bluuebunny/crossref_metadata_2025 huggingface dataset:
Managing a patient with globus pharyngeus
Authors: Harvey Philip R , Theron Byron T , Trudgill Nigel J
Published: August 2017

A woman aged 47 years reported the feeling of a lump in her throat for the past year. The sensation was present intermittently and usually improved when she ate. She noted it was worse with dry swallows when she felt like a tablet was stuck in her throat. The sensation had become more persistent in recent weeks leading her to worry that she had cancer. She had no cough, sore throat or hoarseness. There were no precipitating factors and no symptoms of weight loss, dysphagia, odynophagia or change in her voice. She had smoked previously and rarely had heartburn. She had no other anxieties and was not under any unusual stress. She was initially assessed by an ear, nose and throat surgeon, who found no abnormalities on examination of her neck, throat and oral cavity. Nasolaryngoscopy was normal. An upper gastrointestinal endoscopy was organised and reported a hiatus hernia, but a 3-month trial of a proton pump inhibitor did not have any impact on her symptoms. The benign nature of her symptoms was discussed at her gastroenterology follow-up appointment. She was discharged back to primary care with a final diagnosis of ’globus'. A trial of speech therapy, cognitive behavioural therapy or amitriptyline would be recommended if her symptoms became more troublesome in future.
Implantable cardiac defibrillator and mortality in non-ischaemic cardiomyopathy: an updated meta-analysis
Authors: Alba Ana C , Foroutan Farid , Duero Posada Juan , Battioni Luciano , Schofield Toni , Alhussein Mosaad , Agoritsas Thomas , Spencer Frederick A , Guyatt Gordon
Published: August 2017

Objectives

The benefit of implantable cardiac defibrillator (ICD) in symptomatic patients with systolic dysfunction and non-ischaemic cardiomyopathy remains controversial. We conducted a systematic review and meta-analysis to determine the effect of ICD in patients with non-ischaemic cardiomyopathy on (1) all-cause mortality, (2) cardiovascular mortality and (3) sudden cardiac death.

Methods

We searched citations in meta-analyses published until 2012, and in MEDLINE, Embase, PubMed and Cochrane databases from 2012 to October 2016. We included randomised controlled trials (RCTs) evaluating the effect of ICD therapy on all-cause and cardiovascular mortality and sudden cardiac death in patients with non-ischaemic cardiomyopathy. Independent reviewers evaluated study eligibility, abstracted data and assessed risk of bias in duplicate. We used random-effect models to meta-analyse relative risks (RR) and hazard ratios (HR) across studies, the Grades of Recommendation, Assessment, Development, and Evaluation system to quantify absolute effects and quality of evidence, and I2 to evaluate heterogeneity.

Results

We identified six RCTs including 1715 patients experiencing 421 deaths. ICD therapy was associated with reduced overall mortality (HR 0.78, 95% CI 0.66 to 0.92, I2 = 0%, risk difference 4.7%, high quality), cardiovascular mortality (RR 0.77, 95% CI 0.60 to 0.98, I2 = 39%, risk difference 3.3%, high quality) and sudden cardiac death (RR 0.45, 95% CI 0.29 to 0.70, I2 = 0%, risk difference 4.1%, high quality). The benefit of ICD was not influenced by the use of amiodarone in the comparison group, the duration of follow-up, by use of Î²-blockers and ACE inhibitors/angiotensin receptor blocker or cardiac resynchronisation therapy.

Conclusion

Primary prevention ICD therapy reduces all-cause and cardiovascular mortality and sudden cardiac death in patients with non-ischaemic cardiomyopathy.
Drug treatment effects on outcomes in heart failure with preserved ejection fraction: a systematic review and meta-analysis
Authors: Zheng Sean Lee , Chan Fiona T , Nabeebaccus Adam A , Shah Ajay M , McDonagh Theresa , Okonko Darlington O , Ayis Salma
Published: August 2017

Background

Clinical drug trials in patients with heart failure and preserved ejection fraction have failed to demonstrate improvements in mortality.

Methods

We systematically searched Medline, Embase and the Cochrane Central Register of Controlled Trials for randomised controlled trials (RCT) assessing pharmacological treatments in patients with heart failure with left ventricular (LV) ejection fraction≥40% from January 1996 to May 2016. The primary efficacy outcome was all-cause mortality. Secondary outcomes were cardiovascular mortality, heart failure hospitalisation, exercise capacity (6-min walk distance, exercise duration, VO2max), quality of life and biomarkers (B-type natriuretic peptide, N-terminal pro-B-type natriuretic peptide). Random-effects models were used to estimate pooled relative risks (RR) for the binary outcomes, and weighted mean differences for continuous outcomes, with 95% CI.

Results

We included data from 25 RCTs comprising data for 18101 patients. All-cause mortality was reduced with beta-blocker therapy compared with placebo (RR: 0.78, 95%CI 0.65 to 0.94, p=0.008). There was no effect seen with ACE inhibitors, aldosterone receptor blockers, mineralocorticoid receptor antagonists and other drug classes, compared with placebo. Similar results were observed for cardiovascular mortality. No single drug class reduced heart failure hospitalisation compared with placebo.

Conclusion

The efficacy of treatments in patients with heart failure and an LV ejection fraction≥40% differ depending on the type of therapy, with beta-blockers demonstrating reductions in all-cause and cardiovascular mortality. Further trials are warranted to confirm treatment effects of beta-blockers in this patient group.
The rise of reimbursement-based medicine: the case of bone metastasis radiation treatment
Authors: Santos Marcos , Solbakk Jan Helge , Garrafa Volnei
Published: August 2017

It has been hypothesised that the reimbursement system pertaining to radiotherapy is influencing prescription practices for patients with cancer with bone metastases. In this paper, we present and discuss the results of an empirical study that was undertaken on patient records, referred to radiotherapy for the treatment of bone metastases, in a medium-size city, in southern Brazil, during the period of March 2006 to March 2014. Our findings seem to confirm this hypothesis: after a change in the reimbursement method, radiation prescriptions were adapted accordingly, in order to maximise profits. Once such patients become highly vulnerable due to their diagnoses, they also become susceptible to a subtle form of exploitation; physicians let patients believe that more radiation will be better for their health, and they do so despite knowing otherwise, and as it seems, out of pecuniary interests.
The UK Mental Capacity Act and consent to research participation: asking the right question
Authors: Willner Paul
Published: August 2017

This paper considers the meaning of the term ‘intrusive research’, as used in the UK Mental Capacity Act 2005 (MCA), in relation to studies in which an informant is asked to provide information about or on behalf of a person who lacks capacity to consent, and who is not otherwise involved in the study. The MCA defines ‘intrusive research’ as research that would legally require consent if it involved people with capacity. The relevant ethical principles are that consent should be sought from people who would be affected by a piece of research and that this requirement should be implemented proportionately. The critical question, for investigators and research ethics committees, is: would provision of the personal information specified in the research protocol significantly affect a person whose capacity is not impaired? If the answer to this question is ‘no’, then the study falls outside the definition of ‘intrusive research’, and the MCA does not apply.
Association between childhood health, socioeconomic and school-related factors and effort-reward imbalance at work: a 25-year follow-up study
Authors: Wang Shuo , Sanderson Kristy , Venn Alison , Dwyer Terence , Gall Seana
Published: August 2017

Objectives

Stress pathways can have origins in childhood, but few early predictors have been explored in relation to adult job stress. This study examined whether childhood school, health or socioeconomic factors were associated with adult job stress.

Methods

Data came from the Childhood Determinants of Adult Health study that began in 1985 with children aged 7–15 years who reported effortreward imbalance (ERI) scales at ages 31–41 years. Linear regression assessed the association between childhood factors and adult ERI adjusted for age and socioeconomic position (SEP) in childhood and adulthood.

Results

There were between 999 and 1390 participants in each analysis. Lower adulthood ERI, indicating less job stress, was predicted by several school-related factors in men. For example, each higher category of learner self-concept was associated with a 19% (95% CI – 32% to 6%) reduction in adult ERI, and each unit increase in academic attainment was associated with a 15% (95% CI –28% to 3%) reduction in adult ERI. Childhood health was associated with adult ERI. For example, in women, overweight children had 14% (95% CI 5% to 22%) higher adult ERI scores compared with healthy weight children, and each unit of negative affect was associated with 2% (95% CI 1% to 4%) increase in adult ERI. Adult SEP had no effect on these associations for men but explained some of the effect in women. Childhood SEP had inconsistent associations with adult ERI.

Conclusion

Our findings suggest that a range of childhood socioeconomic, school- and health-related factors might contribute to the development of job stress in adulthood.
Intensive versus standard physical rehabilitation therapy in the critically ill (EPICC): a multicentre, parallel-group, randomised controlled trial
Authors: Wright Stephen E , Thomas Kirsty , Watson Gillian , Baker Catherine , Bryant Andrew , Chadwick Thomas J , Shen Jing , Wood Ruth , Wilkinson Jennifer , Mansfield Leigh , Stafford Victoria , Wade Clare , Furneval Julie , Henderson Andrea , Hugill Keith , Howard Philip , Roy Alistair , Bonner Stephen , Baudouin Simon
Published: August 2017

Background

Early physical rehabilitation in the intensive care unit (ICU) has been shown to improve short-term clinical outcomes but long-term benefit has not been proven and the optimum intensity of rehabilitation is not known.

Methods

We conducted a randomised, parallel-group, allocation-concealed, assessor-blinded, controlled trial in patients who had received at least 48 hours of invasive or non-invasive ventilation. Participants were randomised in a 1:1 ratio, stratified by admitting ICU, admission type and level of independence. The intervention group had a target of 90 min physical rehabilitation per day, the control group a target of 30 min per day (both Monday to Friday). The primary outcome was the Physical Component Summary (PCS) measure of SF-36 at 6 months.

Results

We recruited 308 participants over 34 months: 150 assigned to the intervention and 158 to the control group. The intervention group received a median (IQR) of 161 (67–273) min of physical rehabilitation on ICU compared with 86 (31–139) min in the control group. At 6 months, 62 participants in the intervention group and 54 participants in the control group contributed primary outcome data. In the intervention group, 43 had died, 11 had withdrawn and 34 were lost to follow-up, while in the control group, 56 had died, 5 had withdrawn and 43 were lost to follow-up. There was no difference in the primary outcome at 6 months, mean (SD) PCS 37 (12.2) in the intervention group and 37 (11.3) in the control group.

Conclusions

In this study, ICU-based physical rehabilitation did not appear to improve physical outcomes at 6 months compared with standard physical rehabilitation.

Trial registration number

ISRCTN 20436833.
Local dornase alfa treatment reduces NETs-induced airway obstruction during severe RSV infection
Authors: Cortjens Bart , de Jong Rineke , Bonsing Judith G , van Woensel Job B M , Antonis Adriaan F G , Bem Reinout A
Published: August 2017

Respiratory syncytial virus (RSV) infection is characterised by airway obstruction with mucus plugs, containing DNA networks in the form of neutrophil extracellular traps (NETs). We investigated the effect of dornase alfa on histopathological NETs-induced airway obstruction and viral load in an age-relevant calf model ofseverebovine RSV disease. As compared with the control animals, dornase alfa treatment resulted in a strong reduction of NETs-induced airway obstruction. Viral load in the lower respiratory tract was not different between the two groups. We conclude that NETs form a relevant target for treatment of airway obstruction in severe RSV disease.
Assessing the effects of weekly preweaning health scores on dairy calf mortality and productivity parameters: cohort study
Authors: Mahendran Sophie Anne , Booth Richard , Beekhuis Lies , Manning Al , Blackmore Tania , Vanhoudt Arne , Bell Nick
Published: August 2017

A longitudinal cohort study was conducted to follow the health of 787 calves from one UK dairy farm over a two‐and‐a‐half‐year period. Weekly health scores were gathered using a modified version of the Wisconsin Calf Scoring system (which did not record ear position) until calves were eight weeks of age, combined with data on colostral passive transfer, mortality, age at first conception and 305‐day milk yield. High morbidity levels were detected, with 87 per cent of calves experiencing at least one clinically significant event (diarrhoea, pyrexia, pneumonia, nasal or ocular discharge, navel ill or joint ill). High rectal temperature, diarrhoea and a cough were the most prevalent findings. The effect of total protein levels was significantly associated with the development of pyrexia as a preweaning calf (P<0.01), but no other clinical health scores. The majority of moribund calves had just one clinically severe clinical sign detected at each of the weekly recordings. The overall mortality rate was 21.5 per cent up to 14 months of age, with 12.7 per cent of calves dying during the preweaning period. However, most calves that died were not recorded as having experienced a severe clinical sign in the time between birth and death, indicating a limitation in weekly calf scoring in detecting acute disease leading to death. Therefore, more frequent calf scoring or use of technology for continuous calf monitoring on farms is required to reduce mortality on farms with high disease incidence rates.
M-theory, graphene-branes and superconducting wormholes
Authors: Sepehri Alireza , Pincak Richard , Olmo Gonzalo J.
Published: August 2017

Exploiting an M-brane system whose structure and symmetries are inspired by those of graphene (what we call a graphene-brane), we propose here a similitude between two layers of graphene joined by a nanotube and wormholes scenarios in the brane world. By using the symmetries and mathematical properties of the M-brane system, we show here how to possibly increase its conductivity, to the point of making it as a superconductor. The questions of whether and under which condition this might point to the corresponding real graphene structures becoming superconducting are briefly outlined.
On some weighted zero-sum constants II
Authors: Chintamani Mohan N. , Paul Prabal
Published: August 2017

For a finite abelian group [Formula: see text] with exponent [Formula: see text], let [Formula: see text]. The constant [Formula: see text] (respectively [Formula: see text]) is defined to be the least positive integer [Formula: see text] such that given any sequence [Formula: see text] over [Formula: see text] with length [Formula: see text] has a [Formula: see text]-weighted zero-sum subsequence of length [Formula: see text] (respectively at most [Formula: see text]). In [M. N. Chintamani and P. Paul, On some weighted zero-sum constants, Int. J. Number Theory 13(2) (2017) 301–308], we proved the exact value of this constant for the group [Formula: see text] and proved the structure theorem for the extremal sequences related to this constant. In this paper, we prove the similar results for the group [Formula: see text] and we obtained an upper bound when [Formula: see text] is replaced by any integer [Formula: see text].
Extended Gate Field Effect Transistor Using GaN/Si Hybrids Nanostructures for pH Sensor
Authors: Zhang Manchen , Wang Ruzhi , Shen Zhen , Ji Yuhang
Published: August 2017

The pH sensor of an extended gate field effect transistor (EGFET) with gallium nitride/silicon hybrid nanostructure is fabricated and analyzed. Si nanowires (NWs) are fabricated via the Ag-assisted electroless etching technique and are then covered by GaN NWs through plasma-enhanced chemical vapor deposition (PECVD). The GaN nanostructure is synthesized by introducing gallium oxide (Ga2O3) and nitrogen (N2) for the growth of NWs. The GaN nanowires supply a larger surface area than that of the pristine Si NWs, where there is a better sensitivity for pH sensor. The GaN/Silicon hybrid sensors exhibit a sensitivity higher (50.4[Formula: see text]mV/pH) than that of pristine Si NWs sensors (41.2[Formula: see text]mV/pH). This GaN/Si hybrid pH sensor prepared by simple and low-cost method may be potentially applied for cheap biosensor devices.
Analysis of the interaction among weed, inorganic fertilizer and herbivore in paddy ecosystem in fallow season
Authors: Xiang Meihong , Wu Zhaohua , Zhou Tiejun
Published: August 2017

Paddy growth is influenced by the amount of inorganic fertilizer in paddy ecosystem in fallow season. To discover the interaction among weed, inorganic fertilizer and herbivore in the system, we put forward a differential equation model and investigate its properties. Results show that the system has a weed and herbivore extinct equilibrium and a herbivore extinct equilibrium. The two equilibria are proven to be unstable using the center manifold method. Under certain conditions, the system also has a positive equilibrium point. We give the stable region and the unstable region of the positive equilibrium point, which are determined by some parameters. We find that the system has the Hopf bifurcation phenomenon, and give the critical value of Hopf bifurcation by taking a system parameter as the bifurcation parameter. By comparing the equilibrium states between a paddy ecosystem with herbivore and one without herbivore, we find that the content of inorganic fertilizer can be improved by putting herbivore into a paddy field. An example is given to illustrate the feasibility of the results. Numerical simulation shows that Hopf bifurcation phenomena exist in the system.
Design and Performance Analysis of Depletion-Mode InSb Quantum-Well Field-Effect Transistor for Logic Applications
Authors: Islam R. , Uddin M. M. , Hossain M. Mofazzal , Matin M. A.
Published: August 2017

The design of a 1[Formula: see text][Formula: see text]m gate length depletion-mode InSb quantum-well field-effect transistor (QWFET) with a 10[Formula: see text]nm-thick Al2O3 gate dielectric has been optimized using a quantum corrected self-consistent Schrödinger-Poisson (QCSP) and two-dimensional drift-diffusion model. The model predicts a very high electron mobility of 4.42[Formula: see text]m2V[Formula: see text]s[Formula: see text] at [Formula: see text][Formula: see text]V, a small pinch off gate voltage ([Formula: see text]) of [Formula: see text]0.25[Formula: see text]V, a maximum extrinsic transconductance ([Formula: see text]) of [Formula: see text][Formula: see text]4.85[Formula: see text]mS/[Formula: see text]m and a drain current density of more than 3.34[Formula: see text]mA/[Formula: see text]m. A short-circuit current-gain cut-off frequency ([Formula: see text]) of 374[Formula: see text]GHz and a maximum oscillation frequency ([Formula: see text]) of 645[Formula: see text]GHz are predicted for the device. These characteristics make the device a potential candidate for low power, high-speed logic electronic device applications.
Robust Control of Aeronautical Electrical Generators for Energy Management Applications
Authors: Canciello Giacomo , Cavallo Alberto , Guida Beniamino
Published: August 2017

A new strategy for the control of aeronautical electrical generators via sliding manifold selection is proposed, with an associated innovative intelligent energy management strategy used for efficient power transfer between two sources providing energy to aeronautical loads, having different functionalities and priorities. Electric generators used for aeronautical application involve several machines, including a main generator and an exciter. Standard regulators (PI or PID-like) are normally used for the rectification of the generator voltage to be used to supply a high-voltage DC bus. The regulation is obtained by acting on a DC/DC converter that imposes the field voltage of the exciter. In this paper, the field voltage is fed to the generator windings by using a second-order sliding mode controller, resulting into a stable, robust (against disturbances) action and a fast convergence to the desired reference. By using this strategy, an energy management strategy is proposed that dynamically changes the voltage set point, in order to intelligently transfer power between two voltage busses. Detailed simulation results are provided in order to show the effectiveness of the proposed energy management strategy in different scenarios.
Transactional Sex between Men and Its Implications on HIV and Sexually Transmitted Infections in Nigeria
Authors: Bamgboye Eniola A. , Badru Titilope , Bamgboye Afolabi
Published: August 2017

Introduction. Men who have transactional sex with men (MTSM) are known to be at higher risk for HIV and sexually transmitted infections (STIs). This study explored the risk factors associated with STI symptoms and HIV prevalence among men who have transactional sex with men in Nigeria. Methods. In 2014, a cross-sectional study, using respondent driven sampling technique, was carried out to recruit 3,172 MSM across eight states in Nigeria. Relevant information on sociodemographic characteristics, sexual behaviors, and self-reported symptoms of STI was obtained. Bivariate and multivariate analysis was performed to identify risk factors for STI symptoms and HIV. Results. 38.2% of the MSM were involved in transactional sex. Prevalence of self-reported STI symptoms was higher among MTSM than other MSM, while HIV prevalence was higher among other MSM than MTSM. Identified factors associated with STI symptoms and HIV among MSTM were being single, alcohol consumption, oral sex, and history of rape by a male partner. Conclusion. Sexually transmitted infections are a significant challenge to men who have transactional sex with men. Adolescents and single men are more at risk of these infections. Youth empowerment needs to be invested on to avoid increased risk among these groups of people.
The Better You Feel the Better You Learn: Do Warm Colours and Rounded Shapes Enhance Learning Outcome in Multimedia Learning?
Authors: Münchow Hannes , Mengelkamp Christoph , Bannert Maria
Published: August 2017

The aim of the present study was to examine whether fostering positive activating affect during multimedia learning enhances learning outcome. University students were randomly assigned to either a multimedia learning environment designed to induce positive activating affect through the use of “warm” colours and rounded shapes (n = 61) or an affectively neutral environment that used achromatic colours and sharp edges (n = 50). Participants learned about the topic of functional neuroanatomy for 20 minutes and had to answer several questions for comprehension and transfer afterwards. Affective states as well as achievement goal orientations were investigated before and after the learning phase using questionnaires. The results show that participants in the affectively positive environment were superior in comprehension as well as transfer when initial affect was strong. Preexperimental positive affect was therefore a predictor of comprehension and a moderator for transfer. Goal orientations did not influence these effects. The findings support the idea that positive affect, induced through the design of the particular multimedia learning environment, can facilitate performance if initial affective states are taken into account.
Angiosarcoma Developing in an Arteriovenous Fistula after Kidney Transplantation
Authors: Costa Bruna Natacha Leite , Rivera Constantino Fernández , Rodríguez Maria Calvo , Romero Teresa Hermida , Muñiz Andrés López , Hermida Tamara Ferreiro , Lista Felipe Sacristán , Díaz Pilar Iglesias , Hernández Ángel Alonso
Published: August 2017

After transplantation, the main concerns involve immunosuppression, the prevention and treatment of infections and graft rejection, and tumor prevention. Sometimes the complications that may appear in the arteriovenous fistula are neglected following kidney transplantation. This is the reason why we are presenting the case of an angiosarcoma developing in an arteriovenous fistula after kidney transplantation. It is a very rare case and our goal is to create an alarm so that after kidney transplantation clinicians do not lose sight of the patients’ previous history.
Subpixel Mapping Method of Hyperspectral Images Based on Modified Binary Quantum Particle Swarm Optimization
Authors: Chen Shuhan , Li Xiaorun , Zhao Liaoying
Published: August 2017

Subpixel mapping technology can determine the specific location of different objects in the mixed pixel and effectively solve the uncertainty of the ground features spatial distribution in traditional classification technology. Existing methods based on linear optimization encounter the premature and local convergence of the optimization algorithm. This paper proposes a subpixel mapping method based on modified binary quantum particle swarm optimization (MBQPSO) to solve the above issues. The initial subpixel mapping imagery is obtained according to spectral unmixing results. We focus mainly on the discretization of QPSO, which is implemented by modifying the discrete update process of particle location, to minimize the objective function, which is formulated based on different connected regional perimeter calculating methods. To reduce time complexity, a target optimization strategy of global iteration combined with local iteration is performed. The MBQPSO is tested on standard test functions and results show that MBQPSO has the best performance on global optimization and convergent rate. Then, we analyze the proposed algorithm qualitatively and quantitatively by simulated and real experiment; results show that the method combined with MBQPSO and objective function, which is formulated based on the gap length between region and background, has the best performance in accuracy and efficiency.
Use of 5-Fluorouracil-Soaked Bioamniotic Membranes in Trabeculectomy for Primary Open-Angle Glaucoma: A Retrospective Analysis
Authors: Zhang Chenming , Wu Min , Wang Jianrong , Zhang Miaomiao , Wang Xu , Liu Wei
Published: August 2017

The study is a retrospective analysis of 51 patients (76 eyes) with primary open-angle glaucoma (POAG) who admitted to our hospital from 2008 to 2010 to analyze the efficacy of trabeculectomy in combination with 5-fluorouracil- (5-FU-) soaked amniotic membranes for the treatment of POAG patients. Among them, 30 patients (41 eyes) were treated with trabeculectomy in combination with 5-FU-soaked amniotic membrane and 21 patients (35 eyes) were treated with trabeculectomy in combination with MMC. Preoperative and postoperative intraocular pressures (IOP), cup/disc ratio, visual acuity and postoperative macular OCT, complications, treatment, and number of corneal endothelial cells were measured, recorded, and analyzed. At the end of 2 years of follow-up, IOP of 36 (87.8%) eyes of patients in the 5-FU group and IOP of 28 (80%) eyes of patients in the MMC group were ≤21 mmHg and patients in the 5-FU group had more stable IOP than patients in the MMC group. During the two years of follow-up, the visual acuity of 22 (53.7%) eyes in the 5-FU group remained unchanged or even improved. Trabeculectomy in combination with 5-FU-soaked biological amniotic membranes can be a surgical option for POAG patients.
Stress‐Activated Degradation of Sphingolipids Regulates Mitochondrial Function and Cell Death in Yeast
Authors: Manzanares-Estreder Sara , Pascual-Ahuir Amparo , Proft Markus
Published: August 2017

Sphingolipids are regulators of mitochondria‐mediated cell death in higher eukaryotes. Here, we investigate how changes in sphingolipid metabolism and downstream intermediates of sphingosine impinge on mitochondrial function. We found in yeast that within the sphingolipid degradation pathway, the production via Dpl1p and degradation via Hfd1p of hexadecenal are critical for mitochondrial function and cell death. Genetic interventions, which favor hexadecenal accumulation, diminish oxygen consumption rates and increase reactive oxygen species production and mitochondrial fragmentation and vice versa. The location of the hexadecenal‐degrading enzyme Hfd1p in punctuate structures all along the mitochondrial network depends on a functional ERMES (endoplasmic reticulum‐mitochondria encounter structure) complex, indicating that modulation of hexadecenal levels at specific ER‐mitochondria contact sites might be an important trigger of cell death. This is further supported by the finding that externally added hexadecenal or the absence of Hfd1p enhances cell death caused by ectopic expression of the human Bax protein. Finally, the induction of the sphingolipid degradation pathway upon stress is controlled by the Hog1p MAP kinase. Therefore, the stress‐regulated modulation of sphingolipid degradation might be a conserved way to induce cell death in eukaryotic organisms.
A Novel Audio Cryptosystem Using Chaotic Maps and DNA Encoding
Authors: Sheela S. J. , Suresh K. V. , Tandur Deepaknath
Published: August 2017

Chaotic maps have good potential in security applications due to their inherent characteristics relevant to cryptography. This paper introduces a new audio cryptosystem based on chaotic maps, hybrid chaotic shift transform (HCST), and deoxyribonucleic acid (DNA) encoding rules. The scheme uses chaotic maps such as two-dimensional modified Henon map (2D-MHM) and standard map. The 2D-MHM which has sophisticated chaotic behavior for an extensive range of control parameters is used to perform HCST. DNA encoding technology is used as an auxiliary tool which enhances the security of the cryptosystem. The performance of the algorithm is evaluated for various speech signals using different encryption/decryption quality metrics. The simulation and comparison results show that the algorithm can achieve good encryption results and is able to resist several cryptographic attacks. The various types of analysis revealed that the algorithm is suitable for narrow band radio communication and real-time speech encryption applications.
Interaction between Corneal and Internal Ocular Aberrations Induced by Orthokeratology and Its Influential Factors
Authors: Chen Qingzhong , Li Min , Yuan Ying , Me Rao , Yu Yunjie , Shi Guangsen , Ke Bilian
Published: August 2017

Purpose. To investigate the interaction between corneal, internal, and total wavefront aberrations (WAs) and their influential factors during orthokeratology (OK) treatment in Chinese adolescents.Methods. Thirty teenagers (n=30eyes) were enrolled in the study; spherical equivalent refraction (SE), corneal curvature radius (CCR), central corneal thickness (CCT), WAs, and the difference in limbal transverse diameter and OK lens diameter (ΔLLD) were detected before and after one-month OK treatment. Every component of WAs was measured simultaneously by iTrace aberrometer. The influential factors of OK-induced WAs were analyzed.Results. SE and CCT decreased while CCR increased significantly (P<0.01). Higher-order aberrations (HOAs), Spherical aberrations (SAs), and coma increased significantly (P<0.01). Corneal horizontal coma (Z31-C) and corneal spherical aberrations (Z40-C) increased (P<0.01). The HOAs, coma, SAs, Z31-C, Z31-T, Z40-C, and Z40-T were positively correlated with SE and CCR (P<0.01). Z3−1-C showed negative correlations with (ΔLLD) and positive correlations with SE (P<0.05).Conclusions. The increase in OK-induced HOAs is mainly attributed to Z31and Z40of cornea. Z3−1in the internal component showed a compensative effect on the corneal vertical coma. The degree of myopic correction and increase in CCR may be the essential influential factors of the increase in Z31and Z40. The appropriate size of the OK lens may be helpful to decrease OK-induced vertical coma.
Symptomatic Long Pauses and Bradycardia due to Massive Multinodular Goiter
Authors: Deshmukh Amrish , Ozcan Cevher
Published: August 2017

Sinus node dysfunction with symptomatic bradycardia or chronotropic incompetence is generally an indication for pacemaker implantation. However, in patients with symptomatic sinus bradycardia, the identification and treatment of underlying pathologies may avoid the need for permanent pacemaker implantation. We present a case of carotid sinus syndrome and severe obstructive sleep apnea due to a massive multinodular goiter in a patient who presented with recurrent sinus pauses and syncope. The patient was managed without pacemaker implantation but instead with thyroidectomy resulting in decompression of the carotid sinus and airway and resolution of bradycardic episodes.
Hollow Abutment Screw Design for Easy Retrieval in Case of Screw Fracture in Dental Implant System
Authors: Sim Bo Kyun , Kim Bongju , Kim Min Jeong , Jeong Guk Hyun , Ju Kyung Won , Shin Yoo Jin , Kim Man Yong , Lee Jong-Ho
Published: August 2017

The prosthetic component of dental implant is attached on the abutment which is connected to the fixture with an abutment screw. The abutment screw fracture is not frequent; however, the retrieval of the fractured screw is not easy, and it poses complications. A retrieval kit was developed which utilizes screw removal drills to make a hole on the fractured screw that provides an engaging drill to unscrew it. To minimize this process, the abutment screw is modified with a prefabricated access hole for easy retrieval. This study aimed to introduce this modified design of the abutment screw, the concept of easy retrieval, and to compare the mechanical strengths of the conventional and hollow abutment screws by finite element analysis (FEA) and mechanical test. In the FEA results, both types of abutment screws showed similar stress distribution in the single artificial tooth system. A maximum load difference of about 2% occurred in the vertical load by a mechanical test. This study showed that the hollow abutment screw may be an alternative to the conventional abutment screws because this is designed for easy retrieval and that both abutment screws showed no significant difference in the mechanical tests and in the FEA.
Full Wave Modeling of Array Structures Using Generalized Single-Source Tangential Equivalence Principle Algorithm
Authors: Shao Hanru , Dong Jianfeng , Hu Jun
Published: August 2017

The generalized single-source tangential equivalence principle algorithm (GSST-EPA) is proposed to solve the electromagnetic scattering of array structures with very small distance or even connected elements. For the traditional EPA scheme, it is difficult to deal with those situations. Based on source reconstruction method (SRM), the new GSST-EPA can be used to solve this problem efficiently. This scheme can also reduce the number of unknowns by half via the extinction theorem and keep the good accuracy by using tangential field projection. Furthermore, the multilevel fast multipole algorithm (MLFMA) is used to accelerate the matrix-vector multiplication in the GSST-EPA. Several numerical results are given to demonstrate the accuracy and efficiency of the proposed method.
Cobalt Cardiomyopathy Secondary to Hip Arthroplasty: An Increasingly Prevalent Problem
Authors: Tilney Russel , Burg Melanie Roberta , Sammut Mark Adrian
Published: August 2017

A forty-year-old man experienced worsening heart failure four years following bilateral complicated total hip replacement. His condition was extensively worked up but no underlying pathology was immediately evident. Given the cobalt-chromium alloy component present in the hip arthroplasties, the raised cobalt blood levels, and a fitting clinical picture coupled with radiological findings, the patient underwent right hip revision. Evidence of biotribocorrosion was present on direct visualisation intraoperatively. The patient subsequently experienced symptomatic improvement (NYHA class III to class I) and echocardiography showed recovery of ejection fraction. Cobalt exists as a bivalent and trivalent molecule in circulation and produces a cytotoxicity profile similar to nanoparticles, causing neurological, thyroid, and cardiological pathology. Blood levels are not entirely useful as there is no identifiable conversion factor for levels in whole blood, serum, and erythrocytes which seem to act independently of each other. Interestingly cobalt cardiomyopathy is frequently compounded by other possible causes of cardiomyopathy such as alcohol and a link has been postulated. Definitive treatment is revision of the arthroplasty as other treatments are unproven.
Local Diversity and Biting Pattern of Anopheles Species in Southern Minahasa
Authors: Pinontoan O. R. , Supadmanaba I. G. P. , Manuaba I. B. A. , Sukrama I. D. M. , Manuaba I. B. P.
Published: August 2017

Background. To optimize the preventive measures of malaria, it is important to synchronize the efforts with the behavior of local Anopheles species. However, the data of Anopheles species and their behavior in Indonesia is still lacking. Method. Explorative research was conducted from April to September 2016 in Southern Minahasa district. The Anopheles mosquito was baited by using animal and human (indoor or outdoor) from 18.00 to 06.00 hours. Then, the species were identified and Man Biting Rate (MBR) and Man/Animal Biting per Hour (MBPH) were calculated followed by statistical analysis by using SPSS 17. Result. The data showed that the dominant species in Southern Minahasa were An. barbirostris, An. kochi, and An. vagus. An. vagus was found to be zoophilic and An. barbirostris was showing strict anthropophilic characteristics. Meanwhile, An. kochi feeds on both human and animal. The MBR of An. kochi was found to be the highest (P<0.005), but its MBPH only significantly exceeded that of An. vagus. All species tend to be more active during the early evening. Conclusion. An. barbirostris, An. kochi, and An. vagus were the dominant Anopheles species in Southern Minahasa. Further research is needed to determine the Plasmodium infestation rate of these species.
TB Notification from Private Health Sector in Delhi, India: Challenges Encountered by Programme Personnel and Private Health Care Providers
Authors: Satpati Mahasweta , Burugina Nagaraja Sharath , Shewade Hemant Deepak , Aslesh Prabhakaran Ottapura , Samuel Blesson , Khanna Ashwani , Chadha Sarabjit
Published: August 2017

Objective. To identify the challenges encountered by private health care providers (PHCP) to notify tuberculosis cases through a programme developed web-based portal mechanism called “NIKSHAY.” Study Design. It is a descriptive qualitative study conducted at two revised national tuberculosis control programme (RNTCP) districts of New Delhi. The study included in-depth interviews of PHCP registered with “NIKSHAY” and RNTCP programme personnel. Grounded theory was used to conceptualise the latent social patterns in implementation of tuberculosis case notification process and promptly identifying their challenges. Results. The analysis resulted in identification of three broad themes: (a) system implementation by RNTCP: it emphasizes the TB notification process by the RNTCP programme personnel; (b) challenges faced by PHCP for TB notification with five different subthemes; and (c) perceived gaps and suggestions: to improvise the TB notification process for the private health sector. The challenges encountered by PHCP were mainly related to unsystematic planning and suboptimal implementation by programme personnel at the state and district level. The PHCP lacked clarity on the need for TB notification. Conclusion. Implementation of TB notification among private health care providers requires systematic planning by the programme personnel. The process should be user-friendly with additional benefits to the patients.
Association Patterns of Ontological Features Signify Electronic Health Records in Liver Cancer
Authors: Chan Lawrence W. C. , Wong S. C. Cesar , Chiau Choo Chiap , Chan Tak-Ming , Tao Liang , Feng Jinghan , Chiu Keith W. H.
Published: August 2017

Electronic Health Record (EHR) system enables clinical decision support. In this study, a set of 112 abdominal computed tomography imaging examination reports, consisting of 59 cases of hepatocellular carcinoma (HCC) or liver metastases (so-called HCC group for simplicity) and 53 cases with no abnormality detected (NAD group), were collected from four hospitals in Hong Kong. We extracted terms related to liver cancer from the reports and mapped them to ontological features using Systematized Nomenclature of Medicine (SNOMED) Clinical Terms (CT). The primary predictor panel was formed by these ontological features. Association levels between every two features in the HCC and NAD groups were quantified using Pearson’s correlation coefficient. The HCC group reveals a distinct association pattern that signifies liver cancer and provides clinical decision support for suspected cases, motivating the inclusion of new features to form the augmented predictor panel. Logistic regression analysis with stepwise forward procedure was applied to the primary and augmented predictor sets, respectively. The obtained model with the new features attained 84.7% sensitivity and 88.4% overall accuracy in distinguishing HCC from NAD cases, which were significantly improved when compared with that without the new features.
Phytotherapy and Nutritional Supplements on Breast Cancer
Authors: Lopes C. M. , Dourado A. , Oliveira R.
Published: August 2017

Breast cancer is the most frequent type of nonskin malignancy among women worldwide. In general, conventional cancer treatment options (i.e., surgery, radiotherapy, chemotherapy, biological therapy, and hormone therapy) are not completely effective. Recurrence and other pathologic situations are still an issue in breast cancer patients due to side effects, toxicity of drugs in normal cells, and aggressive behaviour of the tumours. From this point of view, breast cancer therapy and adjuvant methods represent a promising and challenging field for researchers. In the last few years, the use of some types of complementary medicines by women with a history of breast cancer has significantly increased such as phytotherapeutic products and nutritional supplements. Despite this, the use of such approaches in oncologic processes may be problematic and patient’s health risks can arise such as interference with the efficacy of standard cancer treatment. The present review gives an overview of the most usual phytotherapeutic products and nutritional supplements with application in breast cancer patients as adjuvant approach. Regardless of the contradictory results of scientific evidence, we demonstrated the need to perform additional investigation, mainly well-designed clinical trials in order to establish correlations and allow for further validated outcomes concerning the efficacy, safety, and clinical evidence-based recommendation of these products.
Neuropsychological Outcome following Resuscitation after Out-of-Hospital Cardiac Arrest: A One-Year Follow-Up
Authors: Overbeck Jeannette , Schweers Frank-Michael
Published: August 2017

A 61-year-old woman survived resuscitation after out-of-hospital cardiac arrest. The heterogeneity of the resulting cognitive impairments and the recovery over a one-year period are presented, highlighting the need for standardized neuropsychological testing even after short cardiac arrests and for effective treatment both out of hospital and in hospital.
Arterial Thoracic Outlet Syndrome Treated Successfully with Totally Endoscopic First Rib Resection
Authors: Mitsos Sofoklis , Patrini Davide , Velo Sara , Antonopoulos Achilleas , Hayward Martin , George Robert S. , Lawrence David , Panagiotopoulos Nikolaos
Published: August 2017

Thoracic outlet syndrome (TOS) is a constellation of signs and symptoms caused by compression of the neurovascular structures in the thoracic outlet. TOS may be classified as either neurogenic TOS (NTOS) or vascular TOS: venous TOS (VTOS) or arterial TOS (ATOS), depending on the specific structure being affected. The basis for the surgical treatment of TOS is resection of the first rib, and it may be combined with scalenectomy or cervical rib resection. Herein, we describe a case of arterial thoracic outlet syndrome which was successfully treated with totally endoscopic video-assisted thoracoscopic surgery (VATS) first rib resection.
A Nonlocal Method with Modified Initial Cost and Multiple Weight for Stereo Matching
Authors: Gao Shenyong , Ge Haohao , Zhang Hua , Zhang Ying
Published: August 2017

This paper presents a new nonlocal cost aggregation method for stereo matching. The minimum spanning tree (MST) employs color difference as the sole component to build the weight function, which often leads to failure in achieving satisfactory results in some boundary regions with similar color distributions. In this paper, a modified initial cost is used. The erroneous pixels are often caused by two pixels from object and background, which have similar color distribution. And then inner color correlation is employed as a new component of the weight function, which is determined to effectively eliminate them. Besides, the segmentation method of the tree structure is also improved. Thus, a more robust and reasonable tree structure is developed. The proposed method was tested on Middlebury datasets. As can be expected, experimental results show that the proposed method outperforms the classical nonlocal methods.
Modulation of Central Synapses by Astrocyte-Released ATP and Postsynaptic P2X Receptors
Authors: Boué-Grabot Eric , Pankratov Yuriy
Published: August 2017

Communication between neuronal and glial cells is important for neural plasticity. P2X receptors are ATP-gated cation channels widely expressed in the brain where they mediate action of extracellular ATP released by neurons and/or glia. Recent data show that postsynaptic P2X receptors underlie slow neuromodulatory actions rather than fast synaptic transmission at brain synapses. Here, we review these findings with a particular focus on the release of ATP by astrocytes and the diversity of postsynaptic P2X-mediated modulation of synaptic strength and plasticity in the CNS.
Two-Segment Foot Model for the Biomechanical Analysis of Squat
Authors: Panero E. , Gastaldi L. , Rapp W.
Published: August 2017

Squat exercise is acquiring interest in many fields, due to its benefits in improving health and its biomechanical similarities to a wide range of sport motions and the recruitment of many body segments in a single maneuver. Several researches had examined considerable biomechanical aspects of lower limbs during squat, but not without limitations. The main goal of this study focuses on the analysis of the foot contribution during a partial body weight squat, using a two-segment foot model that considers separately the forefoot and the hindfoot. The forefoot and hindfoot are articulated by the midtarsal joint. Five subjects performed a series of three trials, and results were averaged. Joint kinematics and dynamics were obtained using motion capture system, two force plates closed together, and inverse dynamics techniques. The midtarsal joint reached a dorsiflexion peak of 4°. Different strategies between subjects revealed 4° supination and 2.5° pronation of the forefoot. Vertical GRF showed 20% of body weight concentrated on the forefoot and 30% on the hindfoot. The percentages varied during motion, with a peak of 40% on the hindfoot and correspondently 10% on the forefoot, while the traditional model depicted the unique constant 50% value. Ankle peak of plantarflexion moment, power absorption, and power generation was consistent with values estimated by the one-segment model, without statistical significance.