bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship between early prescription dispensing patterns and work disability in a cohort of low back pain workers’ compensation claimants: a historical cohort study
Authors: Carnide Nancy , Hogg-Johnson Sheilah , Koehoorn Mieke , Furlan Andrea D , Côté Pierre
Published: May 2019

Objectives

To examine and compare whether dispensing of prescription opioids, non-steroidal anti-inflammatory drugs (NSAIDs) and skeletal muscle relaxants (SMRs) within 8 weeks after a work-related low back pain (LBP) injury is associated with work disability.

Methods

A historical cohort study of 55 571 workers’ compensation claimants with LBP claims in British Columbia from 1998 to 2009 was conducted using linked compensation, dispensing and healthcare data. Four exposures were constructed to estimate the effect on receipt of benefits and days on benefits 1 year after injury: drug class(es) dispensed, days' supply, strength of opioids dispensed and average daily morphine-equivalent dose.

Results

Compared with claimants receiving NSAIDs and/or SMRs, the incidence rate ratio (IRR) of days on benefits was 1.09 (95% CI 1.04 to 1.14) for claimants dispensed opioids only and 1.26 (95% CI 1.22 to 1.30) for claimants dispensed opioids with NSAIDs and/or SMRs. Compared with weak opioids only, the IRR for claimants dispensed strong opioids only or strong and weak opioids combined was 1.21 (95% CI 1.12 to 1.30) and 1.29 (95% CI 1.20 to 1.39), respectively. The incident rate of days on benefits associated with each 7-day increase in days supplied of opioids, NSAIDs and SMRs was 10%, 4% and 3%, respectively. Similar results were seen for receipt of benefits, though effect sizes were larger.

Conclusions

Findings suggest provision of early opioids leads to prolonged work disability compared with NSAIDs and SMRs, though longer supplies of all drug classes are also associated with work disability. Residual confounding likely partially explains the findings. Research is needed that accounts for prescriber, system and workplace factors.
Pulsed radiofrequency to the dorsal root ganglion or the sciatic nerve reduces neuropathic pain behavior, decreases peripheral pro-inflammatory cytokines and spinal β-catenin in chronic constriction injury rats
Authors: Jiang Ren , Li Ping , Yao Yong-Xing , Li Hong , Liu Rongjun , Huang Ling-Er , Ling Sunbin , Peng Zhiyou , Yang Juan , Zha Leiqiong , Xia Li-Ping , Chen Xiaowei , Feng Zhiying
Published: May 2019

Background and objectives

Pulsed radiofrequency (PRF) is a minimal neurodestructive interventional pain therapy. However, its analgesic mechanism remains largely unclear. We aimed to investigate the peripheral and spinal mechanisms of PRF applied either adjacent to the ipsilateral L5 dorsal root ganglion (PRF-DRG) or PRF to the sciatic nerve (PRF-SN) in the neuropathic pain behavior induced by chronic constriction injury (CCI) in rats.

Methods

On day 0, CCI or sham surgeries were performed. Rats then received either PRF-DRG, PRF-SN, or sham PRF treatment on day 4. Pain behavioral tests were conducted before surgeries and on days 1, 3, 5, 7, 9, 11, 13, and 14. After the behavioral tests, the rats were sacrificed. The venous blood or sciatic nerve samples were collected for ELISAs and the dorsal horns of the L4–L6 spinal cord were collected for western blot examination.

Results

The mechanical allodynia and the thermal hyperalgesia has been relieved by a single PRF-DRG or PRF-SN application. In addition, the analgesic effect of PRF-DRG was superior to PRF-SN on CCI-induced neuropathic pain. Either PRF-DRG or PRF-SN reversed the enhancement of interleukin 1β (IL-1β) and tumor necrosis factor alpha (TNF-α) levels in the blood of CCI rats. PRF-DRG or PRF-SN also downregulated spinal β-catenin expression.

Conclusions

PRF treatment either to DRG or to sciatic nerve reduced neuropathic pain behavior, and reduced peripheral levels of pro-inflammatory cytokines and spinal β-catenin expression in CCI rats. PRF to DRG has a better analgesic effect than PRF to the nerve.
Randomized comparison between epidural waveform analysis through the needle versus the catheter for thoracic epidural blocks
Authors: Tangjitbampenbun Amornrat , Layera Sebastián , Arnuntasupakul Vanlapa , Apinyachon Worapot , Venegas Karen , Godoy Jaime , Aliste Julián , Bravo Daniela , Blanch Alonso , Webar Javier , Saadawi Mohammed , Owen Andrew , Finlayson Roderick J , Tran De Q
Published: May 2019

Background

Epidural waveform analysis (EWA) provides a simple confirmatory adjunct for loss of resistance (LOR): when the needle/catheter tip is correctly positioned inside the epidural space, pressure measurement results in a pulsatile waveform. Epidural waveform analysis can be carried out through the tip of the needle (EWA-N) or the catheter (EWA-C). In this randomized trial, we compared the two methods. We hypothesized that, compared with EWA-C, EWA-N would result in a shorter performance time.

Methods

One hundred and twenty patients undergoing thoracic epidural blocks for thoracic or abdominal surgery were randomized to EWA-N or EWA-C. In the EWA-N group, LOR was confirmed by connecting the epidural needle to a pressure transducer. After obtaining a satisfactory waveform, the epidural catheter was advanced 5 cm beyond the needle tip. In the EWA-C group, the epidural catheter was first advanced 5 cm beyond the needle tip after the occurrence of LOR. Subsequently, the catheter was connected to the pressure transducer to detect the presence of waveforms. In both study groups, the block procedure was repeated at different intervertebral levels until positive waveforms could be obtained (through the needle or catheter as per the allocation) or until a predefined maximum of three intervertebral levels had been reached. Subsequently, the operator administered a 4 mL test dose of lidocaine 2% with epinephrine 5 µg/mL through the catheter. An investigator present during the performance of the block recorded the performance time (defined as the temporal interval between skin infiltration and local anesthetic administration through the epidural catheter). Fifteen minutes after the test dose, a blinded investigator assessed the patient for sensory block to ice. Success was defined as a bilateral block in at least two dermatomes. Furthermore, postoperative pain scores, local anesthetic consumption, and breakthrough analgesic consumption were recorded.

Results

No intergroup differences were found in terms of performance time, success rate, postoperative pain, local anesthetic requirement, and breakthrough analgesic consumption.

Conclusion

EWA can be carried out through the needle or through the catheter with similar efficiency (performance time) and efficacy (success rate, postoperative analgesia).

Trial registration number

NCT03603574.
Risk of CIN2+ following a diagnosis of genital warts: a nationwide cohort study
Authors: Blomberg Maria , Dehlendorff Christian , Kjaer Susanne K.
Published: May 2019

Objectives

Individuals with genital warts may be particularly susceptible to human papillomavirus since they have failed to clear the virus. Consequently, women with genital warts could be at increased risk of cervical dysplasia. In this cohort study we aimed to compare the incidence of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) in women with a diagnosis of genital warts with that of the general female population without genital warts.

Methods

Using the Danish nationwide population-based health data registers, we identified women between 15 and 45 years and followed them for diagnoses of CIN2+ from 1995 to 2006. Genital wart diagnoses were recorded from birth, and Cox regression with attained age as underlying scale was used to estimate age-dependent HRs for the risk of CIN2+ with genital warts as a time-varying exposure.

Results

Among 918 609 women without genital warts and 32 218 women with genital warts, 30 209 and 1533 women, respectively, had a subsequent diagnosis of CIN2+. A significantly higher risk of CIN2+ was found among women with genital warts relative to those without (HR, 2.43; 95% CI 2.30 to 2.56). Treatment-resistant genital warts posed a significantly higher risk of CIN2+ than did transient genital warts (HR, 1.20; 95% CI 1.01 to 1.43). The risks remained elevated more than 4 years after the genital wart diagnosis.

Conclusion

Clinicians should ensure that women with genital warts are screened for cervical cancer after the genital wart diagnosis and that they continue to be screened on time.
Mucormycosis emboli: a rare cause of segmental bowel ischemia
Authors: Baiu Ioana , Knowlton Lisa Marie
Published: May 2019

The patient is a 34-year-old man with a history of primary refractory acute myeloblastic leukemia diagnosed 1 year prior, with multiple relapses. As rescue treatment, he underwent allogeneic bone marrow transplant from cord blood 27 days prior to surgical consult. His post-transplant course has been notable for delayed engraftment, prolonged severe neutropenia, resulting in vancomycin-resistantEnterococcus,Streptococcus viridansandStreptococcus mitisbacteremia for which he treated with tedizolid, cefepime, Flagyl and daptomycin per guidance from the Infectious Disease team. On the day of consultation, he developed acute abdominal pain, he was on filgrastim to promote hematopoiesis, and prophylaxis with acyclovir, Bactrim, and caspofungin as well as the above antibiotics for bacteremia. A second antifungal was not started due to the potential toxicity and data from prior infections that he had. On surgical evaluation, his examination was notable for fever to 38.2°C, tachycardia to 155 basic metabolic panel, hypotension to 99/81 and tachypnea to 36; he was ill appearing with a distended abdomen and localized peritonitis. His white cell count was 0.2 x 109/L with an absolute neutrophil count (ANC) of zero. Additionally, he was anemic with a hemoglobin of 7 g/L, thrombocytopenic with a platelet count of 10 x 109/L, and a lactic acid of 3.1 mmol/L. His CT scan earlier in the morning revealed segmental ischemia of the small bowel (figure 1).

Figure 1

CT scan or initial presentation showing lack of wall enhancement of a discrete segment of small bowel.

What would you do?

Offer non-operative management with broad spectrum antibiotics.

Transition to comfort care.

Perform a small bowel resection with primary anastomosis.

Perform a small bowel resection with end ileostomy.
Socio-Spatial Differentiation of Tourist Towns: A Case Study of Huangshui Town, Chongqing
Authors: LI Yue , XI Jianchao
Published: May 2019

Tourism urbanization is one of the important patterns of China’s new-type urbanization. Combining Participatory Rural Appraisal (PRA), ArcGIS spatial analysis and high-resolution remote sensing images, the paper takes a case study of Huangshui Town in Chongqing and explores the socio-spatial features such as the spatial functions, spatial culture and social relations of tourist towns. The research results are as follows: (i) From 2007 to 2017, the number of people permanently living in Huangshui Town over the last 10 years increased from 5,923 to 12,699, up by 2.14 times; the urban construction area expanded from 0.15[Formula: see text]km2 to 1.65[Formula: see text]km2, increased by 11 times. (ii) The space of tourist towns has gradually changed from a homogeneous traditional community tied by blood to a heterogeneous social space containing multiple components and dominated by functions such as residence, business, trade and tourism. (iii) This development pattern is centered at indigenous community-based towns, supplemented by second homes of tourism real estate and extended by tourism clusters featuring pan-leisure services. It is of great practical and theoretical value to the full participation of local indigenous people and the transformation of community functions towards tourism. This pattern prevents the current problem of isolating tourist resorts from local communities, and provides a sustainable development path for the resorts. Besides, this tourism urbanization pattern based on indigenous communities also serves as a correction to the existing creative destruction model, and a boost to the protection and inheritance of culture and ecology and sustainable development of tourist towns.
Using regolith and spinifex chemistry to detect fault-controlled fluids in the Ngururrpa area of northeastern Western Australia, with implications for Pb–Zn mineralization
Authors: Morris Paul
Published: May 2019

Regolith and vegetation (spinifex) chemistry from transects across the Stansmore Fault in the Ngururrpa area of northeastern Western Australia have been used to detect the presence of fault-controlled fluid, and whether the fluid has been in contact with concealed mineralization. On one transect, the fine fraction of the regolith on the fault trace has elevated concentrations of low field strength elements (LFSE), rare earth elements (REE) and some chalcophile elements (Zn and Tl). On the second transect, which is more structurally complex, elevated LFSE, REE and Zn concentrations are coincident with the position of one fault and indicate the location of a second. Both fault traces are indicated by spinifex REE, B, Zn, REE and high field strength element (HFSE) chemistry, and are independently verified by passive seismic data. The wide range in the ionic potentials of elements on or close to fault traces indicates a high fluid flux, whereas high Zn, Tl, Re, Cd, and B concentrations are indicative of sediment-hosted Pb–Zn mineralization. Basin-bounding faults, such as the Stansmore Fault, are spatially related to Mississippi Valley Type (MVT) mineralization elsewhere in the Canning Basin, and rocks hosting sedimentary exhalative (SEDEX)-style mineralization in the adjacent west Arunta Orogen have been reported from the southeastern part of the Ngururrpa area.
Implementing inclusive practices in an active learning STEM classroom
Authors: Johnson Kathryn M. S.
Published: May 2019

What do you bring to a conversation about diversity, equity, and inclusion? While acknowledging this conversation is important, many science, technology, engineering, and math (STEM) faculty shy away from engaging these topics. STEM educators often hesitate to participate in these discussions due to their self-perceived lack of knowledge or training. However, as institutions welcome ever-diversifying student populations, STEM faculty must consider how their teaching and mentoring approaches affect their students. During the 2018 American Physiological Society (APS) Institute for Teaching and Learning, STEM faculty and administrators engaged in conversations to better understand how their own approaches to diversity, equity, and inclusion affect the success of their students. During my plenary workshop, “Inclusive Practices for Diverse Student Populations,” participants investigated their own perspectives and practices. They also discussed approaches to implementing inclusive practices that complement active pedagogical best practices. In an attempt to replicate this workshop environment, I ask you to engage with an interactive set of exercises to investigate your own perspective on the topics of diversity, inclusion, and equity. After you consider your own approaches to these topics, I provide practical examples of inclusive practices that align or enhance active leaning pedagogy. By building confidence, providing support, and promoting various pathways to success, inclusive practices enhance student learning and decrease social disparities in STEM education, ultimately supporting STEM innovation.
A new assessment to monitor student performance in introductory neurophysiology: Electrochemical Gradients Assessment Device
Authors: Cerchiara Jack A. , Kim Kerry J. , Meir Eli , Wenderoth Mary Pat , Doherty Jennifer H.
Published: May 2019

The basis for understanding neurophysiology is understanding ion movement across cell membranes. Students in introductory courses recognize ion concentration gradients as a driving force for ion movement but struggle to simultaneously account for electrical charge gradients. We developed a 17-multiple-choice item assessment of students’ understanding of electrochemical gradients and resistance in neurophysiology, the Electrochemical Gradients Assessment Device (EGAD). We investigated the internal evidence validity of the assessment by analyzing item characteristic curves of score probability and student ability for each question, and a Wright map of student scores and ability. We used linear mixed-effect regression to test student performance and ability. Our assessment discriminated students with average ability (weighted likelihood estimate: −2 to 1.5 Θ); however, it was not as effective at discriminating students at the highest ability (weighted likelihood estimate: >2 Θ). We determined the assessment could capture changes in both assessment scores (model r2 = 0.51, P < 0.001, n = 444) and ability estimates (model r2 = 0.47, P < 0.001, n = 444) after a simulation-based laboratory and course instruction for 222 students. Differential item function analysis determined that each item on the assessment performed equitably for all students, regardless of gender, race/ethnicity, or economic status. Overall, we found that men scored higher ( r2 = 0.51, P = 0.014, n = 444) and had higher ability scores ( P = 0.003) on the EGAD assessment. Caucasian students of both genders were positively correlated with score ( r2 = 0.51, P < 0.001, n = 444) and ability ( r2 = 0.47, P < 0.001, n = 444). Based on the evidence gathered through our analyses, the scores obtained from the EGAD can distinguish between levels of content knowledge on neurophysiology principles for students in introductory physiology courses.
Regulation of breathing pattern by IL-10
Authors: Giannakopoulou Charoula Eleni , Sotiriou Adamantia , Dettoraki Maria , Yang Michael , Perlikos Fotis , Toumpanakis Dimitrios , Prezerakos Georgios , Koutsourelakis Ioannis , Kastis Georgios A. , Vassilakopoulou Vyronia , Mizi Eleftheria , Papalois Apostolos , Greer John J. , Vassilakopoulos Theodoros
Published: May 2019

Proinflammatory cytokines like interleukin-1β (IL-1β) affect the control of breathing. Our aim is to determine the effect of the anti-inflammatory cytokine IL-10 οn the control of breathing. IL-10 knockout mice (IL-10−/−, n = 10) and wild-type mice (IL-10+/+, n = 10) were exposed to the following test gases: hyperoxic hypercapnia 7% CO2-93% O2, normoxic hypercapnia 7% CO2-21% O2, hypoxic hypercapnia 7% CO2-10% O2, and hypoxic normocapnia 3% CO2-10% O2. The ventilatory function was assessed using whole body plethysmography. Recombinant mouse IL-10 (rIL-10; 10 μg/kg) was administered intraperitoneally to wild-type mice ( n = 10) 30 min before the onset of gas challenge. IL-10 was administered in neonatal medullary slices (10–30 ng/ml, n = 8). We found that IL-10−/−mice exhibited consistently increased frequency and reduced tidal volume compared with IL-10+/+mice during room air breathing and in all test gases (by 23.62 to 33.2%, P < 0.05 and −36.23 to −41.69%, P < 0.05, respectively). In all inspired gases, the minute ventilation of IL-10−/−mice was lower than IL-10+/+(by −15.67 to −22.74%, P < 0.05). The rapid shallow breathing index was higher in IL-10−/−mice compared with IL-10+/+mice in all inspired gases (by 50.25 to 57.5%, P < 0.05). The intraperitoneal injection of rIL-10 caused reduction of the respiratory rate and augmentation of the tidal volume in room air and also in all inspired gases (by −12.22 to −29.53 and 32.18 to 45.11%, P < 0.05, respectively). IL-10 administration in neonatal rat ( n = 8) in vitro rhythmically active medullary slice preparations did not affect either rhythmicity or peak amplitude of hypoglossal nerve discharge. In conclusion, IL-10 may induce a slower and deeper pattern of breathing.
Endothelium-dependent impairments to cerebral vascular reactivity with type 2 diabetes mellitus in the Goto-Kakizaki rat
Authors: Halvorson Brayden D. , Whitehead Shawn N. , McGuire John J. , Wiseman Robert W. , Frisbee Jefferson C.
Published: May 2019

Type 2 diabetes mellitus (T2DM) is a prevalent pathology associated with elevated cerebrovascular disease risk. We determined wall mechanics and vascular reactivity in ex vivo middle cerebral arteries (MCA) from male Goto-Kakizaki rats (GK; ~17 wk old) versus control Wistar Kyoto rats (WKY) to test the hypothesis that the diabetic environment in GK, in the absence of obesity and other comorbidities, leads to endothelial dysfunction and impaired vascular tone regulation. Dilation of MCA following challenge with acetylcholine and hypoxia was blunted in MCA from GK versus WKY, due to lower nitric oxide bioavailability and altered arachidonic acid metabolism, whereas myogenic activation and constrictor responses to serotonin were unchanged. MCA wall distensibility and cross-sectional area were not different between GK and WKY, suggesting that wall mechanics were unchanged at this age, supported by the determination that MCA dilation to sodium nitroprusside was also intact. With the use of ex vivo aortic rings as a bioassay, altered vascular reactivity determined in MCA was paralleled by relaxation responses in artery segments from GK, whereas measurements of vasoactive metabolite production indicated a loss of nitric oxide and prostacyclin bioavailability and an increased thromboxane A2production with both methacholine challenge and hypoxia. These results suggest that endothelium-dependent dilator reactivity of MCA in GK is impaired with T2DM, and that this impairment is associated with the genesis of a prooxidant/pro-inflammatory condition with diabetes mellitus. The restriction of vascular impairments to endothelial function only, at this age and development, provide insight into the severity of multimorbid conditions of which T2DM is only one constituent.
Bile acid signaling in renal water regulation
Authors: Li Suchun , Li Chunling , Wang Weidong
Published: May 2019

Emerging evidence has shown that bile acids play important roles in renal physiology and diseases by activating two major receptors, the nuclear farnesoid X receptor (FXR) and the membrane G protein-coupled bile acid receptor-1 (Gpbar1; also known as TGR5). Both FXR and TGR5 have been identified in human and rodent kidneys, where they are deeply involved in renal water handling. In mice, FXR- or TGR5-related gene deficiency has been associated with reduced aquaporin-2 expression accompanied with impaired urinary concentration ability. In this mini-review, we briefly discuss the current understanding of FXR/TGR5 signaling in the kidneys, with a special focus on the regulation of aquaporin-2 expression by bile acids in the collecting ducts and its potential significance in disease conditions.
Renal sensory nerves increase sympathetic nerve activity and blood pressure in 2-kidney 1-clip hypertensive mice
Authors: Ong Jason , Kinsman Brian J. , Sved Alan F. , Rush Brittney M. , Tan Roderick J. , Carattino Marcelo D. , Stocker Sean D.
Published: May 2019

Renal denervation lowers arterial blood pressure (ABP) in multiple clinical trials and some experimental models of hypertension. These antihypertensive effects have been attributed to the removal of renal afferent nerves. The purpose of the present study was to define the function, anatomy, and contribution of mouse renal sensory neurons to a renal nerve-dependent model of hypertension. First, electrical stimulation of mouse renal afferent nerves produced frequency-dependent increases in ABP that were eliminated by ganglionic blockade. Stimulus-triggered averaging revealed renal afferent stimulation significantly increased splanchnic, renal, and lumbar sympathetic nerve activity (SNA). Second, kidney injection of wheat germ agglutinin into male C57Bl6 mice (12–14 wk; Jackson Laboratories) produced ipsilateral labeling in the T11–L2 dorsal root ganglia. Next, 2-kidney 1-clip (2K1C) hypertension was produced in male C57Bl6 mice (12–14 wk; Jackson Laboratories) by placement of a 0.5-mm length of polytetrafluoroethylene tubing around the left renal artery. 2K1C mice displayed an elevated ABP measured via telemetry and a greater fall in mean ABP to ganglionic blockade at day 14 or 21 vs. day 0. Renal afferent discharge was significantly higher in 2K1C-clipped vs. 2K1C-unclipped or sham kidneys. In addition, 2K1C-clipped vs. 2K1C-unclipped or sham kidneys had lower renal mass and higher mRNA levels of several proinflammatory cytokines. Finally, both ipsilateral renal denervation (10% phenol) or selective denervation of renal afferent nerves (periaxonal application of 33 mM capsaicin) at time of clipping resulted in lower ABP of 2K1C mice at day 14 or 21. These findings suggest mouse renal sensory neurons are activated to increase SNA and ABP in 2K1C hypertension.

NEW & NOTEWORTHY This study documents the function, anatomy, and contribution of mouse renal sensory nerves to neurogenic hypertension produced by renal stenosis. Activation of renal afferents increased sympathetic nerve activity and blood pressure. Renal afferent activity was elevated in hypertensive mice, and renal afferent denervation lowered blood pressure. Clinically, patients with renal stenosis have been excluded from clinical trials for renal denervation, but this study highlights the potential therapeutic efficacy to target renal nerves in these patients.
Granular Cell Tumor over the Mons Pubis: An Uncommon Tumor
Authors: Patabendige M. , Wickramasooriya D. J. , Dasanayake L.
Published: May 2019

Granular cell tumors are uncommon, usually benign, soft tissue neoplasms of neural origin. They occur throughout the body; vulval involvement is uncommon and labium majus is the commonest site in vulva. Complete surgical excision is the preferred treatment of choice to prevent recurrence. Here, we present a benign granular cell tumor over the mons pubis of vulva in a 27-year-old woman.
Effect of Kinesio Taping on the Walking Ability of Patients with Foot Drop after Stroke
Authors: Sheng Yilan , Kan Shifeng , Wen Zixing , Chen Wenhua , Qi Qi , Qu Qiang , Yu Bo
Published: May 2019

Objective. The purpose of this study was to investigate the effect of kinesio taping on the walking ability in patients with foot drop after stroke. Methods. Sixty patients were randomly divided into the experimental group (with kinesio taping) and the control group (without kinesio taping). The 10-Meter Walking Test (10MWT), Timed Up and Go Test (TUGT), stride length, stance phase, swing phase, and foot rotation of the involved side were measured with the German ZEBRIS gait running platform analysis system and were used to evaluate and compare the immediate effects of kinesio taping. All the measurements were made in duplicate for each patient. Results. The demographic variables of patients in both groups were comparable before the treatment (p>0.05). After kinesio taping treatment, significant improvement was found in the 10MWT and the TUGT for patients in the experimental group (p<0.05). There were significant differences in the 10MWT and TUGT between the experimental and control groups after treatment (p<0.05). In terms of gait, we found significant improvement in stride length (p<0.001), stance phase (p<0.001), swing phase (p<0.001), and foot rotation (p<0.001) of the involved side in experimental group after treatment compared with those before treatment. Further, the functional outcomes and gait ability were significantly improved in the experimental group after treatment (p<0.05), compared to the control group. Conclusion. Kinesio taping can immediately improve the walking function of patients with foot drop after stroke.
Permeability Properties of Jointed Rock with Periodic Partially Filled Fractures
Authors: Ye Fei , Duan Jun-Chao , Fu Wen-Xi , Yuan Xing-Yu
Published: May 2019

Rock fractures always influence the hydrological properties of a rock mass. To investigate the seepage characteristics of a rock mass with partly filled fractures, a mathematical model is established. In this model, the clear fluid in fractures is governed by the Navier-Stokes equation, and the fluid both in the porous medium and rock matrix are subjected to the Brinkman-Extended Darcy equation. The analytic solution of an equivalent permeability coefficient for a rock mass with partly filled fractures is solved, and it could be reduced to some special known results. Comparisons with experimental data show good agreement, thus verifying the validity of the present computations.
A Rare Case of an Ectopic Liver Presenting as Right Atrial Mass
Authors: Doshi Adhirath , Shah Dhaval , Gupta Shradha , Panday Deepika , Farji-Cisneros Arie , Ramsaran Eddison , Bojar Robert
Published: May 2019

Ectopic liver tissue is commonly observed in the abdominal cavity in adjacent organs. Extension of hepatic tissue into the intrathoracic cavity is rarely reported. We present the case of a 46-year-old woman with a 2.1×1.8 cm mass confirmed by transesophageal echocardiogram to be at the right atrial and inferior vena cava junction that was initially thought to be a myxoma which prompted surgical excision but subsequently identified as ectopic liver by histology.
Congenital Megaprepuce: Literature Review and Surgical Correction
Authors: Werner Zachary , Hajiran Ali , Al-Omar Osama
Published: May 2019

Congenital megaprepuce (CMP) is a type of buried penis characterized by extensive redundancy and ballooning of the inner prepuce as a result of preputial stenosis and phimosis. The malformation typically presents with difficulty voiding, often requiring manual expression of stagnant urine. Multiple techniques have been reported for the treatment of CMP with varying levels of positive outcomes. The authors provide a review of published literature, in addition to describing the procedure and results of our surgical technique in three children aged eleven months, two years, and twelve years. The literature review was conducted using PubMed with keywords “congenital megaprepuce,” “megaprepuce,” “buried penis,” “CMP,” and “correction.” Results were then differentiated based on presence or absence of true congenital megaprepuce and the surgical correction thereof. Regarding our cases, all patients completed the procedure with excellent cosmesis and without complication. Our technique is shown to provide consistent, excellent esthetic outcome across a wide range of ages and may be replicated by others.
Retrospective Analysis of Bone Metabolism in Patients on Waiting List for Simultaneous Pancreas-Kidney Transplantation
Authors: Kratochvílová Simona , Brunová Jana , Wohl Petr , Lánská Věra , Saudek František
Published: May 2019

Posttransplant osteoporosis, which evolves from preexisting bone pathologies, represents a serious complication with deteriorating consequences. The aim of our study was to evaluate epidemiological data on bone mineral density (BMD) in subjects with type 1 diabetes (T1DM) in advanced stages of diabetic nephropathy indicated for simultaneous pancreas-kidney transplantation (SPK). We retrospectively compiled biochemical and densitometrical data from 177 patients with T1DM at CKD (chronic kidney disease) stages G4-G5 (115 men, 62 women, median age 40 yr, diabetes duration 23 yr) enrolled on waiting list for SPK for the first time between the years 2011 and 2016. MedianZ-scores were as follows: lumbar spine (LS): -0.8 [interquartile range -1.75 to 0.1]; total hip (TH): -1.2 [-1.75 to -0.6]; femoral neck (FN): -1.2 [-1.9 to -0.7]; and distal radius (DR): -0.8 [-1.4 to -0.1]. We noted a gender difference in LS, with worse results for men (-1.1 vs. -0.3) even after adjusting for BMI (body mass index) and glomerular filtration (p<0.001). Osteoporotic and osteopenic ranges (based onT-scores) for all major sites were 27.7% and 56.5%, respectively, with similar results across both genders. Women had a significantly higher proportion of normal BMD in LS than men (67.7 vs. 49.4%,p<0.05). Patients with T1DM at CKD stages G4-G5 exhibited serious BMD impairment despite their young age. Men surprisingly displayed lowerZ-scores and higher percentages of pathological BMD values in LS than women did. The introduction of adequate preventive measures during the advanced stages of diabetic nephropathy to prevent bone loss is recommended.
Sensors of Smart Devices in the Internet of Everything (IoE) Era: Big Opportunities and Massive Doubts
Authors: Masoud Mohammad , Jaradat Yousef , Manasrah Ahmad , Jannoud Ismael
Published: May 2019

Smart device industry allows developers and designers to embed different sensors, processors, and memories in small-size electronic devices. Sensors are added to enhance the usability of these devices and improve the quality of experience through data collection and analysis. However, with the era of big data and machine learning, sensors’ data may be processed by different techniques to infer various hidden information. The extracted information may be beneficial to device users, developers, and designers to enhance the management, operation, and development of these devices. However, the extracted information may be used to compromise the security and the privacy of humans in the era of Internet of Everything (IoE). In this work, we attempt to review the process of inferring meaningful data from smart devices’ sensors, especially, smartphones. In addition, different useful machine learning applications based on smartphones’ sensors data are shown. Moreover, different side channel attacks utilizing the same sensors and the same machine learning algorithms are overviewed.
Mechanical Properties and Statistical Damage Constitutive Model of Rock under a Coupled Chemical-Mechanical Condition
Authors: Lin Yun , Gao Feng , Zhou Keping , Gao Rugao , Guo Hongquan
Published: May 2019

Chemical corrosion has a significant impact on the damage evolution behavior of rock. To investigate the mechanical damage evolution process of rock under a coupled chemical-mechanical (CM) condition, an improved statistical damage constitutive model was established using the Drucker-Prager (D-P) strength criterion and two-parameter Weibull distribution. The damage variable correction coefficient and chemical damage variable which was determined by porosity were also considered in the model. Moreover, a series of conventional triaxial compressive tests were carried out to investigate the mechanical properties of sandstone specimens under the effect of chemical corrosion. The relationship between rock mechanics properties and confining pressure was also explored to determine Weibull distribution parameters, including the shape parametermand scale parameterF0. Then, the reliability of the damage constitutive model was verified based on experimental data. The results of this study are as follows: (i) the porosity of sandstone increased and the mechanical properties degraded after chemical corrosion; (ii) the relationships among the compressive strength, the peak axial strain, and confining pressures were linear, while the relationships among the elastic modulus, the residual strength, and confining pressures were exponential functions; and (iii) the improved statistical damage constitutive model was in good agreement with the testing curves withR2>0.98. It is hoped that the study can provide an alternative method to analyze the damage constitutive behavior of rock under a coupled chemical-mechanical condition.
Quantification of Bioactive Compounds and Evaluation of the Antioxidant Activity of Carissa edulis Valh (Apocynaceae) Leaves
Authors: Fanta Yadang Sabine Adeline , Taiwe Sotoing Germain , Ngatcha Zouakeu Katoucha Sidoine , Khan Muhammad Ahsan , Agbor Gabriel Agbor , Ur-Rahman Nisar , Ngo Bum Elisabeth
Published: May 2019

Carissa edulis is a plant used in the management of oxidative stress and inflammatory related disorders such as malaria, rheumatism inflammation, and cardiovascular diseases. The present study evaluates the total phenolic content, antioxidant capacity (DPPH, ABTS, and FRAP), and the bioactive compounds present in the various extracts of C. edulis (HEC, MEC, AEC, and PC). An HPLC analysis determined the different compounds present in the extracts. High concentration of total phenolic content was observed in aqueous and methanolic extracts more than in the hydroethanolic extract though not significantly different. Flavonoids were higher in the hydroethanolic and methanolic extracts, respectively, with 14.84 mg RE/g extract and 12.02 mg RE/g extract. Tannins were also found in large amounts in the same two extracts with 26.76 mg TAE/g extract and 34.67 mg TEE/g extract. The percentage radical scavenging activity DPPH ranged between 58.63% and 94.67% for aqueous extract and for ABTS between 51.39% and 94.12% for the methanolic extract. The highest FRAP was obtained in the methanolic extract (6.73 g AAE/100 g extract). HPLC analysis revealed the presence of quercetin, rutin, and gallic acid in the different extracts. C. edulis represents a potential source of bioactive components with antioxidant capacity.
The Effective Healing Strategy against Localized Attacks on Interdependent Spatially Embedded Networks
Authors: Gong Kai , Wu Jia-Jian , Liu Ying , Li Qing , Liu Run-Ran , Tang Ming
Published: May 2019

Many real‐world infrastructure networks, such as power grids and communication networks, always depend on each other by their functional components that share geographic proximity. A lot of works were devoted to revealing the vulnerability of interdependent spatially embedded networks (ISENs) when facing node failures and showed that the ISENs are susceptible to geographically localized attacks caused by natural disasters or terrorist attacks. How to take emergency methods to prevent large scale of cascading failures on interdependent infrastructures is a longstanding problem. Here, we propose an effective strategy for the healing of local structures using the connection profile of a failed node, called the healing strategy by prioritizing minimum degrees (HPMD), in which a new link between two active low‐degree neighbors of a failed node is established during the cascading process. Afterwards, comparisons are made between HPMD and three healing strategies based on three metrics: random choice, degree centrality, and local centrality, respectively. Simulations are performed on the ISENs composed of two diluted square lattices with the same size under localized attacks. Results show that HPMD can significantly improve the robustness of the system by enhancing the connectivity of low‐degree nodes, which prevent the diffusion of failures from low‐degree nodes to moderate‐degree nodes. In particular, HPMD can outperform other three strategies in the size of the giant component of networks, critical attack radius, and the number of iterative cascade steps for a given quota of newly added links, which means HPMD is more effective, more timely, and less costly. The high performance of HPMD indicates low‐degree nodes should be placed on the top priority for effective healing to resist the cascading of failures in the ISENs, which is totally different from the traditional methods that usually take high‐degree nodes as critical nodes in a single network. Furthermore, HPMD considers the distance between a pair of nodes to control the variation in the network structures, which is more applicable to spatial networks than previous methods.
Multifractal Detrended Cross‐Correlation Analysis of Electricity and Carbon Markets in China
Authors: Zou Shaohui , Zhang Tian
Published: May 2019

With the development of carbon market, the complex dynamic relationship between electricity and carbon market has become the focus of energy research area. In this paper, we applied a new developed multifractal detrended cross‐correlation analysis method to investigate the cross‐correlation and multifractality between electricity and carbon markets. We analyze the daily return of electricity and carbon prices over a period of 6 years to do the research. The results show that, firstly, we find that there is a strong negative correlation between domestic carbon price and electricity price and a significant cross‐correlation between the return series of electricity and carbon markets. Secondly, through multifractal detrended fluctuation analysis, it is proven that there are obvious multifractal characteristics in the return series of electricity and carbon markets, and the results of traditional linear analysis are unreliable. We also find that, based on multifractal detrended cross‐correlation analysis, the law cross‐correlation between electricity and carbon markets exists significantly. The long‐range correlation of small fluctuations and large fluctuations and the fat tail distribution of return series are the reasons for the formation of multifractality.
Global Solar Radiation Forecasting Using Square Root Regularization‐Based Ensemble
Authors: Dong Yao , Jiang He
Published: May 2019

In recent decades, the integration of solar energy sources has gradually become the main challenge for global energy consumption. Therefore, it is essential to predict global solar radiation in an accurate and efficient way when estimating outputs of the solar system. Inaccurate predictions either cause load overestimation that results in increased cost or failure to gather adequate supplies. However, accurate forecasting is a challenging task because solar resources are intermittent and uncontrollable. To tackle this difficulty, several machine learning models have been established; however, the forecasting outcomes of these models are not sufficiently accurate. Therefore, in this study, we investigate ensemble learning with square root regularization and intelligent optimization to forecast hourly global solar radiation. The main structure of the proposed method is constructed based on ensemble learning with a random subspace (RS) method that divides the original data into several covariate subspaces. A novel covariate‐selection method called square root smoothly clipped absolute deviation (SRSCAD) is proposed and is applied to each subspace with efficient extraction of relevant covariates. To combine the forecasts obtained using RS and SRSCAD, a firefly algorithm (FA) is used to estimate the weights assigned to individual forecasts. To handle the complexity of the proposed ensemble system, a simple and efficient algorithm is derived based on a thresholding rule and accelerated gradient method. To illustrate the validity and effectiveness of the proposed method, global solar radiation datasets of eight locations of Xinjiang province in China are considered. The experimental results show that the proposed RS‐SRSCAD‐FA achieves the best performances with a mean absolute percentage error, root‐mean‐square error, Theil inequality coefficient, and correlation coefficient of 0.066, 20.21 W/m2, 0.016, 3.40 s, and 0.98 in site 1, respectively. For the other seven datasets, RS‐SRSCAD‐FA still outperforms other approaches. Finally, a nonparametric Friedman test is applied to perform statistical comparisons of results over eight datasets.
Metoprolol Significantly Improves Visual Clarity and Hemodynamic Parameters during Functional Endoscopic Sinus Surgery
Authors: Sadek Ahmed A. , Mostafa Mokhtar , Abdel-Monem Tarek
Published: May 2019

Background and Objectives: The success of functional endoscopic sinus surgery (FESS) depends on the visual clarity of the surgical field, which is understudied. Controlled hypotension has many advantages for FESS including reduction in blood loss and improved quality of the surgical field. This study determined whether the use of β-blockers as a premedication could improve the operative field in FESS. Methods: Sixty patients aged from 18 to 50 years, undergoing septoplasty and FESS were included in this prospective, randomized, double-blind, placebo-controlled study. Patients were randomly assigned to receive either metoprolol (100 mg, group 1) or a placebo (a vitamin tablet, group 2) 60 min before surgery. Results: The average blood loss and surgery duration were not significantly higher in the placebo group. The surgical field was graded using the Fromme-Boezaart scale, and it was significantly clearer (p < 0.001) in metoprolol group. The mean arterial blood pressure was significantly lower in the metoprolol group after 30 min of induction until the end of surgery (p < 0.001). The heart rate was also significantly lower (p < 0.001) in those who received metoprolol from before induction of anesthesia up to the end of surgery. Conclusion: Metoprolol significantly improves visual clarity and hemodynamics during FESS. We would recommend the use of metoprolol in FESS and septoplasty.
The Heterogeneous Pathogenesis of Selective Immunoglobulin A Deficiency
Authors: Bagheri Yasser , Sanaei Roozbeh , Yazdani Reza , Shekarabi Mehdi , Falak Reza , Mohammadi Javad , Abolhassani Hassan , Aghamohammadi Asghar
Published: May 2019

Selective immunoglobulin A deficiency (SIgAD) is the most prevalent type of primary immunodeficiency disorder. The phenotypic feature of SIgAD is related to a defect in B lymphocyte differentiation into plasma cell-producing immunoglobulin A (IgA). In this review, we summarize the recent advances in this regard. Genetic (including major histocompatibility complex [MHC] and non-MHC genes), immunologic (including B and T lymphocyte subsets abnormality), cytokines/chemokines and their related receptors, apoptosis and microbiota defects are reviewed. The mechanisms leading to SIgAD are most likely multifactorial and it can be speculated that several pathways controlling B cells functions or regulating epigenetic of the IGHA gene encoding constant region of IgA heavy chain and long-term survival of IgA switched memory B cells and plasma cells may be defective in different SIgAD patients.
Topiramate plus Cooling for Hypoxic-Ischemic Encephalopathy: A Randomized, Controlled, Multicenter, Double-Blinded Trial
Authors: Nuñez-Ramiro Antonio , Benavente-Fernández Isabel , Valverde Eva , Cordeiro Malaika , Blanco Dorotea , Boix Hector , Cabañas Fernando , Chaffanel Mercedes , Fernández-Colomer Belén , Fernández-Lorenzo Jose Ramón , Kuligowski Julia , Loureiro Begoña , Moral-Pumarega Maria Teresa , Pavón Antonio , Sánchez-Illana Angel , Tofé Inés , Hervás David , García-Robles Ana , Parra-Llorca Anna , Cernada Maria , Martinez-Rodilla Juan , Lorente-Pozo Sheila , Llorens Roberto , Marqués Remedios , Vento Máximo ,   on behalf of the Hypotop Study Group
Published: May 2019

Background and Objectives: Therapeutic interventions to improve the efficacy of whole-body cooling for hypoxic-ischemic encephalopathy (HIE) are desirable. Topiramate has been effective in reducing brain damage in experimental studies. However, in the clinical setting information is limited to a small number of feasibility trials. We launched a randomized controlled double-blinded topiramate/placebo multicenter trial with the primary objective being to reduce the antiepileptic activity in cooled neonates with HIE and assess if brain damage would be reduced as a consequence. Study Design: Neonates were randomly assigned to topiramate or placebo at the initiation of hypothermia. Topiramate was administered via a nasogastric tube. Brain electric activity was continuously monitored. Topiramate pharmacokinetics, energy-related and Krebs’ cycle intermediates, and lipid peroxidation biomarkers were determined using liquid chromatography-mass spectrometry and MRI for assessing brain damage. Results: Out of 180 eligible patients 110 were randomized, 57 (51.8%) to topiramate and 53 (48.2%) to placebo. No differences in the perinatal or postnatal variables were found. The topiramate group exhibited less seizure burden in the first 24 h of hypothermia (topiramate, n = 14 [25.9%] vs. placebo, n = 22 [42%]); needed less additional medication, and had lower mortality (topiramate, n = 5 [9.2%] vs. placebo, n = 10 [19.2%]); however, these results did not achieve statistical significance. Topiramate achieved a therapeutic range in 37.5 and 75.5% of the patients at 24 and 48 h, respectively. A significant association between serum topiramate levels and seizure activity (p < 0.016) was established. No differences for oxidative stress, energy-related metabolites, or MRI were found. Conclusions: Topiramate reduced seizures in patients achieving therapeutic levels in the first hours after treatment initiation; however, they represented only a part of the study population. Our results warrant further studies with higher loading and maintenance dosing of topiramate.