bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultrasound and NICOM in the assessment of fluid responsiveness in patients with mild sepsis in the emergency department: a pilot study
Authors: Oord Martha , Olgers Tycho J , Doff-Holman Mirjam , Harms Mark P M , Ligtenberg Jack J M , ter Maaten Jan C
Published: January 2017

Objective

We investigated whether combining the caval index, assessment of the global contractility of the heart and measurement of stroke volume with Noninvasive Cardiac Output Monitoring (NICOM) can aid in fluid management in the emergency department (ED) in patients with sepsis.

Setting

A prospective observational single-centre pilot study in a tertiary care centre.

Primary and secondary outcomes

Ultrasound was used to assess the caval index, heart contractility and presence of B-lines in the lungs. Cardiac output and stroke volume were monitored with NICOM. Primary outcome was increase in stroke volume after a fluid bolus of 500 mL, while secondary outcome included signs of fluid overload.

Results

We included 37 patients with sepsis who received fluid resuscitation of at least 500 mL saline. The population was divided into patients with a high (>36.5%, n=24) and a low caval index (<36.5%, n=13). We observed a significant increase (p=0.022) in stroke volume after 1000 mL fluid in the high caval index group in contrast to the low caval index group but not after 500 mL of fluid. We did not find a significant association between global contractility of the left ventricle and the response on fluid therapy (p=0.086). No patient showed signs of fluid overload.

Conclusions

Our small pilot study suggests that at least 1000 mL saline is needed to induce a significant response in stroke volume in patients with sepsis and a high caval index. This amount seems to be safe, not leading to the development of fluid overload. Therefore, combining ultrasound and NICOM is feasible and may be valuable tools in the treatment of patients with sepsis in the ED. A larger trial is needed to confirm these results.
Ibobbly mobile health intervention for suicide prevention in Australian Indigenous youth: a pilot randomised controlled trial
Authors: Tighe Joseph , Shand Fiona , Ridani Rebecca , Mackinnon Andrew , De La Mata Nicole , Christensen Helen
Published: January 2017

Objectives

Rates of youth suicide in Australian Indigenous communities are 4 times the national youth average and demand innovative interventions. Historical and persistent disadvantage is coupled with multiple barriers to help seeking. Mobile phone applications offer the opportunity to deliver therapeutic interventions directly to individuals in remote communities. The pilot study aimed to evaluate the effectiveness of a self-help mobile app (ibobbly) targeting suicidal ideation, depression, psychological distress and impulsivity among Indigenous youth in remote Australia.

Setting

Remote and very remote communities in the Kimberley region of North Western Australia.

Participants

Indigenous Australians aged 18–35 years.

Interventions

61 participants were recruited and randomised to receive either an app (ibobbly) which delivered acceptance-based therapy over 6 weeks or were waitlisted for 6 weeks and then received the app for the following 6 weeks.

Primary and secondary outcome measures

The primary outcome was the Depressive Symptom Inventory—Suicidality Subscale (DSI-SS) to identify the frequency and intensity of suicidal ideation in the previous weeks. Secondary outcomes were the Patient Health Questionnaire 9 (PHQ-9), The Kessler Psychological Distress Scale (K10) and the Barratt Impulsivity Scale (BIS-11).

Results

Although preintervention and postintervention changes on the (DSI-SS) were significant in the ibobbly arm (t=2.40; df=58.1; p=0.0195), these differences were not significant compared with the waitlist arm (t=1.05; df=57.8; p=0.2962). However, participants in the ibobbly group showed substantial and statistically significant reductions in PHQ-9 and K10 scores compared with waitlist. No differences were observed in impulsivity. Waitlist participants improved after 6 weeks of app use.

Conclusions

Apps for suicide prevention reduce distress and depression but do not show significant reductions on suicide ideation or impulsivity. A feasible and acceptable means of lowering symptoms for mental health disorders in remote communities is via appropriately designed self-help apps.

Trial registration number

ACTRN12613000104752.
Compensatory changes in energy balance during dapagliflozin treatment in type 2 diabetes mellitus: a randomised double-blind, placebo-controlled, cross-over trial (ENERGIZE)—study protocol
Authors: Rajeev Surya Panicker , Sprung Victoria S , Roberts Carl , Harrold Jo A , Halford Jason C G , Stancak Andrej , Boyland Emma J , Kemp Graham J , Cuthbertson Daniel J , Wilding John P H
Published: January 2017

Introduction

Sodium glucose cotransporter 2 (SGLT2) inhibitors are effective blood-glucose-lowering medications with beneficial effects on body weight in patients with type 2 diabetes mellitus (T2DM). However, observed weight loss is less than that predicted from quantified glycosuria, suggesting a compensatory increase in energy intake or a decrease in energy expenditure. Studies using dual-energy X-ray absorptiometry (DEXA) have suggested most body weight change is due to loss of adipose tissue, but organ-specific changes in fat content (eg, liver, skeletal muscle) have not been determined. In this randomised, double-blind, placebo-controlled crossover study, we aim to study the compensatory changes in energy intake, eating behaviour and energy expenditure accompanying use of the SGLT2 inhibitor, dapagliflozin. Additionally, we aim to quantify changes in fat distribution using MRI, in liver fat using proton magnetic resonance spectroscopy (1H-MRS) and in central nervous system (CNS) responses to food images using blood oxygen level dependent (BOLD) functional MRI (fMRI).

Methods and analysis

This outpatient study will evaluate the effect of dapagliflozin (10 mg), compared with placebo, on food intake and energy expenditure at 7 days and 12 weeks. 52 patients with T2DM will be randomised to dapagliflozin or placebo for short-term and long-term trial interventions in a within participants, crossover design. The primary outcome is the difference in energy intake during a test meal between dapagliflozin and placebo. Intake data are collected automatically using a customised programme operating a universal eating monitor (UEM). Secondary outcomes include (1) measures of appetite regulation including rate of eating, satiety quotient, appetite ratings (between and within meals), changes in CNS responses to food images measured using BOLD-fMRI, (2) measures of energy expenditure and (3) changes in body composition including changes in liver fat and abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT).

Ethical approval

This study has been approved by the North West Liverpool Central Research Ethics Committee (14/NW/0340) and is conducted in accordance with the Declaration of Helsinki and the Good Clinical Practice (GCP).

Trial registration number

ISRCTN14818531. EUDRACT number 2013-004264-60.
Challenges in data quality: the influence of data quality assessments on data availability and completeness in a voluntary medical male circumcision programme in Zimbabwe
Authors: Xiao Y , Bochner A F , Makunike B , Holec M , Xaba S , Tshimanga M , Chitimbire V , Barnhart S , Feldacker C
Published: January 2017

Objectives

To assess availability and completeness of data collected before and after a data quality audit (DQA) in voluntary medical male circumcision (VMMC) sites in Zimbabwe to determine the effect of this process on data quality.

Setting

4 of 10 VMMC sites in Zimbabwe that received a DQA in February, 2015 selected by convenience sampling.

Participants

Retrospective reviews of all client intake forms (CIFs) from November, 2014 and May, 2015. A total of 1400 CIFs were included from those 2 months across four sites.

Primary and secondary outcomes

Data availability was measured as the percentage of VMMC clients whose CIF was on file at each site. A data evaluation tool measured the completeness of 34 key CIF variables. A comparison of pre-DQA and post-DQA results was conducted using χ2and t-tests.

Results

After the DQA, high record availability of over 98% was maintained by sites 3 and 4. For sites 1 and 2, record availability increased by 8.0% (p=0.001) and 9.7% (p=0.02), respectively. After the DQA, sites 1, 2 and 3 improved significantly in data completeness across 34 key indicators, increasing by 8.6% (p<0.001), 2.7% (p=0.003) and 3.8% (p<0.001), respectively. For site 4, CIF data completeness decreased by 1.7% (p<0.01) after the DQA.

Conclusions

Our findings suggest that CIF data availability and completeness generally improved after the DQA. However, gaps in documentation of vital signs and adverse events signal areas for improvement. Additional emphasis on data completeness would help support high-quality programme implementation and availability of reliable data for decision-making.
Patient preferences, knowledge and beliefs about kidney allocation: qualitative findings from the UK-wide ATTOM programme
Authors: Gibbons Andrea , Cinnirella Marco , Bayfield Janet , Wu Diana , Draper Heather , Johnson Rachel J , Tomson Charles R V , Forsythe John L R , Metcalfe Wendy , Fogarty Damian , Roderick Paul , Ravanan Rommel , Oniscu Gabriel C , Watson Christopher J E , Bradley J Andrew , Bradley Clare
Published: January 2017

Objective

To explore how patients who are wait-listed for or who have received a kidney transplant understand the current UK kidney allocation system, and their views on ways to allocate kidneys in the future.

Design

Qualitative study using semistructured interviews and thematic analysis based on a pragmatic approach.

Participants

10 deceased-donor kidney transplant recipients, 10 live-donor kidney transplant recipients, 12 participants currently wait-listed for a kidney transplant and 4 participants whose kidney transplant failed.

Setting

Semistructured telephone interviews conducted with participants in their own homes across the UK.

Results

Three main themes were identified: uncertainty of knowledge of the allocation scheme; evaluation of the system and participant suggestions for future allocation schemes. Most participants identified human leucocyte anitgen matching as a factor in determining kidney allocation, but were often uncertain of the accuracy of their knowledge. In the absence of information that would allow a full assessment, the majority of participants consider that the current system is effective. A minority of participants were concerned about the perceived lack of transparency of the general decision-making processes within the scheme. Most participants felt that people who are younger and those better matched to the donor kidney should be prioritised for kidney allocation, but in contrast to the current scheme, less priority was considered appropriate for longer waiting patients. Some non-medical themes were also discussed, such as whether parents of dependent children should be prioritised for allocation, and whether patients with substance abuse problems be deprioritised.

Conclusions

Our participants held differing views about the most important factors for kidney allocation, some of which were in contrast to the current scheme. Patient participation in reviewing future allocation policies will provide insight as to what is considered acceptable to patients and inform healthcare staff of the kinds of information patients would find most useful.
Guided internet-administered self-help to reduce symptoms of anxiety and depression among adolescents and young adults diagnosed with cancer during adolescence (U-CARE: YoungCan): a study protocol for a feasibility trial
Authors: Ander Malin , Wikman Anna , Ljótsson Brjánn , Grönqvist Helena , Ljungman Gustaf , Woodford Joanne , Lindahl Norberg Annika , von Essen Louise
Published: January 2017

Introduction

A subgroup of adolescents and young adults diagnosed with cancer during adolescence reports elevated levels of anxiety and depressive symptoms and unmet needs for psychological support. Evidence-based psychological treatments tailored for this population are lacking. This protocol describes a feasibility study of a guided-internet-administered self-help programme (YoungCan) primarily targeting symptoms of anxiety and depression among young persons diagnosed with cancer during adolescence and of the planned study procedures for a future controlled trial.

Methods/analysis

The study is an uncontrolled feasibility trial with a pre-post and 3-month follow-up design. Potential participants aged 15–25 years, diagnosed with cancer during adolescence, will be identified via the Swedish Childhood Cancer Registry. 30 participants will be included. Participants will receive YoungCan, a 12-week therapist-guided, internet-administered self-help programme consisting primarily of cognitive–behavioural therapy organised into individually assigned modules targeting depressive symptoms, worry and anxiety, body dissatisfaction and post-traumatic stress. Interactive peer support and psychoeducative functions are also available. Feasibility outcomes include: recruitment and eligibility criteria; data collection; attrition; resources needed to complete the study and programme; safety procedures; participants' and therapists' adherence to the programme; and participants' acceptability of the programme and study methodology. Additionally, mechanisms of impact will be explored and data regarding symptoms of anxiety, depression, post-traumatic stress, body dissatisfaction, reactions to social interactions, quality of life, axis I diagnoses according to the Mini International Neuropsychiatric Interview and healthcare service use will be collected. Exploratory analyses of changes in targeted outcomes will be conducted.

Ethics/dissemination

This feasibility protocol was approved by the Regional Ethical Review Board in Uppsala, Sweden (ref: 2016/210). Findings will be disseminated to relevant research, clinical, health service and patient communities through publications in peer-reviewed and popular science journals and presentations at scientific and clinical conferences.

Trial registration number

ISRCTN97835363.
Use of magnesium sulfate before 32 weeks of gestation: a European population-based cohort study
Authors: Wolf H T , Huusom L , Weber T , Piedvache A , Schmidt S , Norman M , Zeitlin J
Published: January 2017

Objectives

The use of magnesium sulfate (MgSO4) in European obstetric units is unknown. We aimed to describe reported policies and actual use of MgSO4in women delivering before 32 weeks of gestation by indication.

Methods

We used data from the European Perinatal Intensive Care in Europe (EPICE) population-based cohort study of births before 32 weeks of gestation in 19 regions in 11 European countries. Data were collected from April 2011 to September 2012 from medical records and questionnaires. The study population comprised 720 women with severe pre-eclampsia, eclampsia or HELLP and 3658 without pre-eclampsia delivering from 24 to 31 weeks of gestation in 119 maternity units with 20 or more very preterm deliveries per year.

Results

Among women with severe pre-eclampsia, eclampsia or HELLP, 255 (35.4%) received MgSO4before delivery. 41% of units reported use of MgSO4whenever possible for pre-eclampsia and administered MgSO4more often than units reporting use sometimes. In women without pre-eclampsia, 95 (2.6%) received MgSO4. 9 units (7.6%) reported using MgSO4for fetal neuroprotection whenever possible. In these units, the median rate of MgSO4use for deliveries without severe pre-eclampsia, eclampsia and HELLP was 14.3%. Only 1 unit reported using MgSO4as a first-line tocolytic. Among women without pre-eclampsia, MgSO4use was not higher in women hospitalised before delivery for preterm labour.

Conclusions

Severe pre-eclampsia, eclampsia or HELLP are not treated with MgSO4as frequently as evidence-based medicine recommends. MgSO4is seldom used for fetal neuroprotection, and is no longer used for tocolysis. To continuously lower morbidity, greater attention to use of MgSO4is needed.
New predictive model for microsurgical outcome of intracranial arteriovenous malformations: study protocol
Authors: Tong Xianzeng , Wu Jun , Cao Yong , Zhao Yuanli , Wang Shuo
Published: January 2017

Introduction

Although microsurgical resection is currently the first-line treatment modality for arteriovenous malformations (AVMs), microsurgery of these lesions is complicated due to the fact that they are very heterogeneous vascular anomalies. The Spetzler-Martin grading system and the supplementary grading system have demonstrated excellent performances in predicting the risk of AVM surgery. However, there are currently no predictive models based on multimodal MRI techniques. The purpose of this study is to propose a predictive model based on multimodal MRI techniques to assess the microsurgical risk of intracranial AVMs.

Methods and analysis

The study consists of 2 parts: the first part is to conduct a single-centre retrospective analysis of 201 eligible patients to create a predictive model of AVM surgery based on multimodal functional MRIs (fMRIs); the second part is to validate the efficacy of the predictive model in a prospective multicentre cohort study of 400 eligible patients. Patient characteristics, AVM features and multimodal fMRI data will be collected. The functional status at pretreatment and 6 months after surgery will be analysed using the modified Rankin Scale (mRS) score. The patients in each part of this study will be dichotomised into 2 groups: those with improved or unchanged functional status (a decreased or unchanged mRS 6 months after surgery) and those with worsened functional status (an increased mRS). The first part will determine the risk factors of worsened functional status after surgery and create a predictive model. The second part will validate the predictive model and then a new AVM grading system will be proposed.

Ethics and dissemination

The study protocol and informed consent form have been reviewed and approved by the Institutional Review Board of Beijing Tiantan Hospital Affiliated to Capital Medical University (KY2016-031-01). The results of this study will be disseminated through printed media.

Trial registration number

NCT02868008.
Obstetrical brachial plexus injury (OBPI): Canada's national clinical practice guideline
Authors: Coroneos Christopher J , Voineskos Sophocles H , Christakis Marie K , Thoma Achilleas , Bain James R , Brouwers Melissa C
Published: January 2017

Objective

The objective of this study was to establish an evidence-based clinical practice guideline for the primary management of obstetrical brachial plexus injury (OBPI). This clinical practice guideline addresses 4 existing gaps: (1) historic poor use of evidence, (2) timing of referral to multidisciplinary care, (3) Indications and timing of operative nerve repair and (4) distribution of expertise.

Setting

The guideline is intended for all healthcare providers treating infants and children, and all specialists treating upper extremity injuries.

Participants

The evidence interpretation and recommendation consensus team (Canadian OBPI Working Group) was composed of clinicians representing each of Canada's 10 multidisciplinary centres.

Outcome measures

An electronic modified Delphi approach was used for consensus, with agreement criteria defined a priori. Quality indicators for referral to a multidisciplinary centre were established by consensus. An original meta-analysis of primary nerve repair and review of Canadian epidemiology and burden were previously completed.

Results

7 recommendations address clinical gaps and guide identification, referral, treatment and outcome assessment: (1) physically examine for OBPI in newborns with arm asymmetry or risk factors; (2) refer newborns with OBPI to a multidisciplinary centre by 1 month; (3) provide pregnancy/birth history and physical examination findings at birth; (4) multidisciplinary centres should include a therapist and peripheral nerve surgeon experienced with OBPI; (5) physical therapy should be advised by a multidisciplinary team; (6) microsurgical nerve repair is indicated in root avulsion and other OBPI meeting centre operative criteria; (7) the common data set includes the Narakas classification, limb length, Active Movement Scale (AMS) and Brachial Plexus Outcome Measure (BPOM) 2 years after birth/surgery.

Conclusions

The process established a new network of opinion leaders and researchers for further guideline development and multicentre research. A structured referral form is available for primary care, including referral recommendations.
Psychological distress and type 2 diabetes mellitus: a 4-year policemen cohort study in China
Authors: Li C , Liu J C , Xiao X , Chen X , Yue S , Yu H , Tian F S , Tang N J
Published: January 2017

Objectives

This study investigated whether psychological distress predicts the development of type 2 diabetes mellitus (T2DM) and if the association differs between populations at a high or low diabetes risk level among Chinese police officers.

Design

Prospective cohort study.

Setting

Single centre.

Participants

6559 participants underwent clinical measurements at the hospital in April 2007. 5811 police officers participated in the follow-up consisting of new-onset diabetes (NOD) events occurring annually between 2008 and 2011.

Primary outcome measures

Baseline data were collected from policemen who completed the Symptom Checklist 90-Revised (SCL-90-R) questionnaire and a self-designed questionnaire. Psychological distress was measured by the SCL-90-R questionnaire. Hong Kong Chinese Diabetes Risk Score (HKCDRS) was used to evaluate the risk of T2DM, and the participants were divided into low-risk group and high-risk group based on the HKCDRS. Cox proportional hazards regression was used to calculate the HRs of the incidence of T2DM related to psychological distress and further stratified the analysis based on HKCDRS.

Results

Among 5811 participants, 179 subjects developed NOD during the 4-year follow-up. 54 subjects (1.63%) with a HKCDRS 0–7 vs 125 subjects (4.98%) with a HKCDRS>7 developed NOD (p<0.05). There was a significant association between psychological distress and T2DM (HR=1.46; 95% CI 1.05 to 2.02). Among the participants with a high-risk score (HKCDRS>7), 7.07% of those with psychological distress developed T2DM compared with 4.43% of participants without psychological distress (p<0.05). The corresponding adjusted HR for psychological distress was 1.61 (95% CI 1.10 to 2.37).

Conclusions

Psychological distress is an independent risk factor for T2DM in this prospective cohort study. Stratification analysis indicated that psychological distress was associated with T2DM in a high-risk level population.
Increasing general practitioners' confidence and self-efficacy in managing obesity: a mixed methods study
Authors: Sturgiss Elizabeth , Haesler Emily , Elmitt Nicholas , van Weel Chris , Douglas Kirsty
Published: January 2017

Objectives

Internationally, general practitioners (GPs) are being encouraged to take an active role in the care of their patients with obesity, but as yet there are few tools for them to implement within their clinics. This study assessed the self-efficacy and confidence of GPs before and after implementing a weight management programme in their practice.

Design

Nested mixed methods study within a 6-month feasibility trial.

Setting

4 urban general practices and 1 rural general practice in Australia.

Participants

All vocationally registered GPs in the local region were eligible and invited to participate; 12 GPs were recruited and 11 completed the study.

Interventions

The Change Programme is a structured GP-delivered weight management programme that uses the therapeutic relationship between the patient and their GP to provide holistic and person-centred care. It is an evidence-based programme founded on Australian guidelines for the management of obesity in primary care.

Primary outcome measures

Self-efficacy and confidence of the GPs when managing obesity was measured using a quantitative survey consisting of Likert scales in conjunction with pro forma interviews.

Results

In line with social cognitive theory, GPs who experienced performance mastery during the pilot intervention had an increase in their confidence and self-efficacy. In particular, confidence in assisting and arranging care for patients was improved as demonstrated in the survey and supported by the qualitative data. Most importantly from the qualitative data, GPs described changing their usual practice and felt more confident to discuss obesity with all of their patients.

Conclusions

A structured management tool for obesity care in general practice can improve GP confidence and self-efficacy in managing obesity. Enhancing GP ‘professional self-efficacy’ is the first step to improving obesity management within general practice.

Trial registration number

ACTRN12614001192673; Results.
Hypothermia induced by inhibition of fatty acid metabolism in anesthetized rats: contributions of the forebrain and vagal afferents
Authors: Osaka Toshimasa
Published: January 2017

2-Mercaptoacetate (MA) is an antimetabolic drug that inhibits the utilization of fatty acids as an energy source. The intravenous injection of MA (1.2 mmol·kg−1) elicited an increase in tail skin temperature and a decrease in body core temperature in urethane–chloralose-anesthetized, neuromuscularly blocked, artificially ventilated rats, although administration of the same amount of NaCl did not. The respiratory exchange ratio was significantly higher after administration of MA than that after the saline treatment. On the other hand, heat production was increased by either the MA- or NaCl-injection, suggesting a nonspecific effect caused by the hyperosmolality of the solutions. These results indicate that the MA-induced hypothermia was caused by an increase in heat loss but not by a decrease in heat production. The amplitudes of heat loss responses to MA in rats fasted overnight were significantly smaller than those in fed ones, suggesting a mechanism for suppression of heat loss in the fasted state. Rats pretreated with vagotomy, capsaicin-induced desensitization of sensory nerve fibers or decerebration did not exhibit the MA-induced hypothermic responses. It is possible that the MA-induced heat loss and hypothermia were mediated by the vagal afferents and required the forebrain for the full expression of the responses.
Possible involvement of ATP-sensitive potassium channels in the antidepressant-like effects of gabapentin in mouse forced swimming test
Authors: Ostadhadi Sattar , Akbarian Reyhaneh , Norouzi-Javidan Abbas , Nikoui Vahid , Zolfaghari Samira , Chamanara Mohsen , Dehpour Ahmad-Reza
Published: January 2017

Gabapentin as an anticonvulsant drug also has beneficial effects in treatment of depression. Previously, we showed that acute administration of gabapentin produced an antidepressant-like effect in the mouse forced swimming test (FST) by a mechanism that involves the inhibition of nitric oxide (NO). Considering the involvement of NO in adenosine triphosphate (ATP)-sensitive potassium channels (KATP), in the present study we investigated the involvement of KATPchannels in antidepressant-like effect of gabapentin. Gabapentin at different doses (5–10 mg/kg) and fluoxetine (20 mg/kg) were administrated by intraperitoneal route, 60 and 30 min, respectively, before the test. To clarify the probable involvement of KATPchannels, mice were pretreated with KATPchannel inhibitor or opener. Gabapentin at dose 10 mg/kg significantly decreased the immobility behavior of mice similar to fluoxetine (20 mg/kg). Co-administration of subeffective dose (1 mg/kg) of glibenclamide (inhibitor of KATPchannels) with gabapentin (3 mg/kg) showed a synergistic antidepressant-like effect. Also, subeffective dose of cromakalim (opener of KATPchannels, 0.1 mg/kg) inhibited the antidepressant-like effect of gabapentin (10 mg/kg). None of the treatments had any impact on the locomotor movement. Our study, for the first time, revealed that antidepressant-like effect of gabapentin in mice is mediated by blocking the KATPchannels.
Ursolic acid suppresses leptin-induced cell proliferation in rat vascular smooth muscle cells
Authors: Yu Ya-Mei , Tsai Chiang-Chin , Tzeng Yu-Wen , Chang Weng-Cheng , Chiang Su-Yin , Lee Ming-Fen
Published: January 2017

Accumulating lines of evidence indicate that high leptin levels are associated with adverse cardiovascular health in obese individuals. Proatherogenic effects of leptin include endothelial cell activation and vascular smooth muscle cell proliferation and migration. Ursolic acid (UA) has been reported to exhibit multiple biological effects including antioxidant and anti-inflammatory properties. In this study, we investigated the effect of UA on leptin-induced biological responses in rat vascular smooth muscle cells (VSMCs). A-10 VSMCs were treated with leptin in the presence or absence of UA. Intracellular reactive oxygen species (ROS) was probed by 2′,7′-dichlorofluorescein diacetate. The expression of extracellular signal-regulated kinase (ERK)1/2, phospho-(ERK)1/2, nuclear factor-kappa B (NF-κB) p65 and p50, and matrix metalloproteinase-2 (MMP2) was determined by Western blotting. Immunocytochemistry and confocal laser scanning microscopy were also used for the detection of NF-κB. The secretion of MMP2 was detected by gelatin zymography. UA exhibited antioxidant activities in vitro. In rat VSMCs, UA effectively inhibited cell growth and the activity of MMP2 induced by leptin. These suppressive effects appeared by decreasing the activation of (ERK)1/2, the nuclear expression and translocation of NF-κB, and the production of ROS. UA appeared to inhibit leptin-induced atherosclerosis, which may prevent the development of obesity-induced cardiovascular diseases.
Chimaphilin inhibits human osteosarcoma cell invasion and metastasis through suppressing the TGF-β1-induced epithelial-to-mesenchymal transition markers via PI-3K/Akt, ERK1/2, and Smad signaling pathways
Authors: Dong Feng , Liu Tingting , Jin Hao , Wang Wenbo
Published: January 2017

Epithelial-to-mesenchymal transition is a cellular process associated with cancer invasion and metastasis. However, the antimetastatic effects of chimaphilin remain elusive. In this study, we attempted to investigate the potential use of chimaphilin as an inhibitor of TGF-β1-induced epithelial-to-mesenchymal transition in U2OS cells. We found that TGF-β1 induced epithelial-to-mesenchymal transition to promote U2OS cell invasion and metastasis. Western blotting demonstrated that chimaphilin inhibited U2OS cell invasion and migration, increased the expression of the epithelial phenotype marker E-cadherin, repressed the expression of the mesenchymal phenotype marker vimentin, as well as decreased the level of epithelial-to-mesenchymal-inducing transcription factors Snail1 and Slug during the initiation of TGF-β1-induced epithelial-to-mesenchymal transition. In this study, we revealed that chimaphilin up-regulated the E-cadherin expression level and inhibited the production of vimentin, Snail1, and Slug in TGF-β1-induced U2OS cells by blocking PI-3K/Akt and ERK 1/2 signaling pathway. Additionally, the TGF-β1-mediated phosphorylated levels of Smad2/3 were inhibited by chimaphilin pretreatment. Above all, we conclude that chimaphilin represents an effective inhibitor of the metastatic potential of U2OS cells through suppression of TGF-β1-induced epithelial-to-mesenchymal transition.
Chapter 13 Anatomy of the Andaman–Nicobar subduction system from seismic reflection data
Authors: Singh Satish C. , Moeremans Raphaële
Published: February 2017

The Andaman–Nicobar subduction system is the northwestern segment of the Sunda subduction system, where the Indian Plate subducts beneath the Sunda Plate in a nearly arc-parallel direction. The entire segment ruptured during the 2004 great Andaman–Sumatra earthquake (
M
w
=9.3). Using recently acquired high-resolution seismic reflection data, we characterize the shallow structure of the whole Andaman–Nicobar subduction system from west to east, starting from the nature of the subducting plate in the Bay of Bengal to back-arc spreading in the Andaman Sea. We find that the Ninety-East Ridge is overlain by thick continental margin sediments beneath the recent Bengal Fan sediments. The boundary between these two sedimentary units defines the plate interface. We observe evidence of re-activation of fracture zones on the subducting plate beneath the forearc, influencing the morphology of the upper plate. The forearc region, which includes the accretionary wedge, the forearc high and the forearc basin, is exceptionally wide (250 km). We observe an unusually large bathymetric depression within the forearc high. The forearc high is bounded in the east by a normal fault, whereas the forearc basin contains an active backthrust. The forearc basin is floored by the continental crust of Malayan Peninsula origin. The active sliver strike-slip fault lies in a deep basin, created during the rifting of the forearc continental crust and the Malayan Peninsula. The sliver fault connects with the Great Sumatra Fault in the south and with the Sagaing Fault in the north, via the Andaman Sea spreading centre and a large transform fault in the Andaman Sea.
Chapter 15 The 26 December 2004 earthquake and tsunami
Authors: Carter A. , Bandopadhyay P. C.
Published: February 2017

The 26 December 2004 earthquake and tsunami had variable impacts on the Andaman and Nicobar islands. While the earthquake rupture caused land-elevation changes (uplift in the west, subsidence in the east and south) and co-seismic shaking damaged buildings and weakened the infrastucture (roads, bridges, jetties), the tsunami caused most devastation. The largely tribal-populated, low-elevation smaller islands in the Nicobars were the most affected with two islands (Katchall and Pilmillow) losing nearly 90% of their population. This chapter documents and presents new evidence of the impacts of the earthquake and tsunami.
Hydrological Evaluation of Satellite Soil Moisture Data in Two Basins of Different Climate and Vegetation Density Conditions
Authors: Zhuo Lu , Han Dawei
Published: January 2017

Accurate soil moisture information is very important for real-time flood forecasting. Although satellite soil moisture observations are useful information, their validations are generally hindered by the large spatial difference with the point-based measurements, and hence they cannot be directly applied in hydrological modelling. This study adopts a widely applied operational hydrological model Xinanjiang (XAJ) as a hydrological validation tool. Two widely used microwave sensors (SMOS and AMSR-E) are evaluated, over two basins (French Broad and Pontiac) with different climate types and vegetation covers. The results demonstrate SMOS outperforms AMSR-E in the Pontiac basin (cropland), while both products perform poorly in the French Broad basin (forest). The MODIS NDVI thresholds of 0.81 and 0.64 (for cropland and forest basins, resp.) are very effective in dividing soil moisture datasets into “denser” and “thinner” vegetation periods. As a result, in the cropland, the statistical performance is further improved for both satellites (i.e., improved to NSE = 0.74, RMSE = 0.0059 m and NSE = 0.58, RMSE = 0.0066 m for SMOS and AMER-E, resp.). The overall assessment suggests that SMOS is of reasonable quality in estimating basin-scale soil moisture at moderate-vegetated areas, and NDVI is a useful indicator for further improving the performance.
Protein Adsorption to Titanium and Zirconia Using a Quartz Crystal Microbalance Method
Authors: Kusakawa You , Yoshida Eiji , Hayakawa Tohru
Published: January 2017

Protein adsorption onto titanium (Ti) or zirconia (ZrO2) was evaluated using a 27 MHz quartz crystal microbalance (QCM). As proteins, fibronectin (Fn), a cell adhesive protein, and albumin (Alb), a cell adhesion-inhibiting protein, were evaluated. The Ti and ZrO2sensors for QCM were characterized by atomic force microscopy and electron probe microanalysis observation, measurement of contact angle against water, and surface roughness. The amounts of Fn and Alb adsorbed onto the Ti and ZrO2sensors and apparent reaction rate were obtained using QCM measurements. Ti sensor showed greater adsorption of Fn and Alb than the ZrO2sensor. In addition, amount of Fn adsorbed onto the Ti or ZrO2sensors was higher than that of Alb. The surface roughness and hydrophilicity of Ti or ZrO2may influence the adsorption of Fn or Alb. With regard to the adsorption rate, Alb adsorbed more rapidly than Fn onto Ti. Comparing Ti and ZrO2, Alb adsorption rate to Ti was faster than that to ZrO2. Fn adsorption will be effective for cell activities, but Alb adsorption will not. QCM method could simulatein vivoFn and Alb adsorption to Ti or ZrO2.
Design of a SIW Bandpass Filter Using Defected Ground Structure with CSRRs
Authors: Li Weiping , Tang Zongxi , Cao Xin
Published: January 2017

In this paper, a substrate integrated waveguide (SIW) bandpass filter using defected ground structure (DGS) with complementary split ring resonators (CSRRs) is proposed. By using the unique resonant properties of CSRRs and DGSs, two passbands with a transmission zero in the middle have been achieved. The resonant modes of the two passbands are different and the bandwidth of the second passband is much wider than that of the first one. In order to increase out-of-band rejection, a pair of dumbbell DGSs has been added on each side of the CSRRs. The structure is analyzed using equivalent circuit models and simulated based on EM simulation software. For validation, the proposed filter is fabricated and measured. The measurement results are in good agreement with the simulated ones.
Excess Body Mass Index Loss at 3 Months: A Predictive Factor of Long-Term Result after Sleeve Gastrectomy
Authors: Philouze Guillaume , Voitellier Eglantine , Lacaze Laurence , Huet Emmanuel , Gancel Antoine , Prévost Gaëtan , Bubenheim Michael , Scotté Michel
Published: January 2017

Introduction.Laparoscopic Sleeve Gastrectomy (SG) is considered as successful if the percentage of Excess Body Mass Index Loss (% EBMIL) remains constant over 50% with long-term follow-up. The aim of this study was to evaluate whether early % EBMIL was predictive of success after SG.Methods.This retrospective study included patients who had SG with two years of follow-up. Patients had follow-up appointments at 3 (M3), 6, 12, and 24 months (M24). Data as weight and Body Mass Index (BMI) were collected systematically. We estimated the % EBMIL necessary to establish a correlation between M3 and M24 compared to % EBMIL speeds and calculated a limit value of % EBMIL predictive of success.Results.Data at operative time, M3, and M24 were available for 128 patients. Pearson test showed a correlation between % EBMIL at M3 and that at M24 (r=0.74;  p<0.0001). % EBMIL speed between surgery and M3 (p=0.0011) was significant but not between M3 and M24. A linear regression analysis proved that % EBMIL over 20.1% at M3 (p<0.0001) predicted a final % EBMIL over 50%.Conclusions.% EBMIL at M3 after SG is correlated with % EBMIL in the long term. % EBMIL speed was significant in the first 3 months. % EBMIL over 20.1% at M3 leads to the success of SG.
“Being with a Buddha”: A Case Report of Methoxetamine Use in a United States Veteran with PTSD
Authors: Striebel Joan M. , Nelson Emily E. , Kalapatapu Raj K.
Published: January 2017

Methoxetamine (MXE) is a ketamine analogue with a high affinity for the N-methyl-D-aspartate (NMDA) receptor. MXE is a newly emerging designer drug of abuse and is widely available through on-line sources and is not detected by routine urine drug screens. In this report, we describe a United States (US) veteran with posttraumatic stress disorder (PTSD) and heavy polysubstance use, who injected high dose MXE for its calming effect. Given MXE’s structural similarities to ketamine and recent work showing that ketamine reduces PTSD symptoms, we hypothesize that MXE alleviated this veteran’s PTSD symptoms through action at the NMDA receptor and via influences on brain-derived neurotrophic factor (BDNF). To our knowledge, this is the first case report of self-reported use of MXE in the US veteran population. More awareness of designer drugs, such as MXE, is an important first step in engaging patients in the treatment of designer drug addiction in both military/veteran settings and civilian settings.
Effectiveness and Safety of Acupuncture for Poststroke Dysphagia: Study Protocol for a Pragmatic Multicenter Nonrandomized Controlled Trial
Authors: Chan Yu Tat , Zhang Hong Wei , Guo Yuan Qi , Lin Zhi-Xiu
Published: January 2017

Background. Dysphagia is one of the most common complications of stroke. Acupuncture is widely employed to treat poststroke dysphagia in East Asia. No evidence is established to support such treatment approach. This proposed study aims to evaluate the effectiveness and safety of acupuncture for the treatment of poststroke dysphagia. Methods and Design. This is a multicenter, pragmatic, single‐blinded, nonrandomized controlled clinical trial. A total of 140 eligible patients will be enrolled in the study. Subjects who are eligible in study but refuse to have acupuncture treatment will be put on the no‐acupuncture control arm. Both groups of patients will receive standard routine care, while the patients of intervention group will receive add‐on standardized acupuncture treatment. Each participant in intervention group will receive a total of 24 sessions of acupuncture treatment (three times per week). The primary outcome measure is the Royal Brisbane Hospital Outcome Measure for Swallowing (RBHOMS). Secondary outcome measures include functional oral intake scale, swallow quality‐of‐life questionnaire in Chinese version, BMI of the participant, and adverse events. All outcome measures will be assessed at baseline, at the end of acupuncture treatment (month 2), and at two months after treatment (month 4). Ethics and Dissemination. The ethics approval of clinical research study was granted by the Research Ethics Committee of both New Territories East and West Cluster of Hong Kong. Written informed consent will be obtained from all participants and the study will be undertaken according to the ICH‐GCP Guidelines. Trial Registration. This trial is registered with chictr.org (registration number: ChiCTR-TRC-12002621 and registration date: 2012‐10‐26).
Dynamic Reliability Evaluation of Road Vehicle Subjected to Turbulent Crosswinds Based on Monte Carlo Simulation
Authors: Wang Bin , Li Yongle , Yu Helu , Liao Haili
Published: January 2017

As a vehicle moves on roads, a complex vibration system of the running vehicle is formed under the collective excitations of random crosswinds and road surface roughness, together with the artificial handing by the drivers. Several numerical models in deterministic way to assess the safety of running road vehicles under crosswinds were proposed. Actually, the natural wind is a random process in time domain due to turbulence, and the surface roughness of a road is also a random process but in spatial domain. The nature of a running vehicle therefore is an extension of dynamic reliability excited by random processes. This study tries to explore the dynamic reliability of a road vehicle subjected to turbulent crosswinds. Based on a nonlinear vibration system, the dynamic responses of a road vehicle are simulated to obtain the dynamic reliability. Monte Carlo Simulation with Latin Hypercube Sampling is then applied on the possible random variables including the vehicle weight, road friction coefficient, and driver parameter to look at their effects. Finally, a distribution model of the dynamic reliability and a corresponding index for the wind-induced vehicle accident considering these random processes and variables is proposed and employed to evaluate the safety of the running vehicle.
Impact of In Situ Stress Distribution Characteristics on Jointed Surrounding Rock Mass Stability of an Underground Cavern near a Hillslope Surface
Authors: Li Bangxiang , Li Yong , Zhu Weishen , Li Chao , Dong Zhenxing
Published: January 2017

In this paper, a series of numerical simulations are performed to analyze the in situ stress distribution characteristics of the rock mass near different slope angles hillslope surfaces, which are subjected to the vertical gravity stress and different horizontal lateral stresses and the influence which the in situ stress distribution characteristics of 45° hillslope to the integral stability of surrounding rock mass when an underground cavern is excavated considering three different horizontal distances from the underground cavern to the slope surface. It can be concluded from the numerical results that different slope angles and horizontal lateral stresses have a strong impact on the in situ stress distribution and the integral surrounding rock mass stability of the underground cavern when the horizontal distance from the underground cavern to the slope surface is approximately 100 m to 200 m. The relevant results would provide some important constructive suggestions to the engineering site selection and optimization of large-scale underground caverns in hydropower stations.
Primary Pure Squamous Cell Carcinoma of the Gallbladder Locally Invading the Liver, Duodenum, and Stomach: A Case Report and Literature Review
Authors: Alpuerto Aldrin C. , Mora Maximo E. , Robitsek R. Jonathan , Schubl Sebastian D.
Published: January 2017

Primary pure squamous cell carcinoma (SCC) of the gallbladder is an exceptionally rare type of tumor that comprises only 1% of all gallbladder cancer. SCC of the gallbladder portends a worse prognosis than the more common adenocarcinoma variant because of its aggressive invasion to local structures and because it is often diagnosed at an advanced stage. Owing to its rarity, diagnosis and management can be challenging. Herein, we present the case of a 75-year-old female complaining of abdominal pain, nausea, and vomiting. Computed tomography and ultrasonography results of the abdomen were consistent with acute cholecystitis and cholelithiasis. Histologic evaluation of the resected mass revealed a malignant tumor with prominent keratinization, confirming the diagnosis of an invasive primary pure SCC of the gallbladder. Microscopic examination showed direct infiltration to the liver, duodenum, and stomach. This case report describes the hospital course of a patient with SCC of the gallbladder and suggests that gallbladder cancer should be considered as part of the differential diagnosis in elderly patients presenting with acute cholecystitis. In addition, this article will review existing literature to examine the utility of different diagnostic techniques and treatment modalities available in the management of gallbladder cancer.