bluuebunny/crossref_metadata_2025 huggingface dataset:
Assestment of Grade 5 Social Studies Textbook Content in Light of Teacher Opinios
Authors: Tomal Necati
Published: June 2019

There have been significant changes in social studies textbooks through time. Especially since the 2005 syllabus entered into force, these textbooks have seen important changes both in content and form. While comprising of a little citizenship knowledge and mostly history and geography subjects before, since 2005 these textbooks came to contain many fields of knowledge including science and technology, psychology, sociology and economy, in addition to the history and geography subjects before. This new form of the textbooks has also passed through many changes until today. Finally, social studies textbooks were updated in 2018-2019 academic year based on the changes in the program. The goal of this study is to assess the contents of this updated grade 5 social studies textbook in line with opinions of the teachers.In scope of this study an interview form mostly comprised of open-ended question was applied with 28 teachers working in various provinces in order to assess the contents of the grade 5 social studies textbook put into use in the 2018-2019 academic year. The responses given to these open-ended questions are processed by content analysis method, which is a qualitative research technique. The study process was conducted in a planned and transparent manner. This is also important for reliability and validity of the study.It is found that teachers are generally satisfied with the content of grade 5 social studies textbook. There are some problems cited in regard of the language of the book not being suitable for the student level in context of some subjects. In particular, teachers have important suggestions regarding use of a storytelling language in regard of culture and heritage subjects in the textbook. The textbook is found adequate in regard of actuality and inner circle teaching. The teacher largely think compatibility of visuals with the content of textbook is sufficient; however, the textbook used in the previous year was also deemed agreeable in this regard.
Perovskite LEDs begin to shine
Authors: Service Robert F.
Published: June 2019

Solar cell wonder materials could also revolutionize lighting and displays.
DNA barcodes jump-start search for new species
Authors: Pennisi Elizabeth
Published: June 2019

$180 million project aims to identify 2 million species.
The mismeasure of hands?
Authors: Leslie Mitch
Published: June 2019

Some researchers say a simple ratio of finger lengths can predict personality and health. Others say that's wishful thinking.
PhiA, a Peptidoglycan Hydrolase Inhibitor of
Brucella
Involved in the Virulence Process
Authors: Del Giudice Mariela G. , Romani Alexis M. , Ugalde Juan E. , Czibener Cecilia
Published: June 2019

The peptidoglycan in Gram-negative bacteria is a dynamic structure in constant remodeling. This dynamism, achieved through synthesis and degradation, is essential because the peptidoglycan is necessary to maintain the structure of the cell but has to have enough plasticity to allow the transport and assembly of macromolecular complexes in the periplasm and outer membrane. In addition, this remodeling has to be coordinated with the division process.
Proficiency Testing of Virus Diagnostics Based on Bioinformatics Analysis of Simulated
In Silico
High-Throughput Sequencing Data Sets
Authors: Brinkmann Annika , Andrusch Andreas , Belka Ariane , Wylezich Claudia , Höper Dirk , Pohlmann Anne , Nordahl Petersen Thomas , Lucas Pierrick , Blanchard Yannick , Papa Anna , Melidou Angeliki , Oude Munnink Bas B. , Matthijnssens Jelle , Deboutte Ward , Ellis Richard J. , Hansmann Florian , Baumgärtner Wolfgang , van der Vries Erhard , Osterhaus Albert , Camma Cesare , Mangone Iolanda , Lorusso Alessio , Marcacci Maurilia , Nunes Alexandra , Pinto Miguel , Borges Vítor , Kroneman Annelies , Schmitz Dennis , Corman Victor Max , Drosten Christian , Jones Terry C. , Hendriksen Rene S. , Aarestrup Frank M. , Koopmans Marion , Beer Martin , Nitsche Andreas
Published: June 2019

Quality management and independent assessment of high-throughput sequencing-based virus diagnostics have not yet been established as a mandatory approach for ensuring comparable results. The sensitivity and specificity of viral high-throughput sequence data analysis are highly affected by bioinformatics processing using publicly available and custom tools and databases and thus differ widely between individuals and institutions.
Draft Genome Sequence of
Salipaludibacillus keqinensis
ACCC 60430
T
, an Aerobic Halophilic Bacterium Isolated from a Salt Lake
Authors: Dong Luna , Wang Shuangyan , Cao Hao , Zhao Baisuo , Wu Kun , Wang Haisheng
Published: June 2019

The haloalkaliphilic bacterium
Salipaludibacillus keqinensis
ACCC 60430
T
, which grows optimally at 8.0% (wt/vol) Na
+
and pH 9.0, was isolated from Keqin Lake in Qiqihaer, China. The draft genome includes 4,006 predicted genes and 3,784 coding sequences (CDSs).
Complete Genome Sequence of a Novel
Myoviridae
Phage, SfΦ01, Infecting Shigella spp
Authors: Kitajima Masaaki , Ishii Satoshi , Takagi Tatsuma , Okabe Satoshi
Published: June 2019

The
Shigella
bacterium is one of the most significant causes of waterborne and foodborne bacterial dysentery. A lytic bacteriophage infecting
Shigella flexneri
was isolated from wastewater in Japan.
Body mass index and outcomes of patients with laparoscopic adrenalectomy: a systematic review and meta-analysis protocol
Authors: Danwang Celestin , Agbor Valirie Ndip , Bigna Jean Joel
Published: June 2019

Introduction

Recent advances in the field of medical imaging and minimal invasive surgery have improved the diagnosis and treatment of adrenal incidentalomas. Recent studies suggest increased morbidity and mortality among patients with obesity following laparoscopic adrenalectomy compared with patients without obesity. However, this claim remains to be ascertained. This review seeks to assess the outcome of patients with and without obesity after adrenalectomy.

Methods and design

We will include cohort studies, case-control studies, cross-sectional studies and case series with more than 30 participants. EMBASE, Medline and Web of Science (Web of Science Core Collection, Current Contents Connect, KCI-Korean Journal Database, SciELO Citation Index, Russian Science Citation Index) will be searched for relevant abstracts of studies published between 1 January 2000 and 31 May 2019, without language restriction. The review will be reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. After screening of abstracts, study selection, data extraction and methodological quality assessment, we shall assess the studies individually for clinical and statistical heterogeneity. Random-effect meta-analysis will be used to pool studies judged to be clinically homogenous. The Harbord’s test and visual inspection of funnel plots will be used to assess publication bias. Results will be presented by country and region.

Ethics and dissemination

Since primary data are not collected in this study, ethical approval is not required. This review is expected to provide relevant data on the impact of body mass index on the outcome of laparoscopic adrenalectomy. The final report will be published in a peer-reviewed journal.

PROSPERO registration number

CRD42018117070.

Review status

Preliminary searches.
Exercise-based cardiac rehabilitation for stable angina: systematic review and meta-analysis
Authors: Long Linda , Anderson Lindsey , He jingzhou , Gandhi Manish , Dewhirst Alice , Bridges Charlene , Taylor Rod
Published: June 2019

Objective

A systematic review was undertaken to assess the effects of exercise-based cardiac rehabilitation (CR) for patients with stable angina.

Methods

Databases (Cochrane Central Register of Controlled Trials, MEDLINE, Embase and CINAHL) were searched up to October 2017, without language restriction. Randomised trials comparing CR programmes with no exercise control in adults with stable angina were included. Where possible, study outcomes were pooled using meta-analysis. Grading of Recommendations Assessment, Development and Evaluation was used to assess the quality of evidence. The protocol was published on the Cochrane Database of Systematic Reviews.

Results

Seven studies (581 patients), with a median of 12-month follow-up, were included. The effect of exercise-based CR on all-cause mortality (risk ratio (RR) 1.01, 95 % CI: 0.18 to 5.67), acute myocardial infarction (RR 0.33, 95% CI: 0.07 to 1.63) and cardiovascular-related hospital admissions (RR 0.14, 95% CI: 0.02 to 1.1) relative to control were uncertain. We found low-quality evidence that exercise-based CR results in a moderate improvement in exercise capacity (standard mean difference 0.45, 95% CI: 0.20 to 0.70). There was limited and very low-quality evidence for the effect of exercise-based CR on health-related quality of life (HRQoL), adverse events and costs. No data were identified on cost-effectiveness or return to work.

Conclusions

Exercise-based CR may improve the short-term exercise capacity of patients with stable angina pectoris. Well-designed randomised controlled trials are needed to definitely determine the impact of CR on outcomes including mortality, morbidity, HRQoL, and costs in the population of patients with stable angina receiving contemporary medical therapy.
Genetic diversity and structure in the northern populations of European hazelnut (Corylus avellanaL.)
Authors: Tanhuanpää Pirjo , Heinonen Maarit , Bitz Lidija , Rokka Veli-Matti
Published: June 2019

European hazelnut (Corylus avellana L.) is a strictly cross-pollinated diploid tree species, which has its northernmost populations in Fennoscandia, and it was one of the first species to recolonize northern Europe after the last ice age. Hazelnut produces edible nuts in Finland but nowadays they are underutilized as food, and currently no breeding programmes exist. In the present study, 300 hazelnut specimens were collected from 20 different locations (= populations) in Finland, and they were genetically analyzed using nine simple sequence repeat (SSR) markers. Most of the genetic diversity existed within populations (83%). According to different genetic analyses (STRUCTURE, principal coordinates analysis, and clustering), a general lack of structure was observed, suggesting extensive gene flow among hazelnuts between 17 investigated populations. However, genetic structuring was clearly observed in three populations: Hakavuori, Mustiala, and Pähkinämäki, which might have become isolated due to geographical barriers that kept them separate, diminishing gene flow from other populations. Studying the diversity of European hazelnut is of great interest for understanding population genetics of a species distributed in its marginal areas in the north, and the results are also valuable for further uses in plant conservation, selection, and possible future breeding actions in Finland.
An Improved Method for Scheduling Aircraft Ground Handling Operations From a Global Perspective
Authors: Padrón Silvia , Guimarans Daniel
Published: June 2019

The turnaround is a critical airport process where a set of interrelated operations need to be performed to get an aircraft ready for its next flight. These activities are carried out by different vehicles, which need to be coordinated to guarantee an efficient utilization of resources. Due to the relations between operations, the order in which these resources are scheduled has a critical influence on the planning and performance of the turnaround. In this work, we present a novel methodology for solving the proposed bi-objective ground handling scheduling problem from a global perspective. This means solving a set of interconnected routing problems with restrictive time windows for each operation. We first explore the solution space using a fast heuristic, focusing then on the most promising solutions to intensify the search in the vicinity of the Pareto frontier. This two-step schema permits significantly reducing the required computational time, which, in turn, allows a more thorough exploration of solutions. Different experiments over real data from two Spanish airports have been conducted to assess the proposed methodology. Our results show that the new method not only outperforms previous approaches in terms of computational requirements, but can also improve the quality of scheduling solutions.
On the Diminished-1 Modulo 2n+1 Addition and Subtraction
Authors: Efstathiou Constantinos , Pekmestzi Kiamal , Moshopoulos Nikolaos
Published: June 2019

In this work, the design of the diminished-1 modulo [Formula: see text] adders, subtractors and adders/subtractors are examined. Some of the existing modulo [Formula: see text] adders, subtractors and adder/subtractors are redesigned and improved. Compared to other existing implementations, the proposed subtractor and adder/subtractors offer reduced area complexity and lower power consumption, while operating at the same speed. All the considered architectures are modified parallel-prefix adders with fast input carry processing. The totally parallel-prefix and carry look ahead implementation of the proposed arithmetic units are also discussed.
Multilevel approximation of parametric and stochastic PDES
Authors: Zech Jakob , Dũng Dinh , Schwab Christoph
Published: June 2019

We analyze the complexity of the sparse-grid interpolation and sparse-grid quadrature of countably-parametric functions which take values in separable Banach spaces with unconditional bases. Assuming a suitably quantified holomorphic dependence on the parameters, we establish dimension-independent convergence rate bounds for sparse-grid approximation schemes. Analogous results are shown in the case that the parametric families are obtained as approximate solutions of corresponding parametric-holomorphic, nonlinear operator equations as considered in [A. Cohen and A. Chkifa and Ch. Schwab: Breaking the curse of dimensionality in sparse polynomial approximation of parametric PDEs, J. Math. Pures Appl. 103 (2015) 400–428], for example by means of stable, finite-dimensional approximations. We discuss in detail nonlinear Petrov–Galerkin projections. Error and convergence rate bounds for constructive and explicit multilevel, sparse tensor approximation schemes combining sparse-grid interpolation in the parameter space and general, multilevel discretization schemes in the physical domain are proved. The present results unify and generalize earlier works in terms of the admissible multilevel approximations in the physical domain (comprising general stable Petrov–Galerkin and discrete Petrov–Galerkin schemes, collocation and stable domain approximations) and in terms of the admissible operator equations (comprising smooth, nonlinear locally well-posed operator equations). Additionally, a novel computational strategy to localize sequences of nested index sets for the anisotropic Smolyak interpolation in parameter space is developed which realizes best [Formula: see text]-term benchmark convergence rates. We also consider Smolyak-type quadratures in this general setting, for which we establish improved convergence rates based on cancellations in the integrands’ gpc expansions by symmetries of quadratures and the probability measure [J.Z̃ech and Ch.S̃chwab: Convergence rates of high dimensional Smolyak quadrature, Report 2017-27, SAM ETH Zürich (2017)]. Several examples illustrating the abstract theory include domain uncertainty quantification (UQ) for general, linear, second-order, elliptic advection–reaction–diffusion equations on polygonal domains, where optimal convergence rates of FEM are known to require local mesh refinement near corners. Further applications of the presently developed theory comprise evaluations of posterior expectations in Bayesian inverse problems.
CNN-Based Facial Expression Recognition from Annotated RGB-D Images for Human–Robot Interaction
Authors: Li Jing , Mi Yang , Li Gongfa , Ju Zhaojie
Published: June 2019

Facial expression recognition has been widely used in human computer interaction (HCI) systems. Over the years, researchers have proposed different feature descriptors, implemented different classification methods, and carried out a number of experiments on various datasets for automatic facial expression recognition. However, most of them used 2D static images or 2D video sequences for the recognition task. The main limitations of 2D-based analysis are problems associated with variations in pose and illumination, which reduce the recognition accuracy. Therefore, an alternative way is to incorporate depth information acquired by 3D sensor, because it is invariant in both pose and illumination. In this paper, we present a two-stream convolutional neural network (CNN)-based facial expression recognition system and test it on our own RGB-D facial expression dataset collected by Microsoft Kinect for XBOX in unspontaneous scenarios since Kinect is an inexpensive and portable device to capture both RGB and depth information. Our fully annotated dataset includes seven expressions (i.e., neutral, sadness, disgust, fear, happiness, anger, and surprise) for 15 subjects (9 males and 6 females) aged from 20 to 25. The two individual CNNs are identical in architecture but do not share parameters. To combine the detection results produced by these two CNNs, we propose the late fusion approach. The experimental results demonstrate that the proposed two-stream network using RGB-D images is superior to that of using only RGB images or depth images.
Preservation of the superficial temporal artery during resection of a pseudoaneurysm: A case report and review of the literature
Authors: Ng Wee Hsuan , Chan Wai Seng , Poh Eugene Hze-Khoong , Petersson Fredrik
Published: June 2019

The superficial temporal artery (STA) is a structure that is particularly vulnerable to injury, given its prominent location in the head and neck region. Pseudoaneurysms of this artery may be encountered during the management of maxillofacial trauma. This article presents a review of the relevant literature on this topic. One of the common surgical interventions includes ligation of the entire feeding artery, which compromises the corresponding blood supply. Preservation of the main trunk of the STA can be achieved in certain cases; one such case is detailed in this report.
Efficiency of immunomodulatory therapy in the complex treatment of patients with combined craniofacial injuries
Authors: Ibragimov D. D. , Boymuradov Shuhrat A.
Published: June 2019

Background: Our aim is to study the effectiveness of immunomodulatory therapy with Polyoxidonium in the complex treatment of patients with combined craniofacial injuries.

Methods: In accordance with the intended purpose of this study, we conducted a comprehensive immunological examination of patients with combined craniofacial injuries in the dynamics of treatment with the drug authorized for use in healthcare practice: Polyoxidonium. In total 22 patients with combined craniofacial injuries in the complex therapy received Polyoxidonium at a dosage level of 6[Formula: see text]mg/m once for 5 days.

Results: We conducted a comprehensive immunological study of the clinical course of the post-traumatic period in patients with combined craniofacial injuries which showed that the immunomodulatory therapy with Polyoxidonium during the complex treatment has a high clinical and immunological efficacy.

Conclusions: Thus, in patients with combined craniofacial injuries, there is an immunodeficiency state involving both cellular immunity, manifested by a decrease in the level of T-lymphocytes, T-helpers, NK-cells and B-lymphocytes, and decrease of immunoglobulin production. The use of Polyoxidonium immunomodulator in complex therapy in patients with combined craniofacial injuries helped in improving the condition of patients in a shorter period of time and in preventing the development of purulent-inflammatory complications due to the positive dynamics of cellular and humoral immunity.
Rich Visual and Language Representation with Complementary Semantics for Video Captioning
Authors: Tang Pengjie , Wang Hanli , Li Qinyu
Published: June 2019

It is interesting and challenging to translate a video to natural description sentences based on the video content. In this work, an advanced framework is built to generate sentences with coherence and rich semantic expressions for video captioning. A long short term memory (LSTM) network with an improved factored way is first developed, which takes the inspiration of LSTM with a conventional factored way and a common practice to feed multi-modal features into LSTM at the first time step for visual description. Then, the incorporation of the LSTM network with the proposed improved factored way and un-factored way is exploited, and a voting strategy is utilized to predict candidate words. In addition, for robust and abstract visual and language representation, residuals are employed to enhance the gradient signals that are learned from the residual network (ResNet), and a deeper LSTM network is constructed. Furthermore, three convolutional neural network based features extracted from GoogLeNet, ResNet101, and ResNet152, are fused to catch more comprehensive and complementary visual information. Experiments are conducted on two benchmark datasets, including MSVD and MSR-VTT2016, and competitive performances are obtained by the proposed techniques as compared to other state-of-the-art methods.
From Selective Deep Convolutional Features to Compact Binary Representations for Image Retrieval
Authors: Do Thanh-Toan , Hoang Tuan , Tan Dang-Khoa Le , Le Huu , Nguyen Tam V. , Cheung Ngai-Man
Published: June 2019

In the large-scale image retrieval task, the two most important requirements are the discriminability of image representations and the efficiency in computation and storage of representations. Regarding the former requirement, Convolutional Neural Network is proven to be a very powerful tool to extract highly discriminative local descriptors for effective image search. Additionally, to further improve the discriminative power of the descriptors, recent works adopt fine-tuned strategies. In this article, taking a different approach, we propose a novel, computationally efficient, and competitive framework. Specifically, we first propose various strategies to compute masks, namely,

SIFT-masks

,

SUM-mask

, and

MAX-mask

, to select a representative subset of local convolutional features and eliminate redundant features. Our in-depth analyses demonstrate that proposed masking schemes are effective to address the burstiness drawback and improve retrieval accuracy. Second, we propose to employ recent embedding and aggregating methods that can significantly boost the feature discriminability. Regarding the computation and storage efficiency, we include a hashing module to produce very compact binary image representations. Extensive experiments on six image retrieval benchmarks demonstrate that our proposed framework achieves the state-of-the-art retrieval performances.
Paracellular transport of phosphate along the intestine
Authors: Knöpfel Thomas , Himmerkus Nina , Günzel Dorothee , Bleich Markus , Hernando Nati , Wagner Carsten A.
Published: June 2019

Inorganic phosphate (Pi) is crucial for many biological functions, such as energy metabolism, signal transduction, and pH buffering. Efficient systems must exist to ensure sufficient supply for the body of Pifrom diet. Previous experiments in humans and rodents suggest that two pathways for the absorption of Piexist, an active transcellular Pitransport and a second paracellular pathway. Whereas the identity, role, and regulation of active Pitransport have been extensively studied, much less is known about the properties of the paracellular pathway. In Ussing chamber experiments, we characterized paracellular intestinal Pipermeabilities and fluxes. Dilution potential measurements in intestinal cell culture models demonstrated that the tight junction is permeable to Pi, with monovalent Pihaving a higher permeability than divalent Pi. These findings were confirmed in rat and mouse intestinal segments by use of Ussing chambers and a combination of dilution potential measurements and fluxes of radiolabeled32Pi. Both techniques yielded very similar results, showing that paracellular Pifluxes were bidirectional and that Pipermeability was ~50% of the permeability for Na+or Cl−. Pifluxes were a function of the concentration gradient and Pispecies (mono- vs. divalent Pi). In mice lacking the active transcellular Pitransport component sodium-dependent Pitransporter NaPi-IIb, the paracellular pathway was not upregulated. In summary, the small and large intestines have a very high paracellular Pipermeability, which may favor monovalent Pifluxes and allow efficient uptake of Pieven in the absence of active transcellular Piuptake.

NEW & NOTEWORTHY The paracellular permeability for phosphate is high along the entire axis of the small and large intestine. There is a slight preference for monovalent phosphate. Paracellular phosphate fluxes do not increase when transcellular phosphate transport is genetically abolished. Paracellular phosphate transport may be an important target for therapies aiming to reduce intestinal phosphate absorption.
Loss of acid-sensing ion channel 2 enhances pulmonary vascular resistance and hypoxic pulmonary hypertension
Authors: Detweiler Neil D. , Herbert Lindsay M. , Garcia Selina M. , Yan Simin , Vigil Kenneth G. , Sheak Joshua R. , Resta Thomas C. , Walker Benjimen R. , Jernigan Nikki L.
Published: June 2019

Acid-sensing ion channels (ASICs) are voltage-insensitive cation channels that contribute to cellular excitability. We previously reported that ASIC1 in pulmonary artery smooth muscle cells (PASMC) contribute to pulmonary vasoreactivity and vascular remodeling during the development of chronic hypoxia (CH)-induced pulmonary hypertension. However, the roles of ASIC2 and ASIC3 in regulation of pulmonary vasoreactivity and the development of CH-induced pulmonary hypertension are unknown. We tested the hypothesis that ASIC2 and ASIC3 contribute to increased pulmonary vasoreactivity and development of CH-induced pulmonary hypertension using ASIC2- and ASIC3-knockout (−/−) mice. In contrast to this hypothesis, we found that ASIC2−/−mice exhibit enhanced CH-induced pulmonary hypertension compared with WT and ASIC3−/−mice. This response was not associated with a change in ventilatory sensitivity or systemic cardiovascular function but was instead associated with direct changes in pulmonary vascular reactivity and pulmonary arterial morphology in ASIC2−/−mice. This increase in reactivity correlated with enhanced pulmonary arterial basal tone, elevated basal PASMC [Ca2+] and store-operated calcium entry (SOCE) in PASMC from ASIC2−/−mice. This increase in PASMC [Ca2+] and vasoreactivity was dependent on ASIC1-mediated Ca2+influx but was not contingent upon an increase in ASIC1 mRNA or protein expression in PASMC from ASIC2−/−mice. Together, the results from this study demonstrate an important role for ASIC2 to regulate pulmonary vascular reactivity and for ASIC2 to modulate the development of CH-induced pulmonary hypertension. These data further suggest that loss of ASIC2 enhances the contribution of ASIC1 to overall pulmonary vascular reactivity.

NEW & NOTEWORTHY This study demonstrates that loss of ASIC2 leads to increased baseline pulmonary vascular resistance, enhanced responses to a variety of vasoconstrictor stimuli, and greater development of hypoxic pulmonary hypertension. Furthermore, these results suggest that loss of ASIC2 enhances the contribution of ASIC1 to pulmonary vascular reactivity.
Mixed Cryoglobulinemia in a Patient with Juvenile Idiopathic Arthritis
Authors: Bnatig Fahad , Raddaoui Leen , Hijji Talal , El Kibbi Lina
Published: June 2019

Cryoglobulinemia is a rare illness of cryoglobulin accumulation in the blood which can typically present with arthralgia, purpura, skin ulcers, glomerulonephritis, and peripheral neuropathy. It is classified as mixed cryoglobulinemia when cryoglobulins contain more than one immune component such as IgM rheumatoid factor and polyclonal IgG. Typically, it presents in the setting of clonal hematologic disease, viral infection, or certain connective tissue diseases. Herein, we report the case of a 24-year-old man diagnosed and treated as mixed cryoglobulinemia in the setting of juvenile idiopathic arthritis (JIA). Investigations for viral etiologies, including HBV, HCV, and HIV, and all serologic tests were negative. Additionally serum protein and urine protein electrophoresis did not reveal monoclonal gammopathy; however, testing for plasma cryoglobulins was positive, and qualitative analysis revealed a faint polyclonal pattern. Thus, he was diagnosed with cryoglobulinemia in the setting of JIA, which has not been reported in the literature before. He dramatically improved upon initiation of rituximab and methotrexate.
Comparisons of Therapeutic Efficacy and Safety of Solifenacin versus Tolterodine in Patients with Overactive Bladder: A Meta-Analysis
Authors: Wang Hai-Tao , Xia Ming
Published: June 2019

Objectives: This meta-analysis was to assess solifenacin and tolterodine in patients with overactive bladder. Methods: We searched PubMed, the Cochrane Library, EMBASE, CNKI, Wanfang, and ClinicalTrials.gov databases for randomized controlled trials (RCTs). The efficacy endpoint was daily micturition frequency, daily urgency episodes, daily incontinence episodes, and micturition volume per voiding. The safety endpoint was the incidence of the rate of major bleeding, intracranial bleeding, and gastrointestinal bleeding. Results:Seven RCTs met the inclusion criteria and 1,318 patients were included. The meta-analysis showed that, compared with tolterodine, solifenacin was associated with similar daily micturition frequency, daily urgency episodes, daily incontinence episode, and micturition volume per voiding at 8 and 12 weeks of follow-up. Moreover, no significant difference was obtained in the incidence of dry mouth between solifenacin and tolterodine at 8 and 12 weeks of follow-up. However, tolterodine decreased the constipation rate at 12 weeks compared with solifenacin. Conclusion: Solifenacin and tolterodine yielded similar results on daily micturition frequency, daily urgency episodes, daily incontinence episodes, micturition volume per voiding, and the incidence of dry mouth. However, tolterodine can decrease the constipation rate at 12 weeks compared with solifenacin.
Frontiers in Clinical Practice of Long-Term Care of Chronic Ventilatory Failure
Authors: Schwarz Esther I. , Bloch Konrad E.
Published: June 2019

Home mechanical ventilation (HMV) is an effective long-term treatment for chronic hypercapnic respiratory failure. In addition to the established practice of providing HMV for the treatment of chronic ventilatory failure in slowly progressive neuromuscular and chest wall disease, there is accumulating evidence for improvement of quality of life and prolongation of survival by HMV in highly prevalent diseases like chronic obstructive pulmonary disease and ever-increasing obesity hypoventilation syndrome as well as rapidly progressive neuromuscular disease. The key concepts for successful HMV are an experienced team selecting the right patients, timely initiation of adequate ventilation via an appropriate interface, and monitoring effectiveness during regular long-term follow-up. Coaching of patients with chronic respiratory failure on long-term HMV within a dedicated service and collaborations with community services for home care are essential. The current review describes various important practical aspects of HMV that remain frontiers in the implementation of the current knowledge in clinical practice and may help in providing effective HMV to all those in need.
Age-Dependent Calcium-Binding Protein Expression in the Spiral Ganglion and Hearing Performance of C57BL/6J and 129/SvJ Mice
Authors: Fischer Natalie , Johnson Chacko Lejo , Majerus Alexandra , Potrusil Thomas , Riechelmann Herbert , Schmutzhard Joachim , Schrott-Fischer Anneliese , Glueckert Rudolf
Published: June 2019

Background/Aims: Calcium-binding proteins in neurons buffer intracellular free Ca2+ ions, which interact with proteins controlling enzymatic and ion channel activity. The heterogeneous distribution of calretinin, calbindin, and parvalbumin influences calcium homeostasis, and calcium-related neuronal processes play an important role in neuronal aging and degeneration. This study evaluated age-related changes in calretinin, calbindin, and parvalbumin immune reactivity in spiral ganglion cells. Methods: A total of 16 C57BL/6J and 16 129/SvJ mice at different ages (2, 4, 7, and 12 months) were included in the study. Hearing thresholds were assessed using auditory brainstem response before inner ears were excised for further evaluation. Semiquantitative immunohistochemistry for the aforementioned calcium-binding proteins was performed at the cellular level. Results: The hearing thresholds of C57BL/6J and 129/SvJ mice increased significantly by 7 months of age. The average immune reactivity of calbin­din as well as the relative number of positive cells increased significantly with aging, but no significant alterations in calretinin or parvalbumin were observed. Conclusions: Upregulation of calbindin could serve as a protection to compensate for functional deficits that occur with aging. Expression of both calretinin and parvalbumin seem to be stabilizing factors in murine inner ears up to the age of 12 months in C57BL/6J and 129/SvJ mice.
Functional and Anatomical Testing in Intermediate Risk Chest Pain Patients with a High Coronary Calcium Score: Rationale and Design of the FACC Study
Authors: Øvrehus Kristian A. , Veien Karsten T. , Lambrechtsen Jess , Rohold Allan , Steffensen Flemming H. , Gerke Oke , Jensen Lisette O. , Mickley Hans
Published: June 2019

Current guidelines do not recommend coronary computed tomography angiography (CCTA) in patients with high levels of coronary calcium, as severe calcification leads to difficulties in estimating stenosis severity due to blooming artifacts obscuring the vessel lumen. Whether the CCTA-derived fractional flow reserve (FFRCT) improves the diagnostic performance of CCTA in patients with high levels of coronary calcification has not been sufficiently evaluated. We hypothesize that a noninvasive diagnostic strategy using FFRCT will perform comparably to an invasive diagnostic strategy in the detection of hemodynamically significant coronary artery disease (CAD) in clinical stable chest pain patients with high levels of coronary calcium. In this prospective, blinded, multicenter study, patients with suspected stable CAD referred for CCTA and demonstrating an Agatston score >399 will be included. Patients accepting inclusion will, in addition to CCTA, undergo invasive coronary angiography (ICA) and invasive FFR measurement. FFRCT analyses are performed by an external core laboratory blinded to any patient data, and the FFRCT results are blinded to all participating study sites. The primary objective is to evaluate whether FFRCT can identify patients with and without hemodynamically significant CAD, when ICA with FFR is the reference standard. A negative study result would question the clinical usefulness of FFRCT in patients with high levels of coronary calcium. A positive study result, however, would imply a reduction in the number of patients referred for coronary catheterization and, at the same time, increase the proportion of patients with hemodynamically significant CAD at the subsequent invasive examination.
Shared Decision-Making for Patients with Advanced Urological Malignancies: Evaluation of a Joint Urological-Oncological Clinic Model
Authors: Betschart Patrick , Babst Christa , Schmid Sabine , Rothermundt Christian , Abt Dominik , Schwab Christoph , Gillessen Silke , Engeler Daniel Stephan , Klingbiel Dirk , Schmid Hans-Peter , Omlin Aurelius
Published: June 2019

Background: To provide rapid evaluation of patients with advanced urological malignancies, a joint urological-oncological clinic was initiated at our institution in January 2015. We present the first 3-year evaluation of this joint urological-oncological clinic in Switzerland. Method: We performed a retrospective analysis of the characteristics and treatment of all patients reviewed at the joint clinic between January 2015 and December 2017. Statistical analysis was performed by survival analysis. A patient satisfaction questionnaire was handed out to new patients (from April to September 2017). Results: A total of 135 new patients were counseled in the joint clinic and 563 consultations were performed in the period from January 2015 to December 2017. The majority were men with prostate cancer (85%), followed by bladder cancer (9%), and renal cell carcinoma (4%). Men with newly diagnosed metastatic prostate cancer (n = 69) received ADT alone (57%), ADT with docetaxel or abiraterone (33%), and metastasis-directed therapy (10%). High rates of patient satisfaction were reported based on the questionnaire. Conclusions: The joint clinic model has been successfully implemented at our institution and continues on a weekly basis. The clinic is increasingly used, not only for newly diagnosed metastatic prostate cancer, but also for other complex uro-oncological cases. The clinic allows optimized oncological treatment without delay and with a reduced effort for patients.
Intraoperative Arterial Biopsy in Incident Hemodialysis Patients: Differences Observed
Authors: Fayed Ahmed , Soliman Ahmed , El Mahdy Hossam , Hamza Wael , Abdulazim Dina O. , Salem Mona M. , Sharaf El Din Usama A. ,   on behalf of the Vascular Calcification Group (VCG)
Published: June 2019

Introduction: Arterial calcification (AC) is a common complication in chronic kidney disease (CKD) patients that starts to develop before these patients need renal replacement therapy. In these patients, calcification can involve tunica intima or tunica media. This study has looked for the prevalence, severity, and distribution of arterial wall calcification in incident hemodialysis patients through intraoperative arterial biopsy obtained during creation of arteriovenous vascular access for hemodialysis. Methodology: One hundred and seventy-two stage 5 CKD adults (98 male and 74 female) were included. Beside histopathology of the obtained arterial samples, all these cases were tested for serum calcium (Ca), phosphorus (P), alkaline phosphatase, uric acid, parathormone (PTH), fibroblast growth factor 23 (FGF23), and 25 hydroxy vitamin D. Results: Eighty six (50%) of the cases had AC (group I); 29 (17%) as intimal (subgroup Ii), 36 (21%) as medial (subgroup Im), while 21 (12%) had both intimal and medial calcification (subgroup Iim). Eighty-six patients (50%) were devoid of calcification (group II). Apart from the significantly higher serum level of PTH in group I, statistical analysis failed to disclose significant difference in any of the other studied parameters between the 2 groups. On the other hand, there were significant differences in serum P, Ca × P product, serum PTH, and FGF23 between patients according to intensity of calcification. Conclusion: Half of incident hemodialysis CKD patients have developed AC mainly in tunica media. Discrepancy in serum P can have an impact on calcification intensity.
B-Mode Ultrasonography versus Contrast-Enhanced Ultrasonography for Surveillance of Hepatocellular Carcinoma: A Prospective Multicenter Randomized Controlled Trial
Authors: Kudo Masatoshi , Ueshima Kazuomi , Osaki Yukio , Hirooka Masashi , Imai Yasuharu , Aso Kazunobu , Numata Kazushi , Kitano Masayuki , Kumada Takashi , Izumi Namiki , Sumino Yasukiyo , Ogawa Chikara , Akazawa Kohei ,   for the SELECTED Study Group, Japan
Published: June 2019

Background: Current practice guidelines recommend the use of ultrasound (US) as an initial surveillance tool for hepatocellular carcinoma (HCC) in patients with liver cirrhosis. Patients with liver cirrhosis, however, frequently have coarse liver parenchyma, masking the presence of tiny nodules during B-mode US. Contrast-enhanced US (CEUS) with Sonazoid has a long-lasting, stable Kupffer phase, which makes it possible to scan the entire liver to depict small lesions. In addition, defect reperfusion imaging (reinjection imaging) enables to determine whether the detected nodule is HCC or not. This prospective, multicenter, randomized, controlled trial was conducted to demonstrate the usefulness of Kupffer phase surveillance in the detection of small HCC compared to B-mode US. Methods: A total of 23 institutions joined this study. In total, 656 patients with hepatitis B- or C-related liver cirrhosis were randomized either to the B-mode US surveillance group (n = 313) or the Kupffer phase CEUS with Sonazoid surveillance group (n = 309). The primary endpoint was the maximum size of HCC at the time of the first detection. Secondary endpoints included time to HCC detection, number of tumors, and Barcelona Clinic Liver Cancer stage at the first detection, and sensitivity, specificity, and accuracy of each method in the diagnosis, and the cumulative detection rate of HCC. Results: The mean HCC size at the first detection was significantly smaller in the CEUS (13.0 ± 4.1 mm; n = 28) than in the B-mode US group (16.7 ± 4.1 mm; n = 26) (p = 0.011). Of the 38 patients with HCV cirrhosis diagnosed with HCC by US alone, mean tumor size at the first detection was significantly smaller in the 20 patients diagnosed by CEUS alone than in the 18 diagnosed by B-mode US alone (12.7 ± 3.1 vs. 17.6 ± 7.0 mm, p = 0.012). In contrast, among the 16 patients with HBV cirrhosis diagnosed by US alone, mean tumor size at the first detection was similar in the 8 patients diagnosed by CEUS alone and the 8 diagnosed by B-mode US (13.6 ± 6.0 vs. 14.5 ± 2.7 mm, p = 0.715). Conclusion: Kupffer phase CEUS surveillance with Sonazoid is extremely useful for the early detection and confirmation of HCC using a reinjection technique. Kupffer phase CEUS with Sonazoid contrast combined with the reinjection technique is, therefore, recommended as first-line screening tool for HCC in patients with liver cirrhosis, especially those with very coarse liver parenchyma.
Prognostic Impact of Atrial Fibrillation in Acute Myocardial Infarction and Cardiogenic Shock
Authors: Feistritzer Hans-Josef , Desch Steffen , Zeymer Uwe , Fuernau Georg , de Waha-Thiele Suzanne , Dudek Dariusz , Huber Kurt , Stepinska Janina , Schneider Steffen , Ouarrak Taoufik , Thiele Holger
Published: June 2019

Background:

It is unclear whether atrial fibrillation (AF) influences prognosis in patients with cardiogenic shock and multivessel disease. We aimed to investigate the prognostic impact of AF in patients with cardiogenic shock complicating acute myocardial infarction.

Methods and Results:

In a subanalysis of the CULPRIT-SHOCK trial (Culprit Lesion Only PCI versus Multivessel PCI in Cardiogenic Shock), patients were grouped according to the presence of AF during index hospital stay. The primary end point was all-cause death at 30 days, and the key secondary end point was all-cause death at 1 year. AF was documented in 142 (21%) of 686 patients. AF was not a significant predictor of 30-day (adjusted odds ratio, 1.01; 95% CI 0.67–1.54;
P
=0.95) and 1-year (adjusted odds ratio, 0.80; 95% CI, 0.52–1.22;
P
=0.30) all-cause mortality. Patients with AF already on admission showed higher all-cause mortality at 30 days (52 of 90, 58% versus 19 of 52, 37%;
P
=0.02) and 1 year (57 of 90, 63% versus 20 of 52, 39%;
P
=0.004) compared with patients with newly detected AF during hospital stay. AF was associated with a longer time to hemodynamic stabilization (4, interquartile range, 1–8 days versus 3, interquartile range, 1–6 days;
P
=0.04) at 30 days.

Conclusions:

In cardiogenic shock complicating acute myocardial infarction, all-cause mortality is similar in patients with and without AF. Adverse outcome was detected in the subgroup of patients showing AF already on hospital admission.

Clinical Trial Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01927549.
Farmalarm
Authors: Requena Manuel , Montiel Estefanía , Baladas María , Muchada Marian , Boned Sandra , López Rosa , Rodríguez-Villatoro Noelia , Juega Jesús , García-Tornel Álvaro , Rodríguez-Luna David , Pagola Jorge , Rubiera Marta , Molina Carlos A. , Ribo Marc
Published: June 2019

Background and Purpose—

Risk factor control and treatment compliance in the following months after stroke are poor. We aim to validate a digital platform for smartphones to raise awareness among patients about the need to adopt healthy lifestyle, improve communication with medical staff, and treatment compliance.

Methods—

Farmalarm is an application (app) for smartphones designed to increase stroke awareness by medication alerts and compliance control, chat communication with medical staff, didactic video files, exercise monitoring. Patients with stroke discharged home were screened for participation and divided into groups: to follow the FARMALARM program for 3 to 4 weeks or standard of care follow-up. We determined achievement of risk factor control goals at 90 days.

Results—

From August 2015 to December 2016, from the 457 patients discharged home, 159 (34.8%) were included: Farmalarm (n=107); age 57±12, Control (n=52), age 59±10; without significant differences in baseline characteristics between groups. At 90 days, knowledge of vascular risk factors was higher in FARMALARM group (86.0% versus 69.2%,
P
<0.01). The rate of patients with diabetes mellitus (83.2% versus 63.5%,
P
<0.01) and hypercholesterolemia (80.3% versus 63.5%,
P
=0.03) under control and the rate of patients with 4 out of 4 risk factors under control was higher in FARMALARM group (50.4% versus 30.7%,
P
=0.02). A regression model showed that the use of Farmalarm was independently associated with all risk factors under control at 90 days (odds ratio, 2.3; 95% CI, 1.14–4.6;
P
=0.02).

Conclusions—

In patients with stroke discharged home, the use of mobile apps to monitor medication compliance and increase stroke awareness is feasible and seems to improve the control of vascular risk factors.
Sex Differences in Management and Outcomes of Acute Ischemic Stroke With Large Vessel Occlusion
Authors: Uchida Kazutaka , Yoshimura Shinichi , Sakai Nobuyuki , Yamagami Hiroshi , Morimoto Takeshi ,   RESCUE-Japan Registry 2 Investigators
Published: June 2019

Background and Purpose—

Sex differences in the management and outcomes of acute ischemic stroke with large vessel occlusion are unknown in the era of endovascular therapy (EVT). This study investigated these differences in the RESCUE (Recovery by Endovascular Salvage for Cerebral Ultra-Acute Embolism)-Japan Registry 2 patient database.

Methods—

RESCUE-Japan Registry 2 registered patients with large vessel occlusion who were admitted within 24 hours of onset were enrolled in this study. We estimated the likelihood to receive EVT according to sex. The primary outcome was good outcome defined as a modified Rankin Scale score of 0 to 2 at 90 days after onset. Secondary outcomes were mortality within 90 days, any or symptomatic intracranial hemorrhage within 72 hours, and recurrence of stroke or transient ischemic attack within 90 days.

Results—

Among 2399 patients, 1087 patients were female and 1312 were male; 47.9% of females and 57.7% of males received EVT (adjusted odds ratio, 0.71; 95% CI, 0.59–0.86). Good outcome was observed in 27.3% and 44.2% of the females and males, respectively (
P<
0.0001). The adjusted odds ratio of a good outcome in females was 0.80 (95% CI, 0.65–0.99). Mortality was 12.3% and 9.9% in females and males, respectively (
P
=0.06); the adjusted odds ratio was 0.78 (95% CI, 0.58–1.05).

Conclusions—

Females with acute ischemic stroke with large vessel occlusion showed poor functional outcome compared to males. Females were less likely to receive EVT; lower utilization of EVT accounted for a portion of the poor outcome.