bluuebunny/crossref_metadata_2025 huggingface dataset:
An educational tool for the prophylaxis of hepatic encephalopathy
Authors: Garrido Maria , Turco Matteo , Formentin Chiara , Corrias Michela , De Rui Michele , Montagnese Sara , Amodio Piero
Published: September 2017

Background

Providing structured information for the understanding of hepatic encephalopathy (HE) might be relevant to the prevention and management of the syndrome. The aim of our study was to design a brief, structured educational intervention and evaluate its usefulness in preventing HE-related hospitalisation over time.

Methods

Thirty-nine cirrhotic outpatients with a history of HE were enrolled and randomly assigned to an intervention (group A; n=20) or control group (group B; n=19). All of them underwent evaluation of HE (clinical and quantitative neuropsychiatric assessment) and completed the Questionnaire on the Awareness of Encephalopathy. A 15 min educational session was then provided to patients in group A, including basic information on the pathophysiology, hygienic and medical management of HE.

Results

No demographic/clinical differences were observed at baseline between the two groups. Similarly, there were no significant differences in HE-related information available at baseline between the two groups; knowledge of HE was limited in both. The intervention was highly effective in increasing patients’ understanding of treatment of the condition (from 5% to 80%). The educational intervention also reduced the risk of developing an episode of HE over a period of 12 months.

Conclusion

The educational intervention confirmed the poor knowledge of patients with previous HE about their condition, served as a tool to increase patients’ awareness, and minimised HE-related readmission rates over a period of 1 year.
Trauma resource designation: an innovative approach to improving trauma system overtriage
Authors: Tominaga Gail T , Dandan Imad S , Schaffer Kathryn B , Nasrallah Fady , Gawlik R N Melanie , Kraus Jess F
Published: September 2017

Background

Effective triage of injured patients is often a balancing act for trauma systems. As healthcare reimbursements continue to decline,1innovative programs to effectively use hospital resources are essential in maintaining a viable trauma system. The objective of this pilot intervention was to evaluate a new triage model using ‘trauma resource’ (TR) as a new category in our existing Tiered Trauma Team Activation (TA) approach with hopes of decreasing charges without adversely affecting patient outcome.

Methods

Patients at one Level II Trauma Center (TC) over seven months were studied. Patients not meeting American College of Surgeons criteria for TA were assigned as TR and transported to a designated TC for expedited emergency department (ED) evaluation. Such patients were immediately assessed by a trauma nurse, ED nurse, and board-certified ED physician. Diagnostic studies were ordered, and the trauma surgeon (TS) was consulted as needed. Demographics, injury mechanism, time to physician evaluation, time to CT scan, time to disposition, hospital length of stay (LOS), and in-hospital mortality were analyzed.

Results

Fifty-two of the 318 TR patients were admitted by the TS and were similar to TA patients (N=684) with regard to gender, mean Injury Severity Score, mean LOS and in-hospital mortality, but were older (60.4 vs 47.2 years, p<0.0001) and often involved in a fall injury (52% vs 35%, p=0.0170). TR patients had increased door to physician evaluation times (11.5 vs 0.4 minutes, p<0.0001) and increased door to CT times (76.2 vs 25.9 minutes, p<0.0001). Of the 313 TR patients, 52 incurred charges totaling US$253 708 compared with US$1 041 612 if patients had been classified as TA.

Conclusions

Designating patients as TR prehospital with expedited evaluation by an ED physician and early TS consultation resulted in reduced use of resources and lower hospital charges without increase in LOS, time to disposition or in-hospital mortality.

Level of evidence

Level II
Case report and literature review of the outcome following reimplantation of the arm
Authors: Fletcher Cary
Published: September 2017

The following case report and literature review will detail the management of a traumatic amputation of the arm in a 12-year-old boy. Compared with lower limbs, upper limb prosthesis usually results in significant suboptimal function by any measure. While the literature lacks high-quality evidence with regard to functional outcomes following proximal amputations of the upper limb, especially in children, it is known that children generally have superior functional outcomes compared with their adult counterparts. The mechanism of injury, transportation of the amputated part, type of ischemia, timing of surgery, surgical techniques/factors and postoperative rehabilitation will be discussed as factors affecting outcome of reimplantation.

Level of evidence: V
Slow imbibition of Annona emarginata (Annonaceae) seeds: metabolic and ultrastructural evaluations
Authors: Gimenez Juliana Iassia , Esteves Amaro Amanda Cristina , Machado Silvia Rodrigues , Ferreira Gisela
Published: September 2017

Germination pattern may be affected when seeds are dispersed under flooded conditions or subjected to pre-germination treatments such as immersion in plant growth regulators and priming. We evaluated the metabolic and ultrastructural changes in the seeds of Annona emarginata (Schltdl.) H. Rainer seeds caused by immersion in water (0 MPa) during the imbibition phase (phase I). The immersion time necessary for initially dry seeds (10% water content) to reach a water content of 15%, 20%, and 35% was recorded. The seeds were also immersed in a polyethylene glycol 6000 solution (–1.2 MPa) to decrease the rate of water uptake and increase the immersion times required for the seeds to reach the selected water contents. With shorter immersion times, seed damage did not decrease germinability. Seeds immersed for 122 h sustained damage to the cell membrane system and organelles, resulting in a decreased percentage and rate of germination. Decreasing the rate of water uptake increased the time required to finish imbibition phase to 317 h and resulted in more ultrastructural damages and a decreased germination index. We conclude that in seeds with slower imbibition, longer immersion times may cause severe metabolic damage if the seeds are immersed until the end of the imbibition phase, resulting in reduced germination.
Temporal Coherence Transitions Induced by Channel Noise in Scale-Free Neuronal Networks with Time Delay
Authors: Xie Huijuan , Gong Yubing
Published: September 2017

In this paper, we study the effect of channel noise on the temporal coherence of scale-free Hodgkin–Huxley neuronal networks with time delay. It is found that the temporal coherence of the neuronal networks changes as channel noise intensity is varied in different ways depending on the range of channel noise intensity. The temporal coherence monotonically decreases with the increase of channel noise intensity for too small or too big channel noise intensity. However, for intermediate channel noise intensity it intermittently and rapidly becomes high and low as channel noise intensity is varied, exhibiting temporal coherence transitions. Moreover, this phenomenon is dependent on coupling strength and network average degree and becomes strongest when they are optimal. This result shows that channel noise has a regulation effect on the temporal coherence of the delayed neuronal networks by inducing temporal coherence transitions. This provides a new insight into channel noise for the information processing and transmission in neural systems.
MPTM: A tool for mining protein post-translational modifications from literature
Authors: Sun Dongdong , Wang Minghui , Li Ao
Published: September 2017

Due to the importance of post-translational modifications (PTMs) in human health and diseases, PTMs are regularly reported in the biomedical literature. However, the continuing and rapid pace of expansion of this literature brings a huge challenge for researchers and database curators. Therefore, there is a pressing need to aid them in identifying relevant PTM information more efficiently by using a text mining system. So far, only a few web servers are available for mining information of a very limited number of PTMs, which are based on simple pattern matching or pre-defined rules. In our work, in order to help researchers and database curators easily find and retrieve PTM information from available text, we have developed a text mining tool called MPTM, which extracts and organizes valuable knowledge about 11 common PTMs from abstracts in PubMed by using relations extracted from dependency parse trees and a heuristic algorithm. It is the first web server that provides literature mining service for hydroxylation, myristoylation and GPI-anchor. The tool is also used to find new publications on PTMs from PubMed and uncovers potential PTM information by large-scale text analysis. MPTM analyzes text sentences to identify protein names including substrates and protein-interacting enzymes, and automatically associates them with the UniProtKB protein entry. To facilitate further investigation, it also retrieves PTM-related information, such as human diseases, Gene Ontology terms and organisms from the input text and related databases. In addition, an online database (MPTMDB) with extracted PTM information and a local MPTM Lite package are provided on the MPTM website. MPTM is freely available online at http://bioinformatics.ustc.edu.cn/mptm/ and the source codes are hosted on GitHub: https://github.com/USTC-HILAB/MPTM .
Exploring Antecedent Difference between Early and Late Adopters of Disruptive Innovation in E-business Microcredit Context: Evidence from China
Authors: Zhang Wenyao , Zhang Qingpu
Published: September 2017

This paper aims to explore the antecedents affecting adoption intention and behavior independently of early and late adopters of disruptive innovation (DI) in e-business microcredit context in China. The authors make an integrative overview of consumer innovation adoption relevant literature and DI theory, combined with features in e-business microcredit context, to develop a conceptual framework based on seven antecedents. A qualitative approach incorporating focus group interviews and semi-structured interviews was utilized. Findings suggest that adoption intention increases with perceived benefits or innovativeness or knowledge, thus easily becoming early adopters, and vice versa; adoption behavior is hindered with increased perceived risks, thus easily becoming late adopters, and vice versa; mass media has an impact for early adopters, herd behavior and word of mouth for late adopters but no effect for early adopters; perceived compatibility and perceived complexity have no incentives for early or late adopters. This study makes theoretical contribution to DI theory development with regard to its market diffusion and adoption from the demandside perspective, and also provides practical implications for e-business microcredit service and other internet-based financial product adoptions.
On the existence of equivalent Dirichlet polynomials whose zeros preserve a topological property
Authors: Dubon Eric , Sepulcre Juan Matías
Published: September 2017

In this paper, we study the distribution of zeros of the ordinary Dirichlet polynomials which are generated by an equivalence relation introduced by Harald Bohr. Through the use of completely multiplicative functions, we construct equivalent Dirichlet polynomials which have the same critical strip, where all their zeros are situated, and satisfy the same topological property consisting of possessing zeros arbitrarily near every vertical line contained in some substrips inside their critical strip. We also show that the real projections of the zeros of the partial sums of the alternating zeta function, for some particular cases, are dense in their critical intervals.
A construction of maximal asymptotic nonbases
Authors: Ling Dengrong
Published: September 2017

Let [Formula: see text] denote the set of all nonnegative integers and [Formula: see text] be a subset of [Formula: see text]. The set [Formula: see text] is called an asymptotic basis of order [Formula: see text] if every sufficiently large integer can be written as the sum of two elements of [Formula: see text]. Otherwise, [Formula: see text] is called an asymptotic nonbasis of order [Formula: see text]. Let [Formula: see text] denote the number of representations of [Formula: see text] in the form [Formula: see text], where [Formula: see text] and [Formula: see text]. An asymptotic nonbasis [Formula: see text] of order [Formula: see text] is called a maximal asymptotic nonbasis of order [Formula: see text] if [Formula: see text] is an asymptotic basis of order [Formula: see text] for every [Formula: see text]. In this paper, a maximal asymptotic nonbasis [Formula: see text] is constructed satisfying [Formula: see text] for all [Formula: see text] and [Formula: see text] as [Formula: see text], where [Formula: see text] is an increasing sequence of [Formula: see text].
Research at VMware
Authors: Tennenhouse David
Published: September 2017

VMware has its roots in the academic research community, starting with the commercialization of the work on x86 virtualization of Prof. Mendel Rosenblum and his team at Stanford University [1]. Developers embraced VMware's original workstation product and the ensuing work on server virtualization led to today's vSphere platform, which has enabled significant server consolidation, numerous operational benefits, and isolation-based security. In addition, the vast improvements in server utilization provide VMware's customers with significant cost savings and is a key contributor to the environmental sustainability of modern data centers [2].

VMware has remained true to its research roots, with a strong engineering culture that emphasizes grassroots innovation through hackathons, incubation projects, open source activities, seminars and RADIO, an annual R&D innovation offsite that brings together a substantial fraction of the company's developers. Just a few examples of current activities are open vSwitch (OVS), the virtualization and exploration of non-volatile memory (NVM), securing and managing the Internet of Things (IoT), and support for Containers.

Over time, there has been a dramatic increase in the scope for innovation at VMware. This paper provides an overview of how that scope has grown and how it has expanded the range of relevant research opportunities along with a description of VMware's recently formed research group, including its mission, composition and significant research thrusts.
Exploring Machine Learning for Thread Characterization on Heterogeneous Multiprocessors
Authors: Li Cha V. , Petrucci Vinicius , Mossé Daniel
Published: September 2017

We introduce a thread characterization method that explores hardware performance counters and machine learning techniques to automate estimating workload execution on heterogeneous processors. We show that our characterization scheme achieves higher accuracy when predicting performance indicators, such as instructions per cycle and last-level cache misses, commonly used to determine the mapping of threads to processor types at runtime. We also show that support vector regression achieves higher accuracy when compared to linear regression, and has very low (1%) overhead. The results presented in this paper can provide a foundation for advanced investigations and interesting new directions in intelligent thread scheduling and power management on multiprocessors.
Editorial message
Authors: Wadler Philip
Published: September 2017

Welcome to the Proceedings of the ACM on Programming Languages (PACMPL)!
Analysis of the Seismic Performance of Site-Bolted Beam to Column Connections in Modularized Prefabricated Steel Structures
Authors: Liu Xuechun , Cui Xiaoxiong , Yang Zhiwei , Zhan Xinxin
Published: September 2017

This paper proposes a site-bolted connection that is suitable for modularized prefabricated steel structures. Excellent ductility is achieved by various structural measures. Six connection specimens with different parameters were subjected to quasi-static loading tests and finite element analysis (FEA) to determine the seismic performance of the proposed connection (e.g., hysteretic behavior, skeleton curve, ductility, and failure mode). The results of the tests and FEA showed that the connection underwent sufficient plastic deformation under cyclic loading and that its ultimate rotation angle could reach 0.09 rad. A clear plastic hinge formed on the beam before the connection failed, which suggests a ductile failure mode. The connection exhibited a wide hysteresis loop, which indicated good seismic performance. The results also showed that the connection does not slip under small earthquakes and could dissipate energy through slippage in the connection region under a moderate earthquake and through slippage in the connection region as well as plastic deformation at the beam end under a severe earthquake. The number of bolts was the main parameter that affected the seismic performance of the connection. The test and FEA results demonstrated that all six specimens had excellent seismic and ductile performance and an exceptional plastic rotation capacity.
Auris System: Providing Vibrotactile Feedback for Hearing Impaired Population
Authors: Alves Araujo Felipe , Lima Brasil Fabricio , Candido Lima Santos Allison , de Sousa Batista Junior Luzenildo , Pereira Fonseca Dutra Savio , Eduardo Coelho Freire Batista Carlos
Published: September 2017

Deafness, an issue that affects millions of people around the globe, is manifested in different intensities and related to many causes. This impairment negatively affects different aspects of the social life of the deaf people, and music-centered situations (concerts, religious events, etc.) are obviously not inviting for them. The Auris System was conceived to provide the musical experimentation for people who have some type of hearing loss. This system is able to extract musical information from audio and create a representation for music pieces using different stimuli, a new media format to be interpreted by other senses than the hearing. In addition, the system defines a testing methodology based on a noninvasive brain activity recording using an electroencephalographic (EEG) device. The results of the tests are being used to better understand the human musical cognition, in order to improve the accuracy of the Auris musical representation.
Data-Driven Iterative Vibration Signal Enhancement Strategy Using Alpha Stable Distribution
Authors: Żak Grzegorz , Wyłomańska Agnieszka , Zimroz Radosław
Published: September 2017

The authors propose a novel procedure for enhancement of the signal to noise ratio in vibration data acquired from machines working in mining industry environment. Proposed method allows performing data-driven reduction of the deterministic, high energy, and low frequency components. Furthermore, it provides a way to enhance signal of interest. Procedure incorporates application of the time-frequency decomposition,α-stable distribution based signal modeling, and stability parameter in the time domain as a stoppage criterion for iterative part of the procedure. An advantage of the proposed algorithm is data-driven, automative detection of the informative frequency band as well as band with high energy due to the properties of the used distribution. Furthermore, there is no need to have knowledge regarding kinematics, speed, and so on. The proposed algorithm is applied towards real data acquired from the belt conveyor pulley drive’s gearbox.
Group 2 Innate Lymphoid Cells Are Involved in Skewed Type 2 Immunity of Gastric Diseases Induced by Helicobacter pylori Infection
Authors: Li Rong , Jiang Xiao-xia , Zhang Lin-fang , Liu Xiao-ming , Hu Ting-zi , Xia Xiu-juan , Li Ming , Xu Can-xia
Published: September 2017

H. pylori induces a complicated local and systematic immune response and contributes to the carcinogenesis of gastric cancer. A primary type 1 immune response is evoked by H. pylori since its occurrence. However, it is not unusual that an inhibitory immunity is dominant in H. pylori-associated diseases, which are promoted by the formation of immunosuppressive microenvironment. But whether group 2 innate lymphoid cells (ILC2s) plays a critical role in H. pylori-induced skewed type 2 immunity is still unclear. In the present study, firstly, we confirmed that type 1 immunity was inhibited and type 2 immunity were undisturbed or promoted after H. pylori infection in vitro and in vivo. Secondly, GATA-3 was firstly found to be increased in the interstitial lymphocytes from H. pylori-associated gastric cancer, among them, Lin−GATA-3+ cells and Lin+GATA-3+ cells were also found to be enhanced, which indicated an important role for ILC2s in H. pylori infection. More importantly, ILC2s were found to be increased after H. pylori infection in clinical patients and animal models. In conclusion, our results indicated that ILC2-mediated innate immune response might play a potential role in dominant type 2 phenotype and immunosuppressive microenvironment in H. pylori infection.
The Predictive Value ofPITX2DNA Methylation for High-Risk Breast Cancer Therapy: Current Guidelines, Medical Needs, and Challenges
Authors: Aubele Michaela , Schmitt Manfred , Napieralski Rudolf , Paepke Stefan , Ettl Johannes , Absmaier Magdalena , Magdolen Viktor , Martens John , Foekens John A. , Wilhelm Olaf G. , Kiechle Marion
Published: September 2017

High-risk breast cancer comprises distinct tumor entities such as triple-negative breast cancer (TNBC) which is characterized by lack of estrogen (ER) and progesterone (PR) and theHER2receptor and breast malignancies which have spread to more than three lymph nodes. For such patients, current (inter)national guidelines recommend anthracycline-based chemotherapy as the standard of care, but not all patients do equally benefit from such a chemotherapy. To further improve therapy decision-making, predictive biomarkers are of high, so far unmet, medical need. In this respect, predictive biomarkers would permit patient selection for a particular kind of chemotherapy and, by this, guide physicians to optimize the treatment plan for each patient individually. Besides DNA mutations, DNA methylation as a patient selection marker has received increasing clinical attention. For instance, significant evidence has accumulated that methylation of thePITX2(paired-like homeodomain transcription factor 2) gene might serve as a novel predictive and prognostic biomarker, for a variety of cancer diseases. This review highlights the current understanding of treatment modalities of high-risk breast cancer patients with a focus on recommended treatment options, with special attention on the future clinical application ofPITX2as a predictive biomarker to personalize breast cancer management.
Vaginoscopy in Ewes Utilizing a Laparoscopic Surgical Port Device
Authors: Easley Jeremiah , Shasa Desiree , Hackett Eileen
Published: September 2017

Vaginoscopy allows for diagnostic evaluation and treatment of the vaginal vault. A laparoscopic surgical port device and rigid telescope were utilized for serial vaginoscopy in 8 healthy anesthetized ewes. Vaginoscopy examinations were performed in each ewe at days 1, 14, and 28. This technique was well-tolerated and facilitated carbon dioxide vaginal inflation, complete vaginal examination, identification of the cervix, and targeted biopsy collection. No complications were encountered during or following the vaginoscopy procedures. The laparoscopic port device was well-suited to the ewe vulvar size. This technique could be applied to clinical evaluation in ewes for the purposes of examination, biopsy, culture, foreign body removal, and minor surgical procedures.
Assessment of Differential Item Functioning in Health-Related Outcomes: A Simulation and Empirical Analysis with Hierarchical Polytomous Data
Authors: Sharafi Zahra , Mousavi Amin , Ayatollahi Seyyed Mohammad Taghi , Jafari Peyman
Published: September 2017

Background. The purpose of this study was to evaluate the effectiveness of two methods of detecting differential item functioning (DIF) in the presence of multilevel data and polytomously scored items. The assessment of DIF with multilevel data (e.g., patients nested within hospitals, hospitals nested within districts) from large-scale assessment programs has received considerable attention but very few studies evaluated the effect of hierarchical structure of data on DIF detection for polytomously scored items. Methods. The ordinal logistic regression (OLR) and hierarchical ordinal logistic regression (HOLR) were utilized to assess DIF in simulated and real multilevel polytomous data. Six factors (DIF magnitude, grouping variable, intraclass correlation coefficient, number of clusters, number of participants per cluster, and item discrimination parameter) with a fully crossed design were considered in the simulation study. Furthermore, data of Pediatric Quality of Life Inventory™ (PedsQL™) 4.0 collected from 576 healthy school children were analyzed. Results. Overall, results indicate that both methods performed equivalently in terms of controlling Type I error and detection power rates. Conclusions. The current study showed negligible difference between OLR and HOLR in detecting DIF with polytomously scored items in a hierarchical structure. Implications and considerations while analyzing real data were also discussed.
SARC006: Phase II Trial of Chemotherapy in Sporadic and Neurofibromatosis Type 1 Associated Chemotherapy-Naive Malignant Peripheral Nerve Sheath Tumors
Authors: Higham Christine S. , Steinberg Seth M. , Dombi Eva , Perry Arie , Helman Lee J. , Schuetze Scott M. , Ludwig Joseph A. , Staddon Arthur , Milhem Mohammed M. , Rushing Daniel , Jones Robin L. , Livingston Michael , Goldman Stewart , Moertel Christopher , Wagner Lars , Janhofer David , Annunziata Christina M. , Reinke Denise , Long Lauren , Viskochil David , Baker Larry , Widemann Brigitte C.
Published: September 2017

Background. Worse chemotherapy response for neurofibromatosis type 1- (NF1-) associated compared to sporadic malignant peripheral nerve sheath tumors (MPNST) has been reported. Methods. We evaluated the objective response (OR) rate of patients with AJCC Stage III/IV chemotherapy-naive NF1 MPNST versus sporadic MPNST after 4 cycles of neoadjuvant chemotherapy, 2 cycles of ifosfamide/doxorubicin, and 2 cycles of ifosfamide/etoposide. A Simon optimal two-stage design was used (target response rate 40%). Results. 34 NF1 (median age 33 years) and 14 sporadic (median age 40 years) MPNST patients enrolled. Five of 28 (17.9%) evaluable NF1 MPNST patients had a partial response (PR), as did 4 of 9 (44.4%) patients with sporadic MPNST. Stable disease (SD) was achieved in 22 NF1 and 4 sporadic MPNST patients. In both strata, results in the initial stages met criteria for expansion of enrollment. Only 1 additional PR was observed in the expanded NF1 stratum. Enrollment was slower than expected and the trial closed before full accrual. Conclusions. This trial was not powered to detect differences in response rates between NF1 and sporadic MPNST. While the OR rate was lower in NF1 compared to sporadic MPNST, qualitative responses were similar, and disease stabilization was achieved in most patients.
Lesion Pattern, Mechanisms, and Long-Term Prognosis in Patients with Monoparetic Stroke: A Comparison with Nonmonoparetic Stroke
Authors: Lee Seung-Jae , Lee Dong-Geun , Moon Hye-Jin , Lee Tae-Kyeong
Published: September 2017

Background. Monoparetic stroke is rare but could be misdiagnosed as peripheral neuropathy. We investigated the prevalence, lesion pattern, stroke mechanism, and long-term prognosis in patients with monoparetic stroke.Methods. 586 acute ischemic stroke patients (including 31 with monoparesis) were studied. Monoparetic stroke was defined as a motor deficit in either an arm or a leg but without facial weakness or speech disturbance. Median follow-up period was 32.0 months. Kaplan-Meier survival curves, log-rank tests, logistic regressions, and Cox proportional hazards models were used for clinical outcome analyses.Results. The mean age (313 men and 273 women) was 67.6 years. Among monoparetic patients, most had cortical (80.6%) and multiple (64.5%) lesions. The main stroke mechanisms were cardioembolism (38.7%) and large artery atherosclerosis (29.0%). Precentral gyrus with additional regions was most frequently involved in monoparesis (45.2%). Upper motor neuron signs were found in only 11 patients (35.5%). Compared with the nonmonoparetic group, these patients had better functional outcomes (6-month modified Rankin scale ≤2) and long-term survival but had comparable risks for further vascular events, including stroke recurrences.Conclusions. Although monoparetic stroke may have a better functional outcome, the risk of the further vascular event seems similar to nonmonoparetic stroke.
Timing of Angiography and Outcomes in High-Risk Patients With Non–ST-Segment–Elevation Myocardial Infarction Managed Invasively
Authors: Deharo Pierre , Ducrocq Gregory , Bode Christoph , Cohen Marc , Cuisset Thomas , Mehta Shamir R. , Pollack Charles , Wiviott Stephen D. , Elbez Yedid , Sabatine Marc S. , Steg Philippe Gabriel
Published: September 2017

Background:

In patients with non–ST-segment–elevation myocardial infarction (NSTEMI) and GRACE (Global Registry of Acute Coronary Events) score >140, coronary angiography (CAG) is recommended by European and American guidelines within 24 hours. We sought to study the association of very early (ie, ≤12 hours), early (12–24 hours), and delayed (>24 hours) CAG in patients with NSTEMI with GRACE score >140 with ischemic outcomes.

Methods:

The TAO trial (Treatment of Acute Coronary Syndrome With Otamixaban) randomized patients with NSTEMI and CAG scheduled within 72 hours to heparin plus eptifibatide versus otamixaban. In this post hoc analysis, patients with a GRACE score >140 were categorized into 3 groups according to timing of CAG from admission (<12, ≥12–<24, and ≥24 hours). The primary ischemic outcome was the composite of all-cause death and myocardial infarction within 180 days of randomization.

Results:

CAG was performed in 4071 patients (<12 hours, n=1648 [40.5%]; 12–24 hours, n=1420 [34.9%]; ≥24 hours, n=1003 [24.6%]). With CAG ≥24 hours as a reference, CAG from 12 to 24 hours was not associated with a lower risk of primary ischemic outcome at 180 days (odds ratio, 0.96; 95% confidence interval, 0.75–1.23), whereas CAG <12 hours was associated with a lower risk of death and myocardial infarction (odds ratio, 0.71; 95% confidence interval, 0.55–0.91). Performing CAG <12 hours was also associated with a lower risk of death and myocardial infarction (odds ratio, 0.76; 95% confidence interval, 0.61–0.94;
P
=0.01) compared with CAG performed at 12 to 24 hours. No difference was observed in bleeding complications.

Conclusions:

In patients with high-risk NSTEMI, undergoing CAG within the initial 12 hours after admission (as opposed to later, either 12–24 or ≥24 hours) was associated with lower risk of ischemic outcomes at 180 days.
Impact of Age and Target-Organ Damage on Prognostic Value of 24-Hour Ambulatory Blood Pressure
Authors: Olesen Thomas B. , Stidsen Jacob V. , Blicher Marie K. , Pareek Manan , Rasmussen Susanne , Vishram-Nielsen Julie K.K. , Olsen Michael H.
Published: September 2017

Markers of target-organ damage and 24-hour ambulatory blood pressure (BP) measurement improve cardiovascular risk stratification. The prevalence of target-organ damage and raised BP increases with aging. The study aim was to evaluate the impact of age and target-organ damage on the prognostic value of ambulatory BP. Markers of target-organ damage and ambulatory BP were measured in 1408 healthy people aged 41 or 51 (middle-aged group), and 61 or 71 (older group) years. The primary outcome was cardiovascular events after 16 years of follow-up, with data obtained from national registries. The prognostic value of BP was evaluated with Cox regression models, adjusted for traditional risk factors and target-organ damage, including left ventricular mass, pulse wave velocity, carotid plaques, and urine albumin/creatinine ratio. A total of 323 events were observed. In comparison with traditional risk factors, adding systolic BP and presence of target-organ damage improved risk stratification by increasing concordance index from 0.711 to 0.728 (
P
=0.01). In middle-aged subjects with target-organ damage, increment in pulse pressure (hazard ratio, 1.70; 95% confidence interval, 1.31–2.21;
P
<0.01) and increment in average real variability (hazard ratio, 1.29; 95% confidence interval, 1.05–1.59;
P
=0.02) were associated with a greater risk of cardiovascular disease compared with subjects without target-organ damage: hazard ratio, 1.04 (95% confidence interval, 0.74–1.46;
P
=0.81);
P
for interaction, 0.02; and hazard ratio, 0.89 (95% confidence interval, 0.69–1.14;
P
=0.36);
P
for interaction, 0.01. Target-organ damage may be a marker of individual susceptibility to the harmful effects of pulse pressure and BP variability on the cardiovascular system in middle-aged individuals.
Discovery and natural history of the mussel leech Batracobdella kasmiana (Oka, 1910) (Hirudinida: Glossiphoniidae) in Russia
Authors: BOLOTOV IVAN N. , VIKHREV ILYA V. , AKSENOVA OLGA V. , BESPALAYA YULIA V. , GOFAROV MIKHAIL Y. , KONDAKOV ALEXANDER V. , SOKOLOVA SVETLANA E.
Published: September 2017

The mussel leech Batracobdella kasmiana (Oka, 1910) (Hirudinida: Glossiphoniidae) inhabits the mantle cavity of large freshwater mussels (Sawyer 1986; Lai & Chen 2010). This specific lifestyle is unusual in leeches although a few additional parasitic species from mussels have been reported (Grizzle & Brunner 2009). The known localities of B. kasmiana are situated in Japan (Honshu), continental China and Taiwan (Oka 1910, 1917; Gee 1919; Yang 1996; Yamauchi et al. 2008; Lai & Chen 2010). The majority of records were reported from continental China, in which this species is widely distributed across the eastern half of the country from Yunnan to Beijing (Yang 1996). It has never been mentioned as a member of the Russian fauna (Lukin 1976). A few naiad species in the family Unionidae are known hosts of B. kasmiana, including Sinanodonta spp., Cristaria plicata (Leach, 1815), and Nodularia douglasiae (Griffith and Pidgeon, 1833) (Oka 1917; Yang 1996; Yamauchi et al. 2008). The biology and ecological preferences of this leech species are poorly known (Yang 1996; Yamauchi et al. 2008; Lai & Chen 2010).
Pterophoridae (Lepidoptera) fauna of the Republic of Tuva
Authors: USTJUZHANIN PETER , REKELJ JURIJ , KOVTUNOVICH VASILY , USTJUZHANINA ANNA
Published: September 2017

The present study gives a review of the Pterophoridae species recorded in the Republic of Tuva (Russia). 37 species of 17 genera are reported, new data on the distribution are provided, the distribution map of Pterophoridae in the Republic of Tuva is given, and Stenoptilia lasani Ustjuzhanin, Rekelj & Kovtunovich, sp. nov., is described.
Nocturnal Velvet Ants (Hymenoptera: Mutillidae) of Joshua Tree National Park, Riverside County, California with the description of three new species
Authors: SADLER EMILY A. , PITTS JAMES P. , WILSON JOSEPH S.
Published: September 2017

The diversity of nocturnal velvet ants at Joshua Tree National Park (JTNP) is investigated along with seasonal activity. The diversity of velvet ants found at JTNP is compared to the diversity of velvet ants found at the Algodones Sand Dunes, Philip L. Boyd Deep Canyon Desert Research Center, Ash Meadows National Wildlife Refuge and the Nevada Test Site. Diagnoses and a key are provided for the velvet ants of JTNP. Forty-one species in six genera, based on 10,202 specimens collected from a transect of 14 sampling sites transitioning from the Mojave to the Sonoran deserts, are found to inhabit areas in and around the park. Odontophotopsis dalyi, O. odontoloxia and Photomorphus schoenwerthi are described as new species. Odontophotopsis (Odontophotopsis) ambigua Mickel (1983) is a junior synonym of O. delodonta Viereck (1904), new synonym. The females of too few of the species are known, so only the males are treated. A key to all of the species and illustrations for those species not previously illustrated are provided for the males.
Misunderstandings about ‘Freedom’ in John 8:31–36
Authors: Hollander Harm W.
Published: September 2017

In John 8:31–41a, Jesus (as the author of the Gospel portrays him) rejects the claims of his Jewish interlocutors that they are the descendants of Abraham and do not need to be set free. In vv. 31–36, he first denies their implicit claim to be free people; instead, he calls them slaves. The author of the Gospel introduces a popular Hellenistic topos, which is often used to demonstrate that being free (in the philosophical-theological-ethical sense of the word) has nothing to do with one’s birth or the social status of one’s ancestors; the only ones who are truly free are those who are free in a religious or moral sense. However, Jesus gives a unique twist to this topos, for he even contests the claim of his Jewish interlocutors to belong to the ‘household’ of Abraham (v. 35), which he explains in more detail in vv. 37–41a.
Finger-Based Numerical Skills Link Fine Motor Skills to Numerical Development in Preschoolers
Authors: Suggate Sebastian , Stoeger Heidrun , Fischer Ursula
Published: September 2017

Previous studies investigating the association between fine-motor skills (FMS) and mathematical skills have lacked specificity. In this study, we test whether an FMS link to numerical skills is due to the involvement of finger representations in early mathematics. We gave 81 pre-schoolers (mean age of 4 years, 9 months) a set of FMS measures and numerical tasks with and without a specific finger focus. Additionally, we used receptive vocabulary and chronological age as control measures. FMS linked more closely to finger-based than to nonfinger-based numerical skills even after accounting for the control variables. Moreover, the relationship between FMS and numerical skill was entirely mediated by finger-based numerical skills. We concluded that FMS are closely related to early numerical skill development through finger-based numerical counting that aids the acquisition of mathematical mental representations.
No Girls Allowed: Women in Male-Dominated Majors Experience Increased Gender Harassment and Bias
Authors: Dresden Brooke E. , Dresden Alexander Y. , Ridge Robert D. , Yamawaki Niwako
Published: September 2017

The prevalence of gender harassment in male-dominated workforces has been well established, but little is known regarding the experiences of women in male-dominated majors within academia. The current study examines the experiences and gender-related biases of 146 male and female students in male-dominated (MD) and gender-equivalent (GE) majors. This study hypothesizes that men from MD majors, as opposed to GE majors, will exhibit more explicit and implicit bias regarding women in positions of power and authority, resulting in a higher prevalence of gender harassment towards women in MD majors. Results showed that there was no significant difference in self-reported explicit bias against women in positions of power and authority between men from MD and GE majors, but there was significantly more implicit bias among men from MD majors as opposed to GE majors. Additionally, women from MD majors experienced significantly more gender harassment than women from GE majors. Implications of these findings and suggestions to assist those working in education to combat these biases and instances of harassment are discussed.
Strategic infarct location for post-stroke cognitive impairment: A multivariate lesion-symptom mapping study
Authors: Zhao Lei , Biesbroek J Matthijs , Shi Lin , Liu Wenyan , Kuijf Hugo J , Chu Winnie WC , Abrigo Jill M , Lee Ryan KL , Leung Thomas WH , Lau Alexander YL , Biessels Geert J , Mok Vincent , Wong Adrian
Published: September 2017

Lesion location is an important determinant for post-stroke cognitive impairment. Although several ‘strategic’ brain regions have previously been identified, a comprehensive map of strategic brain regions for post-stroke cognitive impairment is lacking due to limitations in sample size and methodology. We aimed to determine strategic brain regions for post-stroke cognitive impairment by applying multivariate lesion-symptom mapping in a large cohort of 410 acute ischemic stroke patients. Montreal Cognitive Assessment at three to six months after stroke was used to assess global cognitive functioning and cognitive domains (memory, language, attention, executive and visuospatial function). The relation between infarct location and cognition was assessed in multivariate analyses at the voxel-level and the level of regions of interest using support vector regression. These two assumption-free analyses consistently identified the left angular gyrus, left basal ganglia structures and the white matter around the left basal ganglia as strategic structures for global cognitive impairment after stroke. A strategic network involving several overlapping and domain-specific cortical and subcortical structures was identified for each of the cognitive domains. Future studies should aim to develop even more comprehensive infarct location-based models for post-stroke cognitive impairment through multicenter studies including thousands of patients.
Dissociating Higher and Lower Order Visual Motion Systems by Priming Illusory Apparent Motion
Authors: Heller Nathan H. , Davidenko Nicolas
Published: September 2017

Motion processing is thought of as a hierarchical system composed of higher and lower order components. Past research has shown that these components can be dissociated using motion priming paradigms in which the lower order system produces negative priming while the higher order system produces positive priming. By manipulating various stimulus parameters, researchers have probed these two systems using bistable test stimuli that permit only two motion interpretations. Here we employ maximally ambiguous test stimuli composed of randomly refreshing pixels in a task that allows observers to report more than just two types of motion percepts. We show that even with such stimuli, motion priming can constrain the unstructured random pixel patterns into coherent percepts of positive or negative apparent motion. Moreover, we find that the higher order system is uniquely susceptible to cognitive influences, as evidenced by a significant suppression of positive priming in the presence of alternative response options.
Validation of the Full Outline of Unresponsiveness score coma scale in patients clinically suspected to have acute stroke in the emergency department
Authors: Lee Tommy Kwok Ping , Kitchell Abdul Karim Bin , Siu Axel Yuet Chung , Chen Ngan Kwan
Published: September 2017

Introduction:

The Full Outline of Unresponsiveness score coma scale is a recently introduced coma scale. The objectives of this study were to assess the interrater reliability of the Full Outline of Unresponsiveness score coma scale when physicians and nurses in the emergency department apply the Full Outline of Unresponsiveness score on patients clinically suspected to have acute stroke and to look for any association between Full Outline of Unresponsiveness score coma scale and in‐hospital mortality.

Methods:

Prospective study of 105 patients clinically suspected to have acute stroke recruited in an emergency department in a 4‐month period. The Full Outline of Unresponsiveness score coma scale and Glasgow Coma Scale of each patient were assessed by one doctor and one nurse independently. The interrater reliability between physicians and nurses using the Full Outline of Unresponsiveness score and Glasgow Coma Scale score was assessed. The association between the Full Outline of Unresponsiveness score coma scale and in‐hospital mortality was analysed using logistic regression, controlled for age, sex and diagnosis.

Results:

Full Outline of Unresponsiveness score had a good interrater reliability when applied to patients suspected to have acute stroke (kappa = 0.742, 95% confidence interval = 0.626–0.858). This was comparable to Glasgow Coma Scale score with a kappa = 0.796 (95% confidence interval = 0.694–0.898). For every 1‐point increase in Full Outline of Unresponsiveness score coma scale, a reduction in in‐hospital mortality was observed with an odds ratio of 0.76 (95% confidence interval = 0.63–0.91, p = 0.003), controlled for age, sex and diagnosis.

Conclusion:

The Full Outline of Unresponsiveness score may be a tool that can be used by emergency department doctors and nurses in assessing clinical stroke patients.
Comparison of Pentax‐AWS®, Glidescope®, and King Vision® for difficult‐airway intubation in manikins model by paramedics
Authors: Lee Sanghyun , Kang Hyunggoo , Oh Jaehoon , Lim Tae Ho , Lee Yoonjae , Kim Changsun
Published: September 2017

Introduction:

Prehospital tracheal intubation of a difficult airway is challenging for paramedics. Thus far, the potential role of video laryngoscopes for this purpose has not been confirmed. Therefore, this study aimed to determine the impact of different types of video laryngoscopes on the success rate and time to intubation by paramedics.

Methods:

This is a prospective, randomized, crossover manikin study involving 18 paramedics. Participants performed intubation on a difficult airway in a high‐fidelity manikin using Pentax‐AWS®, Glidescope®, and King Vision® (with two blade types). Time to intubation and success rate of intubation were determined. Participants also rated the best glottic view and reported their preferences of devices.

Results:

In a difficult‐airway scenario, the median time to intubation with Pentax‐AWS® was 22.9 s (interquartile range, 19.5–24.9 s), which was significantly shorter than using other devices. There were no significant differences in the time to maximal exposure of the vocal cords between four devices (p = 0.156). The time to insert the endotracheal tube with Pentax‐AWS® and King Vision® with a guide‐channel blade was significantly shorter than that with the other two devices (all, p < 0.05). Pentax‐AWS® and King Vision® with a guide‐channel blade showed higher success rates than the other two devices (p = 0.04). With regard to device preference, 14 participants preferred Pentax‐AWS® among all devices analyzed.

Conclusion:

Pentax‐AWS® could be an appropriate device for paramedics in cases of difficult airways, with high success rate.
Hong Kong Poison Information Centre: Annual report 2016
Authors: Chan Yiu Cheung , Chan Chi Keung , Ng Chun Ho , Ng Sze Hong , Lau Kai Kee , Tse Man Li
Published: September 2017

Objective:

To report and analyse the poisoning data of Hong Kong Poison Information Centre in 2016.

Methods:

In 2016, all poisoning cases received by Hong Kong Poison Information Centre were retrieved from its database (Poison Information and Clinical Management System) for analysis.

Results:

A total of 4096 poisoned cases were analysed. There were 1871 male patients (45.7%), 2203 female patients (53.8%) and 22 sex unspecified patients (0.5%). The majority of the cases (63.1%) were between 20 and 59 years old. Common causes for poisoning were suspected self‐harm/suicidal attempt (36.3%), unintentional exposure (18.4%) and abusive use (13.1%). Excluding the common co‐ingestant ethanol, the five commonest types of poisons were benzodiazepines, paracetamol, household products, zopiclone and Chinese herbal medicine. Most patients were managed with supportive measures, while 14.3% and 12.9% of them were treated by decontamination and antidotes, respectively. Majority of the cases had uneventful recovery; 1% resulted in death and 3.9% had major outcomes. Six interesting cases and three poisoning outbreaks were discussed.

Conclusion:

This 11th annual report provided the updated epidemiological information on poisoning pattern in Hong Kong and highlighted important changes in comparing with our previous reports.