bluuebunny/crossref_metadata_2025 huggingface dataset:
Chronic heart failure patients’ experiences of German healthcare services: a protocol for a scoping review
Authors: Dieckelmann Mirjam , Reinhardt Felix , Jeitler Klaus , Semlitsch Thomas , Plath Jasper , Gerlach Ferdinand M , Siebenhofer Andrea , Petersen Juliana J
Published: February 2019

Introduction

Chronic heart failure (CHF) is a heterogeneous condition requiring complex treatment from diverse healthcare services. An increasingly holistic understanding of healthcare has resulted in contextual factors such as perceived quality of care, as well as patients’ acceptance, preferences and subjective expectations of health services, all gaining in importance. How patients with CHF experience the use of healthcare services has not been studied within the scope of a systematic review in a German healthcare context. The aim of this scoping review is therefore to review systematically the experiences of patients affected by CHF with healthcare services in Germany in the literature and to map the research foci. Further objectives are to identify gaps in evidence, develop further research questions and to inform decision makers concerned with improving healthcare of patients living with CHF.

Methods and analysis

This scoping review will be based on a broad search strategy involving systematic and comprehensive electronic database searches in MEDLINE, EMBASE, PsycINFO, PSYNDEX, CINAHL and Cochrane’s Database of Systematic Reviews, grey literature searches, as well as hand searches through reference lists and non-indexed key journals. The methodological procedure will be based on an established six-stage framework for conducting scoping reviews that includes two independent reviewers. Data will be systematically extracted, qualitatively and quantitatively analysed and summarised both narratively and visually. To ensure the research questions and extracted information are meaningful, a patient representative will be involved.

Ethics and dissemination

Ethical approval will not be required to conduct this review. Results will be disseminated through a clearly illustrated report that will be part of a wider research project. Furthermore, it is intended that the review’s findings should be made available to relevant stakeholders through conference presentations and publication in peer-reviewed journals (knowledge transfer). Protocol registration in PROSPERO is not applicable for scoping reviews.
Social determinants of health among residential areas with a high tuberculosis incidence in a remote Inuit community
Authors: Kilabuk Elaine , Momoli Franco , Mallick Ranjeeta , Van Dyk Deborah , Pease Christopher , Zwerling Alice , Potvin Sharon Edmunds , Alvarez Gonzalo G
Published: February 2019

Background

Tuberculosis (TB) remains a significant health burden among Inuit in Canada. Social determinants of health (SDH) play a key role in TB infection, disease and ongoing transmission in this population. The objective of this research was to estimate the prevalence of social determinants of Inuit health as they relate to latent TB infection (LTBI) among people living in residential areas at high risk for TB in Iqaluit, Nunavut.

Methods

Inperson home surveys were conducted among those who lived in predetermined residential areas at high risk for TB identified in a door-to-door TB prevention campaign in Iqaluit, Nunavut in 2011. Risk ratios for SDH and LTBI were estimated, and multiple imputation was used to address missing data.

Results

261 participants completed the questionnaire. Most participants identified as Inuit (82%). Unadjusted risk ratios demonstrated that age, education, smoking tobacco, crowded housing conditions and Inuit ethnicity were associated with LTBI. After adjusting for other SDH, multivariable analysis showed an association between LTBI with increasing age (relative risk, RR 1.07, 95% CI 1.04 to 1.11), crowded housing (RR 1.48, 95% CI 1.10 to 2.00) and ethnicity (RR 2.76, 95% CI 1.33 to 5.73) after imputing missing data.

Conclusion

Among high-risk residential areas for TB in a remote Arctic region of Canada, crowded housing and Inuit ethnicity were associated with LTBI after adjusting for other SDH. In addition to strong screening and treatment programmes, alleviating the chronic housing shortage will be a key element in the elimination of TB in the Canadian Inuit Nunangat.
Suboptimal osteoporosis evaluation and treatment in older men with and without additional high-risk factors for fractures
Authors: Narla Radhika Rao , Hirano Lianne A , Lo Serena H Y , Anawalt Bradley D , Phelan Elizabeth A , Matsumoto Alvin M
Published: February 2019

We compared osteoporosis case-finding, evaluation and treatment in groups of Older Men and Older Women with age alone as a significant risk for fracture and Older Men with Higher Risk (older men additionally having previous hip fracture, corticosteroid use or androgen deprivation therapy). We studied 13,704 older men and women (≥70 years old) receiving care at a Veterans Affairs medical center from January 2000 to August 2010 whose 10-year hip fracture risk was assessed by limited FRAX score. The main outcome measures were the proportion of patients who had bone mineral density (by dual-energy X-ray absorptiometry [DXA]) and serum 25-hydroxy vitamin D (25-OH D) measurements performed, and calcium/vitamin D or bisphosphonates prescribed. The proportion of men with a 10-year hip fracture risk ≥3% with age alone as a risk was 48% and 88% in men aged 75–79 and ≥80 years, respectively. Compared with Older Women, fewer Older Men underwent DXA (12% vs 63%, respectively) and 25-OH D measurements (18% vs 39%), and fewer received calcium/vitamin D (20% vs 63%) and bisphosphonate (5% vs 44%) prescriptions. In Older Men with Higher Risk category, the proportion of men with 10-year hip fracture risk ≥3% ranged from 69% to 95%. Despite a higher risk and expectation that this group would have greater case detection and screening, few Older Men with Higher risk underwent DXA screening (27%–36%) and 25-OH D measurements (23%–28%), and received fewer calcium/vitamin D (40%–50%) and bisphosphonate (13%–24%) prescriptions. Considering the known morbidity and mortality, our findings underscore the need for improved evaluation and management of osteoporosis in older men at high risk for fracture.
Empowering podiatrists to perform pulse checks for opportunistic atrial fibrillation detection during annual diabetes foot checks
Authors: Hicks Linda , Newton Julia , Nayar Rahul , Mackay Kate
Published: February 2019

Objective

To determine whether training podiatrists to provide opportunistic screening for atrial fibrillation (AF) during the local diabetes foot check was feasible and whether it detects previously unknown AF.

Method

During the initiative, 45 podiatrists from across North Durham, Darlington and Durham Dales Easington and Sedgefield Clinical Commissioning Groups were trained to recognise heart irregularities when taking pulse readings of feet of patients with diabetes during their annual foot screening reviews.

Results

Over the course of the 3-month pilot, 5000 patients with diabetes had their feet pulse-tested. The project uncovered that for every 500 patients who had their feet checked, one new case of AF could be identified.

Conclusion

A report following the Podiatry and Atrial Fibrillation Case Finding scheme revealed that the National Health Service in the United Kingdom North East and North Cumbria area could benefit from potential cost savings in excess of £500 000. In 2013, the National Diabetes Information Service, Yorkshire and Humber Public Health Observatory estimated 231 777 people in the North East, North Cumbria, Hambleton and Richmondshire area with diabetes. Therefore 463 patients could be found with AF, preventing 23 strokes and saving £539 742 or in excess of £0.5 M.
Opioid‐free anaesthesia (OFA) in a springer spaniel sustaining a lateral humeral condylar fracture undergoing surgical repair
Authors: Geddes Alexander Thomas , Stathopoulou Thaleia , Viscasillas Jaime , Lafuente Pilar
Published: February 2019

A two‐year, three‐month‐old male entire springer spaniel presented for right thoracic limb lameness. Radiographs of both elbows revealed a right lateral humeral condylar fracture. Local anaesthesia using bupivacaine was supplied to the site using a continuous stay peri‐neural catheter at the brachial plexus. The fracture was stabilised using a lag screw and locking compression plate (LCP) plate. No response to surgical stimulation was noted on the patient’s vital parameters during anaesthesia, systemic analgesia was deemed not to be required. Bupivacaine was administered through the brachial plexus catheter every seven hours postoperatively. Pain scores were noted to be low, hence no systemic opioids were provided. The use of a continuous peripheral nerve block allowed for cold packs and passive range of motion exercises the same day of surgery. It also allowed for a lack of requirement of systemic opioids for the duration of hospitalisation.
Articular type II Monteggia fracture with concurrent humeroulnar luxation in a Bengal cat
Authors: Fernandez‐Sanchez Armiche , Calvo Ignacio , Farrell Michael
Published: February 2019

A seven‐month‐old Bengal cat presented with a fracture of the ulna trochlear notch with concurrent caudal luxation of the radial head and humeroulnar luxation. Open reduction and internal fixation was performed using a lateral 2.0‐mm locking compression plate to repair the ulna fracture and circumferential sutures passed through bone tunnels to treat the humeroulnar instability. Uncomplicated healing occurred and the cat regained normal elbow range of motion without any recurrence of lameness.
Myrmekitic intergrowth of tourmaline and quartz in eclogite-hosting gneisses of the Tso Morari ultrahigh-pressure metamorphic terrane (Eastern Ladakh, India): a possible record of high-pressure conditions
Authors: Broska Igor , Bačík Peter , Kumar Santosh , Janák Marian , Kurylo Sergiy , Filip Jan , Bazarnik Jakub , Mikuš Tomáš
Published: February 2019

Alkaline schorlitic tourmaline with domains of myrmekitic quartz and tourmaline intergrowths is reported for the first time from quartzo-feldspathic gneisses of the Tso Morari Crystalline Complex (TMCC), eastern Ladakh Himalaya. Except for schorlitic tourmaline, the brown-green dravitic tourmaline occurs in melanocratic layers of the gneiss. The schorlitic tourmaline contains REE-rich apatite, which is a typical mineral formed under high-pressure (HP) conditions. The observed myrmekite, marked by vermicular quartz and tourmaline intergrowths, was probably formed during decompression as a consequence of excess silica released from recrystallized tourmaline. The recalculated composition of the tourmaline with quartz myrmekite suggests that Si also occupied the tourmaline octahedral
Z
site during the HP regime. During decompression excess Si from this tourmaline was replaced by Mg and Fe
3+
. At an early stage of exhumation needle-shaped schorlitic tourmaline II and mosaic zoning were formed. The excess of silica and the structural disorder suggest that the Si-oversaturated tourmaline was stable at high-pressure–ultrahigh-pressure (HP–UHP) conditions. The greater stability of dravitic tourmaline compared to schorlitic tourmaline at HP conditions is evidently recorded at the TMCC. The tourmaline-bearing gneisses of the TMCC most probably shared the same metamorphic conditions during Tertiary collision of the Indian and Eurasian plates, similar to that observed for the associated UHP eclogites.
Granites and crustal heat budget
Authors: Moyen Jean-François
Published: February 2019

The origin of large I-type batholiths remains a disputed topic. One model states that I-type granites form by partial melting of older crustal lithologies (amphibolites or intermediate igneous rocks). In another view, granites are trapped rhyolitic liquids occurring at the end of fractionation trends defining a basalt–andesite–dacite–rhyolite series. This paper explores the thermal implications of both scenarios, using a heat balance model that abstracts the heat production and consumption during crustal melting. Heat is consumed by melting and by losses through the surface (conductive or advective, as a result of eruption). It is supplied as a basal conductive heat flux, as internal heat production or as advective heat carried by an influx of hot basalt into the crust. Using this abstract approach, it is possible to explore the role different parameters play in the balance of granites formed by differentiation of basalts or by crustal melting. Two end-member situations appear equally favourable to generating large volumes of granites: (1) short-lived environments dominated by high basaltic flux, where granites result mostly from basalt differentiation; and (2) long-lived systems with no or minimal basalt flux, with granites resulting chiefly from crustal melting.
Performing process-oriented investigations involving mass transfer using Rcrust: a new phase equilibrium modelling tool
Authors: Mayne Matthew Jason , Stevens Gary , Moyen Jean-François , Johnson Tim
Published: February 2019

Modern quantitative phase equilibria modelling allows the calculation of the stable phase assemblage of a rock system given its pressure, temperature and bulk composition. A new software tool (Rcrust) has been developed that allows the modelling of points in pressure–temperature–bulk composition space in which bulk compositional changes can be passed from point to point as the system evolves. This new methodology enables quantitative process-oriented investigation of the evolution of rocks. Procedures are outlined here for using this tool to model: (1) the control of the water content of a subsolidus system based on available pore space; (2) the triggering of melt loss events when a critical melt volume threshold is exceeded, while allowing a portion of melt retention; (3) the entrainment of crystals during segregation and ascent of granitic magmas from its source; (4) the modification of the composition of granite magmas owing to fractional crystallization; and (5) the progressive availability (through dissolution) of slow diffusing species and their control of the effective bulk composition of a system. These cases collectively illustrate thermodynamically constrained methods for modelling systems that involve mass transfer.
Metastability of the Logit Dynamics for Asymptotically Well-Behaved Potential Games
Authors: Ferraioli Diodato , Ventre Carmine
Published: February 2019

Convergence rate and stability of a solution concept are classically measured in terms of “eventually” and “forever,” respectively. In the wake of recent computational criticisms to this approach, we study whether these timeframes can be updated to have states computed “quickly” and stable for “long enough”.

Logit dynamics allows irrationality in players’ behavior and may take time exponential in the number of players
n
to converge to a stable state (i.e., a certain distribution over pure strategy profiles). We prove that every potential game, for which the behavior of the logit dynamics is not chaotic as
n
increases, admits distributions stable for a super-polynomial number of steps in
n
no matter the players’ irrationality and the starting profile of the dynamics. The convergence rate to these
metastable distributions
is polynomial in
n
when the players are not too rational.

Our proofs build upon the new concept of
partitioned Markov chains
, which might be of independent interest, and a number of involved technical contributions.
MicroRNA-135a participates in the development of astrocytes derived from bacterial meningitis by downregulating HIF-1α
Authors: Dong Yan , Wang Jun , Du Kai-Xian , Jia Tian-Ming , Zhu Chang-Lian , Zhang Yan , Xu Fa-Lin
Published: February 2019

Accumulating evidence has highlighted the potential of microRNAs (miRs) as biomarkers in various human diseases. However, the roles of miRs in bacterial meningitis (BM), a severe infectious condition, still remain unclear. Thus, the present study aimed to investigate the effects of miR-135a on proliferation and apoptosis of astrocytes in BM. Neonatal rats were injected with Streptococcus pneumoniae to establish the BM model. The expression of miR-135a and hypoxia-inducible factor 1α (HIF-1α) in the BM rat models were characterized, followed by determination of their interaction. Using gain- and loss-of-function approaches, the effects of miR-135a on proliferation, apoptosis, and expression of glial fibrillary acidic protein (GFAP), in addition to apoptosis-related factors in astrocytes were examined accordingly. The regulatory effect of HIF-1α was also determined along with the overexpression or knockdown of HIF-1α. The results obtained indicated that miR-135a was poorly expressed, whereas HIF-1α was highly expressed in the BM rat models. In addition, restored expression levels of miR-135a were determined to promote proliferation while inhibiting the apoptosis of astrocytes, along with downregulated Bax and Bad, as well as upregulated Bcl-2, Bcl-XL, and GFAP. As a target gene of miR-135a, HIF-1α expression was determined to be diminished by miR-135a. The upregulation of HIF-1α reversed the miR-135a-induced proliferation of astrocytes. Taken together, the key findings of the current study present evidence suggesting that miR-135a can downregulate HIF-1α and play a contributory role in the development of astrocytes derived from BM, providing a novel theoretical perspective for BM treatment approaches.
Dietary restriction of iron availability attenuates UPEC pathogenesis in a mouse model of urinary tract infection
Authors: Bauckman Kyle A. , Matsuda Rina , Higgins Cassandra B. , DeBosch Brian J. , Wang Caihong , Mysorekar Indira U.
Published: February 2019

Iron is a critical nutrient required by hosts and pathogens. Uropathogenic Escherichia coli (UPEC), the principal causative agent of urinary tract infections (UTIs), chelate iron for their survival and persistence. Here, we demonstrate that dietary modulation of iron availability limits UPEC burden in a mouse model of UTI. Mice on a low-iron diet exhibit reduced systemic and bladder mucosal iron availability and harbor significantly lower bacterial burden, concomitant with dampened inflammation. Hepcidin is a master regulator of iron that controls iron-dependent UPEC intracellular growth. Hepcidin-deficient mice ( Hamp1−/−) exhibit accumulation of iron deposits, persistent bacterial burden in the bladder, and a heightened inflammatory response to UTI. However, a low-iron dietary regimen reversed the iron overload and increased bacterial burden phenotypes in Hamp1−/− mice. Thus modulation of iron levels via diet can reduce UPEC infection and persistence, which may have significant implications for clinical management of UTI.
Phase response theory explains cluster formation in sparsely but strongly connected inhibitory neural networks and effects of jitter due to sparse connectivity
Authors: Tikidji-Hamburyan Ruben A. , Leonik Conrad A. , Canavier Carmen C.
Published: February 2019

We show how to predict whether a neural network will exhibit global synchrony (a one-cluster state) or a two-cluster state based on the assumption of pulsatile coupling and critically dependent upon the phase response curve (PRC) generated by the appropriate perturbation from a partner cluster. Our results hold for a monotonically increasing (meaning longer delays as the phase increases) PRC, which likely characterizes inhibitory fast-spiking basket and cortical low-threshold-spiking interneurons in response to strong inhibition. Conduction delays stabilize synchrony for this PRC shape, whereas they destroy two-cluster states, the former by avoiding a destabilizing discontinuity and the latter by approaching it. With conduction delays, stronger coupling strength can promote a one-cluster state, so the weak coupling limit is not applicable here. We show how jitter can destabilize global synchrony but not a two-cluster state. Local stability of global synchrony in an all-to-all network does not guarantee that global synchrony can be observed in an appropriately scaled sparsely connected network; the basin of attraction can be inferred from the PRC and must be sufficiently large. Two-cluster synchrony is not obviously different from one-cluster synchrony in the presence of noise and may be the actual substrate for oscillations observed in the local field potential (LFP) and the electroencephalogram (EEG) in situations where global synchrony is not possible. Transitions between cluster states may change the frequency of the rhythms observed in the LFP or EEG. Transitions between cluster states within an inhibitory subnetwork may allow more effective recruitment of pyramidal neurons into the network rhythm.

NEW & NOTEWORTHY We show that jitter induced by sparse connectivity can destabilize global synchrony but not a two-cluster state with two smaller clusters firing alternately. On the other hand, conduction delays stabilize synchrony and destroy two-cluster states. These results hold if each cluster exhibits a phase response curve similar to one that characterizes fast-spiking basket and cortical low-threshold-spiking cells for strong inhibition. Either a two-cluster or a one-cluster state might provide the oscillatory substrate for neural computations.
Electroceutical Targeting of the Autonomic Nervous System
Authors: Horn Charles C. , Ardell Jeffrey L. , Fisher Lee E.
Published: February 2019

Autonomic nerves are attractive targets for medical therapies using electroceutical devices because of the potential for selective control and few side effects. These devices use novel materials, electrode configurations, stimulation patterns, and closed-loop control to treat heart failure, hypertension, gastrointestinal and bladder diseases, obesity/diabetes, and inflammatory disorders. Critical to progress is a mechanistic understanding of multi-level controls of target organs, disease adaptation, and impact of neuromodulation to restore organ function.
Heat Waves, the New Normal: Summertime Temperature Extremes Will Impact Animals, Ecosystems, and Human Communities
Authors: Stillman Jonathon H.
Published: February 2019

A consequence of climate change is the increased frequency and severity of extreme heat waves. This is occurring now as most of the warmest summers and most intense heat waves ever recorded have been during the past decade. In this review, I describe the ways in which animals and human populations are likely to respond to increased extreme heat, suggest how to study those responses, and reflect on the importance of those studies for countering the devastating impacts of climate change.
The Importance of Resistance Exercise Training to Combat Neuromuscular Aging
Authors: Lavin Kaleen M. , Roberts Brandon M. , Fry Christopher S. , Moro Tatiana , Rasmussen Blake B. , Bamman Marcas M.
Published: February 2019

Older adults undergoing age-related decrements in muscle health can benefit substantially from resistance exercise training, a potent stimulus for whole muscle and myofiber hypertrophy, neuromuscular performance gains, and improved functional mobility. With the use of advancing technologies, research continues to elucidate the mechanisms of and heterogeneity in adaptations to resistance exercise training beyond differences in exercise prescription. This review highlights the current knowledge in these areas and emphasizes knowledge gaps that require future attention of the field.
Energy Considerations for Tracking in DC to DC Power Converters
Authors: Obregón-Pulido G. , Solís-Perales G. , Meda-Campaña J. A. , Vega-Gómez G. A. , Ruiz-Velázquez E.
Published: February 2019

A design of an adaptive controller applied to the boost and buck‐boost converters to deal with the problem of tracking a sinusoidal voltage is proposed. The main contribution is to provide conditions on the design procedure in order to obtain a reduction in the DC voltage (offset of the sinusoidal signal) of the reference signal; in this way the AC energy is maximized. A nonlinear stable system is designed in order to produce the necessary inputs to exactly track the inductor reference current, which is a necessary condition to achieve the tracking behavior of the voltage reference signal f(t) = A + Bsin⁡(wt). A numerical example is provided to corroborate the result.
Colorectal Serrated Neoplasia: An Institutional 12-Year Review Highlights the Impact of a Screening Programme
Authors: McCarthy A. J. , O’Reilly S. M. , Shanley J. , Geraghty R. , Ryan E. J. , Cullen G. , Sheahan K.
Published: February 2019

Background. As the malignant potential of sessile serrated lesions/polyps (SSL/Ps) and traditional serrated adenomas (TSAs) has been clearly demonstrated, it is important that serrated polyps are identified and correctly classified histologically. Aim. Our aim was to characterize the clinicopathological features of a series of SSL/Ps & TSAs, to assess the accuracy of the pathological diagnosis, the incidence, and the rate of dysplasia in SSL/Ps & TSAs. Methods. We identified all colorectal serrated polyps between 01/01/2004 and 31/05/2016, by searching the laboratory information system for all cases assigned a “serrated adenoma” SNOMED code. All available and suitable slides were reviewed by one pathologist, who was blinded to the original diagnosis and the site of the polyp. Subsequently discordant cases, SSL/Ps with dysplasia, and all TSAs were reviewed by a second pathologist. Results. Over a 149-month period, 759 “serrated adenoma” polyps were identified, with 664 (from 523 patients) available for review. 41.1% were reviewed by both pathologists; 15.1% (100/664) were reclassified, with the majority being changed from SSL/P to hyperplastic polyp (HYP) (66/664; 9.9%). 80.3% of these HYPs were located in the left colon, and the majority exhibited prolapse effect. There were 520 SSL/Ps (92.2%) & 40 TSAs (7.1%). The majority of SSL/Ps were in the right colon (86.7%) and were small (64.5% <1 cm), while most TSAs were in the left colon (85.7%) and were large (73.1%≥1 cm). 6.7% of SSL/Ps exhibited dysplasia, the majority of which were large (66.7%≥1 cm). Following consensus review, 13/520 (2.5%) SSL/Ps were downgraded from SSL/P with dysplasia to SSL/P without dysplasia. Detection of SSL/Ps peaked in the most recent years reviewed (87.5% reported between 2013 and 2016, inclusive), coinciding with the introduction of “BowelScreen” (the Irish FIT-based colorectal cancer screening programme). Conclusions. Awareness of, and adherence to, diagnostic criteria is essential for accurate classification of colorectal polyps.
A Graphical Alternating Conditional Expectation to Predict Hydrate Phase Equilibrium Conditions for Sweet and Sour Natural Gases
Authors: Zhong Hai-Quan , Yao Qi-Long , Wang Yu , He Yu-Fa , Li Zi-Han
Published: February 2019

Natural gas hydrate has been widely of concern due to its great potential in application to address problems including gas storage, transmission, separation techniques, and also as energy resource. Accurate prediction of hydrate formation phase equilibrium conditions is essential for the optimized design during natural gas production, processing, and transportation. In this study, a novel graphical alternating conditional expectation (ACE) algorithm was proposed to predict hydrate formation phase equilibrium conditions for sweet and sour natural gases. The accuracy and performance of the presented ACE model were evaluated using 1055 data points (688, 249, and 118 data points for sweet natural gas, CO2‐CH4, and H2S‐CO2‐CH4 systems, respectively) collected from literature. Meanwhile, a comparative study was conducted between the ACE model and commonly used correlations, including thirteen models for sweet natural gases, three models for CO2‐CH4 binary system, and seven thermodynamic models for H2S‐CO2‐CH4 ternary system. The obtained results indicated that the proposed ACE model produces the best results in prediction of hydrate phase equilibrium temperature for sweet natural gases and pressure for CO2‐CH4 system with average absolute relative deviation (AARD) of 0.134% and 2.75%, respectively. The proposed quick and explicit ACE model also provides a better performance in prediction of hydrate phase equilibrium pressure for H2S‐CO2‐CH4 ternary systems with AARD=5.20% compared with seven thermodynamic methods considered in this work, except for CPA/Electrolyte/Chen–Guo combined model (AARD=4.45%).
MHC Class 1 and PDL-1 Status of Primary Tumor and Lymph Node Metastatic Tumor Tissue in Gastric Cancers
Authors: Erdogdu Ibrahim Halil
Published: February 2019

The prognosis of metastatic gastric cancer is poor. Despite the use of VEGF-, EGFR-, and HER2-targeting agents, prognosis is still poor in advanced gastric cancer. Although cancer immunotherapy responds well in some patients, clinical use is limited due to unanswered patients. For this reason, it is necessary to know the characteristics of primary and metastatic cancer cells for patient selection for immunotherapy and additional criteria are required. MHC-1 downregulation is most frequently observed in the tumor escape mechanism of cancer cells from the immune system. MHC-1 downregulation with increased PDL-1 expression of cancer cells has an important role in immune escape. MHC-1 downregulation and PDL-1 expression have been shown in many types of cancers. However, there is no study on the status of MHC-1 and PDL-1 in primary and metastatic tumor tissue. In this study, MHC-1 and PDL-1 score in primary and metastatic tumor cells was evaluated in 43 gastric cancer patients with lymph node metastasis. According to our results, the primary tumor PDL-1 score was correlated with the number of metastatic lymph nodes (r=0.258; p=0.024) and primary tumor size (r=0.341; p=0.045). A similar correlation was found between the primary tumor PDL-1 score and the metastatic tumor PDL-1 score (r=0.213; p=0.015). In our study, MHC-1 was found to be higher in primary tumors than metastatic tumors, although not statistically significant (p=0.054). The results of our study showed high MHC-1 and low PDL-1 expression in primary tumors and low MHC-1 and high PDL-1 expression in metastatic tumors. These results reveal different biological characteristics of primary and metastatic tumor cells.
Analysis of In Vitro Osteoblast Culture on Scaffolds for Future Bone Regeneration Purposes in Dentistry
Authors: Gutiérrez-Prieto Sandra J. , Perdomo-Lara Sandra J. , Diaz-Peraza José M. , Sequeda-Castañeda Luis Gonzalo
Published: February 2019

One of the main focuses of tissue engineering is to search for tridimensional scaffold materials, complying with nature’s properties for tissue regeneration. Determining material biocompatibility is a fundamental step in considering its use. Therefore, the purpose of this study was to analyze osteoblast cell adhesion and viability on different materials to determine which was more compatible for future bone regeneration. Tridimensional structures were fabricated with hydroxyapatite, collagen, and porous silica. The bovine bone was used as material control. Biocompatibility was determined by seeding primary osteoblasts on each tridimensional structure. Cellular morphology was assessed by SEM and viability through confocal microscopy. Osteoblast colonization was observed on all evaluated materials’ surface, revealing they did not elicit osteoblast cytotoxicity. Analyses of four different materials studied with diverse compositions and characteristics showed that adhesiveness was best seen for HA and viability for collagen. In general, the results of this investigation suggest these materials can be used in combination, as scaffolds intended for bone regeneration in dental and medical fields.
Seismic Resistance and Displacement Mechanism of the Concrete Footing
Authors: Namdar Abdoullah , Dong Yun
Published: February 2019

A realistic seismic simulation of the concrete footing has been made by using finite element method (FEM) software called ABAQUS. The effect of concrete footing embedment in soil on concrete footing‐soil foundation interaction has numerically been simulated for considering displacement, stress, strain, and seismic acceleration load response at the base of a concrete footing. The results showed that the height of embedded concrete footing in soil foundation controls (i) mechanism and magnitude of lateral, vertical, and differential displacements of the concrete footing, (ii) strain energy, the acceleration load response, and stress paths, and (iii) concrete footing‐soil foundation interaction. Compared with various theoretical and experimental results reported in the literature, the present study provides realistic seismic behavior of concrete footing‐soil foundation interaction.
A Newly Modified Salter Osteotomy Technique for Treatment of Developmental Dysplasia of Hip That Is Associated with Decrease in Pressure on Femoral Head and Triradiate Cartilage
Authors: Esmaeilnejad-Ganji Seyed Mokhtar , Esmaeilnejad-Ganji Seyed Mohammad Reza , Zamani Mohammad , Alitaleshi Hesam
Published: February 2019

Background and Purpose. The Salter innominate osteotomy has been an effective method to treat the developmental dysplasia of hip (DDH) over the past decades; however, several postoperative complications and deficiencies were reported. In this study, we evaluated outcome of a newly modified Salter osteotomy in patients presenting with DDH. Methods. We reviewed retrospectively 76 patients (90 hips) with DDH aged ≥ 18 months, who underwent open reduction and a modified osteotomy by a single surgeon. The distal osteotomy segment of pelvis was shifted anterolaterally in the amount of osteotomy cross-section, but not downwards. The mean age at surgery was 2 years and 11 months (1.5 to 16 years). Femoral shortening was conducted when necessary. The duration of operation varied between 60 and 90 minutes. The mean follow-up was 4 years and one month (range 15 months to 7 years and 9 months). All patients were followed up both clinically (based on the modified MacKay criteria) and radiologically (based on the modified Severin criteria). Results. Clinically, 94.5% of hips had excellent and good results at final follow-up, and only 5.5% had a fair condition. Radiographically, at the final follow-up 77.8% of hips were grade IA (excellent), 12.2% were grade IB, 6.7% were grade II, and 3.3% were grade III (fair). The preoperative mean acetabular index was 47.85° (41° to 59), which decreased to 17.16° (13° to 22°) immediately after the surgery (p<0.0001) and progressed to 11.24° (7° to 19°) at the final follow-up (p<0.0001). The mean initial postoperative center-edge angle was 30.3° (25° to 42°) significantly improved to 39.1 (31° to 56°) at the final follow-up (p<0.0001). Avascular necrosis of femoral head occurred in 4.4% of hips (4 patients). Conclusion. The results show that our modified Salter osteotomy is safe and associated with significant benefit for the management of patients suffering from DDH.
Prevalence, Antimicrobial Susceptibility Pattern of Bacterial Isolates, and Associated Factors of Urinary Tract Infections among HIV‐Positive Patients at Hiwot Fana Specialized University Hospital, Eastern Ethiopia
Authors: Marami Dadi , Balakrishnan Senthilkumar , Seyoum Berhanu
Published: February 2019

Urinary tract infection remains a major public health problem in developing countries, where there are limited health-care services. Its prevalence is fueled by human immunodeficiency virus (HIV) infection. The emergence of antimicrobial resistance is now widespread and poses a serious clinical threat. This study investigated the prevalence, antimicrobial susceptibility pattern of bacterial isolates, and associated factors of urinary tract infections among HIV-positive adult patients. A cross-sectional study was conducted among 350 randomly selected HIV-positive patients at Hiwot Fana Specialized University Hospital from February to March 2016. Data were collected using a structured questionnaire. Clean-catch midstream urine samples were collected aseptically and examined using the recommended culture methods. Antimicrobial susceptibility testing was performed using the Kirby–Bauer disk diffusion technique. Data were analyzed using Statistical Package for the Social Sciences version 21.0. The logistic regression models were used to explore the predictors of the outcome. A p value < 0.05 was considered statistically significant. The overall prevalence of urinary tract infection was 18% (95% CI: 15.34–22.63). Individuals with age 35–44 years (Adjusted odds ratio (AOR): 4.07; 95% CI: 1.09, 5.10), income less than 46.7 USD (AOR: 2.76; 95% CI: 1.15, 6.07), and a CD4+ count less than 200 cells/mm3 (AOR: 2.07; 95% CI: 1.15, 3.73) had higher odds of UTI. Escherichia coli (38.1%), Klebsiella pneumoniae (23.8%), and Staphylococcus aureus (11.1%) were the predominant causes of urinary tract infection. E. coli was resistant to ampicillin (95.8%), ceftazidime (95.8%), cotrimoxazole (95.8%), amoxicillin (91.7%), ceftriaxone (87.5%), and tetracycline (87.2%). Multidrug resistance was observed in 46% of the isolates. The prevalence of urinary tract infection in this study was high compared to the previous reports in Ethiopia. Age 35–44 years, income less than 46.7 USD, and a CD4+ count < 200 cells/mm3 increase the odds of urinary tract infection. The most common isolates were E. coli, K. pneumoniae, and S. aureus. Almost half of the isolates were multidrug resistant. Actions to help mitigate the further spread of resistance are urgently needed in the study area.
A Hybridization of Cuckoo Search and Differential Evolution for the Logistics Distribution Center Location Problem
Authors: Chi Rui , Su Yixin , Qu Zhijian , Chi Xuexin
Published: February 2019

The location selection of logistics distribution centers is a crucial issue in the modern urban logistics system. In order to achieve a more reasonable solution, an effective optimization algorithm is indispensable. In this paper, a new hybrid optimization algorithm named cuckoo search‐differential evolution (CSDE) is proposed for logistics distribution center location problem. Differential evolution (DE) is incorporated into cuckoo search (CS) to improve the local searching ability of the algorithm. The CSDE evolves with a coevolutionary mechanism, which combines the Lévy flight of CS with the mutation operation of DE to generate solutions. In addition, the mutation operation of DE is modified dynamically. The mutation operation of DE varies under different searching stages. The proposed CSDE algorithm is tested on 10 benchmarking functions and applied in solving a logistics distribution center location problem. The performance of the CSDE is compared with several metaheuristic algorithms via the best solution, mean solution, and convergence speed. Experimental results show that CSDE performs better than or equal to CS, ICS, and some other metaheuristic algorithms, which reveals that the proposed CSDE is an effective and competitive algorithm for solving the logistics distribution center location problem.
Functional Variant rs4442975 Modulating FOXA1 Binding Affinity Can Influence Bone Marrow Suppression during Neoadjuvant Chemotherapy for Luminal A Type Breast Cancer
Authors: Wang Xin , Feng Zhongxin , Li Juan , Han Yanyan , Su Liyu , Wang Feng , Yang Yan , Zhang Yi
Published: February 2019

The expression of the transcription factor FOXA1 is associated with the prognosis of estrogen receptor (ER)-positive breast cancer, and the genetic variant rs4442975 can affect FOXA1 function. Therefore, we investigated the association between rs4442975 and the efficacy of neoadjuvant chemotherapy for luminal A type breast cancer and evaluated its toxic side effects in a Chinese population. One hundred seventy-five patients with luminal A type breast cancer receiving neoadjuvant chemotherapy with a combination protocol of epirubicin and docetaxel (ET protocol) were enrolled in the study. Genotyping was performed in a randomized manner to identify candidate genetic variants. Unconditional logistic regression analysis was used to analyze the association of the variant with the efficacy and side effects of neoadjuvant chemotherapy. The results did not reveal any positive association with the efficacy of neoadjuvant chemotherapy, with an odds ratio (OR) of 0.73 (95% confidence interval = 0.27–1.94) in the additive model. However, analysis of the toxic side effects of neoadjuvant chemotherapy showed that rs4442975 was associated with bone marrow suppression, with an OR of 0.38 (95% confidence interval = 0.17–0.73,p= 0.005) in the dominant model. In summary, the functional genetic variant rs4442975 was associated with bone marrow suppression during neoadjuvant chemotherapy for luminal A type breast cancer. These results may help establish reliable molecular markers for predicting the prognosis of personalized treatment for luminal A type breast cancer and thereby contribute to the development of appropriate therapies.
Nondestructive Testing on Ancient Wooden Components Based on Shapley Value
Authors: Chang Li-hong , Chang Xiao-hong , Chang Hao , Qian Wei , Cheng Li-ting , Han Xiao-li
Published: February 2019

In this study, we propose nondestructive testing methods and combined forecasting models-based stress wave and impedance measurements to obtain accurate internal defects information for wooden building components. Internal defects data for major wooden components of an ancient building in China and reverse laboratory test data on matching tree species indicated various degrees of damage on the pavilion wood structure surface and internal defects in certain pillars. The stress wave method enabled rapid acquisition of two-dimensional plots of test sections; however, the results revealed that the area of stress wave detection was greater than the actual defect area. Moreover, the impedance meter was able to determine the defect position and type in a single path, and the actual defect area was proportional to the absolute error of the drilling resistance. By distributing the errors from the two nondestructive testing methods on the basis of a Shapley value algorithm, we determined the weights of stress wave and impedance meter data in the forecasting models and established combined forecasting models that showed greater accuracy with a mean relative error of less than 6%. This method can improve the prediction accuracy of internal defects in ancient buildings and provide effective data support for practical engineering repair and reinforcement schemes.
On the Wiener Indices of Trees Ordering by Diameter‐Growing Transformation Relative to the Pendent Edges
Authors: Xu Xiaoxin , Gao Yubin , Sang Yanbin , Liang Yueliang
Published: February 2019

The Wiener index of a graph is defined as the sum of distances between all unordered pairs of its vertices. We found that finite steps of diameter‐growing transformation relative to vertices can not always enable the Wiener index of a tree to increase sharply. In this paper, we provide a graph transformation named diameter‐growing transformation relative to pendent edges, which increases Wiener index W(T) of a tree sharply after finite steps. Then, twenty‐two trees are ordered by their Wiener indices, and these trees are proved to be the first twenty‐two trees with the first up to sixteenth smallest Wiener indices.
Some Characterizations ofk-Strictly Convex andk-Smooth Banach Spaces
Authors: Wulede Suyalatu
Published: February 2019

In this paper, some characterizations ofk-strictly convex (k-smooth, respectively) spaces are given. As special cases fork=1, some characterizations of strictly convex (smooth, respectively) spaces are given.
The “Guardian of the Genome”—An Old Key to Unlock the ERCC1 Issue
Authors: Friboulet Luc , Soria Jean-Charles , Olaussen Ken André
Published: February 2019

Excision Repair Cross-Complementation Group 1 (ERCC1) participates in the repair of DNA intrastrand adducts (ISA) and interstrand cross-links, but its role as a predictive biomarker has never been fully validated. It has now been revealed that p53 mutation status should be considered concomitantly with ERCC1 to predict cisplatin efficacy.

See related article by Heyza et al., p. 2523
Customization of Peritoneal Dialysis in Cardiorenal Syndrome by Optimization of Sodium Extraction
Authors: Kazory Amir , Koratala Abhilash , Ronco Claudio
Published: February 2019

Background: Peritoneal dialysis (PD) has emerged as a mechanistically relevant therapeutic option for patients with heart failure (HF), volume overload, and varying degrees of renal dysfunction (i.e., chronic cardiorenal syndrome). Congestion has been identified as a potent ominous prognostic factor in this patient population, outperforming a number of established risk factors. As such, excess fluid removal is recognized as a relevant therapeutic target in this setting. Methods: Accumulating evidence points to the importance of sodium removal as part of any decongestive strategy because extraction of sodium-free water has little or no impact on the outcomes of these patients. Hence, optimization of sodium removal by PD should be the primary focus in the setting of HF and cardiorenal syndrome, especially if PD is started when the patient still has adequate residual renal function for clearance of waste products. Results: Herein, we provide an overview of approaches that can tailor PD treatment to the patients’ characteristics and clinical needs (e.g., choice of PD modality) to fully exploit its decongestive properties. Other methods that could prove helpful in the future will also be briefly discussed. Conclusion: While these strategies could help with efficient sodium extraction and volume optimization, future studies are needed to evaluate their impact on the outcomes of this specific patient population.
Can Surgical Registrars Accurately Identify the Urgent from the Non-Urgent Patient Presenting with Acute Abdominal Pain?
Authors: de Burlet Kirsten J. , Lam Anna B.M. , Harper Simon J. , Larsen Peter D. , Dennett Elizabeth R.
Published: February 2019

Background: Acute abdominal pain is a common surgical presentation with a wide range of causes. Differentiating urgent patients from non-urgent patients is important to optimise patient outcomes and the use of hospital resources. The aim of this study was to determine how accurately urgent and non-urgent patients presenting with abdominal pain can be identified. Methods: A prospective study of consecutive patients admitted with abdominal pain was undertaken. Urgent patients were classified as requiring treatment (theatre, intensive care unit, endoscopy, or radiologic drainage) within 24 h. Differentiation between urgent and non-urgent was made on the basis of the initial assessment prior to the use of advanced imaging. Outcomes were compared to a final classification based on final diagnosis as adjudicated by an expert panel. Results: Of the 301 patients included, 93 (30.9%) were deemed urgent based on initial assessment, compared to 83 (27.6%) on final diagnosis. Overall sensitivity for recognising urgent patients was 74.7% and specificity 89.9%, and overall accuracy was higher for senior registrars compared to junior registrars (p = 0.015). Urgent patients more often looked unwell or had peritonism on examination (39.8 vs. 17.4% and 56.6 vs. 14.7%, respectively, p < 0.001 for both). Conclusions: Registrars can accurately differentiate urgent from non-urgent patients with acute abdominal pain in the majority of cases. Accuracy was higher amongst senior registrars. The “end-of-the-bed-o-gram” and clinical examination are the most important features used for making this differentiation. This demonstrates that there is no substitute for exposure to acute presentations to improve a trainee’s diagnostic skill.