bluuebunny/crossref_metadata_2025 huggingface dataset:
Walled-off pancreatic necrosis: a staged multidisciplinary step-up approach
Authors: Sousa Débora , Freitas Ferreira Ana Carolina , Raimundo Pedro , Maio Rui
Published: March 2020

Walled-off pancreatic necrosis (WOPN) is a rare complication of pancreatitis. We present the case of a woman in her eighties admitted for diffuse abdominal pain. She had a palpable abdominal mass and the CT scan showed necrosis throughout the tail of the pancreas, a peripancreatic and retrogastric hydroaerial collection (19 cm of diameter) and a calculus in the main biliary duct, thus establishing a diagnosis of emphysematous necrotising obstructive pancreatitis. A step-up approach was decided, first with removal of the biliary calculus, followed by a waiting period of 4 weeks in which the patient was under intravenous antibiotics. At re-evaluation, the CT scan showed a smaller and more organised collection, bounded by a wall, defining WOPN. At this stage, transgastric drainage via echoendoscopy was attempted, without success, followed by percutaneous CT-guided drainage, also with little effect. Surgical necrosectomy was then executed, as a final step, with a successful outcome.
The implementation and effectiveness of the one stop centre model for intimate partner and sexual violence in low- and middle-income countries: a systematic review of barriers and enablers
Authors: Olson Rose McKeon , García-Moreno Claudia , Colombini Manuela
Published: March 2020

Introduction

Many low- and middle-income countries have implemented health-system based one stop centres to respond to intimate partner violence (IPV) and sexual violence. Despite its growing popularity in low- and middle-income countries and among donors, no studies have systematically reviewed the one stop centre. Using a thematic synthesis approach, this systematic review aims to identify enablers and barriers to implementation of the one stop centre (OSC) model and to achieving its intended results for women survivors of violence in low- and middle-income countries.

Methods

We searched PubMed, CINAHL and Embase databases and grey literature using a predetermined search strategy to identify all relevant qualitative, quantitative and mixed methods studies. Overall, 42 studies were included from 24 low- and middle-income countries. We used a three-stage thematic synthesis methodology to synthesise the qualitative evidence, and we used the CERQual (Confidence in the Evidence from Reviews of Qualitative Research) approach to assess confidence in the qualitative research. Meta-analysis could not be performed due heterogeneity in results and outcome measures. Quantitative data are presented by individual study characteristics and outcomes, and key findings are incorporated into the qualitative thematic framework.

Results

The review found 15 barriers with high-confidence evidence and identified seven enablers with moderate-confidence evidence. These include barriers to implementation such as lack of multisectoral staff and private consultation space as well as barriers to achieving the intended result of multisectoral coordination due to fragmented services and unclear responsibilities of implementing partners. There were also differences between enablers and barriers of various OSC models such as the hospital-based OSC, the stand-alone OSC and the NGO-run OSC.

Conclusion

This review demonstrates that there are several barriers that have often prevented the OSC model from being implemented as designed and achieving the intended result of providing high quality, accessible, acceptable, multisectoral care. Existing OSCs will likely require strategic investment to address these specific barriers before they can achieve their ultimate goal of reducing survivor retraumatisation when seeking care. More rigorous and systematic evaluation of the OSC model is needed to better understand whether the OSC model of care is improving support for survivors of IPV and sexual violence.

The systematic review protocol was registered and is available online (PROSPERO: CRD42018083988).
Cutaneous mastocytoma with eosinophilia and eosinophilic infiltration of the small intestine in an Arabian gelding
Authors: Williams Natasha Jane , van den Boom Robin
Published: March 2020

A 12‐year‐old Arabian gelding presented to the University of Adelaide for investigation of a firm subcutaneous mass, just proximal to the digital flexor tendon sheath of the right forelimb, that had appeared two weeks prior. The skin overlying the mass was intact. Fine needle aspiration identified eosinophilic and mastocytic infiltrates. One week later, the gelding re‐presented for persistent colic signs. Blood examination showed eosinophilia, and on palpation per rectum the mesenteric root was very firm and enlarged and a number of small intestinal loops had subjectively thickened walls. Colic signs were unabated by the administration of pain relief. The owner declined surgery and the gelding was euthanased. Postmortem examination confirmed a diagnosis of cutaneous mastocytoma and revealed eosinophilic infiltration of the small intestine.
Neonatal neuroimaging after repair of congenital diaphragmatic hernia and long-term neurodevelopmental outcome
Authors: Gunn-Charlton Julia Kate , Burnett Alice C , Malarbi Stephanie , Moran Margaret M , Hutchinson Esther A , Greaves Susan , Hunt Rod W
Published: March 2020

Objective

Previous outcome reports of congenital diaphragmatic hernia (CDH) have described neuroimaging anomalies and neurodevelopmental impairment. However, the link between imaging and outcome has not been described. We aimed to determine whether routine postoperative neonatal neuroimaging in infants with CDH detects later neurodevelopmental impairment.

Methods

In a prospective cohort study within a clinical service in The Royal Children’s Hospital Newborn Intensive Care. Cerebral ultrasound was performed in 81 children and MRI in 57 children who subsequently underwent neurodevelopmental follow-up after surgery for CDH. MRI scans were analyzed using a scoring system designed to identify injury, maturation and volume loss. Neurodevelopmental assessment occurred at 2 years (48) and neurocognitive assessment at 5 years (26) and/or 8 years (27). Brain imaging scores corrected for gestational age at scan time were correlated with outcome measures, adjusting for known clinical confounders.

Results

Clinically significant findings were identified on MRI of 16 (28%) infants. Mean scores were in the normal range for all domains assessed at each age. Language impairment was seen in 23% at 2 years and verbal intellectual impairment in 25% at 8 years. Mean cognitive scores were lower in 2-year-old children with white matter injury on MRI (p=0.03). Mean motor scores were lower in 2-year-old children with brain immaturity (p=0.01). Associations between MRI and 5-year and 8-year assessments were no longer significant when adjusting for known clinical confounders.

Conclusions

Neuroimaging abnormalities were associated with worse neurodevelopment at 2 years, but not with later neurocognitive outcomes, after accounting for clinical risk factors.
Postoperative adhesions after abdominal surgery in children: a pilot study in the Philippines
Authors: Deogracias Jan Miguel C , Almonte Josefina R
Published: March 2020

Background

Postoperative adhesions (POAs) causing mechanical bowel obstruction is a challenging problem for children who underwent prior abdominal surgeries. Unlike in adults, the role of conservative management remains controversial and children tend to require re-operation. However, despite the longer lifetime risk inherent to the pediatric population, studies are still lacking to come up with guidelines on diagnosis and management. This study aimed to review the profiles and outcomes of patients who underwent surgery for POA and to identify significant risk factors.

Methods

This was a retrospective review of 172 patients admitted at the Philippine General Hospital from 2010 to 2018 with the diagnosis of POA. Patients who did not undergo surgery and patients who had a different cause of bowel obstruction with the adhesions being only incidental were excluded from the study.

Results

Ninety-one patients were included in the study. The mean age at surgery was 92.32 months and the male:female ratio was 2.8:1. The most common primary diagnoses were appendicitis, intussusception, and abdominal trauma. POA occurred within the first postoperative year in 63%. The 30-day morbidity and mortality rates were 9.89% and 7.69%, respectively. The most common complications were fascial and anastomotic dehiscences, and sepsis was the most common cause of death. Stoma creation during the index operation, and the presence of bowel gangrene, intestinal resection, and stoma creation during the surgery for POA were statistically significant risk factors for morbidity and mortality.

Conclusion

The findings in this study support the experience in literature that timely operative intervention can prevent bowel strangulation in cases of mechanical bowel obstruction from POA. However, more data and studies are recommended to arrive at an evidence-based guideline in the management of these children.
Recommendation about the perioperative prevention of infection to healthcare workers and the anesthesia management of children with SARS-CoV-2 infection
Authors: Huang Jinjin , Hu Yaoqin , Wang Jiangmei , Wang Dongpi , Zhu Zhirui , Hu Zhiyong , Jin Ziying , Lin Hongfei , Huang Wenfang , Shen Weiqing , Jiang Yilei , Hu Miaofeng , Wu Jingzhen , Suo Yaojun , Shu Qiang
Published: March 2020

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread widely and persistently over 100 countries. New challenges have occurred in the perioperative management of airway and anesthesia in children diagnosed with SARS-CoV-2 infection. According to current publications and to our own experiences in anesthesia management for cases with SARS-CoV-2 suspected, we reviewed concerns about the perioperative prevention of SARS-CoV-2 to medical staff and the anesthesia strategy to the patient.
Identification of sequence stratigraphy in the Dongying Formation of the Liaoxi low uplift, Bohai Bay Basin, China
Authors: Zhou Guangzhao , Hu Zhiming , Duan Xianggang , Chang Jin
Published: March 2020

A change in sea level (or lake level) causes a change in accommodation space and sediment compensation, which then controls the formation and evolution of sequences. A multidisciplinary approach based on the integration of clay minerals, major and trace elements, paleosalinity, and three-dimensional seismic data were applied to interpret the stratigraphic sequence of the Dongying Formation in the Liaoxi low uplift. The sequence surface indicates that multistage tectonic action, paleoclimate, paleosalinity, and lake level change jointly controlled the sequence stratigraphy. The illite and illite–smectite mixed layers indicate an arid to semi-arid climate, whereas kaolinite implies humid conditions. Based on this principle, it is clear that the stratigraphic sequence is closely related to paleoclimate. Interpretation of the continental or marine character of the sediments via paleosalinity is increasingly based on the concentration of some trace elements. Hence, the sequence surface can be better evaluated through paleosalinity data. Based on the Sr/Ba and boron content, paleosalinity was evaluated and the sequence boundary was identified. Analysis of the concentration of major and trace elements was used to identify the lithology of the sedimentary region and further discern the stratigraphic sequence. These sequences are composed of lowstand, transgressive, and highstand system tracts. The work herein aimed to understand the reasons for the changes in sequences under the paleoclimate. In addition, major and trace elements, studied together with paleosalinity and clay mineral content, result in the determination of implications for sequence stratigraphy in many other basins. This paper can provide a novel method for comprehensively discerning a sequence surface.
On Hamiltonians for Kerov functions
Authors: Mironov A. , Morozov A.
Published: March 2020

Kerov Hamiltonians are defined as a set of commuting operators which have Kerov functions as common eigenfunctions. In the particular case of Macdonald polynomials, well known are the exponential Ruijsenaars Hamiltonians, but the exponential shape is not preserved in lifting to the Kerov level. Straightforwardly lifted is a bilinear expansion in Schur polynomials, the expansion coefficients being factorized and restricted to single-hook diagrams. However, beyond the Macdonald locus, the coefficients do not celebrate these properties, even for the simplest Hamiltonian in the set. The coefficients are easily expressed in terms of the eigenvalues: one can build one for each arbitrary set of eigenvalues$$\{E_R\}$${ER}, specified independently for each Young diagramsR. A problem with these Hamiltonians is that they are constructed with the help of Kostka matrix instead of defining it, and thus are less powerful than the Ruijsenaars ones.
Electric transitions of the charmed-strange mesons in a relativistic quark model
Authors: Chen Shao-Feng , Liu Jing , Zhou Hai-Qing , Chen Dian-Yong
Published: March 2020

In the present work, we adopt a relativistic constituent quark model to depict the charmed strange meson spectroscopy, in which $$D_{s0}(2317)$$Ds0(2317) and $$D_{s1}(2460)$$Ds1(2460) are considered as the $$1^3P_0$$13P0 and $$1P_1^\prime $$1P1′ charmed strange mesons, respectively. By using the wave function obtained from the relativistic quark model, we further investigate the electric transitions between charmed strange mesons. We find the long wave length approximation is reasonable for the charmed strange meson radiative decay by comparing the results with different approximations. The estimated partial widths are all safely under the upper limits of the experimental data. Moreover, we find the branching ratio of $$D_{s1}(2536) \rightarrow D_s^*\gamma /D_s \gamma $$Ds1(2536)→Ds∗γ/Dsγ are large enough to be detected, which could be searched by further experiments in Belle II and LHCb.
Downregulated microRNA-130b-5p prevents lipid accumulation and insulin resistance in a murine model of nonalcoholic fatty liver disease
Authors: Liu Xiaonan , Chen Shuhong , Zhang Lanju
Published: March 2020

Nonalcoholic fatty liver disease (NAFLD) amplifies the risk of various liver diseases, ranging from simple steatosis to nonalcoholic steatohepatitis, fibrosis, and cirrhosis, and ultimately hepatocellular carcinoma. Accumulating evidence suggests the involvement of aberrant microRNAs (miRNAs or miRs) in the activation of cellular stress, inflammation, and fibrogenesis in hepatic cells at different stages of NAFLD and liver fibrosis. Here, we explored the potential role of miR-130b-5p in the pathogenesis of NAFLD, including lipid accumulation and insulin resistance, as well as the underlying mechanism. Initially, the expression of miR-130b-5p and insulin-like growth factor binding protein 2 (IGFBP2) was examined in the established high-fat diet-induced NAFLD mouse models. Then, the interaction between miR-130b-5p and IGFBP2 was validated using dual luciferase reporter assay. The effects of miR-130b-5p and IGFBP2 on lipid accumulation and insulin resistance, as well as the AKT pathway-related proteins, were evaluated using gain or loss-of-function approaches. miR-130b-5p was upregulated, and IGFBP2 was downregulated in liver tissues of NAFLD mice. miR-130b-5p targeted IGFBP2 and downregulated its expression. MiR-130b-5p inhibition or IGFBP2 overexpression reduced the expression of SREBP-1, LXRα, ChREBP, stearoyl CoA desaturase 1, acetyl CoA carboxylase 1, and fatty acid synthase, and levels of fasting blood glucose, fasting insulin, and homeostasis model assessment-insulin resistance, while increasing the ratio of p-AKT/AKT in NAFLD mice. Overall, downregulation of miR-130b-5p can prevent hepatic lipid accumulation and insulin resistance in NAFLD by activating IGFBP2-dependent AKT pathway, highlighting the potential use of anti-miR-130b-5p as therapeutic approaches for the prevention and treatment of NAFLD.
Investigation of Flexural Fatigue Behavior of Concrete Beams Reinforced with Intelligent CFRP‐OFBG Plates
Authors: Deng Langni , Liu Yang , Liao Ling , Xie Hong , Huang Xiaoxia , Lai Shijin , Zhong Mengjun
Published: March 2020

The fatigue properties of concrete beams reinforced with carbon fiber‐reinforced polymer‐optical fiber Bragg grating (CFRP‐OFBG) plates under three‐point bending constant cyclic loading were experimentally studied. According to the experimental findings, the mechanism of fatigue failure in reinforced beams was presented, and the corresponding empirical equations were established for the prediction of the fatigue lives of these components. Besides, based on the real‐time monitoring data of the intelligent CFRP‐OFBG plates, a fatigue accumulative damage model was established using flexural bending stiffness for the prediction of fatigue life. Through example verification, it was found that the fatigue life predicted by the model had less error and was safer than the fatigue failure cycle number of the reinforced beam obtained by experimental tests.
Network and Agent Dynamics with Evolving Protection against Systemic Risk
Authors: Park Chulwook
Published: March 2020

The dynamics of protection processes has been a fundamental challenge in systemic risk analysis. The conceptual principle and methodological techniques behind the mechanisms involved (in such dynamics) have been harder to grasp than researchers understood them to be. In this paper, we show how to construct a large variety of behaviors by applying a simple algorithm to networked agents, which could, conceivably, offer a straightforward way out of the complexity. The model starts with the probability that systemic risk spreads. Even in a very random social structure, the propagation of risk is guaranteed by an arbitrary network property of a set of elements. Despite intensive systemic risk, the potential of the absence of failure could also be driven when there has been a strong investment in protection through a heuristically evolved protection level. It is very interesting to discover that many applications are still seeking the mechanisms through which networked individuals build many of these protection processes or mechanisms based on fitness due to evolutionary drift. At the same time, this approach could be useful for researchers and those who need to use protection dynamics to guard against systemic risk under intrinsic randomness in artificial circumstances.
Adjuvant Effects of Health Education of Chinese Medicine for Chronic Diseases: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials
Authors: Wang An-Lu , Zhang He , Zhang Jie , Zhang Yan , Cao Hui-Juan , Liu Jian-Ping , Xu Hao , Chen Ke-Ji
Published: March 2020

Objective. To evaluate the adjuvant effects of health education of Chinese medicine (HECM) for patients with three types of common noncommunicable diseases (NCD‐hypertension, diabetes, and coronary heart disease (CHD)). Methods. The protocol of this review was registered in the PROSPERO website (CRD42017058325). Six databases were searched till Sep. 30, 2019. Randomized controlled trials (RCTs) comparing HECM plus conventional therapy with conventional therapy were retrieved. Participants were diagnosed as one of the 3 above NCDs. HECM is regarded as lectures and classes about diet therapy, exercise therapy, emotion balance, and other knowledge according to Chinese medicine theory. The control rate of the disease was defined as a primary outcome in this review. Outcomes were synthesized using meta‐analyses where reporting was sufficiently homogeneous or alternatively synthesized in a systematic review. Results. In total, 12 trials with 1142 patients were included in this review. Since all the trials may have unclear or high risk of bias, only low quality evidence could be found for supporting the adjunctive effect of HECM in treating hypertension, diabetes, and CHD, to reduce the control rate (risk ratio −1.58), the blood pressure level (mean difference −9.38 mmHg), the fasting plasma glucose level (mean difference −1.26 mmol/L), and the symptoms of angina. Conclusion. The adjunctive effect of HECM on increasing the control rate of hypertension, improving the symptoms of diabetes and CHD, was only supported by low‐quality evidence in this review. More rigorous trials with larger sample sizes and higher quality are warranted to provide a high quality of evidence.
Epidemiologic, Clinical, Ultrasonographic, and Cytological Features of Thyroid Nodules in Predicting Malignancy Risk: A Retrospective Study of 442 French Afro-Caribbean Patients
Authors: Joseph-Auguste Johan , Lin Lucien , Demar Magalie , Duffas Olivier , Molinie Vincent , Sulpicy Caroline , Dorival Marie-Josée , Luxembourger Olivier , Sabbah Nadia
Published: March 2020

Objective. To evaluate epidemiologic, clinical, cytological, and ultrasonographic features of thyroid nodules in a sample French Afro-Caribbean population to determine if the standard criteria for predicting malignancy risk are applicable to this specific ethnic population. Methods and Design. This retrospectively designed study consisted of 442 patients who had consulted with the Endocrinology Department in Martinique (French overseas department) between 2007 and 2011. Of the 442 patients, 641 ultrasound-guided fine-needle aspirations (US-FNA) were performed by two experienced endocrinologists, and 212 patients underwent surgery. The geographical situation, age, gender of the patient, clinical and ultrasonographic features, TSH level, and US-FNA results were considered and cross-referenced with their pathology results. Results. The overall malignancy rate on final histopathology was 9% (women only), 80% of which were papillary cancer, and 20% were follicular cancer. Occult micropapillary carcinoma represented 35% of the papillary cancer. There was no significant difference in age, nodule localization, number of nodules, or thyroid function test between benign and malignant nodules. Contrary to the literature, we found only 12% incidentaloma in our series, while more than half of the nodules were discovered on palpation or as a clinical symptom. Hypoechogenicity in solid pattern nodules and nodules between 2 and 3 cm in size revealed a high diagnostic value in detecting malignancy. The corresponding rate of malignancy on Bethesda system histopathologic examination was as follows: 0% in undiagnosed (I), 0% benign (II) (micropapillary), 5% (FLUS)/atypia (III), 9% follicular neoplasm (IV), 33% suspected malignancy (V), and no malignant cytology (VI). These results show a different Bethesda system predictive value for this French Afro-Caribbean population. Conclusion. Studies evaluating ethnic cancer disparities among patients with thyroid cancer are limited and do not specifically focus on the French Afro-Caribbean population. Despite rare thyroid incidentaloma, 35% of the papillary cancer cases were micropapillary carcinoma, and the incidence and standardized mortality rate in Martinique are lower than in metropolitan France. The malignant risk distribution of thyroid FNA Bethesda classification in this sample population differs from the standard risk, and it is necessary to take that into account in the decision to operate by associating it with echographic malignancy criteria.
Pharmacodynamics of Ceftiofur Selected by Genomic and Proteomic Approaches of Streptococcus parauberis Isolated from the Flounder, Paralichthys olivaceus
Authors: Boby Naila , Abbas Muhammad Aleem , Lee Eon-Bee , Park Seung-Chun
Published: March 2020

We employed an integrative strategy to present subtractive and comparative metabolic and genomic-based findings of therapeutic targets against Streptococcus parauberis. For the first time, we not only identified potential targets based on genomic and proteomic database analyses but also recommend a new antimicrobial drug for the treatment of olive flounder (Paralichthys olivaceus) infected with S. parauberis. To do that, 102 total annotated metabolic pathways of this bacterial strain were extracted from computational comparative metabolic and genomic databases. Six druggable proteins were identified from these metabolic pathways from the DrugBank database with their respective genes as mtnN, penA, pbp2, murB, murA, coaA, and fni out of 112 essential nonhomologous proteins. Among these hits, 26 transmembrane proteins and 77 cytoplasmic proteins were extracted as potential vaccines and drug targets, respectively. From the FDA DrugBank, ceftiofur was selected to prevent antibiotic resistance as it inhibited our selected identified target. Florfenicol is used for treatment of S. parauberis infection in flounder and was chosen as a comparator drug. All tested strains of fish isolates with S. parauberis were susceptible to ceftiofur and florfenicol with minimum inhibitory concentrations (MIC) of 0.0039–1 μg/mL and 0.5–8 μg/mL, IC50 of 0.001–0.5 μg/mL and 0.7–2.7 μg/mL, and minimum biofilm eradication concentrations (MBEC) of 2–256 μg/mL and 4–64 μg/mL, respectively. Similar susceptibility profiles for ceftiofur and florfenicol were found, with ceftiofur observed as an effective and potent antimicrobial drug against both planktonic and biofilm-forming strains of the fish pathogen Streptococcus parauberis, and it can be applied in the aquaculture industry. Thus, our predictive approach not only showed novel therapeutic agents but also indicated that marketed drugs should also be tested for efficacy against newly identified targets of this important fish pathogen.
Elevated Serum Level of Cytokeratin 18 M65ED Is an Independent Indicator of Cardiometabolic Disorders
Authors: Qian Lingling , Zhang Lei , Wu Liang , Zhang Jing , Fang Qichen , Hou Xuhong , Gao Qiongmei , Li Huating , Jia Weiping
Published: March 2020

Background. Recent studies have suggested that cell death might be involved in the pathophysiology of metabolic disorders. The cytokeratin 18 (CK18) fragment, as a cell death marker, plays an important role in nonalcoholic fatty liver disease (NAFLD). However, only a limited number of studies have found elevated serum levels of CK18 in patients with type 2 diabetes. Moreover, no studies have been conducted yet to investigate the role of CK18 in hypertension or dyslipidemia. In particular, CK18 M65ED is a more sensitive marker of cell death, and its role in cardiometabolic disorders has not been revealed yet.Methods. A total of 588 subjects were enrolled from the local communities of Shanghai. Serum CK18 M65ED were determined using the enzyme-linked immunosorbent assay. A cardiometabolic disorder was identified by the presence of at least one of the components including overweight or central obesity, diabetes, dyslipidemia, and hypertension.Results. Subjects with cardiometabolic disorders exhibited significantly higher serum levels of CK18 M65ED than those without cardiometabolic disorders (197.36 (121.13–354.50) U/L versus 83.85 (52.80–153.75) U/L, respectively,P<0.001). Increased serum CK18 M65ED quartiles were associated with the increased prevalence of cardiometabolic disorders and its components (P<0.001for all components). Multiple stepwise regression analysis also revealed that diastolic blood pressure, glycated hemoglobin A1c, alanine transaminase, and high-density lipoprotein cholesterol were independently correlated with serum CK18 M65ED levels (allP<0.01). In addition, logistic regression analysis showed that the serum CK18 M65ED levels were positively correlated with cardiometabolic disorders and in an independent manner. Further, CK18 M65ED was revealed to be an indicator of cardiometabolic disorders in a NAFLD-independent manner.Conclusions. Elevated levels of CK18 M65ED, a sensitive cell death marker, were independently and positively correlated with cardiometabolic disorders, even after the adjustment for the presence of NAFLD and other cardiovascular risk factors.
Fault Diagnosis of Capacitance Aging in DC Link Capacitors of Voltage Source Inverters Using Evidence Reasoning Rule
Authors: Liao Linhao , Gao Haibo , He Yelan , Xu Xiaobin , Lin Zhiguo , Chen Yajie , You Fubing
Published: March 2020

Capacitance aging of DC link capacitors in voltage source inverters (VSIs) is a common fault which can lead to instability of the DC voltage. In such a failure state, although the VSI can still work, its performance gradually deteriorates, resulting in a shorter service life of the equipment. Here, an online monitoring and fault diagnosis method for capacitance aging based on evidence reasoning (ER) rule is presented. Features from the DC link voltage data with different levels of capacitance aging are extracted, and data features are generated as pieces of diagnostic evidence, which are then combined according to the ER rule. Finally, capacitance aging fault levels were estimated using the combined results. This method has better diagnostic performance compared to a backpropagation (BP) neural network approach and can be used to flexibly define the relative weighting of each evidence parameter depending on the application. This approach can therefore be widely used for fault diagnosis of an array of different devices.
Multimodal Anesthesia via Opioid-Free Analgesia and Erector Spinae Plane Block
Authors: Luis-Navarro Juan Carlos , Fornés-Rumbao Carmen , DeLaCalle-Gil Ana Bella , Forero Mauricio
Published: March 2020

Multimodal anesthesia, which combines general and epidural anesthesia, is used in surgical cases in which a large or painful incision is anticipated. However, both epidural blocks and opioid-based analgesia have limitations in application. Here, we present a case of supra-infraumbilical laparotomy in a patient whose history of neurostimulator use and marked scoliosis discouraged the placement of an epidural catheter and whose prior adverse response to opioids prohibited their use. The intraoperative and postoperative management of this patient consisted of a combination of analgesia without opioids and erector spinae plane block. Adequate analgesia was achieved, and intraoperative or postoperative opioids were not required. This case illustrates the importance of mastering alternative and multimodal analgesia techniques that can be used in place of classical analgesia techniques when classical analgesia techniques are not appropriate.
Construction of a CXC Chemokine‐Based Prediction Model for the Prognosis of Colon Cancer
Authors: Liu Kaisheng , Lai Minshan , Wang Shaoxiang , Zheng Kai , Xie Shouxia , Wang Xiao
Published: March 2020

Colon cancer is the third most common cancer, with a high incidence and mortality. Construction of a specific and sensitive prediction model for prognosis is urgently needed. In this study, profiles of patients with colon cancer with clinical and gene expression data were downloaded from Gene Expression Omnibus and The Cancer Genome Atlas (TCGA). CXC chemokines in patients with colon cancer were investigated by differential expression gene analysis, overall survival analysis, receiver operating characteristic analysis, gene set enrichment analysis (GSEA), and weighted gene coexpression network analysis. CXCL1, CXCL2, CXCL3, and CXCL11 were upregulated in patients with colon cancer and significantly correlated with prognosis. The area under curve (AUC) of the multigene forecast model of CXCL1, CXCL11, CXCL2, and CXCL3 was 0.705 in the GSE41258 dataset and 0.624 in TCGA. The prediction model was constructed using the risk score of the multigene model and three clinicopathological risk factors and exhibited 92.6% and 91.8% accuracy in predicting 3‐year and 5‐year overall survival of patients with colon cancer, respectively. In addition, by GSEA, expression of CXCL1, CXCL11, CXCL2, and CXCL3 was correlated with several signaling pathways, including NOD‐like receptor, oxidative phosphorylation, mTORC1, interferon‐gamma response, and IL6/JAK/STAT3 pathways. Patients with colon cancer will benefit from this prediction model for prognosis, and this will pave the way to improve the survival rate and optimize treatment for colon cancer.
Phospholipase D1 Ameliorates Apoptosis in Chronic Renal Toxicity Caused by Low‐Dose Cadmium Exposure
Authors: Huang Ke , Deng Yaotang , Yuan Wenya , Geng Jian , Wang Guanghai , Zou Fei
Published: March 2020

Exposure to cadmium (Cd), a common heavy metal used in industry, can result in long‐term chronic toxicity. It has been well characterized that kidneys are the main organs that are targeted by toxicity, which can cause apoptosis, necrosis, and atrophy of renal tubular epithelial cells. However, the molecular mechanisms associated with Cd toxicity remain unclear. In this study, the expression of renal proteins in Sprague‐Dawley rats exposed to chronic Cd was analyzed with iTRAQ proteomics. Bioinformatics analysis indicated that phospholipase D1 (PLD1) was significantly underexpressed and may correlate strongly with Cd‐induced chronic kidney impairment. Previous studies have shown that PLD1 promotes cell proliferation and inhibits apoptosis, indicating that PLD1 may be implicated in the pathogenesis of kidney injury induced by Cd. Studies in vivo and in vitro all demonstrate that the mRNA and protein levels of PLD1 decrease significantly both in kidney tissue and in proximal tubular cell lines exposed to Cd. Overexpression of PLD1 and its downstream product PA could ameliorate Cd‐induced apoptosis. Moreover, we identified that miR‐122‐5p was a regulatory miRNA of PLD1. miR‐122‐5p was overexpressed after Cd exposure and promoted cell apoptosis by downregulating PLD1 through binding the 3 ′UTR of the locus at 1761–1784 nt. In conclusion, our results indicated that PLD1 and its downstream PA were strongly implicated in Cd‐induced chronic kidney impairment and could be a novel player in the defense against Cd‐induced nephrotoxicity.
Simplified Modeling and Simulation of Electricity Production from a Dish/Stirling System
Authors: Babikir Mahamat Hassane , Chara-Dackou Venant Sorel , Njomo Donatien , Barka Mahamat , Khayal Mahamoud Youssouf , Legue Daniel Roméo Kamta , Gram-Shou Jean Paul
Published: March 2020

This work is part of the dynamic of proposing a solution to the problem of access to electricity in Chad, which has a rate of access to electricity of 3%. N’Djamena has significant solar potential that can be harnessed to generate electricity. In this paper, we present a theoretical study of the performances of the Dish/Stirling system with the purpose of producing electricity, based on a mathematical model taking into account each of the subparts of the system (concentrator, solar cavity receiver, and Stirling engine). Hydrogen is preferred to helium as the working fluid for operating the Stirling engine at high temperatures. This coupled model made it possible to estimate the monthly average of the electric power produced by this modular system and also its overall solar electricity yield.
The Effect of a Modified Constant Flow Insufflation of Oxygen during Cardiopulmonary Resuscitation in a Rat Model of Respiratory Cardiac Arrest on Arterial Oxygenation, Alveolar Barotrauma, and Brain Tissue Injury
Authors: Lee Yoonje , Lee Sang-hyun , Choi Hyuk Joong , Park Jinkyu , Hwang Sejin , Lim Tae Ho , Kim Changsun
Published: March 2020

Aim. Intermittent positive pressure ventilation (IPPV) can adversely affect cardiopulmonary resuscitation outcomes by increasing the intrathoracic pressure. Continuous flow insufflation of oxygen (CFIO) has been investigated as a potential alternative, but evidence supporting its superiority over intermittent positive pressure ventilation in cases of cardiac arrest is scant. The aim of the current study was to compare the effects of continuous flow insufflation of oxygen using a one-way valve during cardiopulmonary-resuscitation with intermittent positive pressure ventilation in a rat model of respiratory arrest. Methods. Male Sprague-Dawley rats weighing 400∼450 g (from minimum to maximum) were randomly assigned to either a sham, IPPV, or CFIO group (n = 10 per group). Respiratory arrest was induced by blocking the endotracheal tube. Arterial blood gas analysis was performed during cardiopulmonary resuscitation to compare the oxygenation levels. Tissues were then harvested to compare the degrees of pulmonary barotrauma and ischemic brain injury. Results. Return of spontaneous circulation was observed in 6/10 rats in the IPPV group and 5/10 in the CFIO group. During cardiopulmonary resuscitation, the mean PaO2 was significantly higher in the CFIO group (83.10 mmHg) than in the IPPV group (56.10 mmHg). Lung biopsy revealed more inflammatory cells and marked thickening of the alveolar wall in the IPPV group; the group also exhibited a higher frequency of neuroglial cells and apoptotic bodies of pyramidal cells, resulting from ischemic injury. Conclusion. In a rat model of respiratory arrest, CFIO using a one-way valve resulted in a greater level of oxygenation and less lung and brain injuries than with IPPV.
Maculopatía media paracentral aguda: a propósito de un caso y revisión de la literatura.
Authors: Sanhueza Ana , Liberman Salazar Paulina , González Contreras Raúl
Published: March 2020

Introducción: la maculopatía media paracentral aguda (PAMM) es una entidad descrita en la tomografía de coherencia óptica de dominio espectral (SD-OCT).  Se caracteriza por la presencia de una banda hiperrefringente de localización parafoveal en las capas medias retinales y se manifiesta por la aparición de escotomas paracentrales. En este artículo se presenta un caso clínico con el diagnóstico de PAMM y una breve revisión de la literatura. Métodos: se solicitó consentimiento informado escrito del paciente bajo la aprobación del comité ético-científico de la Facultad de Medicina de la Pontificia Universidad Católica de Chile. La revisión de la literatura se realizó mediante una estrategia de búsqueda que incluyó los términos explicitados en las palabras clave. Resultados: el paciente consulta por un escotoma paracentral superior en el ojo derecho (OD). En la autofluorescencia se observó una lesión hipoautofluorescente parafoveal inferior del OD. La angiografía retinal mostró tenue filtración en la misma zona, sin signos de oclusión arterial. En la SD-OCT del OD, se observó una lesión hiperrefringente parafoveal inferior en las capas medias retinales. El estudio sistémico descartó causas infeccioso-inflamatorias y vasculares. A partir de lo anterior, se realizó el diagnóstico de PAMM. Conclusiones: la presentación clínica y los resultados obtenidos fueron concordantes con lo reportado en la literatura respecto a la PAMM. Actualmente el manejo se basa en buscar y controlar condiciones relacionadas, puesto que no se ha descrito tratamiento específico. En este caso, se descartaron causas secundarias y se decidió la observación clínica.
Calidad de vida en los pacientes con DM-2: Un estudio transversal en el sureste mexicano
Authors: Guzmán-Priego Crystell Guadalupe , Baeza-Flores Guadalupe Del Carmen , Guzmán-León Raúl , Torres-López Jorge Elías , Ordaz-Candelario Karla , Muñoz-Cano Juan Manuel
Published: March 2020

La diabetes es una enfermedad crónica y compleja con demandas y desafíos que influyen en la calidad de vida relacionada a la salud.
Objetivo:
determinar la calidad de vida en los pacientes con diabetes mellitus tipo 2 que acuden a los servicios médicos de la UJAT durante el periodo junio- julio del 2017.
Métodos:
se realizó un estudio transversal en 80 sujetos con diagnóstico de diabetes mellitus tipo 2 que
acuden a un primer nivel de atención en el sureste mexicano. Se diseñó un instrumento y se obtuvieron datos sociodemográficos, de calidad de vida, antropométrica, bioquímica y clínica. Las variables fueron analizadas a través de estadística descriptiva, además, se utilizó la prueba de Chi cuadrado para explorar asociación entre variables categóricas y para variables continuas la prueba de T, considerando los estadísticamente significativos los resultados de p<0,05.
Resultados:
la media de edad de los pacientes estudiados fue 57,8 años. El dominio de la calidad de vida principalmente afectado fue energía, funcionamiento sexual y movilidad, y los factores que tuvieron efecto sobre la calidad de vida fueron la escolaridad, las comorbilidades, la polifarmacia, el índice de masa corporal y la hiperglucemia.
Discusión:
los pacientes con diagnóstico de diabetes mellitus tipo 2 que acuden a un primer nivel institucional del sureste mexicano están principalmente afectados en 3 dominios: energía y movilidad, ansiedad y preocupación y funcionamiento sexual.
Medios de contraste intravascular en tomografía computada y resonancia magnética: lo que el clínico necesita saber
Authors: Garrido Cisterna Francisco Javier , Rivera González Sofia Viviana , Pesenti Anjel José Patricio , Riquelme Pizarro Carlos Rodrigo , Huete Garín Isidro Álvaro
Published: March 2020

Introducción: los medios de contraste en radiología se utilizan para mejorar la visibilidad de los tejidos normales y patológicos, lo que permite distinguirlos entre sí mediante la modificación de las características de imagen de los tejidos. Permite no solo una mejor evaluación morfológica de las lesiones, sino también una evaluación cinética funcional y de contraste. Objetivos: presentar una revisión actualizada sobre los medios de contraste intravascular en radiología, con énfasis en los conceptos que el médico clínico no radiólogo debe tener presente al momento de su indicación. Métodos: se realizó una revisión bibliográfica de literatura radiológica relevante sobre medios de contraste intravascular: clasificación, indicaciones, contraindicaciones y precauciones que debe adoptar el médico clínico. Resultados: aunque los medios de contraste en radiología tienen un excelente perfil de seguridad, su uso no está exento de riesgos y debe basarse en criterios apropiados después de una evaluación clínica exhaustiva, ponderando riesgos y beneficios para cada paciente individual. Conclusión: la comunicación entre médicos tratantes, nefrólogos y radiólogos es fundamental para evaluar casos clínicos complejos o que requieran consideraciones especiales al momento de indicar la administración de un medio de contraste intravascular.
PRDM15 Is Associated with Risk of Chronic Obstructive Pulmonary Disease in a Rural Population in Chile
Authors: Hosgood III H. Dean , Díaz-Peña Roberto , Blansky Deanna , Jaime Sergio , Parra Viviana , Boekstegers Felix , Bermejo Justo Lorenzo , García-Valero José , Montes Juan F. , Valdivia Gonzalo , Miravitlles Marc , Agustí Àlvar , Silva Rafael S. , Olloquequi Jordi
Published: March 2020

Background: Genome-wide association studies (GWAS) have accelerated our understanding of the genetic underpinnings of chronic obstructive pulmonary disease (COPD); however, GWAS populations have typically consisted of European descent, with ∼1% of Latin American ancestry. Objective: To overcome this limitation, we conducted a GWAS in a rural Chilean population with increased COPD risk to investigate genetic variation of COPD risk in this understudied minority population. Method: We carried out a case-control study of 214 COPD patients (defined by the GOLD criteria) and 193 healthy controls in Talca, Chile. DNA was extracted from venous blood and genotyped on the Illumina Global Screening Array (n = 754,159 markers). After exclusion based on Hardy-Weinberg equilibrium (p ≤ 0.001), call rates (<95%), and minor allele frequencies (<0.5%) in controls, 455,564 markers were available for logistic regression. Results: PRDM15 rs1054761 C allele (p = 2.22 × 10–7) was associated with decreased COPD risk. Three PRDM15 SNPs located on chromosome 21 were significantly associated with COPD risk (p < 10–6). Two of these SNPs, rs1054761 and rs4075967, were located on a noncoding transcript variant region of the gene. Conclusion: PRDM15 overexpression may play a role in the B-cell dysregulation in COPD pathogenesis. To the best of our knowledge, the association between PRDM15 and COPD risk was not previously found in GWAS studies in largely European populations, highlighting the importance of investigating novel variants associated with COPD risk among ethnically diverse populations.
A percepção dos profissionais de saúde sobre o cuidado ao idoso com transtorno mental
Authors: Saidel Maria Giovana Borges , Campos Claudinei José Gomes
Published: March 2020

Objetivo: compreender as percepções da equipe de um Centro de Atenção Psicossocial sobre o cuidado ao idoso com transtorno mental. Método: estudo qualitativo com referencial teóricometodológico: Teoria das Representações Sociais. O campo de estudo foi um Centro de Atenção Psicossocial no interior do estado de São Paulo. Amostra composta por conveniência,fechada por exaustão, constituída por 12 profissionais. A coleta de dados foi realizada por meio da entrevista semiestruturada e estes foram analisados pela análise temática de conteúdo.Resultados: emergiram três categorias que evidenciam contradições sobre a percepção dos profissionais acerca do papel do CAPS. Essas contradições podem estar ancoradas nas representações sobre as dificuldades relatadas na assistência ao idoso, que se sobrepõem às dificuldades no cuidado ao indivíduo com transtorno mental. A ausência de estratégias para o atendimento cotidiano é abordada e a educação profissional é apontada como importante, porém ausente. O desgaste do profissional em saúde mental emerge e a percepção sobre a falta de recursos humanos é revelada nos discursos. Essas problemáticas trazem uma representação de práticas insuficientes que refletirão no cuidado ao idoso com transtorno mental. Conclusão: o estudo contribui com esclarecimentos a serem abordados em estudos de intervenção para potencializar a transformação do cuidado.
Transtorno mental e risco de suicídio em usuários de substâncias psicoativas
Authors: Moreira Roberta Magda Martins , Oliveira Eliany Nazaré , Lopes Roberlandia Evangelista , Lopes Marcos Venícios de Oliveira , Félix Tamires Alexandre , Oliveira Lycélia Da Silva
Published: March 2020

Objetivo: analisar as evidências científicas acerca da presença de transtornos mentais e o risco de suicídio em usuários de substâncias psicoativas. Método: revisão integrativa da literatura, realizada na LILACS, MEDLINE e SCOPUS, mediante os descritores: transtornos relacionados ao uso de substâncias, suicídio e transtornos mentais. Selecionaram-se os artigos completos disponíveis nos idiomas português, inglês ou espanhol, sem recorte temporal, todavia, foram excluídos os duplicados e que não responderam diretamente à pergunta norteadora, totalizando 17 artigos para análise. Resultados: os usuários de substâncias psicoativas apresentam qualidade de vida reduzida e maior comprometimento na saúde mental, que aumentam a probabilidade para comorbidades psiquiátricas associadas, como a depressão, esquizofrenia, transtorno bipolar e ansiedade, principalmente quando há o uso de múltiplas substâncias. Essa associação eleva as chances de os indivíduos cometerem suicídio em até 5,7 vezes. Conclusão: observa-se a relação direta entre os três fatores investigados, em que o uso de substâncias psicoativas aumenta a probabilidade de transtornos mentais e o risco de suicídio, tornando-se necessária a elaboração de estratégias eficazes em saúde para a identificação precoce dessas problemáticas e, assim, desenvolver intervenções a fim de minimizá-las.