bluuebunny/crossref_metadata_2025 huggingface dataset:
Distributed Link Scheduling Algorithm Based on Successive Interference Cancellation in MIMO Wireless Networks
Authors: Wu Junhua , Lin Dandan , Li Guangshun , Liu Yuncui , Yin Yanmin
Published: June 2019

The performance of multiple input multiple output (MIMO) wireless networks is limited mainly by concurrent interference among sensor nodes. Effective link scheduling algorithms with the technology of successive interference cancellation (SIC) can maximize throughput in MIMO wireless networks. Most previous works on link scheduling in MIMO wireless networks did not consider SIC. In this paper, we propose a MIMO-SIC (MSIC) algorithm under the SINR model. First, a mathematical framework is established for the cross-layer optimization of routing and scheduling, with constraints of traffic balance and link capacity. Second, the interference regions are divided to characterize the level of interference between links. Finally, we propose a distributed link scheduling algorithm based on MSIC to eliminate the interference between competing links in the MIMO network. Experimental results show that the MSIC algorithm can increase the end-to-end throughput per unit by approximately 73% on average compared with non-SIC algorithms.
STAT3 Genotypic Variant rs744166 and Increased Tyrosine Phosphorylation of STAT3 in IL-23 Responsive Innate Lymphoid Cells during Pathogenesis of Crohn’s Disease
Authors: Tang Ying , Tan Sanda A. , Iqbal Atif , Li Jian , Glover Sarah C.
Published: June 2019

Crohn’s disease (CD) results from dysregulated immune responses to gut microbiota in genetically susceptible individuals, affecting multiple areas of the gastrointestinal tract. Innate lymphoid cells (ILCs) are tissue-resident innate effector lymphocytes which play crucial roles in mucosal immune defense, tissue repair, and maintenance of homeostasis. The accumulation of IFN-γ-producing ILC1s and increased level of proinflammatory cytokines produced by ILCs has been observed in the inflamed terminal ileum of CD patients. To date, the precise mechanisms of ILC plasticity and gene regulatory pathways in ILCs remain unclear. Signal transducer and activator of transcription 3 (STAT3) regulates gene expression in a cell-specific, cytokine-dependent manner, involving multiple immune responses. This study proposes the positive correlation between the prevalence of STAT3 rs744166 risky allele “A” with the severity of disease in a cohort of 94 CD patients. In addition, the results suggest an increased STAT3 activity in the inflamed ileum of CD patients, compared to unaffected ileum sections. Notably, IL-23 triggers the differentiation of CD117+NKp44- ILC3s and induces the activation of STAT3 in both CD117+NKp44- and CD117-NKp44- ILC subsets, implying the involvement of STAT3 in the initiation of ILC plasticity. Moreover, carriage of STAT3 “A” risk allele exhibited a higher basal level of STAT3 tyrosine phosphorylation, and an increased IL-23 triggered the pSTAT3 level. We also demonstrated that there was no delayed dephosphorylation of STAT3 in ILCs of both A/A and G/G donors. Overall, the results of this study suggest that IL-23-induced activation of STAT3 in the CD117-NKp44- ILC1s involves in ILC1-to-ILC3 plasticity and a potential regulatory role of ILC1 function. Those genetically susceptible individuals carried STAT3 rs744166 risky allele appear to have higher basal and cytokine-stimulated activation of STAT3 signal, leading to prolonged inflammation and chronic relapse.
Ganji Formulation for Patients with Hepatocellular Carcinoma Who Have Undergone Surgery: A Multicenter, Randomized, Double-Blind, Controlled Trial
Authors: Zhang Jing-Hao , Zheng Chao , Zhu Xiao-Jun , Zhang Xin , Hou Zhi-Jun , Zhou Zhen-Hua , Wang Yu-Qing , Wang Kai-Xia , Yu Zhuo , Li Man , Gao Yue-Qiu , Sun Xue-Hua
Published: June 2019

Objective. To ascertain the efficacy and safety of Ganji Formulation (GF) for patients with Hepatocellular carcinoma (HCC) who had undergone surgery. Materials and Methods. A total of 262 HCC patients who had undergone liver resection, local ablation, or transcatheter arterial chemoembolization (TACE) were divided randomly into the treatment group and control group. The former was treated with GF and the later with placebo, both for 6 months. The primary endpoint was overall survival (OS). Second endpoints were disease-free survival (DFS) or time to disease progression (TTP). Results. OS of the treatment group was significantly longer than that of the control group (P < 0.05). Subgroup analysis showed that, for patients who received TACE, the TTP was significantly longer in the treatment group than in the control group (P < 0.05). However, for patients who underwent liver resection or local ablation, there was no significant difference in DFS between the two groups (P > 0.05). Conclusion. GF could improve postoperative cumulative survival and prolong the TTP. This clinical trial number is registered with ChiCTR-IOR-15007349.
A Prospective Study of Toenail Trace Element Levels and Risk of Skin Cancer
Authors: Matthews Natalie H. , Koh Michelle , Li Wen-Qing , Li Tricia , Willett Walter C. , Stampfer Meir J. , Christiani David C. , Morris J. Steven , Qureshi Abrar A. , Cho Eunyoung
Published: June 2019

Background:

Few epidemiologic studies have investigated trace element exposure and skin cancer risk.

Methods:

Toenail levels of mercury, selenium, chromium, iron, and zinc were measured from 6,708 women in the Nurses' Health Study (1984–2012) and 3,730 men in the Health Professionals Follow-up Study (1986–2012) with data from prior nested case–control studies. Participants were free of skin cancer at toenail collection and followed for incident basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and melanoma. Cox proportional hazards models were used to compute hazard ratios (HR) and 95% confidence intervals (CI) of skin cancer associated with the elements in each study. We calculated pooled multivariable HRs using a fixed-effects model. During 26 to 28 years of follow-up, 2,433 BCC, 334 SCC, and 130 melanoma cases were documented.

Results:

Higher toenail mercury levels were associated with risk of BCC [pooled HR for top vs. bottom quintiles = 1.34 (95% CI, 1.18–1.52), Ptrend < 0.0001]. Similar direct associations were found with risks of SCC [pooled HR for top vs. bottom quartiles = 1.41 (95% CI, 1.03–1.94), Ptrend = 0.04] and melanoma [pooled HR for top vs. bottom quartiles = 1.88 (95% CI, 1.12–3.16), Ptrend = 0.02]. Chromium was positively associated with BCC in women only. No associations were found between other metals and skin cancer risk.

Conclusions:

Our prospective data found that increased toenail mercury concentrations were associated with increased skin cancer risk.

Impact:

If our novel findings are confirmed, mercury may play a role in skin carcinogenesis.
Activation of JAK/STAT Signaling in Megakaryocytes Sustains Myeloproliferation In Vivo
Authors: Woods Brittany , Chen Wei , Chiu Sophia , Marinaccio Christian , Fu Chunling , Gu Lilly , Bulic Marinka , Yang Qiong , Zouak Anouar , Jia Shengxian , Suraneni Praveen Kumar , Xu Kailin , Levine Ross L. , Crispino John D. , Wen Qiang Jeremy
Published: June 2019

Purpose:

The myeloproliferative neoplasms (MPN), including polycythemia vera, essential thrombocythemia, and primary myelofibrosis, are characterized by the expansion of the erythroid, megakaryocytic, and granulocytic lineages. A common feature of these disorders is the presence of abnormal megakaryocytes, which have been implicated as causative agents in the development of bone marrow fibrosis. However, the specific contributions of megakaryocytes to MPN pathogenesis remain unclear.

Experimental Design:

We used Pf4-Cre transgenic mice to drive expression of JAK2V617F in megakaryocyte lineage–committed hematopoietic cells. We also assessed the critical role of mutant megakaryocytes in MPN maintenance through cell ablation studies in JAK2V617F and MPLW515L BMT models of MPN.

Results:

JAK2V617F-mutant presence in megakaryocytes was sufficient to induce enhanced erythropoiesis and promote fibrosis, which leads to a myeloproliferative state with expansion of mutant and nonmutant hematopoietic cells. The increased erythropoiesis was associated with elevated IL6 level, which was also required for aberrant erythropoiesis in vivo. Furthermore, depletion of megakaryocytes in the JAK2V617F and MPLW515L BMT models ameliorated polycythemia and leukocytosis in addition to expected effects on megakaryopoiesis.

Conclusions:

Our observations reveal that JAK/STAT pathway activation in megakaryocytes induces myeloproliferation and is necessary for MPN maintenance in vivo. These observations indicate that MPN clone can influence the behavior of the wild-type hematopoietic milieu, at least, in part, via altered production of proinflammatory cytokines and chemokines. Our findings resonate with patients who present with a clinical MPN and a low JAK2V617F allele burden, and support the development of MPN therapies aimed at targeting megakaryocytes.
An EGFR-InducedDrosophilaLung Tumor Model Identifies Alternative Combination Treatments
Authors: Bossen Judith , Uliczka Karin , Steen Line , Pfefferkorn Roxana , Mai Mandy Mong-Quyen , Burkhardt Lia , Spohn Michael , Bruchhaus Iris , Fink Christine , Heine Holger , Roeder Thomas
Published: June 2019

Lung cancer is the leading cause of cancer-associated mortality. Mutations in the EGFR gene are among the most important inducers of lung tumor development, but success of personalized therapies is still limited because of toxicity or developing resistances. We expressed constitutively active EGFR (EGFRCA) exclusively in the airway system of Drosophila melanogaster and performed comprehensive phenotyping. Ectopic expression of EGFRCA induced massive hyper- and metaplasia, leading to early death. We used the lethal phenotype as a readout and screened a library of FDA-approved compounds and found that among the 1,000 compounds, only the tyrosine kinase inhibitors (TKI) afatinib, gefitinib, and ibrutinib rescued lethality in a whole-animal screening approach. Furthermore, we screened the library in the presence of a subtherapeutic afatinib dose and identified bazedoxifene as a synergistically acting compound that rescues EGFR-induced lethality. Our findings highlight the potential of Drosophila-based whole-animal screening approaches not only to identify specific EGFR inhibitors but also to discover compounds that act synergistically with known TKIs. Moreover, we showed that targeting the EGFR together with STAT-signaling is a promising strategy for lung tumor treatment.
Collateral Automation for Triage in Stroke: Evaluating Automated Scoring of Collaterals in Acute Stroke on Computed Tomography Scans
Authors: Grunwald Iris Q. , Kulikovski Johann , Reith Wolfgang , Gerry Stephen , Namias Rafael , Politi Maria , Papanagiotou Panagiotis , Essig Marco , Mathur Shrey , Joly Olivier , Hussain Khawar , Wagner Viola , Shah Sweni , Harston George , Vlahovic Julija , Walter Silke , Podlasek Anna , Fassbender Klaus
Published: June 2019

Computed tomography angiography (CTA) collateral scoring can identify patients most likely to benefit from mechanical thrombectomy and those more likely to have good outcomes and ranges from 0 (no collaterals) to 3 (complete collaterals). In this study, we used a machine learning approach to categorise the degree of collateral flow in 98 patients who were eligible for mechanical thrombectomy and generate an e-CTA collateral score (CTA-CS) for each patient (e-STROKE SUITE, Brainomix Ltd., Oxford, UK). Three experienced neuroradiologists (NRs) independently estimated the CTA-CS, first without and then with knowledge of the e-CTA output, before finally agreeing on a consensus score. Addition of the e-CTA improved the intraclass correlation coefficient (ICC) between NRs from 0.58 (0.46–0.67) to 0.77 (0.66–0.85, p = 0.003). Automated e-CTA, without NR input, agreed with the consensus score in 90% of scans with the remaining 10% within 1 point of the consensus (ICC 0.93, 0.90–0.95). Sensitivity and specificity for identifying favourable collateral flow (collateral score 2–3) were 0.99 (0.93–1.00) and 0.94 (0.70–1.00), respectively. e-CTA correlated with the Alberta Stroke Programme Early CT Score (Spearman correlation 0.46, p < 0.001) highlighting the value of good collateral flow in maintaining tissue viability prior to reperfusion. In conclusion, ­e-CTA provides a real-time and fully automated approach to collateral scoring with the potential to improve consistency of image interpretation and to independently quantify collateral scores even without expert rater input.
Association between Sodium Intake and Urinary Fractional Albumin and Immunoglobulin G Excretion in Chronic Nondialytic Renal Disease: A Prospective Longitudinal Study
Authors: Martinez Marila Gaste , dos Santos Silva Vanessa , do Valle Adriana Polachini , de Oliveira Rogério Carvalho , Banin Vanessa Burgugi , Hokama Newton Key , Martin Luis Cuadrado
Published: June 2019

Background/Aims: Previous studies reported that fractional clearance of urinary proteins is better than total proteinuria in predicting chronic kidney disease (CKD) progression. However, the role of sodium in the fractional excretion of proteins has not been established. We aimed to evaluate the association between sodium intake and fractional albumin and immunoglobulin G (IgG) excretion in nondialytic CKD. Methods: We did a longitudinal, observational, and prospective study that included CKD patients aged 18–80. Included patients performed basal routine laboratory evaluations, urinary sodium excretion, and fractional albumin and IgG excretion that were repeated after 6-month of follow-up. Results: We evaluated 84 patients, mean age 55 ± 15.6 years, 40 women, and 74 whites. The change of estimated sodium intake had an association with the change of fractional albumin (R = 0.54; p < 0.001) and IgG (R = 0.56; p < 0.001) excretion in univariate analysis (increases in sodium intake were paralleled by increases in albumin and IgG excretion fractions). This association was maintained in a multiple generalized linear model even after adjusting for age and for changes in blood pressure, urinary potassium, protein intake, and blood glucose. Conclusion: In CKD patients, changes in estimated sodium intake were associated with changes in the fractional albumin and IgG excretion regardless of confounding factors. Findings of this study support the idea that reducing salt intake, and consequently, albumin and IgG fractional excretions could help to slow CKD progression. This hypothesis must be tested in long-term interventional studies.
AIHA and Pancytopenia as Complications of Pembrolizumab Therapy for Metastatic Melanoma: A Case Report
Authors: Ni Dan , AlZahrani Fatmah , Smylie Michael
Published: June 2019

Immunotherapy has been an emerging treatment for metastatic melanoma and several other malignancies since 2015. Hematological immune-mediated adverse effects from immunotherapy are rarely reported but they can cause serious harm to patients. Antibodies such as ipilimumab, nivolumab and pembrolizumab target different immune checkpoints to promote T cell anti-tumour response. In particular, pembrolizumab is an antibody that inhibits programmed cell death receptor 1 (PD-1) to upregulate tumour suppression. In this report, we present a case of pembrolizumab-induced autoimmune hemolytic anemia and pancytopenia in a patient who was receiving pembrolizumab treatment for metastatic melanoma. This patient has a history of chronic lymphocytic leukemia and was diagnosed with metastatic melanoma in 2017. He developed symptomatic AIHA and pancytopenia after receiving 8 cycles of pembrolizumab in 2018. Pembrolizumab treatment was discontinued and he was treated with blood transfusion and prednisone. After 5 months of tapering prednisone treatment, his anemia and pancytopenia have improved toward successful recovery. Cancer patients already face an increased risk of immunosuppression with conventional chemotherapy. This case report also summarized all reported cases of PD-1 inhibitor hematological adverse effects in the treatment of oncological diseases. These incidents reflect the risk of immune-mediated hematologic adverse effects, which should be considered in all patients using immunotherapy.
Adherence to the European Association of Urology Guidelines Regarding the Therapeutic Indications for the Treatment of Urinary Lithiasis: A Spanish Multicenter Study
Authors: García Fadrique Gonzalo , Budía Alberto , Climent Laura , Palmero José Luis , Morera José , Galán José Antonio , Gil Jesús , Montoya Dolores , García Pedro , Montoliu Ana , Pastor Francisco , Gallego Daniel
Published: June 2019

Introduction: Urinary lithiasis involves a major source of morbidity and economic costs. The aim of this study was to evaluate the adherence to the European Association of Urology Guidelines on Urolithiasis with regard to treatment among Spanish urologists. Methods: A total of 723 patients were included in a prospective study between May 1, 2014, and July 31, 2014. The study involved 8 hospitals responsible of urolithiasis in a geographical area of Spain (Comunidad Valenciana) with approximately 4,500,000 inhabitants. Data were collected about the demographic characteristics of the patients, the characteristics of the stones, and the indicated treatment, in order to analyze the adherence to the clinical guidelines. A 90% threshold was used in concordance with the indications in the guidelines. Results: Adherence to guidelines was poor in chemolysis, distal and ureteral calculi, and >2 cm renal calculi. Adherence was high in <2 cm renal calculi. Conclusions: In our study, the overall adherence to the clinical guidelines regarding the therapeutic indication for urinary lithiasis has been low. In the case of both renal and ureteral stones, the adherence in small lithiasis has been greater, compared with larger ones. In our survey, a trend has been observed in favor of endoscopic procedures even in large lithiasis.
ЧАСТОТА ВИЯВЛЕННЯ АРТЕРІАЛЬНОЇ ГІПЕРТЕНЗІЇ СЕРЕД ПАЦІЄНТІВ ВІДОМЧОЇ ПОЛІКЛІНІКИ
Authors: Karel N. V. , Yarema N. I. , Reha N. I. , Yastremska S. O.
Published: June 2019

У статті наведено статистичні дані щодо частоти виявлення артеріальної гіпертензії на дільниці обслу­говування поліклінічного відділу військово-медичної служби управління СБУ в Тернопільській області.
ФОРМИ І МЕТОДИ ЯКІСНОГО НАВЧАННЯ НА ЗАНЯТТЯХ З ФАРМАКОЛОГІЇ
Authors: Kazaniuk T. V.
Published: June 2019

у статті наведено досвід викладання фармакології для студентів, які навчаються за спеціальністю 223 «Медсестринство». Розглянуто методики проведення аудиторної та позааудиторної роботи студентів, використання яких сприятиме підвищенню ефективності підготовки майбутніх медичних сестер до професійної діяльності.
ВИЗНАЧЕННЯ ЗНАЧИМОСТІ ФАКТОРІВ, ЩО ВИЗНАЧАЮТЬ РЕЗУЛЬТАТИ ДІЯЛЬНОСТІ МЕДСЕСТРИНСЬКОГО ПЕРСОНАЛУ
Authors: Lan L. Z. , Pirus I. V. , Musienko V. A. , Krynytska I. Ya. , Maruschak M. I. , Mialiuk O. P.
Published: June 2019

У статті викладено сучасні дані щодо значимості факторів, які визначають результати діяльності медсестринського персоналу з точки зору медичних сестер – керівників.
СИНДРОМ СУХОГО ОКА
Authors: Bai U. A.
Published: June 2019

У статті проаналізовано етіологію виникнення синдрому сухого ока та методи лікування захворювання.
Inclusão e exclusão: interfaces entre os pressupostos de Theo van Leeuwen e a comunicação organizacional
Authors: Ferreira Dôuglas Aparecido
Published: June 2019

Este artigo é uma tentativa de interface entre as estratégias discursivas de inclusão e exclusão propostas por van Leeuwen e suas potencialidades no entendimento das estruturas de poder dos processos de comunicação organizacional. Para tanto, foi realizada uma análise crítica do discurso do jornal Piãoneiro/Roda Livre. Infere-se que as ideias do autor colaboram para um entendimento mais abrangente da comunicação, contudo, aponta-se um uso moderado das categorias analíticas, uma vez que são diversas e podem diminuir a profundidade de análise.
Em busca de sentidos para a “marca Rio”: as narrativas do site portomaravilha.com.br
Authors: Mello Flávia Barroso de
Published: June 2019

Neste artigo, propõe-se analisar como a Prefeitura, em parceria com a iniciativa privada, constrói sentidos para a “marca Rio”. Sob a perspectiva da semiótica discursiva, são analisadas as narrativas institucionais veiculadas no site portomaravilha. com.br, sobre a reurbanização do Porto do Rio. A análise aponta pistas sobre uma estratégia institucional que, para além de um projeto de “Cidade Olímpica”, busca consolidar novo um éthos urbano, com vistas a inserir o Rio de Janeiro no mercado de cidades globais.
Marketing e Relações Públicas promovendo diálogo com os públicos nas redes sociais
Authors: Mendes Flávia Cristina Martins , Yanaze Mitsuru Higuchi
Published: June 2019

Este artigo procura apresentar como novas estratégias de marketing estão sendo utilizadas pelas organizações para construir um diálogo mais efetivo com seus respectivos públicos, principalmente nas redes sociais, onde eles estão mais presentes e atuantes. É importante mostrar que as mudanças de comportamento dos consumidores transformaram as relações empresa-consumidor fazendo com que o marketing alcançasse novas alternativas para otimizar seu sucesso.
Statin Use and Risk of Vascular Events Among Cancer Patients After Radiotherapy to the Thorax, Head, and Neck
Authors: Boulet Jacinthe , Peña Jessica , Hulten Edward A. , Neilan Tomas G. , Dragomir Alice , Freeman Carolyn , Lambert Christine , Hijal Tarek , Nadeau Lyne , Brophy James M. , Mousavi Negareh
Published: June 2019

Background

This study aimed to explore whether statins reduce radiation‐induced vascular complications in cancer patients postradiotherapy to the thorax, head, and neck.

Methods and Results

We conducted a retrospective cohort study within a provincial linked database of 5718 cardiac patients with thorax and head or neck cancer having undergone radiotherapy between 2000 and 2011. One thousand five hundred fifty‐two patients were identified as nonstatin users and 4166 as statin users. The primary outcome of interest was the composite of cerebrovascular (transient ischemic attack, and fatal or nonfatal stroke) or cardiovascular events (fatal or nonfatal myocardial infarction). Time‐dependent Cox proportional hazard analyses were performed. The crude event rate was 10.31% for nonusers and 9.03% for statin users (hazard ratio of 0.92 [95%
CI
0.76–1.10,
P
=0.3451]), over a mean time to event/censoring of 534±687 days for nonusers and 594±706 days for the statin users. After adjusting for age, sex, prior history of stroke/transient ischemic attack or myocardial infarction, diabetes mellitus, dyslipidemia, atrial fibrillation, chronic kidney disease, heart failure, and hypertension, statin use postradiotherapy was associated with a nonsignificant 15% relative risk reduction, but a strong trend toward reducing the primary outcome (hazard ratio=0.85 95%
CI
0.69–1.04,
P
=0.0811). The use of statins was associated with a significant reduction of 32% for the outcome of stroke alone (hazard ratio=0.68, 95%
CI
0.48–0.98,
P
=0.0368).

Conclusions

Statin use post radiation therapy was associated with a significant reduction in stroke, with a trend toward significantly reducing cardiovascular and cerebrovascular events.
Burden of Cardiovascular Risk Factors Over Time and Arterial Stiffness in Youth With Type 1 Diabetes Mellitus: The SEARCH for Diabetes in Youth Study
Authors: Urbina Elaine M. , Isom Scott , Bell Ronny A. , Bowlby Deborah A. , D'Agostino Ralph , Daniels Stephen R. , Dolan Lawrence M. , Imperatore Giuseppina , Marcovina Santica M. , Merchant Anwar T. , Reynolds Kristi , Shah Amy S. , Wadwa R. Paul , Dabelea Dana ,   for the SEARCH for Diabetes in Youth Study Group
Published: June 2019

Background

The incidence of type 1 diabetes mellitus (T1DM) in children is increasing, resulting in higher burden of cardiovascular diseases due to diabetes mellitus–related vascular dysfunction.

Methods and Results

We examined cardiovascular risk factors (
CVRF
s) and arterial parameters in 1809 youth with T1DM. Demographics, anthropometrics, blood pressure, and laboratory data were collected at T1DM onset and 5 years later. Pulse wave velocity and augmentation index were collected with tonometry.
ANOVA
or chi‐square tests were used to test for differences in measures of arterial parameters by
CVRF
. Area under the curve of
CVRF
s was entered in general linear models to explore determinants of accelerate vascular aging. Participants at the time of arterial measurement were 17.6±4.5 years old, 50% female, 76% non‐Hispanic white, and duration of T1DM was 7.8±1.9 years. Glycemic control was poor (glycated hemoglobin, 9.1±1.8%). All arterial parameters were higher in participants with glycated hemoglobin ≥9% and pulse wave velocity was higher with lower insulin sensitivity or longer duration of diabetes mellitus. Differences in arterial parameters were found by sex, age, and presence of obesity, hypertension, or dyslipidemia. In multivariable models, higher glycated hemoglobin, lower insulin sensitivity, body mass index, blood pressure, and lipid areas under the curve were associated with accelerated vascular aging.

Conclusions

In young people with T1DM, persistent poor glycemic control and higher levels of traditional
CVRF
s are independently associated with arterial aging. Improving glycemic control and interventions to lower
CVRF
s may prevent future cardiovascular events in young individuals with T1DM.
Downregulation of Orexin Receptor in Hypothalamic Paraventricular Nucleus Decreases Blood Pressure in Obese Zucker Rats
Authors: Zhou Jing‐Jing , Ma Hui‐Jie , Shao Jianying , Wei Yan , Zhang Xiangjian , Zhang Yi , Li De‐Pei
Published: June 2019

Background

Orexin and its receptors are critical regulating sympathetic vasomotor tone under physiological and pathophysiological conditions. Orexin receptor 1 (
OXR
1) is upregulated in the paraventricular nucleus (
PVN
) in the hypothalamus and contributes to increased sympathetic outflow in obese Zucker rats (
OZR
s). We hypothesized that silencing
OXR
1 expression in the
PVN
decreases heightened blood pressure and elevated sympathetic outflow in
OZR
s.

Methods and Results

An adeno‐associated virus (
AAV
) vector containing a short hairpin
RNA
(sh
RNA
) targeting rat
OXR
1 was designed to silence
OXR
1 expression in the
PVN
. The
AAV
‐
OXR
1‐sh
RNA
or scrambled sh
RNA
was injected into the
PVN
in
OZR
s. The arterial blood pressure in free‐moving
OZR
s was continuously monitored by using a telemetry approach. The firing activity of spinally projecting
PVN
neurons in rat brain slices was recorded 3 to 4 weeks after injection of viral vectors. The free‐moving
OZR
s treated with
AAV
‐
OXR
1‐sh
RNA
had markedly lower
OXR
1 expression and lower mean arterial blood pressure, heart rate, and ratio of low‐ to high‐frequency components of heart rate variability compared with
OZR
s treated with scrambled sh
RNA
. Furthermore,
AAV
‐
OXR
1‐sh
RNA
treatment markedly reduced renal sympathetic nerve activity and attenuated sympathoexcitatory response induced by microinjection of orexin A into the
PVN
. In addition, treatment with
AAV
‐
OXR
1‐sh
RNA
substantially decreased the basal firing activity of spinally projecting
PVN
neurons in
OZR
s and attenuated the excitatory effect of orexin A on the firing activity of these neurons.

Conclusions

These data suggest that chronic downregulation of
OXR
1 expression in the
PVN
reduces sympathetic vasomotor tone in obesity‐related hypertension.
Efficacy of Long‐Term Remote Ischemic Conditioning on Vascular and Neuronal Function in Type 2 Diabetes Patients With Peripheral Arterial Disease
Authors: Hansen Christian S. , Jørgensen Marit E. , Fleischer Jesper , Bøtker Hans Erik , Rossing Peter
Published: June 2019

Background

Peripheral artery disease is a major socioeconomic challenge in the diabetes mellitus community and non‐surgical treatment options are limited. As remote ischemic conditioning (
RIC
) improves vascular function and attenuates ischemia‐induced tissue damage, we investigated the efficacy of
RIC
on vascular and neuronal function in type 2 diabetes mellitus patients with peripheral artery disease.

Methods and Results

We enrolled 36 type 2 diabetes mellitus patients with moderately reduced toe pressure (40–70 mm Hg) in a randomized sham‐controlled double‐masked trial. Patients were allocated to 12 weeks once daily upper arm cuff‐based treatment of either
RIC
treatment (4 cycles of 5‐minute ischemia followed by 5‐minute reperfusion) or similar sham‐device treatment. Primary outcome was transcutaneous tissue oxygen tension of the instep of the feet. Secondary outcomes were aortic pulse wave velocity, toe pressure and toe‐brachial index. Tertiary outcomes were markers of peripheral and autonomic nerve function. We enrolled 36 patients (83% men). Patients had a mean (
SD
) age of 70.7 years (6.8), diabetes mellitus duration of 18.4 years (8.3), HbA1c (gycated hemoglobin) of 59.7 mmol/mol (11.2). Eighty percent had peripheral symmetrical neuropathy. The mean difference in change of transcutaneous tissue oxygen tension from baseline between the
RIC
and sham‐treated groups was −0.03 mm Hg ([95%
CI
−0.1; 0.04],
P
=0.438).
RIC
did not elicit any change in additional outcomes. Three patients experienced transient skin petechiae in the treated arm.

Conclusions

Long‐term repeated remote ischemic conditioning treatment have no effect on tissue oxygenation, vascular or neuronal function in patients with type 2 diabetes mellitus and moderate peripheral artery disease.

Clinical Trial Registration

URL
:
http://www.ClinicalTrials.gov
. Unique identifier:
NCT
02749942.
Early Versus Delayed Stroke After Cardiac Surgery: A Systematic Review and Meta‐Analysis
Authors: Gaudino Mario , Rahouma Mohammed , Di Mauro Michele , Yanagawa Bobby , Abouarab Ahmed , Demetres Michelle , Di Franco Antonino , Arisha Mohammed J. , Ibrahim Dina A. , Baudo Massimo , Girardi Leonard N. , Fremes Stephen
Published: June 2019

Background

Although it is traditionally regarded as a single entity, perioperative stroke comprises 2 separate phenomena (early/intraoperative and delayed/postoperative stroke). We aimed to systematically evaluate incidence, risk factors, and clinical outcome of early and delayed stroke after cardiac surgery.

Methods and Results

A systematic review (
MEDLINE
,
EMBASE
, Cochrane Library) was performed to identify all articles reporting early (on awakening from anesthesia) and delayed (after normal awakening from anesthesia) stroke after cardiac surgery. End points were pooled event rates of stroke and operative mortality and incident rate of late mortality. Thirty‐six articles were included (174 969 patients). The pooled event rate for early stroke was 0.98% (95%
CI
0.79% to 1.23%) and was 0.93% for delayed stoke (95%
CI
0.77% to 1.11%;
P
=0.68). The pooled event rate of operative mortality was 28.8% (95%
CI
17.6% to 43.4%) for early and 17.9% (95%
CI
14.0% to 22.7%) for delayed stroke, compared with 2.4% (95%
CI
1.9% to 3.1%) for patients without stroke (
P
<0.001 for early versus delayed, and for perioperative stroke, early stroke, and delayed stroke versus no stroke). At a mean follow‐up of 8.25 years, the incident rate of late mortality was 11.7% (95%
CI
7.5% to 18.3%) for early and 9.4% (95%
CI
5.9% to 14.9%) for delayed stroke, compared with 3.4% (95%
CI
2.4% to 4.8%) in patients with no stroke. Meta‐regression demonstrated that off‐pump was inversely associated with early stroke (β=−0.009,
P
=0.01), whereas previous stroke (β=0.02,
P
<0.001) was associated with delayed stroke.

Conclusions

Early and delayed stroke after cardiac surgery have different risk factors and impacts on operative mortality as well as on long‐term survival.
The millipede family Diplomaragnidae Attems 1907 in the Korean Peninsula, with the descriptions of a new genus and new species (Diplopoda, Chordeumatida)
Authors: MIKHALJOVA ELENA V. , LIM KIL-YOUNG
Published: June 2019

The diplopod family Diplomaragnidae Attems 1907 appears to be represented in the Korean Peninsula by five genera and ten species. One genus and three species are described here as new to science: Koreagna gen. n., with the type species Koreagna obtecta sp. n., Tokyosoma bellum sp. n., and Tokyosoma phialiferum sp. n. Keys and taxonomic and distributional notes are given for all species of diplomaragnids currently known from Korea.
Three new species of Bryopharsos Quate, 1996 (Diptera, Psychodidae, Psychodinae) from the Neotropical Region
Authors: BRAVO FREDDY , ARAÚJO MAÍRA XAVIER
Published: June 2019

Bryopharsos Quate, 1996 is a Neotropical genus with four species, all from Central America. This paper describes three new species from Brazil, Bryopharsos uncinatum sp. nov., Bryopharsos paulistensis sp. nov. and Bryopharsos amazonensis sp. nov. A wider concept to the genus Bryopharsos is proposed here to include the species from Brazil. We also provide an identification key for males of the genus.
Estimation of Atlantic Tropical Cyclone Rainfall Frequency in the United States
Authors: Feldmann Monika , Emanuel Kerry , Zhu Laiyin , Lohmann Ulrike
Published: June 2019

Tropical cyclones pose a significant flood risk to vast land regions in their path because of extreme precipitation. Thus it is imperative to quantitatively assess this risk. This study compares exceedance frequencies of tropical cyclone precipitation derived from two independent observational datasets with those estimated using a tropical cyclone rainfall algorithm applied to large sets of synthetic tropical cyclones. The modeled rainfall compares reasonably well to observed rainfall across much of the southern United States but does less well in the mid-Atlantic states. Possible causes of this disparity are discussed.
A Study on Future Projections of Precipitation Characteristics around Japan in Early Summer Combining GPM DPR Observation and CMIP5 Large-Scale Environments
Authors: Yokoyama Chie , Takayabu Yukari N. , Arakawa Osamu , Ose Tomoaki
Published: June 2019

This study estimates future changes in the early summer precipitation characteristics around Japan using changes in the large-scale environment, by combining Global Precipitation Measurement precipitation radar observations and phase 5 of the Coupled Models Intercomparison Project climate model large-scale projections. Analyzing satellite-based data, we first relate precipitation in three types of rain events (small, organized, and midlatitude), which are identified via their characteristics, to the large-scale environment. Two environmental fields are chosen to determine the large-scale conditions of the precipitation: the sea surface temperature and the midlevel large-scale vertical velocity. The former is related to the lower-tropospheric thermal instability, while the latter affects precipitation via moistening/drying of the midtroposphere. Consequently, favorable conditions differ between the three types in terms of these two environmental fields. Using these precipitation–environment relationships, we then reconstruct the precipitation distributions for each type with reference to the two environmental indices in climate models for the present and future climates. Future changes in the reconstructed precipitation are found to vary widely between the three types in association with the large-scale environment. In more than 90% of models, the region affected by organized-type precipitation will expand northward, leading to a substantial increase in this type of precipitation near Japan along the Sea of Japan, and in northern and eastern Japan on the Pacific side, where its present amount is relatively small. This result suggests an elevated risk of heavy rainfall in those regions because the maximum precipitation intensity is more intense in organized-type precipitation than in the other two types.
The Impact of Large-Scale Orography on Northern Hemisphere Winter Synoptic Temperature Variability
Authors: Lutsko Nicholas J. , Baldwin Jane Wilson , Cronin Timothy W.
Published: June 2019

The impact of large-scale orography on wintertime near-surface (850 hPa) temperature variability on daily and synoptic time scales (from days to weeks) in the Northern Hemisphere is investigated. Using a combination of theory, idealized modeling work, and simulations with a comprehensive climate model, it is shown that large-scale orography reduces upstream temperature gradients, in turn reducing upstream temperature variability, and enhances downstream temperature gradients, enhancing downstream temperature variability. Hence, the presence of the Rockies on the western edge of the North American continent increases temperature gradients over North America and, consequently, increases North American temperature variability. By contrast, the presence of the Tibetan Plateau and the Himalayas on the eastern edge of the Eurasian continent damps temperature variability over most of Eurasia. However, Tibet and the Himalayas also interfere with the downstream development of storms in the North Pacific storm track, and thus damp temperature variability over North America, by approximately as much as the Rockies enhance it. Large-scale orography is also shown to impact the skewness of downstream temperature distributions, as temperatures to the north of the enhanced temperature gradients are more positively skewed while temperatures to the south are more negatively skewed. This effect is most clearly seen in the northwest Pacific, off the east coast of Japan.
Do We Really Need More Stages? Comparing the Effects of Likelihood Alarm Systems and Binary Alarm Systems
Authors: Zirk Anna , Wiczorek Rebecca , Manzey Dietrich
Published: June 2019

Objective

This research investigates the potential behavioral and performance benefits of a four-stage likelihood alarm system (4-LAS) contrasting a 3-LAS, a binary alarm system with a liberal threshold (lib-BAS), and a BAS with a conservative threshold (con-BAS).

Background

Prior research has shown performance benefits of 3-LASs over conventional lib-BASs due to more distinct response strategies and better discriminating true from false alerts. This effect might be further enhanced using 4-LASs. However, the increase in stages could cause users to reduce cognitive complexity by responding in the same way to the two lower and the two higher stages, thus treating the 4-LAS like a con-BAS.

Method

All systems were compared using a dual-task paradigm. Response strategies, number of joint human machine (JHM) false alarms (FAs), misses, and sensitivity were regarded.

Results

Compared with the lib-BAS, JHM sensitivity only improved with the 4-LAS and the con-BAS. However, the number of JHM misses was lowest for the con-BAS compared with all other systems.

Conclusion

JHM sensitivity improvements can be achieved by using a 4-LAS, as well as a con-BAS. However, only the latter one may also reduce the number of JHM misses, which is remarkable considering that BASs with conservative thresholds a priori commit more inbuilt misses than other systems.

Application

Results suggest implementing conservative BASs in multi-task working environments to improve JHM sensitivity and reduce the number of JHM misses. When refraining from designing systems which are miss prone, 4-LASs represent a suitable compromise.
The origins of Canada’s feminist foreign policy
Authors: Chapnick Adam
Published: June 2019

In January 2019, a leading Canadian foreign policy blog, OpenCanada.org, declared that “[u]nder the government of Justin Trudeau, Canada has embraced a feminist foreign policy—gradually at first, and with fervor over the past year.” Although critics have debated the policy’s effectiveness, the embrace, if not also the fervor, was indisputable. By 2019, the Trudeau government’s second foreign minister, Chrystia Freeland, was proclaiming Canada’s feminist approach to international relations openly and regularly. The international community had also noticed. This article investigates the origins of the new Canadian foreign policy “brand.” It finds that, contrary to popular thinking, the prime minister himself played at most a minor role in the initiation of what became a full-fledged transformation of Canada’s global image.
There and back again: What the Cold War for Southeast Asia can teach us about Sino-US competition in the region today
Authors: Ngoei Wen-Qing
Published: June 2019

This essay examines how the history of the Cold War in Southeast Asia has shaped, and will likely continue to shape, the current Sino-US rivalry in the region. Expert commentary today typically focuses on the agendas and actions of the two big powers, the United States and China, which actually risks missing the bigger picture. During the Cold War, leaders of ASEAN (Association of Southeast Asian Nations) played a critical role in containing Chinese influence, shaping the terms of Sino-US competition and rapprochement, and deepening the US presence in Southeast Asia. The legacy of ASEAN’s foreign relations during and since the Cold War imposes constraints on Chinese regional ambitions today, which militates against the popular notion that Chinese hegemony in East and Southeast Asia is inevitable. This essay underscores that current analyses of the brewing crisis in and around the South China Sea must routinely look beyond the two superpowers to the under-appreciated agency of small- and middle-sized ASEAN actors who, in reality, are the ones who hold the fate of the region in their hands.
Brand Coolness
Authors: Warren Caleb , Batra Rajeev , Loureiro Sandra Maria Correia , Bagozzi Richard P.
Published: June 2019

Marketers strive to create cool brands, but the literature does not offer a blueprint for what “brand coolness” means or what features characterize cool brands. This research uses a mixed-methods approach to conceptualize brand coolness and identify a set of characteristics typically associated with cool brands. Focus groups, depth interviews, and an essay study indicate that cool brands are perceived to be extraordinary, aesthetically appealing, energetic, high status, rebellious, original, authentic, subcultural, iconic, and popular. In nine quantitative studies (surveys and experiments), the authors develop scale items to reliably measure the component characteristics of brand coolness; show that brand coolness influences important outcome variables, including consumers’ attitudes toward, satisfaction with, intentions to talk about, and willingness to pay for the brand; and demonstrate how cool brands change over time. At first, most brands become cool to a small niche, at which point they are perceived to be more subcultural, rebellious, authentic, and original. Over time, some cool brands become adopted by the masses, at which point they are perceived to be more popular and iconic.
Emotional Memory in Oral Contraceptive Users: Negative Stimuli Are More Forgettable
Authors: Person Brandi , Oinonen Kirsten A.
Published: June 2019

Recent research suggests oral contraceptive use is associated with altered memory for emotional story information, blunted stress hormone responses to emotional stimuli, and altered structure or function of the amygdala and hippocampus. This study examined the extent to which oral contraceptives influence relative recall of (a) the spatial location of emotional versus neutral stimuli and (b) positive versus negative emotional stimuli. Participants (58 oral contraceptive users, 40 nonusers, and 37 men) completed an Emotional Spatial Memory test and were evaluated on short-term recall and long-term (one week) recall. There was no evidence for group differences in recall of the locations of emotional versus neutral stimuli. However, oral contraceptive users remembered relatively more positive than negative items compared with nonusers and men on the spatial memory test. This effect was driven by oral contraceptive users recalling fewer negative items than free cyclers. The results indicate that hormonal contraceptives may decrease immediate recall of negative emotional stimuli.
The Association of Nurse–Physician Teamwork and Mortality in Surgical Patients
Authors: Kang Xiao Linda , Brom Heather M. , Lasater Karen B. , McHugh Matthew D.
Published: June 2019

In this study we describe nurse–physician teamwork, estimate its association with surgical patient outcomes (30-day mortality and failure-to-rescue), and determine whether these relationships depend upon other modifiable hospital nursing characteristics (nurse staffing and education levels) known to be associated with patient outcomes. This cross-sectional analysis included linked data from 29,391 nurses representing 665 acute care hospitals and 1,321,904 adult patients who underwent a general surgical, vascular, or orthopedic procedure. Surgical patients cared for in hospitals with better nurse–physician teamwork had significantly lower odds of 30-day mortality (odds ratio [OR] = 0.95) and failure-to-rescue (OR = 0.95). In addition, the odds of death and failure-to-rescue were lower for patients in hospitals with both higher nurse–physician teamwork and more favorable patient-to-nurse staffing ratios. Similar trends were observed related to nursing education levels. Improving interprofessional teamwork is one strategy to improve patient outcomes with the added importance of also considering additional features of their nursing workforce.
A controlled clinical trial of preoperative pain neuroscience education for patients about to undergo total knee arthroplasty
Authors: Louw Adriaan , Puentedura Emilio J , Reed Jordan , Zimney Kory , Grimm Derek , Landers Merrill R
Published: June 2019

Objective:

The aim of this study was to determine if a preoperative pain neuroscience education program would result in superior outcomes compared to usual preoperative education for total knee arthroplasty.

Design:

Controlled clinical trial with alternating allocation.

Setting:

Community-based hospital.

Subjects:

Consecutive sample of 120 patients scheduled for total knee arthroplasty.

Intervention:

Traditional hospital preoperative total knee arthroplasty education program on its own, or with an additional 30-minute group pain neuroscience education session.

Main measures:

Primary outcomes were measurements at one, three, and six months for pain, function, fear of movement, and pain catastrophization. We also compared opioid usage, healthcare expenses, and patient satisfaction between groups.

Results:

There were no statistically significant differences in any outcome measures between the two groups over time, except for patient satisfaction. Those in the experimental group had more agreement with statements about “preparation for surgery” ( P = .038), “would do again” ( P = .032), and “met expectations” ( P = .033) compared to those in the control group averaged over the three measurement times. Patients improved in several outcome measures over time regardless of group assignment, with a 34% improvement in pain, 36% improvement in function, 16% improvement in fear of movement, and 23% improvement in pain catastrophization scores.

Conclusion:

Adding a brief 30-minute pain neuroscience education session to a traditional preoperative total knee arthroplasty education program did not result in any significant improvements, except patient satisfaction.