bluuebunny/crossref_metadata_2025 huggingface dataset:
Emphysematous pyelonephritis: outcomes of conservative management and literature review
Authors: Deoraj Stuart , Zakharious Fady , Nasim Ashraf , Missouris Constantinos
Published: September 2018

Emphysematous pyelonephritis (EPN) is a rare, necrotising infection of the renal parenchyma, predominantly associated with Escherichia coli infection and unless promptly recognised and dealt with, it carries a poor prognosis. The current treatment is one of antimicrobial therapies together with nephrectomy in a majority of patients. We report an elderly man with multiple comorbidities with a diagnosis of EPN whose condition improved with antimicrobial and supportive therapy, and no surgical intervention was required.
Oral cannabinoid-rich THC/CBD cannabis extract for secondary prevention of chemotherapy-induced nausea and vomiting: a study protocol for a pilot and definitive randomised double-blind placebo-controlled trial (CannabisCINV)
Authors: Mersiades Antony J , Tognela Annette , Haber Paul S , Stockler Martin , Lintzeris Nicholas , Simes John , McGregor Iain , Olver Ian , Allsop David J , Gedye Craig , Kirby Adrienne C , Morton Rachael L , Fox Peter , Clarke Stephen , Briscoe Karen , Aghmesheh Morteza , Wong Nicole , Walsh Anna , Hahn Carmel , Grimison Peter
Published: September 2018

Introduction

Chemotherapy-induced nausea and vomiting (CINV) remains an important issue for patients receiving chemotherapy despite guideline-consistent antiemetic therapy. Trials using delta-9-tetrahydrocannabinol-rich (THC) products demonstrate limited antiemetic effect, significant adverse events and flawed study design. Trials using cannabidiol-rich (CBD) products demonstrate improved efficacy and psychological adverse event profile. No definitive trials have been conducted to support the use of cannabinoids for this indication, nor has the potential economic impact of incorporating such regimens into the Australian healthcare system been established. CannabisCINV aims to assess the efficacy, safety and cost-effectiveness of adding TN-TC11M, an oral THC/CBD extract to guideline-consistent antiemetics in the secondary prevention of CINV.

Methods and analysis

The current multicentre, 1:1 randomised cross-over, placebo-controlled pilot study will recruit 80 adult patients with any malignancy, experiencing CINV during moderate to highly emetogenic chemotherapy despite guideline-consistent antiemetics. Patients receive oral TN-TC11M (THC 2.5mg/CBD 2.5 mg) capsules or placebo capsules three times a day on day −1 to day 5 of cycle A of chemotherapy, followed by the alternative drug regimen during cycle B of chemotherapy and the preferred drug regimen during cycle C. The primary endpoint is the proportion of subjects attaining a complete response to CINV. Secondary and tertiary endpoints include regimen tolerability, impact on quality of life and health system resource use. The primary assessment tool is patient diaries, which are filled from day −1 to day 5. A subsequent randomised placebo-controlled parallel phase III trial will recruit a further 250 patients.

Ethics and dissemination

The protocol was approved by ethics review committees for all participating sites. Results will be disseminated in peer-reviewed journals and at scientific conferences.

Drug supply

Tilray.

Protocol version

2.0, 9 June 2017.

Trial registration number

ANZCTR12616001036404; Pre-results.
Relationships among perceived quality of healthcare services, satisfaction and behavioural intentions of international students in Kuala Lumpur, Malaysia: a cross-sectional study
Authors: Aljaberi Musheer Abdulwahid , Juni Muhamad Hanafiah , Al-Maqtari Rasheed Addulsalam , Lye Munn Sann , Saeed Murad Abdu , Al-Dubai Sami Abdo Radman , Kadir Shahar Hayati
Published: September 2018

Objective

The current study aimed to investigate the relationships among the perceived quality of healthcare services, satisfaction and behavioural intentions among international students in Kuala Lumpur, Malaysia.

Setting

A cross-sectional study on public universities in Kuala Lumpur, Malaysia.

Participants

All participants in this study were international students joining public universities in Kuala Lumpur, Malaysia.

Primary independent variable

Perceived quality of healthcare services measured on a SERVQUAL scale.

Primary dependent variable

Participants’ satisfaction of healthcare services assessed using five items.

Secondary dependent variable

Behavioural intentions measured on six items.

Results

Of the 556 international students, 500 (90%) completed the survey. The study used structural equation modelling (SEM) through the AMOS (Analysis of Moment Structures) software to analyse the data. SEM analyses showed that the perceived quality of healthcare services significantly and directly affected satisfaction, with a value of 89% and an effect size of 0.78. It also had a significant indirect impact on the behavioural intentions (0.78) of international students. The results indicated that participants’ satisfaction had a statistically significant impact on their behavioural intentions (0.77).

Conclusion

Perceived quality of care is an important driver of international students’ satisfaction and their behavioural intention with healthcare services. Such relations of effects among the three investigated factors were also positive and significant.
What are the requirements for developing a successful national registry of auditory implants? A qualitative study
Authors: Mandavia Rishi , Knight Alec , Carter Alexander W , Toal Connor , Mossialos Elias , Littlejohns Peter , Schilder Anne GM
Published: September 2018

Objectives

Hearing loss is an area of unmet need, and industry is targeting this field with a growing range of surgically implanted hearing devices. Currently, there is no comprehensive UK registry capturing data on these devices; in its absence, it is difficult to monitor clinical and cost-effectiveness and develop national policy. Recognising that developing such a registry faces considerable challenges, it is important to gather opinions from stakeholders and patients. This paper builds on our systematic review on surgical registry development and aims to identify the specific requirements for developing a successful national registry of auditory implants.

Design

Qualitative study.

Participants

Data were collected in two ways: (1) semistructured interviews with UK professional stakeholders; and (2) focus groups with patients with hearing loss. The interview and focus group schedules were informed by our systematic review on registry development. Data were analysed using directed content analysis. Judges mapped the themes obtained against a conceptual framework developed from our systematic review on registry development. The conceptual framework consisted of five categories for successful registry development: (1) planning, (2) registry governance, (3) registry dataset, (4) anticipating challenges, (5) implementing solutions.

Results

Twenty-seven themes emerged from 40 semistructured interviews with professional stakeholders and 18 themes emerged from three patient focus groups. The most important factor for registry success was high rates of data completion. Benefits of developing a successful registry of auditory implants include: strengthening the evidence base and regulation of auditory implants, driving quality and safety improvements, increased transparency, facilitating patient decision-making and informing policy and guidelines development.

Conclusions

This study identifies the requirements for developing a successful national registry of auditory implants, benefiting from the involvement of numerous professional stakeholder groups and patients with hearing loss. Our approach may be used internationally to inform successful registry development.
Ruminal impaction in a miniature zebu steer
Authors: Tyma Jesse F , Hart Kelsey A , Vautier Jelline , Williams Jarred M
Published: September 2018

An approximately one-year-old miniature zebu steer was examined for lethargy, anorexia and decreased faecal output of one day’s duration. Based on the steer’s history of malnourishment, physical examination and abdominal radiographic images, ruminal impaction was discussed as the top differential diagnosis. Exploratory flank laparotomy and rumenotomy demonstrated severe ruminal impaction of primarily hickory nuts with additional fibrous feed material, sand and two small, blunt, metallic objects. These materials were manually removed, and the rumen and reticulum were thoroughly lavaged. The steer recovered well from general anaesthesia and was treated with repeated orogastric transfaunation postoperatively. The steer did well for the remainder of his hospitalisation, was returned to a normal diet, resumed passage of normal faeces and was discharged three days postoperatively.
Associations between prolactin receptor (PRLR) polymorphisms and milk production traits in dairy buffalo
Authors: Al-Kal Abakar , Jiang Qin Yang , Qin Guang Sheng , Pan Bin , Chen Bao Jian , Jiang He Sheng
Published: September 2018

Buffalo milk is economically important, and an understanding of the genetic basis of milk production traits may facilitate buffalo breeding for this purpose. In this study, polymerase chain reaction-single strand conformation polymorphism was used to analyze polymorphisms in prolactin receptor (PRLR) exons 3, 5, 7, and 10 in Murrah, Nili-Ravi, and crossbred buffaloes and Holstein cows. A site in PRLR exon 3 exhibited variation in all three buffalo breeds and cows, and the three genotypes GG, GT, and TT were detected. In PRLR exon 5, nucleotide differences were detected between buffalo and Holstein dairy cow populations; the genotypes AA, AG, and GG were observed. In PRLR exon 7, polymorphisms were not detected. In PRLR exon 10, at 9637 bp, the TT, TC, and TT genotypes were observed. At the three polymorphic loci, Hardy–Weinberg equilibrium was reached in the crossbred buffalo population for exons 3 and 5 and in all three buffalo populations for exon 10. In an analysis of the associations of the three polymorphisms with milk production traits, only PRLR exon 10 in Murrah buffaloes was associated with milk yield, with a significant difference between the TT and CC genotypes.
Unique Archaeal Small RNAs
Authors: Gomes-Filho José Vicente , Daume Michael , Randau Lennart
Published: September 2018

Advances in genome-wide sequence technologies allow for detailed insights into the complexity of RNA landscapes of organisms from all three domains of life. Recent analyses of archaeal transcriptomes identified interaction and regulation networks of noncoding RNAs in this understudied domain. Here, we review current knowledge of small, noncoding RNAs with important functions for the archaeal lifestyle, which often requires adaptation to extreme environments. One focus is RNA metabolism at elevated temperatures in hyperthermophilic archaea, which reveals elevated amounts of RNA-guided RNA modification and virus defense strategies. Genome rearrangement events result in unique fragmentation patterns of noncoding RNA genes that require elaborate maturation pathways to yield functional transcripts. RNA-binding proteins, e.g., L7Ae and LSm, are important for many posttranscriptional control functions of RNA molecules in archaeal cells. We also discuss recent insights into the regulatory potential of their noncoding RNA partners.
Calcium Channelopathies: Structural Insights into Disorders of the Muscle Excitation–Contraction Complex
Authors: Pancaroglu Raika , Van Petegem Filip
Published: September 2018

Ion channels are membrane proteins responsible for the passage of ions down their electrochemical gradients and across biological membranes. In this, they generate and shape action potentials and provide secondary messengers for various signaling pathways. They are often part of larger complexes containing auxiliary subunits and regulatory proteins. Channelopathies arise from mutations in the genes encoding ion channels or their associated proteins. Recent advances in cryo-electron microscopy have resulted in an explosion of ion channel structures in multiple states, generating a wealth of new information on channelopathies. Disease-associated mutations fall into different categories, interfering with ion permeation, protein folding, voltage sensing, ligand and protein binding, and allosteric modulation of channel gating. Prime examples of these are Ca2+-selective channels expressed in myocytes, for which multiple structures in distinct conformational states have recently been uncovered. We discuss the latest insights into these calcium channelopathies from a structural viewpoint.
Phage-Encoded Anti-CRISPR Defenses
Authors: Stanley Sabrina Y. , Maxwell Karen L.
Published: September 2018

The battle for survival between bacteria and bacteriophages (phages) is an arms race where bacteria develop defenses to protect themselves from phages and phages evolve counterstrategies to bypass these defenses. CRISPR-Cas adaptive immune systems represent a widespread mechanism by which bacteria protect themselves from phage infection. In response to CRISPR-Cas, phages have evolved protein inhibitors known as anti-CRISPRs. Here, we describe the discovery and mechanisms of action of anti-CRISPR proteins. We discuss the potential impact of anti-CRISPRs on bacterial evolution, speculate on their evolutionary origins, and contemplate the possible next steps in the CRISPR-Cas evolutionary arms race. We also touch on the impact of anti-CRISPRs on the development of CRISPR-Cas-based biotechnological tools.
Surviving in the Valley of Death: Opportunities and Challenges in Translating Academic Drug Discoveries
Authors: Parrish Marcus C. , Tan Yuan Jin , Grimes Kevin V. , Mochly-Rosen Daria
Published: September 2018

With pharmaceutical companies shrinking their research departments and exiting out of efforts related to unprofitable diseases, society has become increasingly dependent on academic institutions to perform drug discovery and early-stage translational research. Academic drug discovery and translational research programs assist in shepherding promising therapeutic opportunities through the so-called valley of death in the hope that a successful new drug will result in saved lives, improved health, economic growth, and financial return. We have interviewed directors of 16 such academic programs in the United States and found that these programs and the projects therein face numerous challenges in reaching the clinic, including limited funding, lack of know-how, and lack of a regional drug development ecosystem. If these issues can be addressed through novel industry partnerships, the revision of government policies, and expanded programs in translational education, more effective new therapies are more likely to reach patients in need.
Systemic arterial hypertension but not IGF-I treatment stimulates cardiomyocyte enlargement in neonatal lambs
Authors: Wilburn Adrienne N. , Giraud George D. , Louey Samantha , Morgan Terry , Gandhi Nainesh , Jonker Sonnet S.
Published: September 2018

Although cardiomyocyte terminal differentiation is nearly complete at birth in sheep, as in humans, very limited postnatal expansion of myocyte number may occur. The capacity of newborn cardiomyocytes to respond to growth stimulation by proliferation is poorly understood. Our objective was to test this growth response in newborn lambs with two stimuli shown to be potent inducers of cardiomyocyte growth in fetuses and adults: increased systolic load (Load) and insulin-like growth factor I (IGF-I). Vascular catheters and an inflatable aortic occluder were implanted in lambs. Hearts were collected for analysis at 18 days of age after a 7-day experiment and compared with control hearts. Load hearts, but not IGF-I hearts, were heavier ( P = 0.001) because of increased mass of the left ventricle (LV), septum, and left atrium (40–50%, P = 0.004). Terminal differentiation and cell cycle activity were not different between groups. Myocyte length was 7% greater in Load lamb hearts ( P < 0.05), and binucleated myocytes, which comprise ~90% of LV cells, were 25% larger in volume ( P = 0.03). Myocyte number per gram of myocardium was decreased in all ventricles of Load lambs ( P = 0.01). Cells from the IGF-I group were not different by any comparison. These results suggest that the newborn sheep LV responds to systolic stress with cardiomyocyte hypertrophy, not proliferation. Furthermore, IGF-I is ineffective at stimulating cardiomyocyte proliferation at this age (despite effectiveness when administered before birth). Thus, to expand cardiomyocyte number in the newborn heart, therapies other than systolic pressure load and IGF-I treatment need to be developed.
Placental insufficiency contributes to fatty acid metabolism alterations in aged female mouse offspring
Authors: Stojanovska Violeta , Sharma Neha , Dijkstra Dorieke J. , Scherjon Sicco A. , Jäger Andrea , Schorle Hubert , Plösch Torsten
Published: September 2018

Intrauterine growth restriction (IUGR) is an accepted risk factor for metabolic disorders in later life, including obesity and type 2 diabetes. The level of metabolic dysregulation can vary between subjects and is dependent on the severity and the type of IUGR insult. Classical IUGR animal models involve nutritional deprivation of the mother or uterine artery ligation. The latter aims to mimic a placental insufficiency, which is the most frequent cause of IUGR. In this study, we investigated whether IUGR attributable to placental insufficiency impacts the glucose and lipid homeostasis at advanced age. Placental insufficiency was achieved by deletion of the transcription factor AP-2y ( Tfap2c), which serves as one of the major trophoblast differentiation regulators. TdelT-IUGR mice were obtained by crossing mice with a floxed Tfap2c allele and mice with Cre recombinase under the control of the Tpbpa promoter. In advanced adulthood (9–12 mo), female and male IUGR mice are respectively 20% and 12% leaner compared with controls. At this age, IUGR mice have unaffected glucose clearance and lipid parameters (cholesterol, triglycerides, and phospholipids) in the liver. However, female IUGR mice have increased plasma free fatty acids (+87%) compared with controls. This is accompanied by increased mRNA levels of fatty acid synthase and endoplasmic reticulum stress markers in white adipose tissue. Taken together, our results suggest that IUGR by placental insufficiency may lead to higher lipogenesis in female mice in advanced adulthood, at least indicated by greater Fasn expression. This effect was sex specific for the aged IUGR females.
Impact of MPO-ANCA-mediated oxidative imbalance on renal vasculitis
Authors: Hilhorst Marc , Maria Alexandre TJ , Kavian Niloufar , Batteux Frédéric , Borderie Didier , Le Quellec Alain , van Paassen Pieter , Guilpain Philippe
Published: September 2018

Glomerulonephritis is a severe complication of microscopic polyangiitis (MPA), a small-vessel vasculitis associated with anti-myeloperoxidase antibodies (MPO-ANCA). We previously showed the pathogenic effects of MPO-ANCA that activate MPO to trigger an oxidative burst mainly through HOCl production, contributing to endothelial injury and lung fibrosis. The aim of this study was to investigate the relationship between MPO-induced oxidative stress, anti-oxidant defenses and renal histological lesions in MPA patients. We therefore analyzed histological data from a prospective cohort of ANCA-associated glomerulonephritis. Serum-mediated HOCl production, advanced oxidation protein products (AOPP), and thiol concentration in sera were determined. From 38 patients included, histological classification noted 50% focal glomerulonephritis, 15.8% crescentic-glomerulonephritis, and 34.2% mixed-glomerulonephritis. MPA patients’ sera displayed higher HOCl production by MPO ( P < 0.001), higher AOPP ( P < 0.001) and thiol ( P < 0.01) levels, compared with healthy subjects. The presence of cellular crescents was associated with higher serum-mediated HOCl production ( P = 0.049) and lower thiol levels ( P = 0.022) at disease onset. Higher thiol concentrations were associated with focal glomerulonephritis ( P = 0.042), less interstitial fibrosis ( P = 0.039) and hyalinosis ( P = 0.066). In remission, HOCl production was decreased ( P < 0.01), and thiol concentration remained high ( P = 0.39). Our findings suggest that HOCl production by activated MPO could contribute to the very early stage of glomerulonephritis, whereas thiol may exert a protective effect against the development of renal vasculitis and glomerulosclerosis. This study highlights the importance of oxidative defenses to counteract the process of MPO-ANCA associated glomerulonephritis.
The chemokine receptor CX3CR1 reduces renal injury in mice with angiotensin II-induced hypertension
Authors: Ahadzadeh Erfan , Rosendahl Alva , Czesla Daniel , Steffens Paula , Prüßner Lennard , Meyer-Schwesinger Catherine , Wanner Nicola , Paust Hans Joachim , Huber Tobias B. , Stahl Rolf A. K. , Wiech Thorsten , Kurts Christian , Seniuk Anika , Ehmke Heimo , Wenzel Ulrich O.
Published: September 2018

The role of CX3CR1, also known as fractalkine receptor, in hypertension is unknown. The present study determined the role of the fractalkine receptor CX3CR1 in hypertensive renal and cardiac injury. Expression of CX3CR1 was determined using CX3CR1GFP/+ mice that express a green fluorescent protein (GFP) reporter in CX3CR1+ cells. FACS analysis of leukocytes isolated from the kidney showed that 34% of CD45+ cells expressed CX3CR1. Dendritic cells were the majority of positive cells (67%) followed by macrophages (10%), NK cells (6%), and T cells (10%). With the use of confocal microscopy, the receptor was detected in the kidney only on infiltrating cells but not on resident renal cells. To evaluate the role of CX3CR1 in hypertensive end-organ injury, an aggravated model of hypertension was used. Unilateral nephrectomy was performed followed by infusion of angiotensin II (ANG II, 1.5 ng·g−1·min−1) and a high-salt diet in wild-type ( n = 15) and CX3CR1-deficient mice ( n = 18). CX3CR1 deficiency reduced the number of renal dendritic cells and increased the numbers of renal CD11b/F4/80+ macrophages and CD11b/Ly6G+ neutrophils in ANG II-infused mice. Surprisingly, CX3CR1-deficient mice exhibited increased albuminuria, glomerular injury, and reduced podocyte density in spite of similar levels of arterial hypertension. In contrast, cardiac damage as assessed by increased heart weight, cardiac fibrosis, and expression of fetal genes, and matrix components were not different between both genotypes. Our findings suggest that CX3CR1 exerts protective properties by modulating the invasion of inflammatory cells in hypertensive renal injury. CX3CR1 inhibition should be avoided in hypertension because it may promote hypertensive renal injury.
Context-dependent tactile texture-sensitivity in monkey M1 and S1 cortex
Authors: Jiang Wan , Tremblay François , Chapman C. Elaine
Published: September 2018

Caudal primary motor cortex (M1, area 4) is sensitive to cutaneous inputs, but the extent to which the physical details of complex stimuli are encoded is not known. We investigated the sensitivity of M1 neurons (4 Macaca mulatta monkeys) to textured stimuli (smooth/rough or rough/rougher) during the performance of a texture discrimination task and, for some cells, during a no-task condition (same surfaces; no response). The recordings were made from the hemisphere contralateral to the stimulated digits; the motor response (sensory decision) was made with the nonstimulated arm. Most M1 cells were modulated during surface scanning in the task (88%), but few of these were texture-related (24%). In contrast, 44% of M1 neurons were texture related in the no-task condition. Recordings from the neighboring primary somatosensory cortex (S1), the potential source of texture-related signals to M1, showed that S1 neurons were significantly more likely to be texture related during the task (57 vs 24%) than M1. No difference was observed in the no-task condition (52 vs. 44%). In these recordings, the details about surface texture were relevant for S1 but not for M1. We suggest that tactile inputs to M1 were selectively suppressed when the animals were engaged in the task. S1 was spared these controls, as the same inputs were task-relevant. Taken together, we suggest that the suppressive effects are most likely exerted directly at the level of M1, possibly through the activation of a top-down gating mechanism specific to motor set/intention.

NEW & NOTEWORTHY Sensory feedback is important for motor control, but we have little knowledge of the contribution of sensory inputs to M1 discharge during behavior. We showed that M1 neurons signal changes in tactile texture, but mainly outside the context of a texture discrimination task. Tactile inputs to M1 were selectively suppressed during the task because this input was not relevant for the recorded hemisphere, which played no role in generating the discrimination response.
Predicting responses to inhibitory synaptic input in substantia nigra pars reticulata neurons
Authors: Simmons D. V. , Higgs M. H. , Lebby S. , Wilson C. J.
Published: September 2018

The changes in firing probability produced by a synaptic input are usually visualized using the poststimulus time histogram (PSTH). It would be useful if postsynaptic firing patterns could be predicted from patterns of afferent synaptic activation, but attempts to predict the PSTH from synaptic potential waveforms using reasoning based on voltage trajectory and spike threshold have not been successful, especially for inhibitory inputs. We measured PSTHs for substantia nigra pars reticulata (SNr) neurons inhibited by optogenetic stimulation of striato-nigral inputs or by matching artificial inhibitory conductances applied by dynamic clamp. The PSTH was predicted by a model based on each SNr cell’s phase-resetting curve (PRC). Optogenetic activation of striato-nigral input or artificial synaptic inhibition produced a PSTH consisting of an initial depression of firing followed by oscillatory increases and decreases repeating at the SNr cell’s baseline firing rate. The phase resetting model produced PSTHs closely resembling the cell data, including the primary pause in firing and the oscillation. Key features of the PSTH, including the onset rate and duration of the initial inhibitory phase, and the subsequent increase in firing probability could be explained from the characteristic shape of the SNr cell’s PRC. The rate of damping of the late oscillation was explained by the influence of asynchronous phase perturbations producing firing rate jitter and wander. Our results demonstrate the utility of phase-resetting models as a general method for predicting firing in spontaneously active neurons and their value in interpretation of the striato-nigral PSTH.

NEW & NOTEWORTHY The coupling of patterned presynaptic input to sequences of postsynaptic firing is a Gordian knot, complicated by the multidimensionality of neuronal state and the diversity of potential initial states. Even so, it is fundamental for even the simplest understanding of network dynamics. We show that a simple phase-resetting model constructed from experimental measurements can explain and predict the sequence of spike rate changes following synaptic inhibition of an oscillating basal ganglia output neuron.
Talus Bipartitus: A Rare Anatomical Variant Presenting as an Entrapment Neuropathy of the Tibial Nerve within the Tarsal Tunnel
Authors: Abrego M. O. , De Cicco F. L. , Gimenez N. E. , Marquesini M. O. , Sotelano P. , Carrasco M. N. , Santini Araujo M. G.
Published: September 2018

Tarsal tunnel syndrome is an entrapment neuropathy of the tibial nerve within the tarsal tunnel that lies beneath the retinaculum on the medial side of the ankle. It is often underdiagnosed. Talus bipartitus is a rare anatomical variant; only a few cases have been described in medical literature. We report a case of a 36-year-old female with tarsal tunnel syndrome secondary to a talus bipartitus undergoing surgical treatment with good clinical outcome. To our knowledge, talus bipartitus presenting as tarsal tunnel syndrome has no previous reports. Image studies and physical examination are crucial to reach precise diagnosis.
Emergency Laparoscopic Repair of Giant Left Diaphragmatic Hernia following Minimally Invasive Esophagectomy: Description of a Case and Review of the Literature
Authors: Erdas Enrico , Canu Gian Luigi , Gordini Luca , Mura Paolo , Laconi Giulia , Pisano Giuseppe , Medas Fabio , Calò Pietro Giorgio
Published: September 2018

Postoperative diaphragmatic hernia (PDH) is an increasingly reported complication of esophageal cancer surgery. PDH occurs more frequently when minimally invasive techniques are employed, but very little is known about its pathogenesis. Currently, no consensus exists concerning preventive measures and its management. A 71-year-old man underwent minimally invasive esophagectomy for esophageal cancer. Three months later, he developed a giant PDH, which was repaired by direct suture via laparoscopic approach. A hypertensive pneumothorax occurred during surgery. This complication was managed by the anaesthesiologist through a high fraction of inspired O2 and several recruitment manoeuvres. The patient remained free of hernia recurrence until he died of neoplastic cachexia 5 months later. Laparoscopic repair of PDH may be safe and effective even in the acute setting and in the case of massive herniation. However, surgeons and anaesthesiologists should be aware of the risk of intraoperative pneumothorax and be prepared to treat it promptly.
Therapy of Dredging the Bowels Enhanced the Neuroprotective Effect of Nourishing Kidney Herbs on Hippocampal Cholinergic System in Alzheimer’s Disease Model Rat Induced by Aβ 1‐42
Authors: Feng Lu-Da , Tian Yang , Wang Xin , Dai Run , Cai Song , Cao Yu-Jia , Si Yin-Chu
Published: September 2018

Background. Therapy of nourishing kidney has been used for treating memory deficits of Alzheimer’s disease (AD) for thousands of years based on traditional Chinese medicine. However, we found the therapy of dredging the bowels could alleviate both memory deficits and mental symptoms of AD in clinic. Objective. To determine whether the therapy of dredging the bowels could enhance the neuroprotective effect of nourishing kidney herbs for treating AD rats, and to explore the underlying mechanism of the combination of nourishing kidney and dredging the bowels (NKDB) herbs. Methods. 60 rats were randomly divided into sham‐operated group (SOG), model group (MG), nourishing kidney group (NKG), dredging the bowels group (DBG), nourishing kidney and dredging the bowels group (NKDBG), and donepezil hydrochloride group (DHG). The model establishment was performed by injecting Aβ 1‐42 into the hippocampal CA1 region. Animals received aqueous solution of Chinese herbal medicine or western medicine while SOG received only distilled water. Ability of learning and memory were assessed by Morris water maze. Acetylcholinesterase(AChE) and choline acetyltransferase (ChAT) activity and positive cells in the hippocampus were detected by the biochemical and immunofluorescent assay. Results. All rats were in the same baseline. While after model establishment, ability of learning and memory of MG, NKG, DBG, NKDBG, and DHG were significantly impaired compared with SOG. Whereas after treatment, ability of learning and memory of NKG, DBG, NKDBG, and DHG were significantly improved compared with MG. Additionally, AChE activity of NKG, DBG, and NKDBG was significantly decreased, meanwhile ChAT activity showed an increased tendency. The number of AChE‐positive cells and ChAT‐positive cells of both NKDBG and DHG were significantly decreased and increased respectively, superior to those when compared with NKG and DBG. What’s more, there was no significant difference between NKDBG and DHG. Conclusion. Therapy of dredging the bowels could enhance the neuroprotective effect of nourishing kidney herbs by reversing morphological damage of hippocampal cholinergic system. Furthermore, treatment with NKDB herbs could be effectively against AD, providing a practical therapeutic strategy in clinic.
Evaluations of Fracture Injection Pressure and Fracture Mouth Width during Separate-Layer Fracturing with Temporary Plugging
Authors: Wang Bo , Zhou Fujian , Liang Tianbo , Wang Daobing , Gao Liyang , Hu Jia
Published: September 2018

Separate-layer fracturing with temporary plugging (SLFTP) is a potential way to stimulate multiple layer reservoirs due to its low cost, low risk, and high efficiency. In this study, based on the cohesive zone model (CZM), a 3D fully fluid-solid coupling and multiple layer model is established to investigate factors influencing fracture injection pressure and fracture mouth width. The cohesive layer properties are based on the reported study, which have been validated through a series of numerical experiments. Innovatively, the spring model is innovatively proposed to represent the plugging effect of diverting agents and prop the aperture of the previous fractures. Simulation results reveal that the effects of previous fractures in multiple layer formations can be neglected, which is quite different from multistage fracturing for horizontal wells. Fracture injection pressure can be evaluated more accurately by taking the following factors into consideration: the minimum horizontal principal stress, rock tensile strength, injection rate, and pore pressure enhancement. Further, fracture mouth width is strongly influenced by rock tensile strength, Young’s modulus, and injection rate. This study provides a guidance for candidate well selection and diverting agent optimization during SLFTP in multilayer formations.
Structural Analysis of Shipping Fleet Capacity
Authors: Fan Lixian , Zhang Sijie , Yin Jingbo
Published: September 2018

With the unprecedented growth of the shipping transportation demand, substantial vessels have been built and delivered to the market. This has led to oversupply after the financial crisis in 2008 because of the abrupt decrease in transportation demand. Notwithstanding the importance of shipping market studies in the investment decision-making, there are relatively few empirical studies modelling the impacts on the structural changes of the fleet supply variables. By considering new orders, current fleet size, and demolitions in ship capacity supply, this study develops a systematic model in both bulker and container markets. The three-stage least squares method is employed to estimate the model to avoid endogenous issues. The primary finding suggests the significant impact of market, cost, and operational factors on fleet capacity supply. It also reveals the relatively rational activities in ordering new vessels and cautious in demolition decisions in the container market because of the large capital investment required. These are relevant to investment and demolition decisions in both the bulker and container markets.
Changes in Intra-Amniotic, Fetal Intrathoracic, and Intraperitoneal Pressures with Uterine Contraction: A Report of Three Cases
Authors: Katsura Daisuke , Takahashi Yuichiro , Iwagaki Shigenori , Chiaki Rika , Asai Kazuhiko , Koike Masako , Yasumi Shunsuke , Furuhashi Madoka
Published: September 2018

Intra-amniotic, fetal intrathoracic, and intraperitoneal pressures during pregnancy have been previously investigated. However, to our knowledge, changes in these pressures during uterine contractions have not been reported. Herein, we present three cases of polyhydramnios, fetal pleural effusion, and fetal ascites, in which intra-amniotic, fetal intrathoracic, intraperitoneal pressures increased with uterine contractions. These pressure increases may affect the fetal circulation. We suggest that managing potential premature delivery (e.g., with tocolysis) is important in cases with polyhydramnios and excess fluid in fetal body areas, such as the thorax, abdomen, and heart. The results of this preliminary study on intrafetal pressure measurements will be useful in performing fetal and neonatal surgeries in the future.
Outcomes Following Salvage Radiation and Systemic Therapy for Isolated Locoregional Recurrence of Breast Cancer after Mastectomy: Impact of Constructed Biologic Subtype
Authors: Wang Xiaofang , Ma Jinli , Mei Xin , Yang Zhaozhi , Yu Xiaoli , Guo Xiaomao , Zhang Zhen , Shao Zhimin
Published: September 2018

Purpose. This study examines factors associated with outcomes following salvage radiation and systemic therapy for breast cancer patients who developed isolated locoregional recurrence (ILRR) after mastectomy alone, while focusing on the prognostic significance of constructed biologic subtype in this setting. Methods and Materials. 269 postmastectomy patients in total treated for ILRR were included. Cumulative incidence of locoregional control (LRC), distant metastasis (DM)-free survival (DMFS), disease-free survival (DFS), and overall survival (OS) were calculated using Kaplan-Meier method. For statistical analysis, biologic subtypes were constructed from hormonal receptors (Rec) and HER2, consisting of Rec+/HER2-, Rec+/HER2+, Rec-/HER2+, and Rec-/HER2-. The association of clinic-pathological and treatment-related parameters with outcomes was evaluated using a Cox regression model. Results. At a median follow-up of 65 months, 56 (20.8%) patients failed to secure LRC after radiotherapy, and 165 patients (61.3%) developed DM. Overall, the actuarial 5-year LRC, DMFS, DFS, and OS rate was 77.3%, 45.6%, 43.9%, and 66.8%, respectively. Multivariate analysis revealed that constructed biologic subtype represented the most significant prognostic factor for any outcome. Compared to patients with Rec+/HER2- disease, those with Rec-/HER2- had significantly poorer 5-year LRC (84.2% versus 58.3%, HR = 4.36, P < 0.001) and worse survivals including 5-year DMFS (63.0% versus 15.8%, HR = 4.28, P < 0.001), DFS (59.7% versus 13.6%, HR=3.92, P < 0.001), and OS (87.8% versus 22.3%, HR = 8.55, P < 0.001). Other factors associated with reduced LRC were no radical surgery and involved field irradiation alone, whereas factors associated with poor survivals included positive nodes at primary diagnosis and regional recurrence. Conclusions. Constructed biologic subtypes remained to be predictive of both disease control and survivals after salvage radiation for postmastectomy ILRR. Notably, Rec-/HER2- patients were demonstrated to be at high risk of locoregional failure and subsequent DM and tended to have worse survivals despite salvage therapies.
Retrospective Multivariate Analysis of Data from Children with Suspected Appendicitis: A New Tool for Diagnosis
Authors: Dokumcu Zafer , Toker Kurtmen Bade , Divarci Emre , Tamay Petek Bayindir , Kose Timur , Sezak Murat , Ozok Geylani , Ergun Orkan , Celik Ahmet
Published: September 2018

Background.Decision-making for management may sometimes be difficult in acute appendicitis (AA). Various diagnostic scoring systems exist, but their sensitivity and specificity rates are far from ideal. In this study, the determination of the predictors and the effect of radiological data and developing a new scoring system were aimed.Methods.Medical records of patients who were hospitalized for AA between February 2012 and October 2016 were retrospectively reviewed. All data were compared between patients with and without appendicitis. The multivariate analysis was performed to define significant variables and to examine the sensitivity and specificity of each group of predictors including radiological data. A new scoring system (NSS) was formed and was compared with two existing scoring systems: pediatric appendicitis score (PAS) and Alvarado scoring system (ASS) by using reclassification method.Results.Negative appendectomy rate was 11.3%. Statistical analysis identified 21 independently significant variables. The heel drop test had the highest odds ratio. Sensitivity and specificity rates of clinical predictors were 84.6% and 94.8%, respectively. Radiological predictors increased the sensitivity rate to 86.9%. Sensitivity and specificity rates for PAS, ASS, and NSS were 86.8% and 83.9%, 84.7% and 81.6%, and 96.8% and 95.6%, respectively. The “re-assessed negative appendectomy rate” was 6.2% and false positive results were remarkably more common in patients with duration of symptoms less than 24 hours.Conclusion.Radiological data improves the accuracy of diagnosis. Containing detailed clinical and radiological data, NSS performs superiorly to PAS and ASS, regarding sensitivity and specificity without any age limitation. The efficiency of NSS may be enhanced by determining different predictors for different phases of the inflammatory process.
Modern Recharge in a Transboundary Groundwater Basin Deduced from Hydrochemical and Isotopic Investigations: Al Buraimi, Oman
Authors: Abdalla O. , Izady A. , Al-Hosni T. , Chen M. , Al-Mamari H. , Semhi K.
Published: September 2018

Groundwater samples (54) collected from different geological units (alluvium, Tertiary, ophiolite, and Hawasina) located in the transboundary groundwater basin in north Oman at the United Arab Emirates (UAE) borders were analyzed for general hydrochemistry and water isotopes, and subsets thereof were analyzed for 14C and 3H and 87Sr/86Sr. The chemical composition, percentage of modern carbon (pmc), δ2H, δ18O, and 87Sr/86Sr of the groundwater in the study area progressively change from the recharge zone in the elevated area of the North Oman Mountains (NOM) to the flat plains at the UAE borders. While the water-rock interaction is the dominant process controlling the groundwater chemistry, evaporation and groundwater mixing affect the hydrochemistry at the UAE borders. Therefore, groundwater evolves from carbonate-dominant in the NOM into sodium chloride-dominant close to the UAE borders. It is also evident that groundwater lateral recharge from the ophiolites into the alluvium retains the chemical affinity of the ophiolites. Groundwater dating (high pmc), homogeneous 87Sr/86Sr ratios, and enriched δ2H and δ18O demonstrate the presence of modern recharge in the shallow zones of the ophiolites and alluvium. However, deep zones and areas at the UAE border contain older groundwater form during cooler and wetter climatic conditions as supported by the depleted δ2H and δ18O and lower 87Sr/86Sr ratios and pmc. Furthermore, the data clearly showed that modern groundwater mixes with older groundwater along the flow path from the NOM into the UAE border. Modern recharge occurs as lateral recharge from NOM and direct recharge in the plain area. The current findings support future development of aflaj system along NOM slopes and shallow wells in the plain areas.
A Simple Empirical Likelihood Ratio Test for Normality Based on the Moment Constraints of a Half-Normal Distribution
Authors: Marange C. S. , Qin Y.
Published: September 2018

A simple and efficient empirical likelihood ratio (ELR) test for normality based on moment constraints of the half-normal distribution was developed. The proposed test can also be easily modified to test for departures from half-normality and is relatively simple to implement in various statistical packages with no ordering of observations required. Using Monte Carlo simulations, our test proved to be superior to other well-known existing goodness-of-fit (GoF) tests considered under symmetric alternative distributions for small to moderate sample sizes. A real data example revealed the robustness and applicability of the proposed test as well as its superiority in power over other common existing tests studied.
Role of Acupuncture in the Management of Severe Acquired Brain Injuries (sABIs)
Authors: Cavalli Loredana , Briscese Lucia , Cavalli Tiziana , Andre Paolo , Carboncini Maria Chiara
Published: September 2018

Acupuncture therapy has been used to treat several disorders in Asian countries and its use is increasing in Western countries as well. Current literature assessed the safety and efficacy of acupuncture in the acute management and rehabilitation of patients with neurologic disorders. In this paper, the role of acupuncture in the treatment of acute severe acquired brain injuries is described, acting on neuroinflammation, intracranial oedema, oxidative stress, and neuronal regeneration. Moreover, beneficial effects of acupuncture on subacute phase and chronic outcomes have been reported in controlling the imbalance of IGF‐1 hormone and in decreasing spasticity, pain, and the incidence of neurovegetative crisis. Moreover, acupuncture may have a positive action on the arousal recovery. Further work is needed to understand the effects of specific acupoints on the brain. Allegedly concurrent neurophysiological measurements (e.g., EEG) may help in studying acupuncture‐related changes in central nervous system activity and determining its potential as an add‐on rehabilitative treatment for patients with consciousness disorders.
M-Polynomials and Degree-Based Topological Indices of Triangular, Hourglass, and Jagged-Rectangle Benzenoid Systems
Authors: Kwun Young Chel , Ali Ashaq , Nazeer Waqas , Ahmad Chaudhary Maqbool , Kang Shin Min
Published: September 2018

Chemical graph theory is a branch of mathematical chemistry which has an important effect on the development of the chemical sciences. The study of topological indices is currently one of the most active research fields in chemical graph theory. Topological indices help to predict many chemical and biological properties of chemical structures under study. The aim of this report is to study the molecular topology of some benzenoid systems. M-polynomial has wealth of information about the degree-based topological indices. We compute M-polynomials for triangular, hourglass, and jagged-rectangle benzenoid systems, and from these M-polynomials, we recover nine degree-based topological indices. Our results play a vital role in pharmacy, drug design, and many other applied areas.
Efficient Multifactor Two‐Server Authenticated Scheme under Mobile Cloud Computing
Authors: Han Ziyi , Yang Li , Wang Shen , Mu Sen , Liu Qiang
Published: September 2018

Because the authentication method based on username‐password has the disadvantage of easy disclosure and low reliability and the excess password management degrades the user experience tremendously, the user is eager to get rid of the bond of the password in order to seek a new way of authentication. Therefore, the multifactor biometrics‐based user authentication wins the favor of people with advantages of simplicity, convenience, and high reliability. Now the biometrics‐based (especially the fingerprint information) authentication technology has been extremely mature, and it is universally applied in the scenario of the mobile payment. Unfortunately, in the existing scheme, biometric information is stored on the server side. As thus, once the server is hacked by attackers to cause the leakage of the fingerprint information, it will take a deadly threat to the user privacy. Aiming at the security problem due to the fingerprint information in the mobile payment environment, we propose a novel multifactor two‐server authenticated scheme under mobile cloud computing (MTSAS). In the MTSAS, it divides the authentication method and authentication means; in the meanwhile, the user’s biometric characteristics cannot leave the user device. Thus, MTSAS avoids the fingerprint information disclosure, protects user privacy, and improves the security of the user data. In the same time, considering user actual requirements, different authentication factors depending on the privacy level of authentication are chosen. Security analysis proves that MTSAS has achieved the authentication purpose and met security requirements by the BAN logic. In comparison with other schemes, the result shows that MTSAS not only has the reasonable computational efficiency, but also keeps the superior communication cost.