bluuebunny/crossref_metadata_2025 huggingface dataset:
Causal Relationship Analysis of the Patient Safety Culture Based on Safety Attitudes Questionnaire in Taiwan
Authors: Lee Yii-Ching , Zeng Pei-Shan , Huang Chih-Hsuan , Wu Hsin-Hung
Published: March 2018

This study uses the decision-making trial and evaluation laboratory method to identify critical dimensions of the safety attitudes questionnaire in Taiwan in order to improve the patient safety culture from experts’ viewpoints. Teamwork climate, stress recognition, and perceptions of management are three causal dimensions, while safety climate, job satisfaction, and working conditions are receiving dimensions. In practice, improvements on effect-based dimensions might receive little effects when a great amount of efforts have been invested. In contrast, improving a causal dimension not only improves itself but also results in better performance of other dimension(s) directly affected by this particular dimension. Teamwork climate and perceptions of management are found to be the most critical dimensions because they are both causal dimensions and have significant influences on four dimensions apiece. It is worth to note that job satisfaction is the only dimension affected by the other dimensions. In order to effectively enhance the patient safety culture for healthcare organizations, teamwork climate, and perceptions of management should be closely monitored.
Efficacy of Diacetate Esters of Macular Carotenoids: Effect of Supplementation on Macular Pigment
Authors: Bone Richard A. , Landrum John T. , Mukherjee Anirbaan
Published: March 2018

The accumulation of the carotenoids lutein, zeaxanthin, and mesozeaxanthin in the center of the human retina, and known as the macula lutea or macular pigment, is believed to protect the retina from age-related macular degeneration. Since the macular pigment is of dietary origin, supplements containing the relevant carotenoids are readily available. In this study, we compared the changes in macular pigment over a 24-week supplementation period for two groups of 24 subjects each assigned to either of two supplement formulations, 20 mg/day of lutein or 20 mg equivalent free carotenoids of a combination of diacetate esters of the macular carotenoids. The latter group responded with a larger increase (0.0666 ± 0.0481) in macular pigment optical density than the former group (0.0398 ± 0.0430), driven largely by the older subjects. The difference was statistically significant (p=0.0287). There was a general trend towards smaller increases in macular pigment for those subjects whose baseline value was high. However, the trend was only significant (p<0.05) for subjects in the diacetate group. No differences in response could be attributed to the gender of the subjects. We also observed no indication that the use of statin drugs by a few of the older subjects influenced their responses.
Performance of Novel Randomly Oriented High Graphene Carbon in Lithium Ion Capacitors
Authors: Kadam Rahul S. , Gadkaree Kishor P.
Published: March 2018

The structure of carbon material comprising the anode is the key to the performance of a lithium ion capacitor. In addition to determining the capacity, the structure of the carbon material also determines the diffusion rate of the lithium ion into the anode which in turn controls power density which is vital in high rate applications. This paper covers details of systematic investigation of the performance of a structurally novel carbon, called Randomly Oriented High Graphene (ROHG) carbon, and graphite in a high rate application device, that is, lithium ion capacitor. Electrochemical impedance spectroscopy shows that ROHG is less resistive and has faster lithium ion diffusion rates (393.7 × 10−3 S·s(1/2)) compared to graphite (338.1 × 10−3 S·s(1/2)). The impedance spectroscopy data is supported by the cell data showing that the ROHG carbon based device has energy density of 22.8 Wh/l with a power density of 4349.3 W/l, whereas baseline graphite based device has energy density of 5 Wh/l and power density of 4243.3 W/l. This data clearly shows advantage of the randomly oriented graphene platelet structure of ROHG in lithium ion capacitor performance.
Design Consideration for High Step-Up Nonisolated Multicellular dc-dc Converter for PV Micro Converters
Authors: Hayashi Yusuke , Matsugaki Yoshikatsu , Ninomiya Tamotsu
Published: March 2018

High step-up nonisolated multicellular dc-dc converter has been newly proposed for PV microconverters. The multicellular converter consists of the nonisolated step-up cell converters using bidirectional semiconductor switches, and these cell converters are connected in Input Parallel Output Series (IPOS). The voltage transformation ratio of the step-up converter is N/(1-D) in case all the transistors in N cell converters are operated at the duty ratio of D. The proposed multicellular dc-dc converter also accomplishes high efficiency because of no magnetic coupling such as the high frequency transformer and the coupled inductor. Laboratory prototype has been fabricated to show the feasibility of the proposed converter. Design consideration for the 20 V–40 V to 384 V, 240 W nonisolated multicellular dc-dc converter has been also conducted, and the potential to achieve the efficiency of 98% has been shown. The proposed multicellular converter contributes to realizing the environmentally aware data centers for future low carbon society.
Are Unnecessary Serial Radiographs Being Ordered in Children with Distal Radius Buckle Fractures?
Authors: Ling Shi-Neng James , Cleary Aidan J.
Published: March 2018

Background.Torus or buckle distal radius fractures are common injuries in the pediatric population. By definition, they are stable and can be treated conservatively with a wrist splint or soft crepe bandage.Objective.The objective of this study was to evaluate the utility of serial radiographs in the clinical outcome of children with stable distal radius buckle fractures.Materials and Methods.A one-month retrospective analysis was undertaken at two major hospitals in Queensland—Logan and Redlands Hospital. Statistical analysis was performed to identify any relationships between serial radiographs and certain demographic parameters including fracture characteristics, age, sex, and limb side.Results.Of the 136 patients, 50% had more than one radiograph series taken. A total of 576 single radiographs and 251 radiograph series were taken. All fractures healed without complications and did not require active intervention. There was a statistically significant relationship (p=0.0015) between fracture angulation and multiple radiographs series. A cost analysis revealed $55,890 per year could be saved by not performing serial radiographs.Conclusion.Serial radiographs did not appear to change the excellent clinical outcome for children with distal radius buckle fractures. There is a potential to reduce costs and prevent unnecessary ionizing radiation exposure to children.
Deep Learning versus Professional Healthcare Equipment: A Fine-Grained Breathing Rate Monitoring Model
Authors: Liu Bang , Dai Xili , Gong Haigang , Guo Zihao , Liu Nianbo , Wang Xiaomin , Liu Ming
Published: March 2018

In mHealth field, accurate breathing rate monitoring technique has benefited a broad array of healthcare-related applications. Many approaches try to use smartphone or wearable device with fine-grained monitoring algorithm to accomplish the task, which can only be done by professional medical equipment before. However, such schemes usually result in bad performance in comparison to professional medical equipment. In this paper, we propose DeepFilter, a deep learning-based fine-grained breathing rate monitoring algorithm that works on smartphone and achieves professional-level accuracy. DeepFilter is a bidirectional recurrent neural network (RNN) stacked with convolutional layers and speeded up by batch normalization. Moreover, we collect 16.17 GB breathing sound recording data of 248 hours from 109 and another 10 volunteers to train and test our model, respectively. The results show a reasonably good accuracy of breathing rate monitoring.
Cytomorphological Spectrum of Thyroiditis: A Review of 110 Cases
Authors: Chandanwale Shirish S. , Nair Rahul , Gambhir Anushree , Kaur Supreet , Pandey Aditi , Shetty Abhinav , Naragude Piyusha
Published: March 2018

Introduction. Different types of thyroiditis may share some parallel clinical and biochemical features. Timely intervention can significantly reduce morbidity and mortality.Aim. Aim of this study is to find the frequency of various thyroiditis, study the cytomorphological features and correlate with clinical findings including radiological findings, thyroid function test, and anti-thyroid peroxidase antibodies (Anti-TPO antibodies).Materials and Methods. The study included consecutive 110 cases of thyroiditis. Detailed cytomorphological features were studied and correlated with ultrasonography findings, thyroid function test, anti-thyroid peroxidase antibodies (anti-TPO) and histopathological features where thyroidectomy specimens were received for histopathological examination.Results. The majority were Hashimoto’s thyroiditis (n=100) and females (n=103). Other forms of thyroiditis were Hashimoto’s thyroiditis with colloid goiter (n=5), De Quervain’s thyroiditis (n=3), and one case each of postpartum thyroiditis and Hashimoto’s thyroiditis with associated malignancy. The majority of patients were in the age group of 21–40 (n=70) and the majority (n=73) had diffuse enlargement of thyroid. The majority of patients were hypothyroid (n=52). The serum anti-TPO antibodies were elevated in 47 patients out of 71 patients. In the 48 patients who underwent ultrasonography, 38 were diagnosed as having thyroiditis. The most consistent cytomorphological features seen in fine-needle aspiration smears of Hashimoto’s thyroiditis were increased background lymphocytes, lymphocytic infiltration of thyroid follicular cell clusters, and Hurthle cells.Conclusion. The diagnostic cytological features in Hashimoto’s thyroiditis are increased background lymphocytes, lymphocytic infiltration of thyroid follicular cell clusters, and Hurthle cells. FNAC remains the “Gold Standard” for diagnosing Hashimoto’s thyroiditis. Clinical history, thyroid function, and biochemical parameters are the key for diagnosis of other forms of thyroiditis.
Commuting Separately Quasihomogeneous Small Hankel Operators on Pluriharmonic Bergman Space
Authors: Wu Qi , Qin Chuntao , Chen Yong , Zhao Yile
Published: March 2018

We study (semi)commutativity of small Hankel operators with separately quasihomogeneous symbols on the pluriharmonic Bergman space of the unit ball. Some product problems are also concerned.
Microsatellite Instability in Mouse Models of Colorectal Cancer
Authors: Currey Nicola , Daniel Joseph J. , Mladenova Dessislava N. , Dahlstrom Jane E. , Kohonen-Corish Maija R. J.
Published: March 2018

Microsatellite instability (MSI) is caused by DNA mismatch repair deficiency and is an important prognostic and predictive biomarker in colorectal cancer but relatively few studies have exploited mouse models in the study of its clinical utility. Furthermore, most previous studies have looked at MSI in the small intestine rather than the colon of mismatch repair deficient Msh2-knockout (KO) mice. Here we compared Msh2-KO, p53-KO, and wild type (WT) mice that were treated with the carcinogen azoxymethane (AOM) and the nonsteroidal anti-inflammatory drug sulindac or received no treatment. The induced tumors and normal tissue specimens from the colon were analysed with a panel of five mononucleotide repeat markers. MSI was detected throughout the normal colon in untreated Msh2-KO mice and this involved contraction of the repeat sequences compared to WT. The markers with longer mononucleotide repeats (37–59) were the most sensitive for MSI while the markers with shorter repeats (24) showed only minor change. AOM exposure caused further contraction of the Bat37 and Bat59 repeats in the distal colon of Msh2-KO mice which was reversed by sulindac. Thus AOM-induced carcinogenesis is associated with increased instability of mononucleotide repeats in the colon of Msh2-KO mice but not in WT or p53-KO mice. Chemoprevention of these tumors by sulindac treatment reversed or prevented the increased MSI.
Behavior of RBS Beams Reinforced by Stiffeners Subjected to Cyclic Loading
Authors: Kanao Iori , He Tianrui , Yu Zheng , Morisako Kiyotaka
Published: March 2018

This paper presents a numerical study of reduced beam section (RBS) beams with vertical and horizontal stiffeners. For RBS beams, it is speculated that strength deterioration will be caused by lateral buckling and local buckling. Supplemental lateral bracing (SLB) can prevent lateral buckling but not prevent local buckling in the RBS portion. In the previous research, the effect of vertical or horizontal stiffeners in RBS portion was shown to restrain local buckling of the RBS portion. But RBS with vertical stiffeners causes stress concentration at flange, and strength of RBS with horizontal stiffeners is lower than RBS with vertical stiffeners. In this paper, various patterns of placing stiffeners at the RBS portion are presented. The effect of vertical stiffeners and horizontal stiffeners arranged at the RBS portion is discussed based on length. It is confirmed that, without placing supplemental lateral bracing (SLB), vertical and horizontal stiffeners can delay the occurrence of local buckling and prevent stress concentration. Moreover, the strength can be sustained above 0.8Mp.
Uniqueness Results for Higher Order Elliptic Equations in Weighted Sobolev Spaces
Authors: Caso Loredana , Di Gironimo Patrizia , Monsurrò Sara , Transirico Maria
Published: March 2018

We prove some uniqueness results for the solution of two kinds of Dirichlet boundary value problems for second- and fourth-order linear elliptic differential equations with discontinuous coefficients in polyhedral angles, in weighted Sobolev spaces.
Convexity of Certain Integral Operators Defined by Struve Functions
Authors: Mahmood Shahid , Mahroz Sana , Rafiq Ayesha , Malik Sarfraz Nawaz , Raza Mohsan
Published: March 2018

This article deals with some functional inequalities involving Struve function, generalized Struve function, and modified Struve functions. We aim to find the convexity of the integral operator defined by Struve function, generalized Struve function, and modified Struve functions.
A Study on Some Fundamental Properties of Continuity and Differentiability of Functions of Soft Real Numbers
Authors: Thakur Ramkrishna , Samanta S. K.
Published: March 2018

We introduce a new type of functions from a soft set to a soft set and study their properties under soft real number setting. Firstly, we investigate some properties of soft real sets. Considering the partial order relation of soft real numbers, we introduce concept of soft intervals. Boundedness of soft real sets is defined, and the celebrated theorems like nested intervals theorem and Bolzano-Weierstrass theorem are extended in this setting. Next, we introduce the concepts of limit, continuity, and differentiability of functions of soft sets. It has been possible for us to study some fundamental results of continuity of functions of soft sets such as Bolzano’s theorem, intermediate value property, and fixed point theorem. Because the soft real numbers are not linearly ordered, several twists in the arguments are required for proving those results. In the context of differentiability of functions, some basic theorems like Rolle’s theorem and Lagrange’s mean value theorem are also extended in soft setting.
Leiomyoma of the Round Ligament of the Uterus Mimicking Inguinal Hernia
Authors: Christodoulou Ioulia Maria , Angelopoulos Argiris , Siaperas Petros , Ioannidis Argyrios , Skarpas Andreas , Tellos Antreas , Velimezis Georgios , Karanikas Ioannis
Published: March 2018

Masses of the round ligament of the uterus are uncommon. Leiomyomas are the most common of them, followed by mesothelial cysts and in some cases endometriosis. The exact incidence is not known, but most cases are frequently encountered during the fertility age. Leiomyomas are benign tumors, which can present as hernias, lymph nodes, or other inguinal masses. Surgical excision is the appropriate treatment. We are presenting a case of a 47-year-old female patient who was admitted to the hospital with a left inguinal mass. Our patient underwent surgery, and a leiomyoma of the round ligament was found.
Axial Fan Performance under the Influence of a Uniform Ambient Flow Field
Authors: Heinemann Till , Becker Stefan
Published: March 2018

In their application to air-cooled condensers, axial fans are often subject to the detrimental influence of ambient flow fields at their inlet or outlet. While effects have been investigated mostly under perpendicular cross-flow conditions on fans operating as part of an array in their target design point, this study aims at examining the integral influence of uniform ambient flow fields on a single axial fan over a wide operating range. For this purpose, a wind tunnel fan test rig has been designed and assessed. Multiple angles between uniform ambient flow field and fan axis are examined in their integral influence on the characteristic curve of two distinct industrial axial fans with varying inlet modifications. Increasingly with the fan flow rate, perpendicular inlet cross-flow was found to always have a detrimental influence on fan performance. The straight bladed fan reacted less sensitively than the forward skewed fan, and the adverse cross-flow influence could be reduced with an inlet guard grille and with short conical shroud extensions. Cross-flow at the fan outlet showed potential static fan pressure increases at low flow rates.
PPARγ Antagonizes Hypoxia-Induced Activation of Hepatic Stellate Cell through Cross Mediating PI3K/AKT and cGMP/PKG Signaling
Authors: Zhang Qinghui , Xiang Shihao , Liu Qingqian , Gu Tao , Yao Yongliang , Lu Xiaojie
Published: March 2018

Background and Aims. Accumulating evidence reveals that PPARγ plays a unique role in the regulation of hepatic fibrosis and hepatic stellate cells (HSCs) activation. This study was aimed at investigating the role of PPARγ in hypoxia-induced hepatic fibrogenesis and its possible mechanism. Methods. Rats used for CCl4-induced hepatic fibrosis model were exposed to hypoxia for 8 hours each day. Rats exposed to hypoxia were treated with or without the PPARγ agonist rosiglitazone. Liver sections were stained with HE and Sirius red staining 8 weeks later. HSCs were exposed to hypoxic environment in the presence or absence of rosiglitazone, and expression of PPARγ and two fibrosis markers, α-SMA and desmin, were measured using western blot and immunofluorescence staining. Next, levels of PPARγ, α-SMA, and desmin as well as PKG and cGMP activity were detected using PI3K/AKT and a cGMP activator or inhibitor. Results. Hypoxia promoted the induction and progress of hepatic fibrosis and HSCs activation. Meanwhile, rosiglitazone significantly antagonized the effects induced by hypoxia. Signaling by sGC/cGMP/PKG promoted the inhibitory effect of PPARγ on hypoxia-induced activation of HSCs. Moreover, PI3K/AKT signaling or PDE5 blocked the above response of PPARγ. Conclusion. sGC/cGMP/PKG and PI3K/AKT signals act on PPARγ synergistically to attenuate hypoxia-induced HSC activation.
Pulmonary Arterial Hypertension Specific Therapy in Patients with Combined Post- and Precapillary Pulmonary Hypertension
Authors: Alfraidi Hassan , Qanash Sultan , Bshouty Zoheir
Published: March 2018

Background. Specific therapy for patients with PAH is associated with good outcomes. Little is known about the effect of this treatment in patients with Cpc-PH (PAPm ≥ 25 mmHg, PAWP > 15 mmHg, DPG ≥ 7 mmHg, and/or PVR > 3 WU). This study evaluates the outcome of treating patients with Cpc-PH using PAH specific therapy. Methods. The primary outcome was survival. Secondary outcomes were WHO functional class and 6-minute walk distance (6-MWD). Results. Twenty-six patients with Cpc-PH (half with VHD and half with HF) received PAHST. Six patients did not tolerate treatment due to pulmonary edema. No predictors for treatment intolerance were identified. In twenty patients who tolerated the treatment, the mean WHO functional class improved from 2.70±0.21 at initial assessment to 2.22±0.21 (p<0.04) and 2.06±0.21 (p<0.03) at 6 and 9 months, respectively. Mean 6-MWD improved from 276.0±38.50 meters at initial assessment to 343.9±22.99 meters (p<0.04) and 364.6±34.85 meters (p=0.07) at 6 and 9 months, respectively. Twelve patients died during the follow-up period. Mean survival for all patients was 1279.7±193.60 days. Conclusion. PAHST may be beneficial in the treatment of Cpc-PH (both short and long term). Prospective randomized controlled trials of PAHST in this population are needed to assess its potential efficacy.
Oral Capecitabine Achieves Response in Metastatic Eccrine Carcinoma
Authors: Larson Kristian , Babiker Hani M. , Kovoor Andrew , Liau Joy , Eldersveld Jordan , Elquza Emad
Published: March 2018

The low prevalence rate and limited literature on eccrine carcinoma (EC) pose a challenge to properly diagnosing and treating this rare malignancy. EC lesions tend to present similarly to other cutaneous neoplasms and dermatitis-like conditions. Efficacious treatment guidelines have not been established for patients diagnosed with EC, and few treatment regimens have demonstrated clinical benefit. Due to the high metastatic potential of EC, recognizing the clinical presentation, properly diagnosing, and utilizing beneficial treatment options are important for managing this disease. We report a case of a 66-year-old female who presented with lesions that her primary care provider misdiagnosed as basal cell carcinoma. The disease responded poorly to taxane- and platinum-based chemotherapies as well as an isolated limb perfusion of an alkylating agent. However, continuous dosing of oral capecitabine achieved an 18-month period of progression free survival (PFS) and ameliorated quality of life. We wish to highlight this rare disease and discuss presentation, diagnosis, and management as it is most often misdiagnosed leading to advanced metastatic disease when patients present to the oncologist. In addition, it is crucial to study and report potentially efficacious regimens considering the lack of clinical trials in this disease.
Association between Breastfeeding Duration and Type of Birth Attendant
Authors: Wallenborn Jordyn T. , Masho Saba W.
Published: March 2018

Introduction. Healthcare providers play an integral role in breastfeeding education and subsequent practices; however, the education and support provided to patients may differ by type of provider. The current study aims to evaluate the association between type of birth attendant and breastfeeding duration. Methods. Data from the prospective longitudinal study, Infant Feeding Practices Survey II, was analyzed. Breastfeeding duration and exclusive breastfeeding duration were defined using the American Academy of Pediatrics’ national recommendations. Type of birth attendant was categorized into obstetricians, other physicians, and midwife or nurse midwife. If mothers received prenatal care from a different type of provider than the birth attendant, they were excluded from the analysis. Multinomial logistic regression was conducted to obtain crude and adjusted odds ratios and 95% confidence intervals. Results. Compared to mothers whose births were attended by an obstetrician, mothers with a family doctor or midwife were twice as likely to breastfeed at least six months. Similarly, mothers with a midwife birth attendant were three times as likely to exclusively breastfeed less than six months and six times more likely to exclusively breastfeed at least six months compared to those who had an obstetrician birth attendant. Conclusions. Findings from the current study highlight the importance of birth attendants in breastfeeding decisions. Interventions are needed to overcome barriers physicians encounter while providing breastfeeding support and education. However, this study is limited by several confounding factors that have not been controlled for as well as by the self-selection of the population.
Study on the Factors Influencing the Extraction of Chenodeoxycholic Acid from Duck Bile Paste by Calcium Salt Method
Authors: Hu Xiangzheng , Feng Na , Zhang Jiaqi
Published: March 2018

New extraction technology of chenodeoxycholic acid from duck bile paste by calcium salt was investigated. The optimum conditions of extraction were determined by orthogonal experimental design. The results indicated that influencing factors on the extraction efficiency of chenodeoxycholic acid were as follows: hydrogen peroxide, methyl alcohol, glacial acetic acid, and calcium chloride. The optimum extracting conditions of chenodeoxycholic acid were 1000 mL amount of methyl alcohol, 50 mL amount of hydrogen peroxide, 500 mL amount of 20% calcium chloride, and 600 mL amount of 60% glacial acetic acid for a quantity of duck paste. The yield of chenodeoxycholic acid was 30%.
Screening of Three Echinoderm Species as New Opportunity for Drug Discovery: Their Bioactivities and Antimicrobial Properties
Authors: Stabili Loredana , Acquaviva Maria Immacolata , Cavallo Rosa Anna , Gerardi Carmela , Narracci Marcella , Pagliara Patrizia
Published: March 2018

Echinoderms are a renewable resource with an economic value due to their increasing demand as food and/or source of bioactive molecules exerting antitumor, antiviral, anticoagulant, antioxidant, and antimicrobial activities. In this framework, the present study is aimed at investigating the antibacterial, antioxidant, and hemolytic activities in the three Echinoderm species Echinaster sepositus, Arbacia lixula, and Sphaerechinus granularis. The sea star E. sepositus showed lysozyme‐like activity (mean diameter of lysis of 13.4 ± 0.2 mm), an antimicrobial activity against the human emerging pathogens Staphylococcus aureus, Pseudomonas aeruginosa, and Candida famata, and a strong lytic activity (100 ± 0.05%) towards the human red blood cells. Furthermore A. lixula and E. sepositus had the highest antioxidant activity (1792.75 ± 233.7 and 1765.65 ± 484.58 nmolTE/mL, resp.). From toxicological assays, it was shown that E. sepositus was not toxic towards HeLa cells and Vibrio fischeri, encouraging the exploitation of this species in the pharmaceutical field. Therefore, our findings have implications due to the ongoing explosion of antibiotic‐resistant infections because of the new opportunistic pathogens and the need to discover antibacterial agents with new modes of action. Also the recorded antioxidant activity taking into account the need to find natural antioxidants useful for human health is intriguing.
Efficacy and Outcomes of Intrathecal Analgesia as Part of an Enhanced Recovery Pathway in Colon and Rectal Surgical Patients
Authors: Merchea Amit , Lovely Jenna K. , Jacob Adam K. , Colibaseanu Dorin T. , Kelley Scott R. , Mathis Kellie L. , Spears Grant M. , Huebner Marianne , Larson David W.
Published: March 2018

Purpose. Multimodal analgesia is an essential component of an enhanced recovery pathway (ERP). An ERP that includes the use of single-injection intrathecal analgesia (IA) has been shown to decrease morbidity and cost and shorten length of stay (LOS). Limited data exist on safety, feasibility, and the optimal IA regimen. Our objective was to characterize the efficacy, safety, and feasibility of IA within an ERP in a cohort of colorectal surgical patients. Methods. We performed a retrospective review of all consecutive patients aged ≥ 18 years who underwent open or minimally invasive colorectal surgery from October 2012 to December 2013. All patients were enrolled in an institutional ERP that included the use of single-injection IA. Demographics, anesthetic management, efficacy (pain scores and opiate consumption), postoperative ileus (POI), adverse effects, and LOS are reported. Results. 601 patients were identified. The majority received opioid-only IA (91%) rather than a multimodal regimen. Median LOS was 3 days. Overall rate of ileus was 16%. Median pain scores at 4, 8, 16, 24, and 48 hours were 3, 2, 3, 4, and 3, respectively. There was no difference in postoperative pain scores, LOS, or POI based on intrathecal medication or dose received. Overall, development of respiratory depression (0.2%) or pruritus (1.2%) was rare. One patient required blood patch for postdural headache. Conclusion. Intrathecal analgesia is safe, feasible, and efficacious in the setting of ERP for colorectal surgery. All regimens and doses achieved a short LOS, low pain scores, and a low incidence of POI. This trial is registered with Clinicaltrails.gov NCT03411109.
Screening for Emotional Expression in Frontotemporal Dementia: A Pilot Study
Authors: Carr Andrew R. , Ashla Mark M. , Jimenez Elvira E. , Mendez Mario F.
Published: March 2018

Objective. Although emotional blunting is a core feature of behavioral variant frontotemporal dementia (bvFTD), there are no practical clinical measures of emotional expression for the early diagnosis of bvFTD. Method. Three age-matched groups (bvFTD, Alzheimer’s disease (AD), and healthy controls (HC)) of eight participants each were presented with real-life vignettes varying in emotional intensity (high versus low) with either negative or positive outcomes. This study evaluated verbal (self-reports of distress) and visual (presence or absence of facial affect) measures of emotional expression during the vignettes. Results. The bvFTD patients did not differ from the AD and HC groups in reported distress or in the amount of facial affect during vignettes with high emotional intensity or type of outcome. However, the bvFTD patients reported significantly less distress and had correspondingly few facial affective expressions when compared on vignettes of low intensity. Conclusions. Patients with bvFTD require a high intensity of emotional stimulus and are significantly hyporesponsive to low-intensity stimuli. Simple screening or observations of verbal and facial responsiveness to mildly arousing stimuli may aid in differentiating bvFTD from normal subjects and patients with other dementias. Future studies can investigate whether delivering information with high emotional intensity can facilitate communication with patients with bvFTD.
Analytical Method Development and Validation for the Quantification of Acetone and Isopropyl Alcohol in the Tartaric Acid Base Pellets of Dipyridamole Modified Release Capsules by Using Headspace Gas Chromatographic Technique
Authors: Valavala Sriram , Seelam Nareshvarma , Tondepu Subbaiah , Jagarlapudi V. Shanmukha Kumar , Sundarmurthy Vivekanandan
Published: March 2018

A simple, sensitive, accurate, robust headspace gas chromatographic method was developed for the quantitative determination of acetone and isopropyl alcohol in tartaric acid-based pellets of dipyridamole modified release capsules. The residual solvents acetone and isopropyl alcohol were used in the manufacturing process of the tartaric acid-based pellets of dipyridamole modified release capsules by considering the solubility of the dipyridamole and excipients in the different manufacturing stages. The method was developed and optimized by using fused silica DB-624 (30 m × 0.32 mm × 1.8 µm) column with the flame ionization detector. The method validation was carried out with regard to the guidelines for validation of analytical procedures Q2 demanded by the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH). All the validation characteristics were meeting the acceptance criteria. Hence, the developed and validated method can be applied for the intended routine analysis.
MicroRNA-378 Promotes Osteogenesis-Angiogenesis Coupling in BMMSCs for Potential Bone Regeneration
Authors: Zhang Bo , Li Yali , Yu Yang , Zhao Jinlong , Ou Yangzhen , Chao Yu , Yang Binhui , Yu Xiaorui
Published: March 2018

Bone tissue regeneration was closely associated with osteogenesis and angiogenesis. The harmonious regulation of osteogenetic and angiogenic growth factors would enhance bone regeneration, while the imbalance of that would lead to local excessive bone formation or vascular mass due to exogenous delivery. Therefore, microRNA is believed to regulate multiple metabolism progress through endogenous signaling pathways on the gene level. In this work, we identified microRNA 378 as a positive regulator of osteogenesis and angiogenesis simultaneously and also observed an increase of microRNA 378 than control in human bone marrow mesenchymal stem cells (hBMMSCs) after osteoblast induction. Besides, osteogenetic and angiogenic gene expression increased simultaneously after overexpression of microRNA 378. Moreover, alizarin red staining and alkaline phosphatase (ALP) staining enhanced, and secretion of vascular endothelial growth factor (VEGF) increased. In this way, we believed miR378 was an ideal target to osteogenesis-angiogenesis coupling for bone regeneration, which provides a potential tool for the gene therapy of bone regeneration.
Architecting a System Model for Personalized Healthcare Delivery and Managed Individual Health Outcomes
Authors: Khayal Inas S. , Farid Amro M.
Published: March 2018

In recent years, healthcare needs have shifted from treating acute conditions to meeting an unprecedented chronic disease burden. The healthcare delivery system has structurally evolved to address two primary features of acute care: the relatively short time period, on the order of a patient encounter, and the siloed focus on organs or organ systems, thereby operationally fragmenting and providing care by organ specialty. Much more so than acute conditions, chronic disease involves multiple health factors with complex interactions between them over a prolonged period of time necessitating a healthcare delivery model that is personalized to achieve individual health outcomes. Using the current acute‐based healthcare delivery system to address and provide care to patients with chronic disease has led to significant complexity in the healthcare delivery system. This presents a formidable systems’ challenge where the state of the healthcare delivery system must be coordinated over many years or decades with the health state of each individual that seeks care for their chronic conditions. This paper architects a system model for personalized healthcare delivery and managed individual health outcomes. To ground the discussion, the work builds upon recent structural analysis of mass‐customized production systems as an analogous system and then highlights the stochastic evolution of an individual’s health state as a key distinguishing feature.
Hydrophilic Interaction Liquid Chromatography-Tandem Mass Spectrometry Analysis of Fosetyl-Aluminum in Airborne Particulate Matter
Authors: Buiarelli Francesca , Di Filippo Patrizia , Riccardi Carmela , Pomata Donatella , Marsiglia Riccardo , Console Carla , Puri Daniele
Published: March 2018

Fosetyl-aluminum is a synthetic fungicide administered to plants especially to prevent diseases caused by the members of the Peronosporales and severalPhytophthoraspecies. Herein, we present a selective liquid chromatography-tandem mass spectrometry (LC-MS/MS) method to analyze residues of fosetyl-A1 in air particulate matter. This study was performed in perspective of an exposure assessment of this substance of health concern in environments where high levels of fosetly-Al, relatively to airborne particulate matter, can be found after spraying it. The cleanup procedure of the analyte, from sampled filters of atmospheric particulate matter, was optimized using a Strata X solid-phase extraction cartridge, after accelerated extraction by using water. The chromatographic separation was achieved using a polymeric column based on hydrophilic interaction in step elution with water/acetonitrile, whereas the mass spectrometric detection was performed in negative electrospray ionization. The proposed method resulted to be a simple, fast, and suitable method for confirmation purposes.
Characterization of  ∑-Semicompleteness via Caristi’s Fixed Point Theorem in Semimetric Spaces
Authors: Suzuki Tomonari
Published: March 2018

Introducing the concept of ∑-semicompleteness in semimetric spaces, we extend Caristi’s fixed point theorem to ∑-semicomplete semimetric spaces. Via this extension, we characterize ∑-semicompleteness. We also give generalizations of the Banach contraction principle.
Thermal Wavelength Measurement of Nanofluid in an Optical-Fiber Thermal Wave Cavity Technique to Determine the Thermal Diffusivity
Authors: Noroozi Monir , Mohammadi Bijan , Radiman Shahidan , Zakaria Azmi
Published: March 2018

The application of optical-fiber thermal wave cavity (OF-TWC) technique was investigated to measure the thermal diffusivity of Ag nanofluids. The thermal diffusivity was obtained by measuring the thermal wavelength of sample in a cavity scan mode. The spherical Ag nanoparticles samples were prepared at various sizes using the microwave method. Applying the thermal wavelength measurement in a flexible OF-TWC technique requires only two experimental data sets. It can be used to estimate thermal diffusivity of a small amount of liquid samples (0.3 ml) in a brief period. UV-Vis spectroscopy and transmission electron microscopy were used to measure the characterization of the Ag nanoparticles. The thermal diffusivity of distilled water, glycerol, and two different types of cooking oil was measured and has an excellent agreement with the reported results in the literature (difference of only 0.3%–2.4%). The nanofluids showed that the highest value of thermal diffusivity was achieved for smaller sized nanoparticles. The results of this method confirmed that the thermal wavelength measurement method using the OF-TWC technique had potential as a tool to measure the thermal diffusivity of nanofluids with different variables such as the size, shape, and concentration of the nanoparticles.
Well-Posedness and Numerical Study for Solutions of a Parabolic Equation with Variable-Exponent Nonlinearities
Authors: Al-Smail Jamal H. , Messaoudi Salim A. , Talahmeh Ala A.
Published: March 2018

We consider the following nonlinear parabolic equation: ut-div(|∇u|p(x)-2∇u)=f(x,t), where f:Ω×(0,T)→R and the exponent of nonlinearity p(·) are given functions. By using a nonlinear operator theory, we prove the existence and uniqueness of weak solutions under suitable assumptions. We also give a two-dimensional numerical example to illustrate the decay of solutions.
The Configuration Space of n-Tuples of Equiangular Unit Vectors for n=3, 4, and 5
Authors: Kamiyama Yasuhiko
Published: March 2018

Let Mn(θ) be the configuration space of n-tuples of unit vectors in R3 such that all interior angles are θ. The space Mn(θ) is an (n-3)-dimensional space. This paper determines the topological type of Mn(θ) for n=3, 4, and 5.
Cross-Cultural Adaptation and Validation of the Portuguese Version of the Physical Therapy Outpatient Satisfaction Survey
Authors: Cavalheiro Luís M. , Cabri Jan M. , Ferreira Pedro L.
Published: March 2018

The aim of this study was to adapt and validate the Physical Therapy Outpatient Satisfaction Survey (PTOPS) for the Portuguese culture. This version was obtained by a forward/backward translation, consensus panels, and pre-test. The Portuguese PTOPS was administered to 76 physical therapy outpatients in 10 health services. The content analysis (panels of experts and lay people) and the factor analysis resulted in a reduction of the original 34 items to 28 items that validly identify 3 constructs. The reliability was acceptable for both internal consistency (Cronbach’s alpha = 0.73) and reproducibility (ICC between 0.84 and 0.87), which represent acceptable levels of validity and reliability.
Effectiveness of Resin-Based Sealants with and without Fluoride Placed in a High Caries Risk Population: Multicentric 2-Year Randomized Clinical Trial
Authors: Muller-Bolla Michèle , Courson Fréderic , Lupi-Pégurier Laurence , Tardieu Corinne , Mohit Shrisha , Staccini Pascal , Velly Ana Miriam
Published: March 2018

A split-mouth randomized clinical trial was carried out to assess the effectiveness of sealants in preventing carious ICDAS (International Caries Detection and Assessment System) 3–6 lesions within a 2-year follow-up. We evaluated the effectiveness of 2 types of resin-based sealants, with and without fluoride, their retention rates, and the caries risk factors related to their outcomes. The study included 663 tooth pairs in 400 children (aged 5–15 years) considered to be at high individual caries risk (ICR) and presenting permanent molars free of caries or affected by ICDAS 1–2 lesions. In the first randomization, molars were either randomized to the treatment group receiving a dental sealant or the control group (nontreatment), and in the second randomization the sealant material to be used in the intervention group was selected. Uni- and multivariate Cox proportional hazard models were employed. At the 2-year follow-up, 483 tooth pairs were assessed: sealed molars had 83% (adjusted HR = 0.17; 95% CI: 0.15–0.20) less risk of developing ICDAS 3–6 lesions than molars without sealant. The magnitude of the protective effect was lower among teeth with ICDAS 1–2 lesions or with occlusal deep fissures than without. If the total retention rate of sealants was 70% at 2 years, sealant loss was not associated with the risk of caries (HR = 1.29, 95% CI: 0.92–1.79, p = 0.14). Sealants allow the prevention of new ICDAS 3–6 lesions or progression of noncavitated carious lesions in children at high ICR, and the effect of the sealant was similar regardless of whether it contained fluoride or not.
A Comparative Study of Albumin-Bilirubin Score with Child-Pugh Score, Model for End-Stage Liver Disease Score and Indocyanine Green R15 in Predicting Posthepatectomy Liver Failure for Hepatocellular Carcinoma Patients
Authors: Zou Heng , Yang Xin , Li Qing-Long , Zhou Qing-Xiang , Xiong Li , Wen Yu
Published: March 2018

Background: The albumin-bilirubin (ALBI) grade is a newly proposed model for assessing the hepatic function. This study aimed to compare the value of the ALBI score with Child-Pugh score, model for end-stage liver disease (MELD) score and indocyanine green (ICG) R15 in predicting posthepatectomy liver failure (PHLF). Methods: Patients undergoing curative resection for hepatocellular carcinoma (HCC) between January 2014 and June 2017 were enrolled. The values of the Child-Pugh score, MELD score, ICG R15 and ALBI score in predicting PHLF were evaluated. Results: A total of 473 HCC patients were enrolled. The ALBI score was identified as an independent predictor of PHLF. The AUCs for the Child-Pugh score, MELD score, ICG R15 and ALBI score in predicting PHLF were 0.665, 0.649, 0.668, and 0.745 respectively. Multivariable analyses revealed that the ALBI score was an independent predictor of PHLF regardless of the hepatectomy subgroups, but the Child-Pugh score and MELD score were not significant predictors of PHLF both in major and minor hepatectomy subgroups, and ICG R15 was only a significant predictor of PHLF in minor hepatectomy subgroup. Conclusion: The ALBI score showed superior predictive value of PHLF over Child-Pugh score, MELD score and ICG R15. We propose to use the ALBI score to evaluate surgical risk for HCC patients undergoing hepatic resection.
High Tumor Volume to Fetal Weight Ratio Is Associated with Worse Fetal Outcomes and Increased Maternal Risk in Fetuses with Sacrococcygeal Teratoma
Authors: Gebb Juliana S. , Khalek Nahla , Qamar Huma , Johnson Mark P. , Oliver Edward R. , Coleman Beverly G. , Peranteau William H. , Hedrick Holly L. , Flake Alan W. , Adzick N. Scott , Moldenhauer Julie S.
Published: March 2018

Objective: Tumor volume to fetal weight ratio (TFR) > 0.12 before 24 weeks has been associated with poor outcome in fetuses with sacrococcygeal teratoma (SCT). We evaluated TFR in predicting poor fetal outcome and increased maternal operative risk in our cohort of SCT pregnancies. Methods: This is a retrospective, single-center review of fetuses seen with SCT from 1997 to 2015. Patients who chose termination of pregnancy (TOP), delivered elsewhere, or had initial evaluation at > 24 weeks were excluded. Receiver operating characteristic (ROC) analysis determined the optimal TFR to predict poor fetal outcome and increased maternal operative risk. Poor fetal outcome included fetal demise, neonatal demise, or fetal deterioration warranting open fetal surgery or delivery < 32 weeks. Increased maternal operative risk included cases necessitating open fetal surgery, classical cesarean delivery, or ex utero intrapartum treatment (EXIT). Results: Of 139 pregnancies with SCT, 27 chose TOP, 14 delivered elsewhere, and 40 had initial evaluation at > 24 weeks. Thus, 58 fetuses were reviewed. ROC analysis revealed that at ≤24 weeks, TFR > 0.095 was predictive of poor fetal outcome and TFR > 0.12 was predictive of increased maternal operative risk. Conclusion: This study supports the use of TFR at ≤24 weeks for risk stratification of pregnancies with SCT.
Heterozygosity and Chain Multivalents during Meiosis Illustrate Ongoing Evolution as a Result of Multiple Holokinetic Chromosome Fusions in the Genus Melinaea (Lepidoptera, Nymphalidae)
Authors: McClure Melanie , Dutrillaux Bernard , Dutrillaux Anne-Marie , Lukhtanov Vladimir , Elias Marianne
Published: March 2018

Mitotic and meiotic chromosomes from 2 taxa of the genus Melinaea, M. satevis cydon and M. “satevis” tarapotensis (Lepidoptera: Nymphalidae), and from hybrids produced in captivity were obtained using an improved spreading technique and were subsequently analyzed. In one of the taxa, the presence of trivalents and tetravalents at diakinesis/metaphase I is indicative of heterozygosity for multiple chromosome fusions or fissions, which might explain the highly variable number of chromosomes previously reported in this genus. Two large and complex multivalents were observed in the meiotic cells of the hybrid males (32 chromosomes) obtained from a cross between M. “s.” tarapotensis (28 chromosomes) and M. s. cydon (40-43 chromosomes). The contribution of the 2 different haploid karyotypes to these complex figures during meiosis is discussed, and a taxonomic revision is proposed. We conclude that chromosome evolution is active and ongoing, that the karyotype of the common ancestor consisted of at least 48 chromosomes, and that evolution by chromosome fusion rather than fission is responsible for this pattern. Complex chromosome evolution in this genus may drive reproductive isolation and speciation, and highlights the difficulties inherent to the systematics of this group. We also show that Melinaea chromosomes, classically considered as holocentric, are attached to unique, rather than multiple, spindle fibers.
Caprio and Merola: Latin American Contribution to the Development of Liver Surgery
Authors: Ruso Martinez Luis
Published: March 2018

Regarding the history of liver surgery, Latin American pioneers have only occasionally been mentioned in the Anglo-Saxon literature. One of such rare cases was Uruguayan surgeon Gerardo Caprio, who in 1931 published a report about a resection of the left lobe of the liver. This was done during an uneventful period in the development of ideas on this surgical technique, following the remarkable advances made in the last quarter of the 19th Century. The anatomic and liver manipulation concepts used by Caprio had been developed by Merola in reports dating back to 1916 and 1920, which revealed well-grounded disagreements with the most renowned anatomists of the time. This paper discusses Merola and Caprio’s academic profile by analyzing their publications, the knowledge base and experience that led the latter to perform such liver resection, and the surgical principles applied to it, which would only be formally adopted worldwide 20 years later.