bluuebunny/crossref_metadata_2025 huggingface dataset:
Cognitive impairment has no impact on hospital‐associated dysphagia in aspiration pneumonia patients
Authors: Maeda Keisuke , Wakabayashi Hidetaka , Shamoto Hiroshi , Akagi Junji
Published: September 2017

Aim

Hospital‐associated dysphagia, characterized by deconditioning of swallowing as a result of hospitalization, is sometimes observed in patients with aspiration pneumonia (AP). Cognitive impairment is known as a negative factor in dysphagia rehabilitation. The present study aimed to examine the association between cognitive impairment and hospital‐associated dysphagia in patients with AP receiving dysphagia rehabilitation.

Methods

A retrospective observational study was carried out in an acute geriatric hospital. A total of 249 AP patients receiving multidisciplinary individualized dysphagia rehabilitation were included. Patients were divided into four groups according to their Mini‐Mental State Examination scores. The Functional Oral Intake Scale (FOIS) was used to assess swallowing ability, and hospital‐associated dysphagia was defined as a FOIS decline of ≥1 or ≥2 levels. Body mass index and Barthel Index were obtained to assess nutritional status and activities of daily living.

Results

The mean age was 85.6 ± 7.3 years, and 47% were men. Frequencies of hospital‐associated dysphagia observed in lowest to highest Mini‐Mental State Examination groups were 43.0%, 36.2%, 47.4% and 27.3% (P = 0.133), and 13.9%, 20.7%, 17.5% and 5.5% (P = 0.117) based on FOIS decline ≥1 or ≥2 levels, respectively. Multivariable regression model showed that the Mini‐Mental State Examination score was not an independent determinant of FOIS at discharge (beta = 0.063, P = 0.378) after adjusting for age, sex, body mass index, Barthel Index, pneumonia severity, speech‐language pathologist intervention, comorbidities, length of hospital stay and premorbid FOIS.

Conclusions

The severity of cognitive impairment has no impact on hospital‐associated dysphagia in AP patients receiving dysphagia rehabilitation. A future interventional study will be expected to further validate our findings. Geriatr Gerontol Int 2018; 18: 233–239.
Helicobacter pylori eradication rates of concomitant and sequential therapies in Korea
Authors: Kim Seung Young , Lee Sang Woo , Choe Jung Wan , Jung Sung Woo , Hyun Jong Jin , Jung Young Kul , Koo Ja Seol , Yim Hyung Joon
Published: September 2017

Background

The efficacy of the standard triple therapy for Helicobacter pylori eradication has decreased to an unacceptable level. We aimed to compare the efficacy of sequential and concomitant therapies as for the first‐line treatments for H. pylori eradication and analyzed the effect of clarithromycin resistance on the eradication rates.

Materials and Methods

Four hundred and seventy‐eight patients with H. pylori infection were randomly assigned to either concomitant therapy (amoxicillin 1000 mg with clarithromycin 500 mg, metronidazole 500 mg, and pantoprazole 40 mg twice daily for 10 days) or sequential therapy (amoxicillin 1000 mg with pantoprazole 40 mg twice daily for 5 days, followed by clarithromycin 500 mg with metronidazole 500 mg and pantoprazole 40 mg twice daily for 5 days). The success of the eradication was evaluated 4‐5 weeks after treatment completion. To evaluate the efficacy of the two regimens according to clarithromycin sensitivity, dual‐priming oligonucleotide‐based multiplex‐polymerase chain reaction was also performed in the final third of the enrolled study populations.

Results

The eradication rates with concomitant or sequential therapy were 81.9% and 76.6% (P = .153) in intention‐to‐treat analysis, and 93.4% and 84.8% (P = .004) in per‐protocol analysis, respectively. Among the 156 patients for whom dual‐priming oligonucleotide‐based multiplex‐polymerase chain reaction was performed, 17.9% were clarithromycin resistant, and the efficacy of concomitant therapy was better than sequential therapy in the clarithromycin‐resistant strains (100% vs 58.3%, P = .010).

Conclusion

Concomitant therapy was superior to sequential therapy as the first‐line treatment for H. pylori eradication, especially in clarithromycin‐resistant strains in Korea.
Muscle volume loss a prognostic factor for death in liver cirrhosis patients and special relationship to portal hypertension
Authors: Hiraoka Atsushi , Kitahata Shogo , Izumoto Hirofumi , Ueki Hidetaro , Aibiki Toshihiko , Okudaira Tomonari , Miyamoto Yuji , Yamago Hiroka , Iwasaki Ryuichiro , Tomida Hideomi , Mori Kenichiro , Kishida Masato , Tsubouchi Eiji , Miyata Hideki , Ninomiya Tomoyuki , Hirooka Masashi , Tokumoto Yoshio , Abe Masanori , Matsuura Bunzo , Hiasa Yoichi , Michitaka Kojiro
Published: September 2017

Aim

We examined the prognosis of liver cirrhosis (LC) patients with and without portal hypertension (PHT) and muscle volume loss (MVL).

Methods

From 2006 to 2016, 346 LC outpatients (PHT/non‐PHT = 173/173) were enrolled (median age, 69 years; men / women, 204/142; Child–Pugh A / B, 230/116; and presence of MVL 15.6% in each group) after propensity matching, following exclusion of those with hepatocellular carcinoma (HCC) beyond the Milan criteria and Child–Pugh C. Portal hypertension was defined as positive for significant esophagogastric varices; MVL was diagnosed based on a previously reported index using CT imaging. Overall survival rate (OSR) was evaluated from the viewpoints of PHT and MVL.

Results

There were no significant differences in clinical background (age, gender, etiology, presence of HCC [within Milan criteria], or Child–Pugh class) between the groups. Although there was no significant difference regarding OSR between patients with and without MVL in the non‐PHT group (P = 0.076, Holm's method), the OSR of patients with MVL in the PHT group was lower compared to those without MVL in both groups (P = 0.017 and P = 0.012, respectively, Holm's method). As a result, the OSR of patients with MVL (n = 54) was lower than the other patients (n = 292) (3‐ and 5‐year OSR, 69.0% vs. 86.4% and 35.8% vs. 74.1%, respectively; P < 0.001). Multivariate Cox hazard analysis showed that positive for HCC (hazard ratio [HR], 2.028; 95% confidence interval [CI], 1.189–3.460; P = 0.009) and positive for MVL (HR, 2.768; 95% CI, 1.575–4.863; P < 0.001) were significant independent prognostic factors for death.

Conclusion

Muscle volume loss and HCC, but not PHT, were found to be independent prognostic factors for death in LC patients.
And the sky is grey: The ambivalent outcomes of the California Master Plan for Higher Education
Authors: Marginson Simon
Published: September 2017

In the 1960 Master Plan for Higher Education, California in the United States famously combined the principles of excellence and access within a steep three‐tiered system of Higher Education. It fashioned the world's strongest system of public research universities, while creating an open access system that brought college to millions of American families for the first time. Since 1960, the Master Plan has been admired and influential across the world. Yet the political and fiscal conditions supporting the Master Plan have now evaporated. California turns away hundreds of thousands of prospective students each year, and the University of California, facing spiralling deficits, finds it more difficult to maintain operating costs and compete with top private universities for leading researchers. The paper discusses the rise and partial fall of the Californian system as embodied in the Master Plan, and identifies general lessons for Higher Education systems.
PhD by publication as an argument for innovation and technology transfer: With emphasis on Africa
Authors: Asongu Simplice A. , Nwachukwu Jacinta C.
Published: September 2017

The contribution of African researchers to knowledge by means of scientific publications is low compared to other regions of the world. This paper presents an argument in favour of PhD by publication as a tool for innovation and technology transfer. The conception of PhD by publication used in this study is more suited for doctorates in science and technology. Building on the literature on the key role of a knowledge economy in 21st‐century development and catch‐up processes, we argue that: (a) in order for PhD dissertations to be more useful to society, they should be harmonised with scientific publications which centre on improving the design and quality of existing and new products in developing countries; (b) obtaining a doctorate degree should not simply be reduced to a change in candidate's title; and (c) the PhD by publication is a more effective route to ensuring that the contribution to knowledge is widely disseminated. The conceptual framework consists primarily of the clarification of the models of PhD by publication and the linkages between the doctoral education, innovation, technology transfer and development catch‐up. Implications for scientific research policies in the light of contemporary challenges to African development are discussed.
Downregulation of Chilo suppressalis alkaline phosphatase genes associated with resistance to three transgenic Bacillus thuringiensis rice lines
Authors: Qiu L. , Wang P. , Wu T. , Li B. , Wang X. , Lei C. , Lin Y. , Zhao J. , Ma W.
Published: September 2017

Insecticidal crystal (Cry) proteins produced by the bacterium Bacillus thuringiensis are highly toxic to lepidopteran pests. Strains of transgenic rice expressing cry genes have been developed that are resistant to rice pests. Understanding the mode of action of Cry toxins in rice pests will improve our ability to use them effectively as insecticides. In this study, we tested the hypothesis that alkaline phosphatases (ALPs) are involved in Cry1A, Cry2Aa and Cry1Ca toxicity in Chilo suppressalis, an important insect pest of rice crops in China. We first cloned three novel C. suppressalis alps (Csalps) from the larval midgut of C. suppressalis. RNA interference knockdown of six different Csalp genes (Csalp1, Csalp2, Csalp3, Csalp4, Csalp5 and Csalp6) showed that knockdown of three of these, Csalp1, Csalp2 and Csalp4, reduced larval mortality to the transgenic rice strain TT51, which expresses a fusion protein of Cry1Ab and Cry1Ac, whereas suppression of Csalp1, Csalp2, Csalp3, Csalp4 and Csalp6 transcripts decreased the susceptibility of larvae to the transgenic rice strain T2A‐1, which expresses cry2Aa. Moreover, downregulation of Csalp1, Csalp2, Csalp3, Csalp4 and Csalp5 transcripts conferred significant tolerance to the transgenic rice strain T1C‐19, which expresses cry1Ca. These results suggest that these ALPs play a key role in the toxicity of Cry1A, Cry2A and Cry1C to C. suppressalis.
A systematic review of the effects of supervised toothbrushing on caries incidence in children and adolescents
Authors: dos Santos Ana Paula Pires , de Oliveira Branca Heloisa , Nadanovsky Paulo
Published: September 2017

Background

The anticaries effect of supervised toothbrushing, irrespective of the effect of fluoride toothpaste, has not been clearly determined yet.

Aim

To assess the effects of supervised toothbrushing on caries incidence in children and adolescents.

Design

A systematic review of controlled trials was performed (CRD42014013879). Electronic and hand searches retrieved 2046 records, 112 of which were read in full and independently assessed by two reviewers, who collected data regarding characteristics of participants, interventions, outcomes, length of follow‐up and risk of bias.

Results

Four trials were included and none of them had low risk of bias. They were all carried out in schools, but there was great variation regarding children's age, fluoride content of the toothpaste, baseline caries levels and the way caries incidence was reported. Among the four trials, two found statistically significant differences favouring supervised toothbrushing, but information about the magnitude and/or the precision of the effect estimate was lacking and in one trial clustering effect was not taken into consideration. No meta‐analysis was performed due to the clinical heterogeneity among the included studies and differences in the reporting of data.

Conclusions

There is no conclusive evidence regarding the effectiveness of supervised toothbrushing on caries incidence.
Whole‐genome sequencing and antigenic analysis of the first equine influenza virus identified in Turkey
Authors: Gahan Jacinta , Garvey Marie , Gildea Sarah , Gür Emre , Kagankaya Anil , Cullinane Ann
Published: September 2017

Background

In 2013, there was an outbreak of acute respiratory disease in racehorses in Turkey. The clinical signs were consistent with equine influenza (EI).

Objective

The aim was to confirm the cause of the outbreak and characterise the causal virus.

Methods

A pan‐reactive influenza type A real‐time RT‐PCR and a rapid antigen detection kit were used for confirmatory diagnosis of equine influenza virus (EIV). Immunological susceptibility to EIV was examined using single radial haemolysis and ELISA. Antigenic characterisation was completed by haemagglutinin inhibition using a panel of specific ferret antisera. Genetic characterisation was achieved by whole‐genome sequencing using segment‐specific primers with M13 tags.

Results

A H3N8 EIV of the Florida clade 2 sublineage (FC2) was confirmed as the causal agent. The index cases were unvaccinated and immunologically susceptible. Phylogenetic analysis of the HA1 and NA genes demonstrated that A/equine/Ankara/1/2013 clustered with the FC2 strains circulating in Europe. Antigenic characterisation confirmed the FC2 classification and demonstrated the absence of significant drift. Whole‐genome sequencing indicated that A/equine/Ankara/1/2013 is most closely related to the viruses described as the 179 group based on the substitution I179V in HA1, for example A/equine/East Renfrewshire/2/2011, A/equine/Cambremer/1/2012 and A/equine/Saone et Loire/1/2015. The greatest diversity was observed in the NS1 segment and the polymerase complex.

Conclusions

The first recorded outbreak of EI in Turkey was caused by an FC2 virus closely related to viruses circulating in Europe. Antigenic and genetic characterisation gave no indication that the current OIE recommendations for EI vaccine composition require modification.
Right ventricular scar‐related ventricular tachycardia in nonischemic cardiomyopathy: Electrophysiological characteristics, mapping, and ablation of underlying heart disease
Authors: Kumar Saurabh , Baldinger Samuel H. , Kapur Sunil , Romero Jorge , Mehta Nishaki K. , Mahida Saagar , Fujii Akira , Tedrow Usha B. , Stevenson William G.
Published: September 2017

Background

Right ventricular (RV)‐scar related ventricular tachycardia (VT) is often due to arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) or cardiac sarcoidosis (CS), but some patients whose clinical course has not been described do not fulfill diagnostic criteria for these diseases. We sought to characterize the electrophysiologic substrate and catheter ablation outcomes of such patients, termed RV cardiomyopathy of unknown source (RCUS).

Methods and results

Data of 100 consecutive patients who presented with RV cardiomyopathy and/or RV‐related VT for ablation were reviewed (51 ARVC/D, 22 CS; 27 RCUS). Compared to ARVC/D, RCUS patients were older (P = 0.001), less commonly had RV dilatation (P = 0.001) or dysfunction (P = 0.01) and fragmented QRS, parietal block, and T‐wave inversion. Compared to CS, R‐CUS patients had less severe LV dysfunction. Extent and distribution of endocardial/epicardial scar and inducible VTs in RCUS patients were comparable with ARVC/D and CS patients. At a median follow‐up of 23 months, RCUS patients had more favorable VT‐free survival (RCUS 71%, ARVC/D 60%, CS 41%, P = 0.03) and survival free of death or cardiac transplant (RCUS 92%, ARVC/D 92%, CS 62%, P = 0.01). No RCUS patients developed new criteria for ARVC/D or CS in follow‐up.

Conclusions

Up to one‐third of patients with RV scar‐related VT are not classifiable as ARVC/D or CS. These patients had a somewhat better prognosis than ARVC/D or sarcoid and did not develop evidence of these diseases during the initial 2 years of follow‐up. The extent to which this population comprises mild ARVC/D, CS, or other diseases is not clear.
Prevalence of Long‐Term Opioid Use in Long‐Stay Nursing Home Residents
Authors: Hunnicutt Jacob N , Chrysanthopoulou Stavroula A , Ulbricht Christine M , Hume Anne L , Tjia Jennifer , Lapane Kate L
Published: September 2017

Background/Objectives

Overall and long‐term opioid use among older adults have increased since 1999. Less is known about opioid use in older adults in nursing homes (NHs).

Design

Cross‐sectional.

Setting

U.S. NHs (N = 13,522).

Participants

Long‐stay NH resident Medicare beneficiaries with a Minimum Data Set 3.0 (MDS) assessment between April 1, 2012, and June 30, 2012, and 120 days of follow‐up (N = 315,949).

Measurements

We used Medicare Part D claims to measure length of opioid use in the 120 days from the index assessment (short‐term: ≤30 days, medium‐term: >30–89 days, long‐term: ≥90 days), adjuvants (e.g., anticonvulsants), and other pain medications (e.g., corticosteroids). MDS assessments in the follow‐up period were used to measure nonpharmacological pain management use. Modified Poisson models were used to estimate adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) for age, gender, race and ethnicity, cognitive and physical impairment, and long‐term opioid use.

Results

Of all long‐stay residents, 32.4% were prescribed any opioid, and 15.5% were prescribed opioids long‐term. Opioid users (versus nonusers) were more commonly prescribed pain adjuvants (32.9% vs 14.9%), other pain medications (25.5% vs 11.0%), and nonpharmacological pain management (24.5% vs 9.3%). Long‐term opioid use was higher in women (aPR = 1.21, 95% CI = 1.18–1.23) and lower in racial and ethnic minorities (non‐Hispanic blacks vs whites: APR = 0.93, 95% CI = 0.90–0.94) and those with severe cognitive impairment (vs no or mild impairment, aPR = 0.82, 95% CI = 0.79–0.83).

Conclusion

One in seven NH residents was prescribed opioids long‐term. Recent guidelines on opioid prescribing for pain recommend reducing long‐term opioid use, but this is challenging in NHs because residents may not benefit from nonpharmacological and nonopioid interventions. Studies to address concerns about opioid safety and effectiveness (e.g., on pain and functional status) in NHs are needed.
Effects of different preprocessing algorithms on the prognostic value of breast tumour microscopic images
Authors: KOLAREVIĆ D. , VUJASINOVIĆ T. , KANJER K. , MILOVANOVIĆ J. , TODOROVIĆ‐RAKOVIĆ N. , NIKOLIĆ‐VUKOSAVLJEVIĆ D. , RADULOVIC M.
Published: September 2017

The purpose of this study was to improve the prognostic value of tumour histopathology image analysis methodology by image preprocessing.

Key image qualities were modified including contrast, sharpness and brightness. The texture information was subsequently extracted from images of haematoxylin/eosin‐stained tumour tissue sections by GLCM, monofractal and multifractal algorithms without any analytical limitation to predefined structures. Images were derived from patient groups with invasive breast carcinoma (BC, 93 patients) and inflammatory breast carcinoma (IBC, 51 patients).

The prognostic performance was indeed significantly enhanced by preprocessing with the average AUCs of individual texture features improving from 0.68 ± 0.05 for original to 0.78 ± 0.01 for preprocessed images in the BC group and 0.75 ± 0.01 to 0.80 ± 0.02 in the IBC group. Image preprocessing also improved the prognostic independence of texture features as indicated by multivariate analysis. Surprisingly, the tonal histogram compression by the nonnormalisation preprocessing has prognostically outperformed the tested contrast normalisation algorithms. Generally, features without prognostic value showed higher susceptibility to prognostic enhancement by preprocessing whereas IDM texture feature was exceptionally susceptible. The obtained results are suggestive of the existence of distinct texture prognostic clues in the two examined types of breast cancer. The obtained enhancement of prognostic performance is essential for the anticipated clinical use of this method as a simple and cost‐effective prognosticator of cancer outcome.
A combination of alfaxalone, medetomidine and midazolam for the chemical immobilization of Rhesus macaque (Macaca mulatta): Preliminary results
Authors: Bertrand Henri G. M. J. , Sandersen Charlotte , Murray Jennifer , Flecknell Paul A.
Published: September 2017

Background

Chemical immobilization of non‐human primates can be required to perform scientific or veterinary procedure with different invasiveness degrees. This preliminary study was undertaken to assess the clinical effects of a combination of alfaxalone, medetomidine and midazolam (AMM).

Methods

Seven rhesus macaques were chemically immobilized, for invasive veterinary procedures, with alfaxan 2 mg kg−1, medetomidine 20 μg kg−1 and midazolam 0.3 mg kg−1 injected subcutaneously.

Results

The alfaxalone combination induced surgical anaesthesia, with a complete absence of response to noxious stimuli, for at least 20 minutes. The total duration of anaesthesia was 56 ± 7 minutes, and the administration of atipamezole, to partially reverse the combination effects, did not appear to alter the depth of anaesthesia.

Conclusion

In conclusion, the AMM combination produced rapid onset general anaesthesia, following subcutaneous administration of a relatively low volume (0.28 mL/kg) of injectate.
Peasant differentiation and service provision in Colombia
Authors: Velásquez Ospina Mauricio
Published: September 2017

This paper contributes to agrarian debates through a discussion of the interactions between the interests and incentives of the rural classes, focusing especially on the leadership exercised by middle‐size farmers. In the recent past, class analysis associated with Marxism has given way to models of individual rational maximization, not least because of the lack of specific findings about the effects of peasant differentiation beyond the dichotomous class conflict between peasants and landlords. Information has replaced asset distribution as the main factor affecting effective governance and service provision. According to these theories, politicians did not deliver less because they were responding to the preferences of the large landowning classes, or because seemingly competitive elections were games of rotating chairs within a single dominant class but, rather, because the voters did not have enough information about the candidates and programmes. I bring the discussion back to peasant differentiation and class endowments using the case of communal action boards in Colombia, showing how the demand for information on candidates and developmental resources matters, but is dependent on class structures. I suggest that different rural groups access, use, and manipulate information with differing aims, and that the rural middle class is a fundamental actor in the demand for public goods.
Organizing women for combat: The experience of the FARC in the Colombian war
Authors: Sanín Francisco Gutiérrez , Carranza Franco Francy
Published: September 2017

The FARC, which used to be Colombia's main guerrilla force and is now in the midst of a peace process, was to a great extent a feminized group. This paper discusses why it recruited so many women, and why it recruited them as combatants. We suggest that only when the FARC adopted a highly hierarchical, self‐contained, and militaristic organizational blueprint did it get involved in the massive recruitment of women as combatants. We discuss the way in which organizational mechanisms and ideology interacted to produce such an outcome, and how this interaction marked both the organization and the trajectories of the women who joined it.
Prevalence of dermatologic manifestations and metabolic biomarkers in women with polycystic ovary syndrome in north China
Authors: Feng Jin‐ge , Guo Yan , Ma Li‐ang , Xing Jin , Sun Rui‐feng , Zhu Wei
Published: September 2017

Background

Cutaneous features of hyperandrogenism in polycystic ovary syndrome (PCOS) include acne, hirsutism, seborrhea, androgenic alopecia (AGA), and acanthosis nigricans (AN). However, the relationships have not been well known broadly in terms of clinical hyperandrogenism and biochemical markers.

Objectives

The aim of this study was to investigate biochemical and metabolic parameters in relation to cutaneous characters women in with and without PCOS. Methods: This was a cross‐sectional retrospective study including 186 women with PCOS and 113 age‐matched without PCOS women. Acne grade, hirsutism, seborrhea, AGA, and AN were recorded. Hormonal and metabolic parameters were measured.

Results

The most common finding was acne, and AN was the least dermatological manifestations between PCOS and non‐PCOS groups. The severity location and type of acne did not differ in PCOS women compared to non‐PCOS women. Significant differences were found with respect to free androgen index (FAI) (P = .036), sex hormone‐binding globulin (SHBG) (P = .023), and body mass index (BMI) (P = .001) between PCOS with acne and PCOS without acne groups. Overall, age (P = .005) was significantly decreased, while BMI (P = .004) was significantly higher in PCOS with hirsutism. The mean serum total testosterone (TT), dehydroepiandrosterone sulfate, and FAI were significantly elevated, but SHBG was decreased between PCOS with and without hirsutism groups. There were significantly different BMI (P = .018) and triglyceride (P = .024) except other hormonal parameter of without AGA group.

Conclusion

This study indicated a strong correlation between hirsutism and metabolic abnormalities. Hirsutism is the most common cutaneous finding in PCOS women. Acne and AGA are associated with other manifestations of clinical hyperandrogenism, but not obvious markers of biochemical hyperandrogenemia and metabolic dysfunction.
Percutaneous pulmonary valve implantation for reconstruction of a patch‐repaired right ventricular outflow tract
Authors: Esmaeili Anoosh , Bollmann Simone , Khalil Markus , De Rosa Roberta , Fichtlscherer Stephan , Akintuerk Hakan , Schranz Dietmar
Published: September 2017

Percutaneous pulmonary valve implantation (PPVI) is nowadays an accepted treatment option to repair post‐surgical conduit dysfunction of the right ventricular outflow tract (RVOT). In addition, many patients need a pulmonary valve to reconstruct a hemodynamically incompetent native or conduit free outflow tract. Based on our experience with percutaneous stent‐valve placement in a cohort of 125 patients, we report here transvenous reconstruction of a conduit‐free, patch repaired outflow tract by utilizing balloon‐expandable stent‐valves in 23 patients with a median age of 22 years (5‐60 years). In 20 patients, the step‐by‐step procedure was performed uneventful with the aimed success. Severe RVOT dysfunction in term of a clinical relevant regurgitation could be changed to mild, as it was confirmed by follow‐up color Doppler echocardiography. In a 5‐year‐old girl a Melody® valve was placed as a surgical‐interventional hybrid approach. In one patient, the procedure was complicated by stent embolization during preparation of the RVOT for stent‐valve implantation. Reposition of the embolized stent was nevertheless successful for finishing percutaneous valve‐implantation. In one patient, surgical approach became necessary because of the inability to advance the balloon‐mounted stent‐valve through a pre‐stented RVOT. Considering the current available balloon‐expandable stent‐valves, transvenous pulmonary valve implantation is feasible to treat even an incompetent conduit‐free RVOT. However, preparation of the RVOT by pre‐stenting, in most patients with more than two stents in telescope technique remains challenging. Reconstruction of RVOT by the current available valves is promising only for a carefully selected group of patients.
Different patients, different outcomes: A case‐control study of spontaneous coronary artery dissection versus acute coronary syndrome
Authors: Adams Heath , Paratz Elizabeth , Somaratne Jithendra , Layland Jamie , Burns Andrew , Palmer Sonny , MacIsaac Andrew , Whitbourn Robert
Published: September 2017

Introduction

There is progressive interest worldwide in spontaneous coronary artery dissection (SCAD). To identify a SCAD cohort and compare risk factors, presentation, and management outcomes compared to acute coronary syndrome (ACS) matched controls.

Methods

Retrospective analysis was performed from 2000 to 2015. Clinical data included a neuropsychiatric history, with management and clinical outcomes assessed at 12 months. Patients were matched on a 1:3 case‐control basis according to type of ACS. Twenty‐two SCAD patients were matched to 66 controls by ACS type (ST‐elevation myocardial infarction 45%, Non‐ST‐elevation myocardial infarction 41%, unstable angina 14%).

Results

The SCAD group were more likely female (77.3% vs 19.7%, P < 0.0001), of younger age (48.7 ± 10.7 years vs 61.3 ± 10.6 years, P < 0.0001) with no cases of diabetes (0% vs 33.3%, P = 0.002), compared to controls. SCAD patients had a high prevalence of anxiety, depression or previous neuropsychiatric history (52.4% SCAD vs 1.5% ACS, P < 0.0001). A conservative revascularization strategy with stenting was performed in a minority of SCAD patients (13.6% SCAD vs 83.3% ACS, P < 0.0001), with no significant difference in cumulative major adverse cardiac or cerebrovascular events (MACCE) of death, stroke, re‐admission, or repeat angiography rates between both groups (13.6% SCAD vs 27.3% ACS P = NS).

Conclusion

SCAD affects young females with a paucity of cardiovascular risk factors. The major risk factor for SCAD was a history of anxiety, depression, or neuropsychiatric illness. A conservative approach to SCAD revascularization led to similar MACCE when compared to ACS controls undergoing guideline revascularization at 12 months.
Prognostic value of the age, creatinine, and ejection fraction score for non‐infarct‐related chronic total occlusion revascularization after primary percutaneous intervention in acute ST‐elevation myocardial infarction patients: A retrospective study
Authors: Deng Jie , Wang Xiaozeng , Shi Yana , Zhao Xin , Han Yaling
Published: September 2017

Objective

It is not known if ACEF scores could evaluate the prognosis of recanalization of non‐infarct‐related coronary arteries (non‐IRA) with chronic total occlusions (CTO) in patients who successfully underwent primary PCI. The objective of the current study was to assess the prognostic value of ACEF scores in acute ST‐segment elevation myocardial infarction (STEMI) patients with non‐IRA CTO after successful primary PCI.

Methods

There were 2952 STEMI patients who underwent successful primary PCI from January 2006 to December 2014 in our hospital, among them 377 patients had a non‐IRA CTO lesion. The patients were divided into successful CTO‐PCI group (n = 221) and failed/non‐attempted CTO‐PCI group (n = 156). Patients were stratified based on the ACEF tertiles. Primary end points measured in the current study were major adverse cardiac events (MACE) defined as the composite of all‐cause death, nonfatal myocardial infarction, ischemia‐driven coronary revascularization and hospitalization for heart failure at 1 year.

Results

The incidence of MACE, all‐cause death and cardiac death were higher in the failed/non‐attempted CTO‐PCI group (P < 0.001). In the successful CTO‐PCI group, the cumulative 1‐year incidences of MACE and all‐cause death were decreased compared to those in the failed/non‐attempted CTO‐PCI group (log‐rank P < 0.001). The risk for MACE was reduced in the successful CTO‐PCI group compared to the failed/non‐attempted CTO‐PCI group in patients with low and intermediate ACEF scores (log‐rank P = 0.02).

Conclusions

Successfully staged CTO‐PCI could gain advantageous clinical outcomes in those patients with low or intermediate ACEF scores.
Cluster Confidence Index: A Streamline‐Wise Pathway Reproducibility Metric for Diffusion‐Weighted MRI Tractography
Authors: Jordan Kesshi M. , Amirbekian Bagrat , Keshavan Anisha , Henry Roland G.
Published: September 2017

BACKGROUND

Diffusion‐weighted magnetic resonance imaging tractography can be used to create models of white matter fascicles. Anatomical and pathological variability between subjects can drastically alter the tractography output, so standardizing results across a cohort is nontrivial. Furthermore, tractography methods have inherently low reproducibility due to stochasticity (for probabilistic methods) and subjective decisions, since the final fascicle model often requires a manual intervention step performed by an expert human operator to control both outliers and systematic false‐positive pathways, as defined by prior knowledge of anatomy.

METHODS

We present an approach that computationally assigns a cluster confidence index (CCI) reflecting the reproducibility of that pathway in the context of a streamline dataset. This metric is a tractography algorithm‐agnostic tool that can be applied to any dataset of streamlines.

RESULTS

Applications of this metric include systematic elimination of outlier streamlines using a CCI threshold and interactive filtering by CCI to facilitate manual segmentation of fascicle models.

CONCLUSIONS

This method is intended to replace the application of a streamline density threshold so that outliers are eliminated based on low pathway density instead of voxel‐wise density.
Commentary on: Sexual and Gender Minority Health Disparities as a Social issue: How Stigma and Intergroup Relations Can Explain and Reduce Health Disparities
Authors: Link Bruce G.
Published: September 2017

The broadly defined field of stigma research has made enormous advances since the watershed moment created by the publication of Goffman's (1963) influential essay. Advances have been made in the conceptualization of what stigma is, how stigmatizing circumstances differ one from another and what the origins of stigma are thought to be. Beyond this useful expansion of concepts has been a robust development of methods aimed at operationalizing important stigma dimensions. In this commentary I point out how several of the papers in this special issue further elaborate and deepen the concepts and measures that have developed since Goffman. But this special issue goes further by bringing an intergroup relations orientation to bear in a focused way. Like other major advances such as concepts and theories associated with “minority stress” and “structural stigma” the current project portends a new set of lenses for further understanding the origins and consequences of stigma.
Combination of cheminformatics and bioinformatics to explore the chemical basis of the rhizomes and aerial parts of Dioscorea nipponica Makino
Authors: Li Xu-zhao , Zhang Shuai-nan , Yang Xu-yan
Published: September 2017

Objectives

This study was aimed to explore the chemical basis of the rhizomes and aerial parts of Dioscorea nipponica Makino (DN).

Methods

The pharmacokinetic profiles of the compounds from DN were calculated via ACD/I-Lab and PreADMET program. Their potential therapeutic and toxicity targets were screened through the DrugBank's or T3DB's ChemQuery structure search.

Key findings

Eleven of 48 compounds in the rhizomes and over half of the compounds in the aerial parts had moderate or good human oral bioavailability. Twenty-three of 48 compounds in the rhizomes and 40/43 compounds from the aerial parts had moderate or good permeability to intestinal cells. Forty-three of 48 compounds from the rhizomes and 18/43 compounds in the aerial parts bound weakly to the plasma proteins. Eleven of 48 compounds in the rhizomes and 36/43 compounds of the aerial parts might pass across the blood–brain barrier. Forty-three 48 compounds in the rhizomes and 18/43 compounds from the aerial parts showed low renal excretion ability. The compounds in the rhizomes possessed 391 potential therapeutic targets and 216 potential toxicity targets. Additionally, the compounds from the aerial parts possessed 101 potential therapeutic targets and 183 potential toxicity targets.

Conclusions

These findings indicated that combination of cheminformatics and bioinformatics may facilitate achieving the objectives of this study.
The reliability of pigment pattern‐based identification of wild bottlenose dolphins
Authors: Bichell Lena Marie Vetters , Krzyszczyk Ewa , Patterson Eric M , Mann Janet
Published: September 2017

Long‐term studies often rely on natural markings for individual identification across time. The primary method for identification in small cetaceans relies on dorsal fin shape, scars, and other natural markings. However, dorsal fin markings can vary substantially over time and the dorsal fin can become unrecognizable after an encounter with a boat or shark. Although dorsal fins have the advantage in that they always break the water surface when the cetacean breathes, other physical features, such as body scars and pigmentation patterns can supplement. The goal of this study was to explore the use of dorso‐lateral pigment patterns to identify wild bottlenose dolphins. We employed photographic pigment matching tests to determine if pigmentation patterns showed (1) longitudinal consistency and (2) bilateral symmetry using a 30 yr photographic database of bottlenose dolphins (Tursiops aduncus). We compared experienced dolphin researchers and inexperienced undergraduate student subjects in their ability to accurately match images. Both experienced and inexperienced subjects correctly matched dolphin individuals at a rate significantly above chance, even though they only had 10 s to make the match. These results demonstrate that pigment patterns can be used to reliably identify individual wild bottlenose dolphins, and likely other small cetacean species at other sites.
The built environment and older adults: A literature review and an applied approach to engaging older adults in built environment improvements for health
Authors: Tuckett Anthony G. , Banchoff Ann W. , Winter Sandra J. , King Abby C.
Published: September 2017

Aims and objectives

This paper presents a review of the literature about the built environment as it impacts the health of older people. It then introduces the gerontological nurse and researcher to the Our Voice framework for engaging older people as citizen scientists in order to empower them as agents of change in improving their local built environment and ultimately advancing community health.

Background

Community‐level strategies to promote successful ageing in place are critical both to optimising health outcomes and containing healthcare costs. Such strategies must take into account the influence of the built environment both on individual health behaviours and on overall community health. At the same time, the perspectives and experiences of older people themselves ought to inform policies and practices in a systematic way.

Design

Integrative literature review.

Method

A wide scan of English language articles published in the EMBASE, PubMed and CINAHL bibliographic databases was conducted. Additional articles were sourced by mining relevant reference lists (i.e., snowball sampling). Papers included were published between 2005 and 2016.

Results

Three distinct components emerged from the review: the impact of the built environment on health—in particular the health of older persons; citizen science and its applicability for older people research; and the promise of the Our Voice citizen science framework to activate changes in the built environment that improve older peoples’ health.

Conclusion

The ageing of the world's population brings with it an increased population‐level risk of chronic disease and disability. We present the Our Voice framework, developed by researchers at Stanford University, as a promising strategy for engaging and empowering older people as citizen scientists, as a framework to apply to gerontological nursing and improving community health.

Implications for practice

Gerontology nurses are encouraged to: (i) Recognise the impact of the built environment and other community‐level factors on the health of their patients. (ii) Encourage older adults to take an active role in documenting features of their environments that promote or hinder healthy living. (iii) Support policies and programmes that promote healthy environments.
Two‐year extractability of novel left ventricular, active fixation leads in the sheep model
Authors: Adler Stuart , Kirchhof Nicole , Thompson Amy E. , Foerster Laurie , Marquard Kyle R. , Hine Douglas S.
Published: September 2017

Background

A cardiac lead with a side helix for active fixation to the coronary vein wall (Attain Stability®, Model 20066, Medtronic, Minneapolis, MN, USA) recently received CE Mark. The lead is designed to improve left ventricular (LV) placement and reduce dislodgement rates. The extractability of this active fixation LV lead has not been studied extensively.

Methods

Seventeen sheep were implanted with either an LV lead with a side helix (Model 20066, Model 20096, Medtronic) or a unipolar LV lead (Model 4193, Medtronic) as a control. Leads were extracted at approximately 26, 52, or 118 weeks. Standard extraction methodology was employed with quantitative traction up to 907 g (2 lbs.) using a locking stylet. Gross pathology and histology of the heart with particular attention to the lead tracts were performed.

Results

All leads were successfully removed in their entirety and required significantly less than 1 kg of traction force. The side helix disengaged from the vein as designed and resulted in no complications. No cardiac tissue was observed on any extracted lead. Gross pathology and histology were devoid of any helix‐induced lesions in the vascular structures. The epicardium over the side helix was normal and the fibrotic reaction around the helix was not significantly different from that around the nonhelix portions of the study leads or the control lead.

Conclusion

Extraction of the side helix, active fixation LV lead from the coronary veins in the sheep model is safe, without procedural complexity, and free of complications after long‐term LV lead implant duration.
Acquired progressive lymphangioma: Case report with partial response to imiquimod 5% cream
Authors: Salman Andac , Sarac Gonca , Can Kuru Burce , Cinel Leyla , Yucelten Ayse Deniz , Ergun Tulin
Published: September 2017

Acquired progressive lymphangioma (APL), or benign lymphangioendothelioma, is an unusual entity derived from vascular structures. Clinically and histopathologically it may resemble Kaposi's sarcoma and well‐differentiated angiosarcoma, causing a diagnostic problem. We report an individual with APL initially diagnosed with Kaposi's sarcoma who underwent unnecessary laboratory testing. Imiquimod 5% cream stopped the progression of the lesion. Awareness of this rare entity may prevent patients from undergoing excessive testing. Imiquimod may be used as a safe, effective treatment option.
Moral agency, autonomy, and heteronomy in early Confucian philosophy
Authors: Seok Bongrae
Published: September 2017

This paper discusses Confucian notions of moral autonomy and moral agency that do not follow strict and ideal notions of autonomy that one can find in many Western theories of moral philosophy. In Kantian deontology, for example, one's autonomy, specifically one's rational will to follow universal moral rules, is a necessary condition of moral agency and moral responsibility. In Confucian moral philosophy, however, this type of strict moral autonomy is rarely observed. A Confucian moral agent is often depicted as a partially heteronomous individual who often accepts and follows others' moral authority and considers external contingencies in her moral deliberations. Yet active moral agency is maintained in Confucian philosophy. In this paper, I will explain and analyze a partially heteronomous but active form of moral agency in Confucian moral philosophy. First, I will survey different notions of moral autonomy and explore philosophical theories of partial autonomy and heteronomy. Second, I will discuss, on the basis of interactive, responsive, and situated notions of the self, how Confucian moral agency can be explained without strict standards of autonomy. In Confucianism, morality or virtuosity reflects the relational, responsive, and situated nature of human being that resonates with other human beings and their environmental contingencies. Mencius, for example, acknowledges and discusses interactive or relational nature of moral action and the dependency of the moral self on external conditions of life without giving up active moral effort and full moral responsibility. Third, based on my analysis of moral autonomy and responsibility in early Confucian philosophy, I will argue that Confucian moral philosophy provides a unique way of understanding moral agency, not through self‐enclosed independency but through relational and interactive interdependency of communal agency.
Precision estimation of the angular resolution of terrestrial laser scanners
Authors: Chen Xijiang , Yu Kegen , Zhang Guang , Hua Xianghong , Wu Hao , An Qing
Published: September 2017

Angular resolution is the key factor governing the level of identifiable detail within a terrestrial laser scanner (TLS) point cloud; its uncertainty is related to the sensitivity of distinguishing fine details. The angular resolution was evaluated using the precision of the sampling angle and laser‐spot diameter of 14 commercially available TLS systems (both pulse‐ and phase‐based). To verify the effectiveness of the developed angular‐resolution precision assessment method, a Riegl VZ‐400 and a Surphaser 25HSX TLS were used to scan a sculptured Chinese character. The results show that a Riegl VZ‐400 can identify detail better than a Surphaser 25HSX. The proposed assessment method is useful for determining the sensitivity of a TLS when recording finely detailed object features.
Robust feature matching for geospatial images via an affine‐invariant coordinate system
Authors: Li Jiayuan , Hu Qingwu , Ai Mingyao
Published: September 2017

Feature matching is a crucial stage for many photogrammetric and remote sensing applications. This paper proposes a novel and robust feature‐matching method based on a normalised barycentric coordinate system (NBCS), which is superior to a Cartesian system for this task. A scale‐invariant feature transform (SIFT) is performed to provide initial matches containing both correct matches (inliers) and false matches (outliers), with a focus on model estimation from contaminated observations (matches with outliers). An affine‐invariant coordinate system calledNBCSis defined based on ratios of areas. The two feature points of a correct match have the same coordinates underNBCSwhile false correspondences do not. This principle is adapted into a hypothesise‐and‐verify framework. The proposed method is robust, efficient and effective. Extensive experiments on real geospatial image pairs show that it significantly outperforms six other state‐of‐the‐art approaches. The source code and datasets used in this paper have been made public.