bluuebunny/crossref_metadata_2025 huggingface dataset:
An optimization technique for national income determination model with stability analysis of differential equation in discrete and continuous process under the uncertain environment
Authors: Sarkar Biswajit , Mondal Sankar Prasad , Hur Sun , Ahmadian Ali , Salahshour Soheil , Guchhait Rekha , Iqbal Muhammad Waqas
Published: September 2018

The paper represents a variation of the national income determination model with discrete and continuous process in fuzzy environment, a significant implication in economics planning, by means of fuzzy assumptions. This model is re-recognized and deliberated with fuzzy numbers to estimate its uncertain parameters whose values are not precisely known. Exhibition of imprecise solutions of the concerned model is carried out by using the proposed two methods: generalized Hukuhara difference and generalized Hukuhara derivative (gH-derivative) approaches. Moreover, the stability analysis of the model in two different systems in fuzzy environment is illustrated. Additionally, different illustrative examples for optimization of national income determination model are undertaken with the constructive graph and table for convenience for clarity of the projected approaches.
Fetal Skeletal Disorders
Authors: Schramm Thomas , Mommsen Helge
Published: September 2018

Skeletal disorders of the fetus are quite common. The incidence is about 5:1000 pregnancies. The disorders affect the extremities or parts of them (dysmelia), the whole skeleton (skeletal dysplasia), the skull (craniosynostosis) and the spine (dysostosis, caudal regression). About half of these diseases are complex. In the majority of cases the complex disorders are caused by single gene mutations or numeric or structural chromosomal aberrations. We explain the classification and diagnostic criteria for prenatal expert and screening ultrasound based on frequent disorders. The main diagnostic challenge concerning malformations of the limbs and craniosynostosis is to find out if they are isolated or symptoms of certain syndromes. In skeletal dysplasia it is clinically important to differentiate lethal entities from non-lethal.
A Governance Model Addressing the Challenges of Contemporary Research
Authors: Downes Linda , Teede Helena , Norman Robert , Garad Rhonda
Published: September 2018

In this paper, we describe the robust governance structures and processes underpinning the development of the first International Evidence-Based Guideline for the Assessment and Management Polycystic Ovary Syndrome (2018). The guideline was an outcome of the Centre of Research Excellence for Polycystic Ovary Syndrome, and an example of a transformative, strategic research initiative to impact delivery model. The governance structure supported and delivered critical ethical and regulatory outcomes, including: broad and diverse representation across health professional and consumer groups and exceeded regulatory standards; adherence to rigorous knowledge creation processes; and compliance with the standards for guidelines set by the approval body, the Australian National Health and Medical Research Council (NHMRC). Well-articulated and appropriately implemented governance structures that meet the complex nature of contemporary research and translation activities are essential to enable distributed leadership and to deliver key outcomes.
Application of Monash Centre for Health Research and Implementation Framework to the Development of Polycycstic Ovary Syndrome Guideline: A Case Study on Implementation
Authors: Skouteris Helen , Melder Angela , Bailey Cate , Morris Heather , Garad Rhonda , Teede Helena , Robinson Tracy
Published: September 2018

Implementation of healthcare guidelines, a set of recommendations aiming to optimize patient care, can be a complex process which is at risk of poor translation into practice. Failure to adopt new evidence-based healthcare findings can contribute to a large variation in care, potentially affecting outcomes for service users. Designed to avoid this issue, the Monash Centre for Health Research and Implementation (MCHRI) knowledge translation framework was created to support the development and future implementation of clinical practice guidelines. The framework is distinguished by a focus on methodological rigor, stakeholder engagement, and partnership, leading to the coproduction of a guideline and research projects. In this article, we use the development of the International Evidence-based Guideline on the Assessment and Management of Polycystic Ovarian Syndrome (2018) as a case study to articulate the MCHRI knowledge translation framework. Specifically, this article discusses stakeholder engagement; development and codesign of evidence-based recommendations; implementation and knowledge generation; dissemination, translation, and scale up; and refinement/learning from evaluation. This case study demonstrates how hybrid frameworks, models, and theories for implementation, such as the MCHRI implementation framework, have their place in healthcare. The underlying principle that informs the framework is stakeholder engagement, including codesign, empowerment, and partnership.
Bladder Outlet Obstruction as a Cause for Late Total Flap Failure in Pelvic Reconstruction with a VRAM
Authors: Stein Michael , Momtazi Moein
Published: September 2018

Background A 67-year-old man presented with abrupt failure of a pedicled vertical rectus abdominus myocutaneous (VRAM) flap 13 days postoperatively.

Methods The patient underwent pelvic reconstruction with a pedicled VRAM flap following sacral chordoma and abdominoperineal resection. The flap remained well perfused and viable until postoperative day 13, at which point the patient was noted to become systemically unwell with fever, chills, and abdominal pain. This clinically coincided with prompt arterial and venous insufficiency of the VRAM flap.

Results Computed tomography of the abdomen was ordered to rule out a pelvic collection and revealed an inflated Foley catheter in the bulbar urethra. This was associated with marked distention of the bladder and bilateral hydronephrosis. Direct compression of the deep inferior epigastric pedicle by the bladder neck was noted.

Conclusion The case highlights the importance of considering bladder outlet obstruction and subsequent distention as a cause of pedicle compression and VRAM flap failure following pelvic reconstruction.
Die gesundheitliche Versorgung von wohnungslosen Menschen mit psychischen Problemen
Authors: Franz M. , Salize H.-J. , Hoell A.
Published: September 2018

Hintergrund: Wohnungslosigkeit ist ein vielerorts kaum zu übersehendes und trotzdem gesamtgesellschaftlich weitgehend ignoriertes Phänomen. Menschen mit psychischen Problemen und bestehender Abhängigkeitserkrankung finden sich überzufällig häufig in der Gruppe Wohnungsloser. Methode: Eine internationale systematische Literaturrecherche wurde mit einer deutschsprachigen Recherche in der Datenbank des Netzwerkes für Versorgungsforschung kombiniert, um aktuelle Ergebnisse von Interventionen für Wohnungslose mit psychischen Erkrankungen darzustellen. Ergebnisse: Insbesondere im anglo-amerikanischen Sprachraum werden viele gemeindenahe Ansätze wie Housing First und Assertive Community Treatment beschrieben, die gute Ergebnisse für Wohnstabilität und Lebenszufriedenheit zeigen. Gemischt sind die Ergebnisse für die psychische Gesundheit. Forschung im deutschsprachigen Raum ist vergleichsweise defizitär. Ausblick: Niedrigschwellige oder aufsuchende Angebote scheinen vorteilhaft zu sein. Doch die Befunde lassen sich aufgrund sozialrechtlicher Unterschiede nicht per se auf die hiesigen Gegebenheiten übertragen. Das Problem wird gegenwärtig durch den sozialstrukturellen Wandel mit dem Aufkommen Geflüchteter verschärft.
The impact of economic crisis on mental and physical health in Italy
Authors: Tomassi S. , Ruggeri M.
Published: September 2018

Background: The global crisis that began in 2007 has been the most prolonged economic recession since 1929. It has caused worldwide tangible costs in terms of cuts in employment and income, which have been widely recognised also as major social determinants of mental health (1, 2). The so-called “Great Recession” has disproportionately affected the most vulnerable part of society of the whole Eurozone (3). Across Europe, an increase in suicides and deaths rates due to mental and behavioural disorders was reported among those who lost their jobs, houses and economic activities as a consequence of the crisis.
Stationäre Psychotherapie der Depression: Kliniken, Leitlinien, Methoden und Herausforderungen
Authors: Nisch C. , Tauber R. F. , Himmerich H.
Published: September 2018

Stationäre Depressionstherapie findet in Deutschland in krankenversicherungsfinanzierten psychiatrisch-psychotherapeutischen oder psychosomatisch-psychotherapeutischen Akutkliniken und in rentenversicherungsfinanzierten Rehabilitationskliniken statt. In Akutkliniken wird die Diagnose nach der Internationalen Klassifikation der Krankheiten (ICD) gestellt und therapeutisch versucht, eine Remission zu erreichen; häufig sind eine spezialisierte Depressionsstation und ein klinikinterner Behandlungsalgorithmus vorhanden. In Rehabilitationskliniken spielt diagnostisch das Modell der internationalen Klassifikation der Funktionsfähigkeit, Behinderung und Gesundheit (ICF) eine wesentliche Rolle; seitens der Deutschen Rentenversicherung wurde ein Reha-Therapiestandard für depressive Störungen entwickelt. Als störungsspezifische Psychotherapieformen empfehlen sich neben der Kognitiven Verhaltenstherapie (KVT) und anderen Richtlinienverfahren für bestimmte Patienten Schematherapie oder Cognitive Behavioral Analysis System of Psychotherapy (CBASP). Das Behandlungsangebot kann außerdem die Therapie mit Antidepressiva, indikative Gruppen bei Komorbidität, Fertigkeitentraining und Psychoedukation sowie Ergo-, Physio-, Bewegungsund Musiktherapie, Sozialarbeit, Angehörigenarbeit und Selbsthilfegruppen umfassen.
Pharmakotherapie der Depression in Schwangerschaft und Stillzeit
Authors: Kittel-Schneider S.
Published: September 2018

Depressive Episoden sind ein ebenso häufiges Problem in der Schwangerschaft und Stillzeit wie in anderen Lebensabschnitten bei Frauen. Insbesondere bei schwer ausgeprägter Symptomatik kann auch in dieser besonderen Lebensspanne eine psychopharmakologische Therapie indiziert sein. Dies sollte allerdings immer nach individuellem Nutzen-Risiko entschieden werden gemeinsam mit der Patienten und ggf. auch dem Partner. Große neuere Studien zeigen nach Adjustierung für verschiedene Risikofaktoren, dass die meisten Antidepressiva und Antipsychotika auch wenn sie im ersten Trimenon der Schwangerschaft gegeben werden, kein erhöhtes Risiko für Fehlbildungen haben. Medikation mit SSRIs im letzten Trimenon der Schwangerschaft wurde in mehreren Studien als assoziiert mit einem erhöhten Risiko für die an sich sehr seltene, aber potenziell schwerwiegende Komplikation des persistierenden pulmonalen Hypertonus gezeigt (PPH). Die in Zusammenhang mit SSRI-Exposition berichteten PPH-Fälle endeten jedoch nicht tödlich, wie das bei PPH aus anderer Ursache potenziell vorkommen kann. Antidepressiva und Antipsychotika-Gabe in der Spätschwangerschaft sind allerdings in bis zu 30% der Kinder mit so genannten Anpassungsstörungen assoziiert. Diese äußern sich z.B. in Tremor, Trinkschwäche und Apathie, sind aber in der Regel nicht lebensbedrohlich und selbstlimitierend. Weniger gut ist die Datenlage bezüglich Medikamenteneinnahme in der Stillzeit. Einige Substanzen können aber als relativ sicher für das gestillte Kind angesehen werden. Sertralin, Paroxetin und Nortriptylin sind aktuell die Substanzen mit der besten Datenlage unter den Antidepressiva. Bei den Antipsychotika sind Olanzapin und Quetiapin die Mittel der ersten Wahl in der Stillzeit.
Alternative und unterstützende Verfahren in der Depressionsbehandlung – Sport und Bewegung
Authors: Hänsel F. , Oertel-Knöchel V.
Published: September 2018

Hauptsymptome depressiver Erkrankungen sind eine gedrückte Stimmung, eine Reduktion des Antriebs, Interessenverlust und kognitive Einschränkungen wie eine Verminderung der Aufmerksamkeitsleistung und der Konzentrationsfähigkeit. Viele depressive Patienten berichten darüber hinaus über Appetitstörungen, Schlafstörungen und Energielosigkeit. Diese können in der Folge zu Aktivitätseinschränkungen und körperliche Inaktivität führen. Davon betroffen sind meist auch die sozialen Interaktionen der Patienten und es kommt zu sozialem Rückzug. Daraus resultiert vielfach eine eingeschränkte Funktionalität sowohl im Alltag als auch im Berufsleben. Körperliche Aktivität hat neben einer Vielzahl positiver metabolischer Effekte einen neuroprotektiven Effekt, indem es die Neurogenese anstößt. Darüber hinaus steigert regelmäßige Bewegung die Lebensqualität bei chronisch psychiatrischen Patienten und reduziert Aggressionen sowie Suizidalität. Weiterhin konnten ein gestärktes Selbstbewusstsein, ein positives Selbstbild, weniger negative Grundüberzeugungen, verbesserte Handlungskompetenzen und der Aufbau von intrinsischer Motivation gezeigt werden. Insgesamt zeigt sich, dass die Wirksamkeit sportlichen Trainings, insbesondere in Bezug auf die Größe des Effekts trotz vieler Studien aufgrund von methodischen Verzerrungen unklar bleibt. Zweitens ist die Frage nach potenziellen Mechanismen eines antidepressiven Effekts sportlichen Trainings bisher nicht ausreichend geklärt (Wirkung).
Postpartale psychische Erkrankungen
Authors: Hornstein C. , Trautmann-Villalba P.
Published: September 2018

Die Mutterschaft und die Beziehung zum Kind prägen das klinische Bild postpartaler psychischer Erkrankungen. Die Defizite der Mutter-Kind-Beziehung können die affektive und kognitive Entwicklung des Kindes nachhaltig negativ beeinflussen, sie verbessern sich nicht allein durch die erfolgreiche psychiatrische Behandlung der mütterlichen Störung. In der Therapie sollten daher neben der störungsspezifischen psychiatrisch- psychotherapeutischen Behandlung die Auseinandersetzung mit der Mutterrolle sowie der Aufbau und die Unterstützung der Mutter-Kind-Beziehung weitere Schwerpunkte sein. Väter spielen eine entscheidende Rolle im mütterlichen Genesungsprozess und können den Kindern wichtige kompensierende Erfahrungen anbieten. Auch sie können unter psychischen Belastungen leiden, insbesondere dann, wenn die Mutter erkrankt ist. Die therapeutische Erreichbarkeit psychisch erkrankter Eltern in der Postpartalzeit hat in den letzten Jahren in Deutschland deutlich zugenommen, ebenso wie die Anzahl differenzierter Versorgungskonzepte und -möglichkeiten.
Pathologisches Horten
Authors: Barocka A.
Published: September 2018

Das pathologische Horten (DSM-5 300.3) scheint mit ca. 2% Punktprävalenz eine häufige Störung zu sein, die aber bei Psychiatern und Psychotherapeuten Zurückhaltung auslöst. Für Betroffene ist es schwer, eine angemessene Therapie zu bekommen. Das hat mehrere Gründe: Die diagnostische Einordnung ist umstritten. Ist es eine Form der Zwangsstörung? Gesichert ist die Tatsache, dass die klassische kognitive Verhaltenstherapie bei Zwangsstörung gut, beim pathologischen Horten kaum hilft. Andere Syndrome wie ADHS, bipolare Störung, soziale Phobie und Depression spielen komorbid oder als Teil des Syndroms mit hinein. Die Störung wird teilweise ich-synton präsentiert. Mit anderen Worten: die Therapie ist schwierig. Während sich die Fachleute zurückhalten, sind Ratgeberbücher, Fernsehen und Selbsthilfegruppen hoch interessiert am „Messie-Syndrom“, einer im Grunde diskriminierenden Bezeichnung für das Pathologische Horten. Der vorliegende Beitrag stellt sich die Aufgabe, Therapieprinzipien bekannt zu machen, die sich in Studien als wirksam erwiesen haben. Eine auf das Störungsbild des Pathologischen Hortens ausgerichtete Therapie kann nicht in allen Fällen zur Vollremission führen, bietet aber gute Chancen für eine symptomatische Verbesserung in vielen Fällen und die Wiederherstellung der Funktionalität in einem Teil der Fälle.
ADHS im Erwachsenenalter und psychiatrische Komorbiditäten
Authors: Paucke M. , Strauß M.
Published: September 2018

Bei bis zu 70% der adulten Patienten mit Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) besteht gleichzeitig eine komorbide psychiatrische Störung. Eine differenzielle diagnostische Abgrenzung, nicht nur der Kernsymptome (Aufmerksamkeitsstörung, Hyperaktivität und Impulsivität), sondern auch anderer ADHS-typischer Symptome (wie emotionale Dysregulation, Desorganisation und Schlafstörungen) ist für eine effektive Behandlung notwendig. Die folgende Arbeit soll einen Überblick über die diagnostische Abgrenzung zu anderen psychiatrischen Störungen geben. Außerdem werden therapeutische Optionen (Hierarchisierung der Behandlungsfolge oder Kombinationsbehandlung) bei komorbiden affektiven Störungen erläutert.
Evaluation of Accuracy of a Three-Dimensional Printed Model in Open-Wedge High Tibial Osteotomy
Authors: Kim Hee-June , Park Jaeyeong , Park Kyeong-Hyeon , Park Il-Hyung , Jang Jin-An , Shin Ji-Yeon , Kyung Hee-Soo
Published: September 2018

The purpose of this study was to evaluate the usefulness of a three-dimensional (3D) printed model for open-wedge high tibial osteotomy (HTO). This study retrospectively evaluated 20 patients with medial knee osteoarthritis and varus deformity. Between October 2015 and July 2016, the patients underwent open-wedge HTO using a 3D printed model. The mean age of patients was 55.2 years (range, 51–60 years). The mean preoperative mechanical femorotibial angle (mFTA) was varus 7.8 degrees (range, varus 4.7–11.6 degrees). After measuring the target angle using full-length lower limb weight-bearing radiography, the osteotomy was simulated using 3D images obtained from computed tomography (CT) with the 3D Slicer program. On the basis of the simulated osteotomy section and the target angle, the model was then designed and printed. Open-wedge HTO was then performed by applying the 3D printed model to the opening gap. The accuracy of osteotomy and the change in posterior tibial slope (PTS) angle were evaluated. The weight-bearing line on the tibial plateau was corrected from a preoperative mean of 19.5 ± 9.8% to a postoperative mean of 63.1 ± 6.1% (p < 0.001). The postoperative values were not statistically significantly different from the preoperative target points (p = 0.688). The mFTA was corrected to a postoperative mean of valgus 3.8 ± 1.4 degrees. The PTS angle showed no significant change (p = 0.256). A 3D printed model using CT may be useful for preoperative planning of open-wedge HTO. Satisfactory correction can be obtained without a change in the PTS.
Studies of MCP-PMTs in the miniTimeCube neutrino detector
Authors: Li V. A. , Koblanski J. , Dorrill R. , Duvall M. J. , Engel K. , Jocher G. R. , Learned J. G. , Matsuno S. , McDonough W. F. , Mumm H. P. , Negrashov S. , Nishimura K. , Rosen M. , Sakai M. , Usman S. M. , Varner G. S. , Wipperfurth S. A.
Published: September 2018

This report highlights two different types of cross-talk in the photodetectors of the miniTimeCube neutrino experiment. The miniTimeCube detector has 24 8 × 8-anode Photonis MCP-PMT Planacon XP85012, totalling 1536 individual pixels viewing the 2-liter cube of plastic scintillator.
Evaporation time effects on structural, optical and X-ray photoresponse properties of thermal evaporated a-Se thin films at low vacuum degree
Authors: Li Jitao , Zhu Xinghua , Yang Dingyu
Published: September 2018

In this work, we prepared the thermal evaporated amorphous selenium (a-Se) thin films with different evaporation time at low vacuum degree 10-2 Pa. The results showed a-Se thin films were easier to be crystallized with prolonging evaporation time. Also, the transmittance absorption edges of a-Se thin films showed a blue shift with the enhanced optical energy gap from 2.08 eV to 2.15 eV. Further, the dark current was found to depend on energy gap, and became lower as extending evaporation time. Moreover, a-Se thin films showed the improved X-ray photocurrent gain, with a rapid photoresponse and a small applied voltage requirement. Overall, this work revealed that the increase of evaporation time led to better deposition quality of thin films, enhancing energy gap and X-ray photoresponse, but thin films were not able to resist to higher temperature anymore.
Polyion Complex Micelles for Protein Delivery
Authors: Chen Fan , Stenzel Martina H.
Published: September 2018

Proteins are ubiquitous in life and next to water, they are the most abundant compounds found in human bodies. Proteins have very specific roles in the body and depending on their function, they are for example classified as enzymes, antibodies or transport proteins. Recently, therapeutic proteins have made an impact in the drug market. However, some proteins can be subject to quick hydrolytic degradation or denaturation depending on the environment and therefore require a protective layer. A range of strategies are available to encapsulate and deliver proteins, but techniques based on polyelectrolyte complex formation stand out owing to their ease of formulation. Depending on their isoelectric point, proteins are charged and can condense with oppositely charged polymers. Using block copolymers with a neutral block and a charged block results in the formation of polyion complex (PIC) micelles when mixed with the oppositely charged protein. The neutral block stabilises the charged protein–polymer core, leading to nanoparticles. The types of micelles are also known under the names interpolyelectrolyte complex, complex coacervate core micelles, and block ionomer complexes. In this article, we discuss the formation of PIC micelles and their stability. Strategies to enhance the stability such as supercharging the protein or crosslinking the PIC micelles are discussed.
Livestock grazing and topographic site effects on grassland plant communities after long-term grazing cessation
Authors: Gornish Elise S. , Eastburn D. J. , Oneto Scott , Roche Leslie M.
Published: September 2018

Ranchers are increasingly expected to manage grasslands for forage production and native biodiversity enhancement goals. However, longstanding relationships between grazing and plant species are often understudied because elucidating effects of grazing absence and presence often requires experimental opportunities that are difficult to establish, such as the introduction of grazing to long-term ungrazed pastures. Addressing this knowledge gap is critical for heterogeneous landscapes where site-specific properties might interact with grazing effects to ultimately structure plant communities. We conducted vegetation surveys for 3 years after grazing was reintroduced to an annual California grassland that was not grazed for more than 60 years. We investigated how grazing affected plant communities in terms of cover and richness of native and invasive species and how topographic sites of summit, backslope and toeslope altered these relationships. The plant communities were affected by the independent effects of grazing, site and year. Across years, native cover was 39% greater in grazed plots compared with ungrazed plots. Native species richness was slightly lower in ungrazed compared with grazed plots for toeslope sites relative to the other topographic positions. Invasive species cover was 17% lower in grazed plots compared with ungrazed plots and no predictors were found to contribute to significant differences across plots. Although we generally did not find expected relationships between site and plant response to grazing, this work demonstrates how managers can use livestock to quickly modify plant communities in areas with a long history of grazing absence.
Nonexistence of small, smooth, time-periodic, spatially periodic solutions for nonlinear Schrödinger equations
Authors: Ambrose David , Wright J.
Published: September 2018

We study the question of nonexistence of small spatially periodic, time-periodic solutions for cubic nonlinear Schrödinger equations. We prove that in certain regions of the period-amplitude plane, time-periodic solutions do not exist. To be more precise, we prove that for almost any value in a bounded set of possible temporal periods, there is an amplitude threshold, below which any initial value is not the initial value for a time-periodic solution. The proof requires a certain level of Sobolev regularity on solutions. The methods used are not based on any special structure of the nonlinear Schrödinger equation, and can be applied more generally.
Renal Mucormycosis: A Rare Cause of Urinary Tract Infection Leading to End-stage Renal Disease (ESRD)
Authors: Mathew Georgie , Arumugam Venkatesh , Murugesan Suresh , Duhli Neelaveni , Agarwal Indira
Published: September 2018

Mucormycosis is a rare fungal infection often seen in immunocompromised hosts. Isolated renal mucormycosis may however present in immunocompetent children as renal failure and has a uniformly poor prognosis if not detected and treated early into the course of illness. We present a 3-year-old boy with unrelenting pyelonephritis in whom serial urine cultures done were negative. A final diagnosis of isolated renal mucormycosis was made by magnetic resonance imaging and renal biopsy.
Acquired Dermal Melanocytosis Associated With Diffuse Systemic Sclerosis in a White Patient
Authors: Ossorio-García Lidia , Millán-Ortega Irene , Jiménez-Gallo David , Báez-Perea José María , Linares-Barrios Mario
Published: September 2018

We report a case of a 65-year-old man who developed an asymptomatic bluish spot that affected the flank and left lumbar region with the onset 10 years prior. He had a history of diffuse systemic sclerosis with anti-Scl-70–positive antibodies. The appearance of the skin lesion coincided with the onset of his disease. The skin biopsy was consistent with the diagnosis of acquired dermal melanocytosis. The relationship between the appearance of acquired pigmented macules and spots and systemic sclerosis has been known for years, although it is an infrequent finding.
Lateral Node Dissection in Rectal Cancer in the Era of Minimally Invasive Surgery: A Step-by-Step Description for the Surgeon Unacquainted with This Complex Procedure with the Use of the Laparoscopic Approach
Authors: Perez Rodrigo Oliva , São Julião Guilherme P. , Vailati Bruna Borba , Fernandez Laura M. , Mattacheo Adrian E. , Konishi Tsuyoshi
Published: September 2018

INTRODUCTION:

Lateral node dissection in rectal cancer has been routinely performed in Eastern countries. Technical and anatomical challenges and potential significant postoperative morbidity associated with the procedure have prevented its implementation into clinical practice in Western countries. However, the minimally invasive approach may offer the opportunity of performing this complex procedure with precise anatomical dissection and minimal intraoperative blood loss. In this setting, proper training and standardization of technical steps is highly warranted for surgeons not fully acquainted with the procedure.

TECHNIQUE:

Access to the lateral nodes along the obturator and internal iliac vessels is described by using specific anatomical landmarks. Opening of the peritoneum along the ureter provides access to the region of interest. Dissection of the medial limit is performed preserving the neurovascular bundle and ureter. The lateral dissection is performed along the external iliac vein to provide access to the obturator muscle. Identification of the obturator nerve with blunt dissection of the fat is a critical part of the procedure. Once the lymphatic connections between the inguinal and iliac nodes are transected, dissection is performed along the internal iliac vessels, and branches are separated from the lymphadenectomy specimen.

RESULTS:

Evidence supports that lateral node dissection performed for highly selected patients with minimally invasive access leads to less intraoperative blood loss and similar oncological outcomes. Technical steps illustrated in the present video may aid surgeons in performing this procedure with precise anatomical landmarks and minimal risk for intraoperative complications.

CONCLUSIONS:

Lateral node dissection for rectal cancer is a procedure that may follow standardized technical steps by using precise anatomical landmarks with the use of minimally invasive approach.
Early Diuresis After Colon and Rectal Surgery Does Not Reduce Length of Hospital Stay: Results of a Randomized Trial
Authors: Danelich Ilya M. , Bergquist John R. , Bergquist Whitney J. , Osborn Jennifer L. , Wright Sampaguita S. , Tefft Brittany J. , Sturm Ashley W. , Langworthy Diana R. , Mandrekar Jay , Devine Richard M. , Kelley Scott R. , Mathis Kellie L. , Pemberton John H. , Jacob Adam K. , Larson David W.
Published: September 2018

BACKGROUND:

Excessive perioperative fluid administration likely increases postoperative cardiovascular, infectious, and GI complications. Early administration of diuretics after elective surgery facilitates rapid mobilization of excess fluid, potentially leading to decreased bowel edema, more rapid return of bowel function, and reduced length of hospital stay.

OBJECTIVE:

This study aimed to evaluate the benefit of early diuresis after elective colon and rectal surgery in the setting of an enhanced recovery after surgery practice.

DESIGN:

This was a prospective study.

SETTINGS:

The study was conducted at a quaternary referral center.

PATIENTS:

A randomized, open-label, parallel-group trial was conducted in patients undergoing elective colon and rectal surgery at a single quaternary referral center.

INTERVENTION:

The primary intervention was administration of intravenous furosemide plus enhanced recovery after surgery on postoperative day 1 and 2 versus enhanced recovery after surgery alone.

MAIN OUTCOME MEASURES:

The primary outcome was length of hospital stay. Secondary outcomes included 30-day readmission rate, time to stool output during hospitalization after surgery, and incidence of various complications within the first 48 hours of hospital stay.

RESULTS:

In total, 123 patients were randomly assigned to receive either furosemide plus enhanced recovery after surgery (n = 62) or enhanced recovery after surgery alone (n = 61). Groups were evenly matched at baseline. At interim analysis, length of hospital stay was not superior in the intervention group (80.6 vs 99.6 hours, p = 0.564). No significant difference was identified in the rates of nasogastric tube replacement (1.6% vs 9.7%, p = 0.125). Time to return of bowel function was significantly longer in the intervention group (45.4 vs 48.8 hours, p = 0.048). The decision was made to end the study early because the conditional power of the study favored futility.

LIMITATIONS:

This was a single-center study.

CONCLUSIONS:

Early administration of furosemide does not significantly reduce the length of hospital stay after elective colon and rectal surgery in the setting of enhanced recovery after surgery practice. See Video Abstract at http://links.lww.com/DCR/A714.
Dietary supplementation with fish oil reverses high fat diet-induced enhanced sensitivity to the behavioral effects of quinpirole
Authors: Hernandez-Casner Caroline , Woloshchuk Claudia J. , Poisson Carli , Hussain Samirah , Ramos Jeremiah , Serafine Katherine M.
Published: September 2018

Consuming a high fat diet can lead to many negative health consequences, such as obesity, insulin resistance, and enhanced sensitivity to drugs acting on dopamine systems. It has recently been demonstrated that dietary supplementation with fish oil, which is rich in omega-3 fatty acids, can prevent this high fat diet-induced enhanced sensitivity to dopaminergic drugs from developing. However, it is not known whether fish oil supplementation can reverse this effect once it has already developed. To test the hypothesis that dietary supplementation with fish oil will reverse high fat diet-induced enhanced sensitivity to quinpirole, a dopamine D2/D3 receptor agonist, male Sprague-Dawley rats were fed either standard chow (17% kcal from fat), high fat chow (60% kcal from fat), standard chow, or high fat chow supplemented with 20% (w/w) fish oil. Body weight, food consumption, and sensitivity to quinpirole-induced (0.0032–0.32 mg/kg) penile erections were examined throughout the course of the experiment. Eating high fat chow enhanced sensitivity of rats to quinpirole-induced penile erections (i.e. resulted in a leftward shift of the ascending limb of the dose–response curve). Dietary supplementation with fish oil successfully treated this effect, as dose–response curves were not different for rats eating standard chow and rats eating high fat chow with fish oil. These results suggest that in addition to preventing the negative health consequences of eating a high fat diet, fish oil can also reverse some of these consequences once they have developed.
Histidine-Rich Glycoprotein Suppresses Hyperinflammatory Responses of Lung in a Severe Acute Pancreatitis Mouse Model
Authors: Terao Kinya , Wake Hidenori , Adachi Naoto , Liu Keyue , Teshigawara Kiyoshi , Takahashi Hideo , Mori Shuji , Nishibori Masahiro
Published: September 2018

Objectives

Severe acute pancreatitis is a highly lethal disease caused by systemic inflammatory response syndrome, leading to multiple organ failure. We recently showed that histidine-rich glycoprotein (HRG) supplemental therapy ameliorated septic acute respiratory distress syndrome due to unnecessary neutrophil activation and immunothrombosis formation. Here, we evaluated the effect of HRG on lung inflammation followed by pancreatitis in a severe acute pancreatitis mouse model.

Methods

Mice received intraperitoneal injections of cerulein 7 times (100 μg/kg each) at 1-hour intervals to induce acute pancreatitis. Immediately after the first cerulein injection, phosphate-buffered saline, human serum albumin (20 mg/kg), or HRG (20 mg/kg) was intravenously injected. One hour after the last cerulein injection, phosphate-buffered saline or lipopolysaccharide (5 mg/kg) was intravenously injected into the tail vein. We evaluated lung inflammatory level after pancreatitis.

Results

We observed significantly decreased plasma HRG levels in an acute pancreatitis mouse model. Histidine-rich glycoprotein treatment inhibited lung edema and the accumulation of neutrophil in severe acute pancreatitis, but HRG did not directly affect pancreatitis. Moreover, HRG suppressed tumor necrosis factor α, inducible nitric oxide synthase, interleukin 6, and neutrophil elastase mRNA expression and myeloperoxidase activity in the lung.

Conclusions

These data suggested that HRG ameliorated lung inflammation secondary to pancreatitis.
Reversing Time Averaging and Reconstructing Extinction Rates with Approaches from Image Processing
Authors: Hohmann Niklas
Published: September 2018

In this paper, the relation between the extinction rate and the rate of last fossil occurrences as well as the relation between the fossil occurrence rate and the time averaged fossil occurrence rate is examined. Both relations are described by the same mathematical operation. This operation is commonly used in image processing, where it generates a blurring effect. Therefore the rate of last fossil occurrences can be taken as a blurred version of the extinction rate, and the time averaged fossil occurrence rate as a blurred version of the fossil occurrence rate. This connection has different applications. It allows to study the patterns different types of time averaging generate or the patterns of last fossil occurrences generated by different extinction rates. More importantly, it opens the possibility to use algorithms from image processing that reverse blurring effects for geological applications. This can be used to reverse the effects of time averaging or to reconstruct extinction rates from the rate of last fossil occurrences.
Concestor kinase activation mechanism uncovers the cyclin dependence of CDK family kinases
Authors: Shamsi Zahra , Shukla Diwakar
Published: September 2018

Evolution has altered the free energy landscapes of protein kinases to introduce different regulatory switches and alters their catalytic functions. An understanding of evolutionary pathways behind these changes at atomistic resolution is of great importance for drug design. In this work, we demonstrate how cyclin dependency has emerged in cyclin-dependent kinases (CDKs) by reconstructing their closest experimentally characterized cyclin-independent ancestor. Using available crystal structures of CDK2, regulatory switches are identified and four possible hypotheses describing why CDK2 requires an extra intra-domain regulatory switch compared to the ancestor are formulated. Each hypothesis is tested using all-atom molecular dynamics simulations. Both systems show similar stability in the K33-E51 hydrogen bond and in the alignment of residues in the regulatory-spine, two key protein kinase regulatory elements, while auto-inhibition due to a helical turn in the a-loop is less favorable in the ancestor. The aspartate of the DFG motif does not form a bidentate bond with Mg in CDK2, unlike the ancestor. Using the results of hypothesizes testing, a set of mutations responsible for the changes in CDK2 are identified. Our findings provide a mechanistic rationale for how evolution has added a new regulatory switch to CDK proteins. Moreover, our approach is directly applicable to other proteins.
Physical environment comfort towards Malaysian universities office employers’ performance and productivity
Authors: Ali Azlan Shah , Chua Shirley Jin Lin , Lim Melissa Ee Ling
Published: September 2018

Purpose

The physical environment comfort in a workplace is claimed to be vital, as it will encourage healthier, more productive and lower absenteeism rate among employees. The purpose of this paper is to investigate the importance of physical environment comfort and establish its relationship with employees’ performance and productivity.

Design/methodology/approach

Evaluation for the selected case studies is made in the aspects of employee’s comfort perceive health and absenteeism rate by wielding the elements of physical comfort consisting room temperature, relative humidity and illuminance level. Field study and questionnaire survey were carried out for three institutional building particularly management department. Spearman’s correlation analysis was conducted to establish the relationship between the physical environment comfort and health symptoms faced by the employees.

Findings

Correlations were found between room temperature, lighting and relative humidity with health-related issues such as feeling stuffy, getting tired easily and facing difficulty in concentration which affect employees’ productivity and work performances. In addition, it was proven that the overall physical environment comfort factors have an impact on employees’ health which indirectly affects their absenteeism rate. The average absenteeism rate was compared between the case studies as well.

Originality/value

Performance and productivity for universities’ office employees are very essential in ensuring that the universities run smoothly and support teaching, innovation, learning and research activities. This study attempts to establish the relationship between physical environment comfort and universities’ office employees’ performance and productivity.
Hazard assessment of drought disaster using a grey projection incidence model for the heterogeneous panel data
Authors: Luo Dang , Ye Lili , Zhai Yanli , Zhu Hanyu , Qian Qicun
Published: September 2018

Purpose

Hazard assessment on drought disaster is of great significance for improving drought risk management. Due to the complexity and uncertainty of the drought disaster, the index values have some grey multi-source heterogeneous characteristics. The purpose of this paper is to construct a grey projection incidence model (GPIM) to evaluate the hazard of the drought disaster characterised by the grey heterogeneity information.

Design/methodology/approach

First, the index system of the drought hazard risk is established based on the formation mechanism of the drought disaster. Then, the GPIM for the heterogeneous panel data is constructed to assess drought hazard of five cities in Henan Province. Subsequently, based on the assessment results, the grey clustering model is employed for the regional division.

Findings

The findings demonstrate that five cities in central Henan Province are divided into three categories, which correspond to three different risk grades, respectively. With respect to different drought risk areas, corresponding countermeasures and suggestions are proposed.

Practical implications

This paper provides a practical and effective new method for the hazard assessment on drought disaster. Meanwhile, these countermeasures and suggestions can help policy makers to improve the efficiency of drought resistance work and reduce the losses caused by drought disasters in Henan Province.

Originality/value

This paper proposes a new GPIM which resolves the assessment problems of the uncertain systems with grey heterogeneous information, such as real numbers, interval grey numbers and three-parameter interval grey numbers. It not only expands the application scope of the grey incidence model, but also enriches the research of panel data.
Big Data, digital demand and decision-making
Authors: Green Steve , McKinney Jr Earl , Heppard Kurt , Garcia Luis
Published: September 2018

Purpose

This paper aims to discuss the viewpoint that Big Data’s major impacts on the accounting community will be changes in consumers’ demand of accounting data and its impact on decision-making. Big Data is leading consumers to prefer more atomized (not summarized but rather reduced to discrete units), reconfigurable and transparent accounting data that they can combine into their own structures to meet their own decision-making needs. Consequently, consumers will demand digital goods that are less static, and summarized.

Design/methodology/approach

This paper discusses the strategic shift to what is referred to as “indirect data,” and develops a model that helps explain “how” and “why” Big Data may impact this change in consumer digital demand.

Findings

There are many evolving Big Data opportunities associated with the shift in consumer demand for more atomized, reconfigurable and transparent accounting data that are discussed in this paper, including strategic capability, auditing, performance measurement and reporting, standardization and education.

Originality/value

This paper provides a discussion of the evolving opportunities of the relationship that is created by a strategic shift in the type of digital goods consumers of information, specifically decision-makers, will demand, as well as the potential impacts on the accounting community.
Corporate governance, accounting information environment and investment-cash flow sensitivity
Authors: Li Ming , Song Liang
Published: September 2018

Purpose

The purpose of this paper is to test the effects of antitakeover protection on investment-cash flow sensitivity and whether these effects are moderated by firms’ accounting information environment and agency problems.

Design/methodology/approach

To test the effects of agency problems, the authors use the passage of second-generation antitakeover laws as the testing ground, which is a pseudo-natural experiment that is widely used in the accounting, finance and economics literature (e.g. Armstrong et al., 2012; Bertrand and Mullainathan, 2003).

Findings

The authors’ analysis shows that investment-cash flow sensitivity is greater when managers are insulated from takeovers. The authors’ results also demonstrate that the effects of the passage of antitakeover laws on investment-cash flow sensitivity are greater when firms’ accounting information environment is poor, which is measured by fewer analysts following and higher analyst forecast dispersion. The authors also show that the effects of the passage of antitakeover laws on investment-cash flow sensitivity are greater when firms have severe agency problems, which are measured by more free cash flow.

Originality/value

The authors’ research extends the empirical accounting literature about the effects of corporate governance and accounting information environment on firms’ operating and financial decisions.
Dwarkanath Tagore as a pioneering entrepreneur of India
Authors: Roy Abhijit
Published: September 2018

Purpose

In the past three centuries in India, outsiders have dominated economic fortunes. Yet, for a brief interlude for two decades (i.e. in the 1830s and 1840s), the Bengalis from Eastern India played a dominant role in the modern business sector of the economy as partners of the British. The singular reason behind this phenomenon was the role of Dwarkanath Tagore (DT) in building multiple multiracial business partnerships in a myriad of businesses. This study aims to demonstrate how all of these activities were synthesized in an integrated marketing approach and how DT was the catalyst in forging these partnerships with the British East India Company and other enterprises.

Design/methodology/approach

A historical research method is used in critically examining the business practices of DT. Resources include a few biographies about him as well as several print sources, including several publications owned by him.

Findings

DT’s approach to an integrated marketing approach in the nineteenth century, involved the traditional production, distributional and promotional components, and he understood the significance of using all tools at his disposal to reach his market using these synergies, each reinforcing his main self-identify was that of an entrepreneur. He used forward integration techniques in running other operations, e.g. distribution, publishing, advertising and promotion of his products. His multiracial social networks for business and social activities are also identified.

Originality/value

This study synthesizes different sections of DT’s businesses and illustrates how he used integrated marketing to build an enterprising, profit-making business, which was good for both the economy of Bengal and that of the British East India Company and his other partners. The study also establishes him as a pioneering Indian entrepreneur and identifies major social networks with other business partners (both Indian and British).