer and its ligand. We also report the structure of the G96A point mutant that prefers ppGpp over PRPP with a dramatic 40,000-fold switch in specificity. The ends of the aptamer form a helix that is not present in the guanidine aptamer and is involved in the expression platform. In the mutant, the base of ppGpp replaces G96 in three-dimensional space. This disrupts the S-turn, which is a primary structural feature of the ykkC RNA motif. These dramatic differences in ligand specificity are achieved with minimal mutations. ykkC aptamers are therefore a prime example of an RNA fold with a rugged fitness landscape. The ease with which the ykkC aptamer acquires new specificity represents a striking case of evolvability in RNA.
Lamellar projections in the endolymphatic sac act as a relief valve to regulate inner ear pressure
Authors: Swinburne Ian A , Mosaliganti Kishore R , Upadhyayula Srigokul , Liu Tsung-Li , Hildebrand David G C , Tsai Tony Y -C , Chen Anzhi , Al-Obeidi Ebaa , Fass Anna K , Malhotra Samir , Engert Florian , Lichtman Jeff W , Kirchhausen Tomas , Betzig Eric , Megason Sean G
Published: June 2018

The inner ear is a fluid-filled closed-epithelial structure whose function requires maintenance of an internal hydrostatic pressure and fluid composition. The endolymphatic sac (ES) is a dead-end epithelial tube connected to the inner ear whose function is unclear. ES defects can cause distended ear tissue, a pathology often seen in hearing and balance disorders. Using live imaging of zebrafish larvae, we reveal that the ES undergoes cycles of slow pressure-driven inflation followed by rapid deflation. Absence of these cycles in lmx1bb mutants leads to distended ear tissue. Using serial-section electron microscopy and adaptive optics lattice light-sheet microscopy, we find a pressure relief valve in the ES comprised of partially separated apical junctions and dynamic overlapping basal lamellae that separate under pressure to release fluid. We propose that this lmx1-dependent pressure relief valve is required to maintain fluid homeostasis in the inner ear and other fluid-filled cavities.
Leading the charge
Authors: Plested Andrew JR
Published: June 2018

A simple label-free method uses the electrical properties of cells to detect how ligands bind to membrane proteins.
Remote ischemic conditioning for acute stroke patients treated with thrombectomy
Authors: Zhao Wenbo , Che Ruiwen , Li Sijie , Ren Changhong , Li Chuanhui , Wu Chuanjie , Lu Hui , Chen Jian , Duan Jiangang , Meng Ran , Ji Xunming
Published: June 2018

Objective

Remote ischemic conditioning (RIC) has been demonstrated to be safe and feasible for patients with acute ischemic stroke (AIS), as well as for those receiving intravenous thrombolysis. We assessed the safety and feasibility of RIC for AIS patients undergoing endovascular treatment (ET).

Methods

We conducted a pilot study with patients with AIS who were suspected of having an emergent large‐vessel occlusion in the anterior circulation and who were scheduled for ET within 6 hours of ictus. Four cycles of RIC were performed before recanalization, immediately following recanalization, and once daily for the subsequent 7 days. The primary outcome was any serious RIC‐related adverse events.

Results

Twenty subjects, aged 66.1 ± 12.1 years, were recruited. No subject experienced serious RIC‐related adverse events. The intracranial pressure, cranial perfusion pressure, mean arterial pressure, heart rate, middle cerebral artery peak systolic flow velocity, and pulsatility index did not change significantly before, during, or after the limb ischemia (P > 0.1 for all). Of 80 cycles, 71 (89%) were completed before recanalization and 80 (100%) were completed immediately after recanalization; 444 of 560 cycles (78%) were completed within 7 days posttreatment. No patients had to stop RIC because it affected routine clinical managements. Six subjects (30%) experienced intracerebral hemorrhage, which was symptomatic in one case (5%). At the 3‐month follow‐up, 11 subjects (55%) had achieved functional independence, and two subjects (10%) died.

Interpretation

RIC appears to be safe and feasible for patients with AIS undergoing ET. Investigations are urgently needed to determine the efficacy of RIC in this patient population.
Energy Harvesting Research: The Road from Single Source to Multisource
Authors: Bai Yang , Jantunen Heli , Juuti Jari
Published: June 2018

Energy harvesting technology may be considered an ultimate solution to replace batteries and provide a long‐term power supply for wireless sensor networks. Looking back into its research history, individual energy harvesters for the conversion of single energy sources into electricity are developed first, followed by hybrid counterparts designed for use with multiple energy sources. Very recently, the concept of a truly multisource energy harvester built from only a single piece of material as the energy conversion component is proposed. This review, from the aspect of materials and device configurations, explains in detail a wide scope to give an overview of energy harvesting research. It covers single‐source devices including solar, thermal, kinetic and other types of energy harvesters, hybrid energy harvesting configurations for both single and multiple energy sources and single material, and multisource energy harvesters. It also includes the energy conversion principles of photovoltaic, electromagnetic, piezoelectric, triboelectric, electrostatic, electrostrictive, thermoelectric, pyroelectric, magnetostrictive, and dielectric devices. This is one of the most comprehensive reviews conducted to date, focusing on the entire energy harvesting research scene and providing a guide to seeking deeper and more specific research references and resources from every corner of the scientific community.