bluuebunny/crossref_metadata_2025 huggingface dataset:
Fundamental study on fatigue measurement in VDT work from speech analysis
Authors: Matsumura Toshie , Kawamura Emi , Kosaka Hiroaki , Hashimoto Hideki , Kagawa Toshiya , Yoshimura Hiroki , Shimizu Tadaaki
Published: November 2018

We aimed at developing a simple fatigue measurement system, so far the influence of the noise is small under laboratory environment and the experimenter side who uses a simulator. We have been studying fatigue measurement in a manageable environment. In order to show the effectiveness of our proposed method in a real environment, we collected fatigue measurement indexes before and after work for technical engineers of Software Development Company operating visual display terminals (VDT) work, changes before and after were compared and examined. As a result, in the conventional indexes, a significant difference was found in the pulse rate and the flicker value. We found that there are significant differences between before and after some speech of fundamental frequency, speech power, and period of speech indexes. In VDT work, there was a difference in flicker value as a fatigue measurement index, which was also supported by subjective symptoms and self‐evaluation results. In addition, since significant differences were also found in the speech index, in the work centering on the VDT work as well as the bicycle simulator so far, it was shown that speech indexes can be effective indicators.
Diastolic stress test echocardiography in patients with suspected heart failure with preserved ejection fraction: a pilot study
Authors: Belyavskiy Evgeny , Morris Daniel A. , Url‐Michitsch Marion , Verheyen Nicolas , Meinitzer Andreas , Radhakrishnan Aravind‐Kumar , Kropf Martin , Frydas Athanasios , Ovchinnikov Artem G. , Schmidt Albrecht , Tadic Marijana , Genger Martin , Lindhorst Ruhdja , Bobenko Anna , Tschöpe Carsten , Edelmann Frank , Pieske‐Kraigher Elisabeth , Pieske Burkert
Published: November 2018

Aims

The purpose of this pilot study was to assess the potential usefulness of diastolic stress test (DST) echocardiography in patients with suspected heart failure with preserved ejection fraction (HFpEF).

Methods and results

Patients with suspected HFpEF (left ventricular ejection fraction ≥ 50%, exertional dyspnoea, septal E/e′ at rest 9–14, and N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) at rest < 220 pg/mL; n = 13) and a control group constituted from asymptomatic patients with arterial hypertension (n = 19) and healthy subjects (n = 18) were included. All patients were analysed by two‐dimensional and Doppler echocardiography at rest and during exercise (DST) and underwent cardiopulmonary exercise testing and NT‐proBNP analysis during exercise. HFpEF during exercise was defined as exertional dyspnoea and peak VO2 ≤ 20.0 mL/min/kg. In patients with suspected HFpEF at rest, 84.6% of these patients developed HFpEF during exercise, whereas in the group of asymptomatic patients with hypertension and healthy subjects, the rate of developed HFpEF during exercise was 0%. Regarding the diagnostic performance of DST to detect HFpEF during exercise, an E/e′ ratio >15 during exercise was the most accurate parameter to detect HFpEF (accuracy 86%), albeit a low sensitivity (45.5%). Nonetheless, combining E/e′ with tricuspid regurgitation (TR) velocity > 2.8 m/s during exercise provided a significant increase in the sensitivity to detect patients with HFpEF during exercise (sensitivity 72.7%, specificity 79.5%, and accuracy 78%). Consistent with these findings, an increase of E/e′ was significantly linked to worse peak VO2, and the combination of an increase of both E/e′ and TR velocity was associated with elevated NT‐proBNP values during exercise.

Conclusions

The findings of this pilot study suggest that DST using E/e′ ratio and TR velocity could be of potential usefulness to diagnose HFpEF during exercise in patients with suspected HFpEF at rest.
Electrode‐Free Triboelectric Nanogenerator for Harvesting Human Biomechanical Energy and as a Versatile Inartificial Physiological Monitor
Authors: Cui Xiaojing , Cao Shengli , Yuan Zhongyun , Xie Gang , Ding Jie , Sang Shengbo , Zhang Hulin
Published: November 2018

The emergence of portable health monitors and wearable versatile sensors brings a promising approach for real‐time physiological surveillance. However, the complicated wiring connections and unsustainable power supplies have largely hindered their combination. Herein, a human body‐based electrode‐free triboelectric nanogenerator (TENG) is demonstrated, which can not only effectively harvest biomechanical energy from human walking and running, but can also serve as a self‐powered versatile inartificial physiological monitor. Most importantly, no electrode material is required in the TENG. In virtue of triboelectrification between the sole and the floor, electricity is produced during human motions with the desirable open‐circuit voltage of more than 150 V under casual walking. The performance of the TENG is investigated under variable environmental conditions and different configurations to evaluate its adaptability. By extracting inartificial electric signals from any part of the human body, information of the footwork, lameness, body weight, and jumping height can be actively transmitted out without using any external power sources. This work provides a new self‐powered route of health surveillance and disease diagnosis.
Production and characterization of rhamnolipids from bioconversion of palm oil mill effluent by the halophilic bacterium Pseudomonas stutzeri BK‐AB12
Authors: Fazli Rahmad Rizki , Hertadi Rukman
Published: November 2018

This study aims to produce and characterize rhamnolipids via bioconversion of palm oil mill effluent (POME) by the halophile Pseudomonas stutzeri BK‐AB12. The bacterial strain was grown in a pre‐optimized mineral salt medium (MSM) containing 20%(v/v) POME, 0.2%(w/v) urea, and 5% (w/v) NaCl, at pH 7.5. Biosurfactant was produced when bacterial growth reached the end of the stationary phase to the death phase, around 96 h. In order to verify that the biosurfactant produced by P. stutzeri BK‐AB12 was a rhamnolipid, a qualitative test on blue agar medium containing cethyltryacetyl bromide‐methylene blue was performed. Characterization of the physicochemical properties of the purified biosurfactant revealed that it had its maximum emulsification index of about 71.4%, under the following conditions: pH 9, 15% (w/v) NaCl, and at 55°C. The critical micelle concentration (CMC) of this biosurfactant was about 390 mg/L with a decrease in surface tension of water about 16 dynes/cm. Structural analysis using Fourier transform infrared and 1‐D 1H NMR reaffirmed that the biosurfactant spectrum profile was similar to rhamnolipids. Further structural analysis using high‐resolution mass spectrophotometry successfully identified several new structures of rhamnolipids produced by P. stutzeri BK−AB12. © 2018 American Institute of Chemical Engineers Environ Prog, 38:e13007, 2019
Early Cretaceous granitic dykes in the western Dabie Orogen, China: Geochronology, petrogenesis, and tectonic implications
Authors: Zhu Jiang , Wang Lianxun , Ma Jian , Zhou Zuomin , Deng Xin , Hu Junliang
Published: November 2018

Whole‐rock major‐trace elemental, whole‐rock Sr–Nd, and zircon U–Pb–Hf isotopic analyses have been carried out on two suites of Early Cretaceous granitic dykes in the western Dabie Orogen (Central China) with the aim of addressing their petrogenesis and geodynamic significance. LA‐ICPMS zircon U–Pb dating reveals that the E‐W‐trending granitic dykes have emplacement ages of 133.9 ± 1.6 and 132.8 ± 1.0 Ma, while the NW‐trending granitic dykes have emplacement ages of 121.4 ± 0.9 and 120.5 ± 0.7 Ma. These rocks have high concentrations of SiO2 and K2O, belonging to the high‐K calc‐alkaline and shoshonitic series. They are metaluminous to peraluminous and are mainly fractionated I‐type granite. The E‐W‐trending granites have moderate initial 87Sr/86Sr ratios (0.70614 to 0.70878) and negative εNd(t) values varying from −16.2 to −17.2 with two‐stage Nd model ages of 2.20 to 2.43 Ga. They exhibit a narrow range of zircon εHf(t) values (−22.34 to −23.70) with two‐stage Hf model ages of 2.31 to 2.36 Ga. These isotopic signatures suggest a homogeneous crustal source without significant magma contamination or mixing. The NW‐trending granites have initial 87Sr/86Sr ratios ranging from 0.70774 to 0.71034 and negative εNd(t) values varying from −10.9 to −9.5 with two‐stage Nd model ages of 1.69 to 1.80 Ga. They yield variable zircon εHf(t) values of −17.06 to −0.39 with two‐stage Hf model ages of 1.07 to 1.99 Ga, implying heterogeneous crustal signatures with minor mantle materials involved. Combining the geological, geochemical, and isotopic evidences, the E‐W‐trending granitic dykes are considered to be derived from partial melting of crustal materials under normal thickness during a transitional period following the tectonic collapse, while the NW‐trending granitic dykes resulted from crust melting in an extensional setting, most likely induced by the asthenospheric upwelling. Our results support that the western Dabie Orogen could have experienced S‐N‐directed compression (pre. 133 Ma), S‐N‐directed extension (ca. 133 Ma), and general E‐W‐directed extension (ca. 120 Ma). We propose that the Dabie Orogen has experienced tectonic collapse of the thickened lower crust and also has been affected by the subduction of the Izanagi (or Palaeo‐Pacific) Plate during the Early Cretaceous.
Resting‐state functional connectivity after concussion is associated with clinical recovery
Authors: Kaushal Mayank , España Lezlie Y. , Nencka Andrew S. , Wang Yang , Nelson Lindsay D. , McCrea Michael A. , Meier Timothy B.
Published: November 2018

There has been a recent call for longitudinal imaging studies to better characterize the time course of physiological recovery following sport‐related concussion (SRC) and its relationship with clinical recovery. To address this, we evaluated changes to resting‐state functional connectivity (rs‐FC) of the whole‐brain network following SRC and explored associations between rs‐FC and measures of clinical outcome. High school and collegiate football athletes were enrolled during preseason. Athletes that suffered SRC (N = 62) were assessed across the acute (within 48 hr) and sub‐acute (days 8, 15, and 45) phases. Matched football athletes without concussion served as controls (N = 60) and participated in similar visits. Multi‐band resting‐state fMRI was used to assess whole‐brain rs‐FC at each visit using network‐based statistic and average nodal strength from regions of interest defined using a common whole‐brain parcellation. Concussed athletes had elevated symptoms, psychological distress, and oculomotor, balance, and memory deficits at 48 hr postconcussion relative to controls, with diminished yet significant elevations in symptoms and psychological distress at 8 days. Both rs‐FC analyses showed that concussed athletes had a global increase in connectivity at 8 days postconcussion relative to controls, with no differences at the 48‐hr, 15‐day, or 45‐day visits. Further analysis revealed the group effect at the 8‐day visit was driven by the large minority of concussed athletes still symptomatic at their visit; asymptomatic concussed athletes did not differ from controls. Findings from this large‐scale, prospective study suggest whole‐brain rs‐FC alterations following SRC are delayed in onset but associated with the presence of self‐reported symptoms.
Discriminating Alzheimer's disease progression using a new hippocampal marker from T1‐weighted MRI: The local surface roughness
Authors: Platero Carlos , López María Eugenia , Carmen Tobar María del , Yus Miguel , Maestu Fernando
Published: November 2018

Hippocampal atrophy is one of the main hallmarks of Alzheimer's disease (AD). However, there is still controversy about whether this sign is a robust finding during the early stages of the disease, such as in mild cognitive impairment (MCI) and subjective cognitive decline (SCD). Considering this background, we proposed a new marker for assessing hippocampal atrophy: the local surface roughness (LSR). We tested this marker in a sample of 307 subjects (normal control (NC) = 70, SCD = 87, MCI = 137, AD = 13). In addition, 97 patients with MCI were followed‐up over a 3‐year period and classified as stable MCI (sMCI) (n = 61) or progressive MCI (pMCI) (n = 36). We did not find significant differences using traditional markers, such as normalized hippocampal volumes (NHV), between the NC and SCD groups or between the sMCI and pMCI groups. However, with LSR we found significant differences between the sMCI and pMCI groups and a better ability to discriminate between NC and SCD. The classification accuracy of the LSR for NC and SCD was 68.2%, while NHV had a 57.2% accuracy. In addition, the classification accuracy of the LSR for sMCI and pMCI was 74.3%, and NHV had a 68.3% accuracy. Cox proportional hazards models adjusted for age, sex, and education were used to estimate the relative hazard of progression from MCI to AD based on hippocampal markers and conversion times. The LSR marker showed better prediction of conversion to AD than NHV. These results suggest the relevance of considering the LSR as a new hippocampal marker for the AD continuum.
CTCs‐derived xenograft development in a triple negative breast cancer case
Authors: Pereira‐Veiga Tais , Abreu Manuel , Robledo Diego , Matias‐Guiu Xavier , Santacana María , Sánchez Laura , Cueva Juan , Palacios Patricia , Abdulkader Ihab , López‐López Rafael , Muinelo‐Romay Laura , Costa Clotilde
Published: November 2018

Triple‐negative breast cancer (TNBC) is characterized by high rates of metastasis and no available molecular targets. CTCs derived xenografts (CDX) have demonstrated to be a promising tool for understanding cancer biology. In our study, a CDX from a TNBC patient was developed for the first time. After CDX characterization, WNT signaling was found as the main mechanism related with this tumor biology and potential CTCs markers were identified and subsequently validated in TNBC patients. In this cohort high levels of MELK expression were associated with poorer survival rates. Overall, our study demonstrates that CTCs from TNBC are tumorigenic and CDXs are a useful model to obtain valuable information about the tumor.
Predictors of successful manual rotation for occiput posterior positions
Authors: Bertholdt Charline , Gauchotte Emilie , Dap Matthieu , Perdriolle‐Galet Estelle , Morel Olivier
Published: November 2018

Objective

To identify predictors of the success of manual rotation of fetuses in an occiput posterior position.

Methods

A prospective, observational, single‐center study included all women with a singleton pregnancy at term with a fetus in an occiput posterior position for whom manual rotation was attempted from December 1, 2013, to April 30, 2015 at a tertiary care maternity unit in Nancy, France. Occiput posterior position was confirmed by ultrasonography, and success of manual rotation was defined by the occiput anterior position of the fetus after the attempt.

Results

Occiput posterior position was diagnosed in 233 (9.2%) of the 2522 deliveries during the study period and the majority of cases were managed successfully by manual rotation (167 [71.7%]). Factors associated with successful rotation were fetal engagement (adjusted odds ratio [aOR] 2.20, 95% confidence interval [CI] 1.05–4.56), spontaneous labor (aOR 1.85, 95% CI 1.01–3.43), and no failure to progress (aOR 2.01, 95% CI 1.02–3.94). Successful manual rotation was associated with lower rates of cesarean (P<0.001) and instrumental (P<0.001) deliveries.

Conclusion

Study findings suggested that manual rotation, especially after fetal engagement, succeeded more often when performed systematically than when it was attempted after failure to progress.
Angiotensin II confers resistance to apoptosis in cardiac myofibroblasts through the AT1/ERK1/2/RSK1 pathway
Authors: Cai Wenfeng , Zhong Shuping , Zheng Fuchun , Zhang Yanmei , Gao Fenfei , Xu Hongquan , Cai Xiangna , Lan Junhong , Huang Danmei , Shi Ganggang
Published: November 2018

Myofibroblast apoptosis is essential for normal resolution of wound repair, including cardiac infarction repair. Impaired cardiac myofibroblast (CMF) apoptosis is associated with excessive extracellular matrix (ECM) deposition, which could be responsible for pathological cardiac fibrosis. Conventionally, angiotensin II (Ang II), a soluble peptide, is implicated in fibrogenesis because it induces cardiac fibroblast (CFb) proliferation, differentiation, and collagen synthesis. However, the role of Ang II in regulation of CMF survival and apoptosis has not been fully clarified. In this report, we cultured neonatal rat CFbs, which transform into CMFs after passage 3 (6–8 days), and investigated the effects of Ang II on CMFs challenged by TNF‐α combined with cycloheximide and the underlying mechanisms. Here, we show that Ang II rapidly activates MAPKs but not AKT in CMFs and confers apoptosis resistance, as evidenced by the inhibition of caspase‐3 cleavage, early apoptotic cells and late apoptotic cells. This inhibitory effect of Ang II was reversed by blockade of AT1 or inactivation of ERK1/2 or RSK1 but not AT2, indicating that activation of the prosurvival AT1/ERK1/2/RSK1 signaling pathway mediates apoptosis resistance. TGF‐β, a latent fibrotic factor, was found to have no relation to Ang II‐induced apoptosis resistance in our study. Furthermore, Ang II‐mediated apoptosis resistance, which was conferred by activation of the AT1/ERK1/2/RSK1 signaling pathway, was also confirmed in human adult ventricular cardiac myofibroblasts. Collectively, our findings suggest a novel profibrotic mechanism of Ang II in which it promotes myofibroblast resistance to apoptosis in addition to classical mechanisms, providing a potential novel therapeutic approach by targeting prosurvival signaling pathways. © 2018 IUBMB Life, 71(1):261–276, 2019
An ONIOM investigation of the effect of conformation on bond dissociation energies in peptides
Authors: Chan Bun , Radom Leo
Published: November 2018

In the present study, we use the ONIOM strategy of Morokuma and coworkers to examine the various CH bond dissociation energies (BDEs) of a small peptide (2ONW) and compare these with values obtained for its component individual amino acid residues. To evaluate suitable methods for ONIOM‐based geometry optimizations, we test an “internal consistency” approach against full B3‐LYP//B3‐LYP results, and find B3‐LYP/6‐31G(d):AM1 to be appropriate. We find that the BDEs at the α‐carbon in 2ONW are generally larger than the corresponding values for the individual residues on their own. This is attributed to the constraints of the peptide backbone leading to conformations that are not ideal for captodative stabilization of the resulting α‐radicals. At the more flexible β‐ and γ‐positions, the differences between the BDEs in 2ONW and the individual residues are smaller. Overall, the α‐BDEs are smaller than the β‐ and γ‐BDEs in most cases. Thus, to rationalize the inertness of peptide backbones with respect to α‐hydrogen abstraction that is frequently found experimentally, it is necessary to consider alternative protection mechanisms such as the polar effect. © 2018 Wiley Periodicals, Inc.
Dynamic relaying properties of a β‐turn peptide in long‐range electron transfer
Authors: Song Xiufang , Zhang Fengying , Bu Yuxiang
Published: November 2018

The relay stations play a significant role in long‐range charge hopping transfer in proteins. Although studies have clarified that many more protein structural motifs can function as relays in charge hopping transfers by acting as intermediate charge carriers, the relaying properties are still poorly understood. In this work, taking a β‐turn oligopeptide as an example, we report a dynamic character of a relay with tunable relaying properties using the density functional theory calculations. Our main finding is that a β‐turn peptide can serve as an effective electron relay in facilitating long‐range electron migration and its relay properties is vibration‐tunable. The vibration‐induced structural transient distortions remarkably affect the lowest occupied molecular orbital (LUMO) energy, vertical electron affinity and electron‐binding mode of the β‐turn oligopeptide and the singly occupied molecular orbital (SOMO) energy of the corresponding electron adduct and thus the relaying properties. Different vibration modes lead to different structural distortions and thus have different effects on the relaying properties and ability of the β‐turn peptide. For the relaying properties, there approximately is a linear negative correlation of electron affinity with the LUMO energy of the β‐turn or the SOMO energy of its electron adduct. Besides, such relaying properties also vary in the vibration evolution process, and the electron‐binding modes may be tunable. As an important addition to the known static charge relaying properties occurring in various protein structural motifs, this work reports the dynamic electron‐relaying characteristics of a β‐turn oligopeptide with variable relaying properties governed by molecular vibrations which can be applied to different proteins in mediating long‐range charge transfers. Clearly, this work reveals molecular vibration effects on the electron relaying properties of protein structural motifs and provides new insights into the dynamics of long‐range charge transfers in proteins. © 2018 Wiley Periodicals, Inc.
Palliation of malignant gastroduodenal obstruction with self‐expandable metal stent using side‐ and forward‐viewing endoscope: Feasibility and outcome
Authors: Kumar Vinay , Ghoshal Uday C , Mohindra Samir , Saraswat Vivek A
Published: November 2018

Background

The endoscopic placement of a self‐expandable metal stent (SEMS), an alternative to surgical bypass for the palliation of malignant gastric outlet obstruction (GOO), is commonly performed using a forward‐viewing endoscope with a wide therapeutic channel; however, due to limited availability, most Indian centers use a side‐viewing duodenoscope. We studied the feasibility and outcome of SEMS placement using side‐ and forward‐viewing endoscopes.

Method

Data of patients undergoing SEMS placement using side‐ and forward‐viewing endoscopes with a therapeutic channel for the palliation of malignant GOO presenting during a 5‐year period were analyzed retrospectively. Follow‐up data were obtained from records and telephonic interviews, and technical and clinical success, complications, and survival were evaluated.

Results

Of 114 patients (age 56.5 ± 11.6 years, 59 [52%] female), 90 (79%) and 24 (21%) underwent SEMS placement using side‐ and forward‐viewing endoscopes, respectively. Technical (89, 98.9% vs. 24, 100%, P = ns) and clinical success (84, 93.3% vs. 23, 95.8%, P = ns) and complication rate (3, 3.3% vs. 0, P = ns) between side‐ and forward‐viewing endoscopes were comparable. However, SEMS could be placed in a shorter time using a forward‐ rather than side‐viewing endoscope (21 min [inter‐quartile range 19.5–35] vs. 34 min [25–45], P = < 0.001). SEMS could be deployed successfully with a forward‐viewing endoscope in two patients in whom an initial attempt using side‐viewing endoscope failed. Gastric outlet obstruction scoring system (GOOSS) improved following stent placement (median 0, range 0–2 vs. 2, 0–3, P = 0.0001). The survival of patients undergoing SEMS placement using side‐ and forward‐viewing endoscopes was comparable.

Conclusion

Although side‐ and forward‐viewing endoscopes are equally effective for antroduodenal SEMS placement, the procedure can be performed faster using the latter.
Characterization and oxidative stability of oils and bioactive compounds of the fruits ofByrsonima cydoniifoliaA. Juss. at different ripening stages
Authors: Marcelino Gabriela , Donadon Juliana R , Caires Anderson RL , Michels Flavio S , Oliveira Lincoln CS , Cortes Mário R , Maldonade Iriani R , Cavalheiro Leandro F , Nazário Carlos ED , Maróstica Júnior Mário R , Santos Nathalia MD , Batista Patrícia B , Pott Arnildo , Nunes Ângela A , Figueiredo Priscila S , Hiane Priscila A , Nascimento Valter A , Guimarães Rita CA
Published: November 2018

BACKGROUND

Fruits present high concentrations of bioactive compounds that are beneficial to health due to their antioxidant properties. New alternatives to vegetable oils with such properties have been studied. We determined the chemical compounds ofByrsonima cydoniifoliaA. Juss. fruits in three ripening stages as well as the optical behavior and quality level of the oils.

RESULTS

The ripening stage affected the chemical composition of the fruits and oils. The fruits presented high values of bioactive compounds, as ascorbic acid (1.46–1.82 g kg−1) and total phenols (3.54–15.91 g gallic acid equivalents kg−1), as well as showed excellent antioxidant activity. The ripe fruits showed high content of carotenoids (45.90 mg kg−1) were lutein is the major carotenoid, representing 55.56%. The oil of the ripe fruits showed high lipid content (252.6 g kg−1) and contained oleic (521.83 g kg−1), palmitic (209.13 g kg−1) and linoleic (195.4 g kg−1) fatty acids. The oil of ripe fruits showed the best oxidative stability, with longer induction period (22.29 h) than the other oils.

CONCLUSION

Fruits ofB. cydoniifoliaA. Juss. demonstrate to possess a promising potential for the use as functional ingredients. The oil of the ripe fruits was more stable and presents a greater potential to be used for edible purposes. © 2018 Society of Chemical Industry
Vision‐tangible interactive display method for mixed and virtual reality: Toward the human‐centered editable reality
Authors: Zhang Zhenliang , Li Yue , Guo Jie , Weng Dongdong , Liu Yue , Wang Yongtian
Published: November 2018

Building a human‐centered editable world can be fully realized in a virtual environment. Both mixed reality (MR) and virtual reality (VR) are feasible solutions to support the attribute of edition. Based on the current development of MR and VR, we present the vision‐tangible interactive display method and its implementation in both MR and VR. We address the issue of MR and VR together because they are similar regarding the proposed method. The editable mixed and virtual reality system is useful for studies, which exploit it as a platform. In this paper, we construct a virtual reality environment based on the Oculus Rift, and an MR system based on a binocular optical see‐through head‐mounted display. In the MR system about manipulating the Rubik's cube, and the VR system about deforming the virtual objects, the proposed vision‐tangible interactive display method is utilized to provide users with a more immersive environment. Experimental results indicate that the vision‐tangible interactive display method can improve the user experience and can be a promising way to make the virtual environment better.
Can Pharyngeal Packing Prevent Postoperative Nausea and Vomiting in Nasal Surgery?
Authors: Jin Ho Joon , Kim Subin , Hwang Se Hwan
Published: November 2018

Objectives

We aimed to perform a meta‐analysis for the efficacy of pharyngeal packing during nasal surgery in the prevention of postoperative nausea and vomiting (PONV).

Data Sources

MEDLINE, SCOPUS, and the Cochrane database.

Methods

Two authors independently searched the databases for relevant studies from inception to October 2017. Included studies were randomized controlled studies published in English comparing pharyngeal packing during intubation (packing group) with no packing (control group) in patients who underwent nasal surgery. Outcomes of interest included the incidence of PONV and throat pain during the first 24 hours postsurgery.

Results

Ten studies were included in the meta‐analysis. The incidence of moderate‐to‐severe PONV in the recovery room was significantly higher in the packing group than in the control group. However, the incidence of moderate‐to‐severe PONV significantly decreased and was lower in the packing group than in the control group at 2 hours postoperative. The incidence of throat pain was higher in the packing group than in the control group until 2 hours postoperative.

Conclusions

Considering the occurrence of postoperative morbidity according to the time course, pharyngeal packing during nasal surgery does not alleviate PONV but instead could aggravate postoperative throat pain. Additionally, pharyngeal packing has the possibility of airway problem such as the foreign body aspiration. Based on our results, we suggest that there is no need to place a pharyngeal pack to prevent PONV in patients undergoing nasal surgery.

Level of Evidence

1b Laryngoscope, 129:291–298, 2019
Caught in broad daylight: Topographic constraints of zooplankton depth distributions
Authors: Aarflot Johanna M. , Aksnes Dag L. , Opdal Anders F. , Skjoldal Hein Rune , Fiksen Øyvind
Published: November 2018

For visual predators, sufficient light is critical for prey detection and capture. Because light decays exponentially with depth in aquatic systems, vertical movement has become a widespread strategy among zooplankton for avoiding visual predation. However, topographical features such as seamounts have been shown to block their descent, trapping them in illuminated waters with potential feeding benefits for visually searching fish. Here, we present an extensive and previously unpublished dataset on the vertical distribution of zooplankton in the topographically rugged Barents Sea, a continental shelf region hosting some of the largest fish stocks in the world. By modeling the ambient light exposure of zooplankton in relation to the bathymetry, we find support for a similar blockage mechanism. During daytime, zooplankton are exposed to four orders of magnitude more light above shallow banks than in the deeper water surrounding the banks. We show that zooplankton depth distributions are highly related to zooplankton size and that the bottom constrains the vertical distributions. Consequently, zooplankton remain in the planktivores’ visual feeding habitat over the banks but not in deeper areas. Bottom topography and light absorbance are significant determinants of the seascape ecology across continental shelves with heterogeneous bathymetry.
In situ Study Unravels Bio‐Nanomechanical Behavior in a Magnetic Bacterial Nano‐cellulose (MBNC) Hydrogel for Neuro‐Endovascular Reconstruction
Authors: Pavón Juan Jose , Allain Jean Paul , Verma Devendra , Echeverry‐Rendón Mónica , Cooper Christy L. , Reece Lisa M. , Shetty Akshath R. , Tomar Vikas
Published: November 2018

Surgical clipping and endovascular coiling are well recognized as conventional treatments of Penetrating Brain Injury aneurysms. These clinical approaches show partial success, but often result in thrombus formation and the rupture of aneurysm near arterial walls. The authors address these challenging brain traumas with a unique combination of a highly biocompatible biopolymer hydrogel rendered magnetic in a flexible and resilient membrane coating integrated to a scaffold stent platform at the aneurysm neck orifice, which enhances the revascularization modality. This work focuses on the in situ diagnosis of nano‐mechanical behavior of bacterial nanocellulose (BNC) membranes in an aqueous environment used as tissue reconstruction substrates for cerebral aneurysmal neck defects. Nano‐mechanical evaluation, performed using instrumented nano‐indentation, shows with very low normal loads between 0.01 to 0.5 mN, in the presence of deionized water. Mechanical testing and characterization reveals that the nano‐scale response of BNC behaves similar to blood vessel walls with a very low Young´s modulus, E (0.0025 to 0.04 GPa), and an evident creep effect (26.01 ± 3.85 nm s−1). These results confirm a novel multi‐functional membrane using BNC and rendered magnetic with local adhesion of iron‐oxide magnetic nanoparticles.
MRI‐guided laser interstitial thermal thalamotomy for medically intractable tremor disorders
Authors: Harris Meghan , Steele John , Williams Rebecca , Pinkston Jim , Zweig Richard , Wilden Jessica Anne
Published: November 2018

Introduction

Medically intractable tremors are a common, difficult clinical situation. Deep brain stimulation decreases Parkinson's disease resting tremor and essential tremor, but not all patients are candidates from a diagnostic, medical, or social standpoint, prompting the need for alternative surgical strategies.

Methods

We describe 13 patients with medically intractable tremor treated with laser interstitial thermal thalamotomy performed under general anesthesia using live MRI‐guidance and the Clearpoint stereotactic system.

Results

All patients had a dramatic decrease in tremor immediately postoperatively, which has been sustained through follow‐up (3‐17 months) in all but 1 patient (mean tremor score reduction of 62%; 10.33 ± 2.69 to 3.89 ± 3.1). Objective side effects were transient and included imbalance and paresthesia.

Conclusion

Medically intractable tremor treated with laser interstitial thermal thalamotomy may be a useful addition to the treatment armamentarium for medically intractable tremor disorders. © 2018 International Parkinson and Movement Disorder Society
Compound heterozygous mutations in CFTR causing CBAVD in Chinese pedigrees
Authors: Yang Bin , Wang Xi , Zhang Wei , Li Hongjun , Wang Binbin
Published: November 2018

Background

Congenital bilateral absence of the vas deferens (CBAVD) is an important cause of obstructive azoospermia and male infertility. Mutations of CFTR caused the majority of CBAVD cases, and ADGRG2 was recently identified as a new pathogenic gene. Yet, most of the genetic evidence came from sporadic cases, and only one mutation in CFTR can be found in patients.

Methods

In present study, we collected two CBAVD pedigrees, each having two affected male siblings. We performed whole exome sequencing on all patients and validated all potential variants by Sanger sequencing.

Results

We excluded ADGRG2 variants but identified compound heterozygous variants of CFTR in both families (NM_000492.3:c.1210‐33_1210‐6GT[13]T[5] and c.4056G>C;p.Gln1352Cys in pedigree 1, c.592G>C;p.Ala198Pro and c.3717G>A;p.Arg1239= in pedigree 2), which were subsequently validated by direct sequencing. c.1210‐33_1210‐6GT[13]T[5] (also known as IVS8‐T5‐TG13) was a known disease‐causing variant causing the skipping of exon 9 of CFTR and inherited from the proband's mother. p.Gln1352Cys and Ala198Pro were rare or novel in public databases and predicted to be deleterious. The p.Arg1239= was a synonymous variant but located at the end of an exon, which was predicted to alter the splicing pattern.

Conclusion

Our study, in which compound heterozygous variants were identified in two pedigrees, provides more familial evidence that only recessive variants (homozygous or compound heterozygous) in CFTR cause CBAVD. Furthermore, whole exome sequencing may be utilized as a useful tool for mutation screening of genes causing CBAVD.
Field pleased with expanded treatment opportunities for SMI, SED population
Authors: Canady Valerie A.
Published: November 2018

Observing the need for more treatment options for adults with serious mental illness (SMI) and children with serious emotional disturbance (SED), the Centers for Medicare & Medicaid Services (CMS) issued a letter to state Medicaid directors outlining opportunities for states to make important improvements to help Medicaid beneficiaries access quality behavioral health care.
The 3D isodose structure‐based method for clinical dose distributions comparison in pretreatment patient‐QA
Authors: Tamborra Pasquale , Martinucci Erica , Massafra Raffaella , Bettiol Marco , Capomolla Caterina , Zagari Annarita , Didonna Vittorio
Published: November 2018

Introduction

Before the approval of any Intensity Modulated Radiation Therapy or Volumetric Modulated Arc Therapy treatment plan, quality assurance (QA) tests are needed to reveal potential errors such as an inaccurate calculation of the dose distribution, the failure of the record‐and‐verify system, or the delivery system of the linear accelerator. Currently, the method adopted to compare the measured dose distribution with the treatment planning system TPS calculated dose distribution is gamma analysis. However, gamma analysis has been shown to be ineffective for the clinical evaluation of treatment plans. We proposed and tested a new method (the isodose structures method) alternative to gamma analysis.

Method

Different errors were introduced in 33 error‐free Head and Neck plans. The modified plans were recalculated using TPS software and the dose distributions obtained were compared to those of the original (error‐free) plans. The comparison was performed using gamma analysis and the new method. The target was to calculate overall and organ‐specific gamma passing rates as well as the overlapping ratio (OR) and volume ratio (VR) factors of the isodose structures method for each error‐included plan.

Results

Eight of the 33 plans passed both the gamma analysis and the isodose structures (IS) analysis, ten plans did not pass either of them, while 13 plans which did not pass the IS analysis, passed the gamma analysis. Two plans which did not pass gamma, passed IS analysis. Furthermore, Dose Volume Histogram (DVH) metrics could not detect the low agreement between the dose distributions of two error‐free plans and the respective modified plans. In this case, the IS analysis also allowed us to detect clinically meaningful differences between measured and TPS dose distributions.

Conclusions

The IS method analysis clearly showed a high efficiency in detecting clinically relevant differences between TPS and measured dose distributions not seen in gamma analysis and in DVH‐based metrics. Therefore, IS analysis proved to be a valid tool, alternative to gamma analysis for dose comparison in patient‐specific QA test.
Free‐breathing, non‐ECG, continuous myocardial T1 mapping with cardiovascular magnetic resonance multitasking
Authors: Shaw Jaime L. , Yang Qi , Zhou Zhengwei , Deng Zixin , Nguyen Christopher , Li Debiao , Christodoulou Anthony G.
Published: November 2018

Purpose

To evaluate the accuracy and repeatability of a free‐breathing, non‐electrocardiogram (ECG), continuous myocardial T1 and extracellular volume (ECV) mapping technique adapted from the Multitasking framework.

Methods

The Multitasking framework is adapted to quantify both myocardial native T1 and ECV with a free‐breathing, non‐ECG, continuous acquisition T1 mapping method. We acquire interleaved high–spatial resolution image data and high–temporal resolution auxiliary data following inversion‐recovery pulses at set intervals and perform low‐rank tensor imaging to reconstruct images at 344 inversion times, 20 cardiac phases, and 6 respiratory phases. The accuracy and repeatability of Multitasking T1 mapping in generating native T1 and ECV maps are compared with conventional techniques in a phantom, a simulation, 12 healthy subjects, and 10 acute myocardial infarction patients.

Results

In phantoms, Multitasking T1 mapping correlated strongly with the gold‐standard spin‐echo inversion recovery (R2 = 0.99). A simulation study demonstrated that Multitasking T1 mapping has similar myocardial sharpness to the fully sampled ground truth. In vivo native T1 and ECV values from Multitasking T1 mapping agree well with conventional MOLLI values and show good repeatability for native T1 and ECV mapping for 60 seconds, 30 seconds, or 15 seconds of data. Multitasking native T1 and ECV in myocardial infarction patients correlate positively with values from MOLLI.

Conclusion

Multitasking T1 mapping can quantify native T1 and ECV in the myocardium with free‐breathing, non‐ECG, continuous scans with good image quality and good repeatability in vivo in healthy subjects, and correlation with MOLLI T1 and ECV in acute myocardial infarction patients.
Simultaneous multi‐slice cardiac cine with Fourier‐encoded self‐calibration at 7 Tesla
Authors: Rapacchi Stanislas , Troalen Thomas , Bentatou Zakarya , Quemeneur Morgane , Guye Maxime , Bernard Monique , Jacquier Alexis , Kober Frank
Published: November 2018

Purpose

To accelerate cardiac cine at 7 tesla using simultaneous multi‐slice (SMS) acquisition with self‐calibration to resolve misalignment between calibration and imaging data due to breathing motion.

Methods

A spoiled‐gradient echo cine sequence was modified with radiofrequency phase‐cycled SMS excitations. A Fourier encoding strategy was applied along the cardiac phase dimension to allow for slice untangling and split‐slice GRAPPA calibration. Split‐slice GRAPPA was coupled with regular GRAPPA (SMS‐GRAPPA) and L1‐SPIRiT (SMS‐L1SPIRiT) for image reconstruction. 3‐slice SMS cine MRI was evaluated in ten subjects against single‐slice cine MRI in terms of SNR and contrast‐to‐noise ratio and slice leakage.

Results

SNR decreased significantly from 10.1 ± 7.1 for single‐slice cine to 7.4 ± 2.8 for SMS‐GRAPPA (P = 0.02) and was recovered to 9.0 ± 4.5 with SMS‐L1SPIRiT (P = 0.02). Contrast to noise ratio decreased significantly from 14.5 ± 8.1 for single‐slice cine to 5.6 ± 3.6 for SMS‐GRAPPA (P < 0.0001) and increased slightly but significantly back to 6.7 ± 4.4 for SMS‐L1SPIRiT (P = 0.03). Specific absorption rate restrictions imposed a reduced nominal flip angle (−37 ± 7%, P = 0.02) for 3‐slice SMS excitations compared to single‐slice acquisitions. SMS slice leakage increased significantly from apex (8.6 ± 6.5 %) to base (13.1 ± 4.1 %, P = 0.03) in the left ventricle.

Conclusion

Three‐fold acceleration of cine at 7T was achieved using the proposed SMS technique. Fourier encoding self‐calibration and regularized image reconstruction enabled simultaneous acquisition of three slices without significant SNR decrease but significant CNR decrease linked to the reduced nominal excitation flip angle.
Interest groups in Macedonia: Growing pains in a strong party state
Authors: Cekik Aneta , Hristova Lidija
Published: November 2018

This article examines the development of the interest group system in Macedonia since independence and the extent to which it has been able to exert any influence in the political arena. We show how security issues, slow economic development, and democratic deficits have impeded the development of an extensive interest group system able to compete freely in national politics. This has resulted in Macedonia having a bifurcated interest group system with influential power elites but low participation by citizens in formal interest groups. Despite this, there have been some diversification of the group system, restructuring of exiting associations, professionalization, and increased ability, especially that of citizens and social movements, to influence national politics.
Long non‐coding RNAs influence the transcriptome in pulmonary arterial hypertension: the role of PAXIP1‐AS1
Authors: Jandl Katharina , Thekkekara Puthenparampil Helene , Marsh Leigh M , Hoffmann Julia , Wilhelm Jochen , Veith Christine , Sinn Katharina , Klepetko Walter , Olschewski Horst , Olschewski Andrea , Brock Matthias , Kwapiszewska Grazyna
Published: November 2018

In idiopathic pulmonary arterial hypertension (IPAH), global transcriptional changes induce a smooth muscle cell phenotype characterised by excessive proliferation, migration, and apoptosis resistance. Long non‐coding RNAs (lncRNAs) are key regulators of cellular function. Using a compartment‐specific transcriptional profiling approach, we sought to investigate the link between transcriptional reprogramming by lncRNAs and the maladaptive smooth muscle cell phenotype in IPAH. Transcriptional profiling of small remodelled arteries from 18 IPAH patients and 17 controls revealed global perturbations in metabolic, neuronal, proliferative, and immunological processes. We demonstrated an IPAH‐specific lncRNA expression profile and identified the lncRNA PAXIP1‐AS1 as highly abundant. Comparative transcriptomic analysis and functional assays revealed an intrinsic role for PAXIP1‐AS1 in orchestrating the hyperproliferative and migratory actions of IPAH smooth muscle cells. Further, we showed that PAXIP1‐AS1 mechanistically interferes with the focal adhesion axis via regulation of expression and phosphorylation of its downstream target paxillin. Overall, we show that changes in the lncRNA transcriptome contribute to the disease‐specific transcriptional landscape in IPAH. Our results suggest that lncRNAs, such as PAXIP1‐AS1, can modulate smooth muscle cell function by affecting multiple IPAH‐specific transcriptional programmes. © 2018 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.
Genetic investigation in dementia: new interpretive challenges
Authors: Williamson John C , Bonello Michael , Larner Andrew J
Published: November 2018

Genetic testing is increasingly used in the assessment and investigation of individuals with dementia and cognitive impairment. Next generation sequencing dementia panels allow simultaneous parallel examination of multiple genes. But with this increased diagnostic power comes also the possibility of incidental findings, of identifying sequence variants which are benign rather than pathogenic. Dr Larner and colleagues discuss two such cases.
A case for adding fluvoxamine to clozapine
Authors: Sharma Avneet
Published: November 2018

Treatment‐refractory schizophrenia affects at least 30% of all patients with schizophrenia. Clozapine remains the gold standard treatment as the chances of response with another non clozapine medication are very low. However, initiating and then maintaining patients on clozapine can be a challenge due to a complex titration regimen, dose‐related side‐effects and the requirement for regular monitoring. In this article, Dr Sharma describes the successful addition of fluvoxamine to clozapine in a patient to achieve a therapeutic level of clozapine.
Cognitive screeners for MCI: is correction of skewed data necessary?
Authors: Larner Andrew J
Published: November 2018

Correct identification of mild cognitive impairment (MCI) may provide the opportunity for intervention with disease‐modifying therapeutics. Pending the development of widely applicable diagnostic biomarkers, use of cognitive screening instruments (CSIs) as part of clinical assessment may represent the best method for early MCI diagnosis. However, skewing of CSI test scores may jeopardise test utility. Here, Dr Larner examines various short CSIs in a secondary care setting to assess whether or not the assumption of normality is valid.
Dynamic Monte Carlo simulations of competition in crystallization of mixed polymers grafted on a substrate
Authors: Nie Yijing , Liu Yong , Liu Rongjuan , Zhou Zhiping , Hao Tongfan
Published: November 2018

Nowadays, preparation of poly(lactide) (PLA) with high content of stereocomplex crystallites (SCs) is receiving more and more attentions. The stereocomplex formation between enantiomeric poly(l‐lactide) and poly(d‐lactide) can efficiently improve the corresponding mechanical properties and thermal stability. In the current work, using dynamic Monte Carlo simulations, the microscopic mechanism of SC formation in grafted polymers was investigated. The increase in grafting density can lead to the enhancement of SC formation. On one hand, the miscibility between the chains of different types can be improved due to the grafting. On the other hand, the increase in grafting density can result in the higher degree of chain extension and the change in crystal nucleation and growth modes. The changes facilitate the stereocomplex formation. These findings not only provide an effective way to prepare PLAs with high content of SCs, but also reveal the underlying mechanisms controlling the SC formation. © 2018 Wiley Periodicals, Inc. J. Polym. Sci., Part B: Polym. Phys. 2019, 57, 89–97