bluuebunny/crossref_metadata_2025 huggingface dataset:
Emerging therapies in adult and paediatric bronchiectasis
Authors: Regan Kate H. , Hill Adam T.
Published: September 2018

Bronchiectasis is a chronic respiratory disorder characterized by persistent productive cough and recurrent chest infections secondary to permanent structural airway damage. The current treatment strategies for this debilitating disorder are limited to prompt antibiotic treatment of infective exacerbations and regular airway clearance techniques. Despite its high morbidity and associated mortality across all age groups, it has been a neglected area of research in respiratory medicine and there remain no licensed disease‐modifying therapies. In this review, we have explored the numerous potential therapeutic targets to break the vicious cycle of infection and inflammation seen in these patients and the novel therapeutic agents that have been developed to target them. We have reviewed the role of novel anti‐inflammatory agents designed to target the persistent neutrophilic inflammatory infiltrate seen in bronchiectatic airways, including neutrophil elastase inhibitors, CXCR2 (CXC chemokine receptor 2) antagonists, DPP‐1 (dipeptidyl peptidase 1) inhibitors, PDE4 (phosphodiesterase 4) inhibitors and statins. Furthermore, we have explored novel targets to improve mucociliary clearance, namely ENaC (epithelial sodium channel) inhibitors, and discussed the potential of alternative antimicrobial strategies such as inhaled phages. Our review highlights the importance of a multi‐faceted approach to bronchiectasis management, which aims not only to eradicate or suppress bronchial infection but also to break the cycle of persistent airway inflammation that results in progressive lung damage in these patients.
Environmental Surveillance System Characteristics and Impacts on Confidence About No Undetected Serotype 1 Wild Poliovirus Circulation
Authors: Kalkowska Dominika A. , Duintjer Tebbens Radboud J. , Thompson Kimberly M.
Published: September 2018

Surveillance for poliovirus during the polio endgame remains uncertain. Building on prior modeling of the potential for undetected poliovirus transmission for conditions like those in Pakistan and Afghanistan, we use a hypothetical model to explore several key characteristics of the poliovirus environmental surveillance (ES) system (e.g., number and quality of sites, catchment sizes, and sampling frequency) and characterize their impacts on the time required to reach high (i.e., 95%) confidence about no circulation (CNC95%) following the last detected case of serotype 1 wild poliovirus. The nature and quality of the existing and future acute flaccid paralysis (AFP) surveillance and ES system significantly impact the estimated CNC95% for places like Pakistan and Afghanistan. The analysis illustrates the tradeoffs between number of sites, sampling frequency, and catchments sizes, and suggests diminishing returns of increasing these three factors beyond a point that depends on site quality and the location of sites. Limitations in data quality and the hypothetical nature of the model reduce the ability to assess the extent to which actual ES systems offer benefits that exceed their costs. Thus, although poliovirus ES may help to reduce the time required to reach high confidence about the absence of undetected circulation, the effect strongly depends on the ability to establish effective ES sites in high‐risk areas. The costs and benefits of ES require further analysis.
When Is a Risk Assessment Deficient According to an Uncertainty‐Based Risk Perspective?
Authors: Røyksund Marie , Flage Roger
Published: September 2018

The Petroleum Safety Authority Norway (PSA‐N) has recently adopted a new definition of risk: “the consequences of an activity with the associated uncertainty.” The PSA‐N has also been using “deficient risk assessment” for some time as a basis for assigning nonconformities in audit reports. This creates an opportunity to study the link between risk perspective and risk assessment quality in a regulatory context, and, in the present article, we take a hard look at the term “deficient risk assessment” both normatively and empirically. First, we perform a conceptual analysis of how a risk assessment can be deficient in light of a particular risk perspective consistent with the new PSA‐N risk definition. Then, we examine the usages of the term “deficient” in relation to risk assessments in PSA‐N audit reports and classify these into a set of categories obtained from the conceptual analysis. At an overall level, we were able to identify on what aspects of the risk assessment the PSA‐N is focusing and where deficiencies are being identified in regulatory practice. A key observation is that there is a diversity in how the agency officials approach the risk assessments in audits. Hence, we argue that improving the conceptual clarity of what the authorities characterize as “deficient” in relation to the uncertainty‐based risk perspective may contribute to the development of supervisory practices and, eventually, potentially strengthen the learning outcome of the audit reports.
Lost in Translation? Integrating Interdisciplinary Disaster Research with Policy Praxis
Authors: Sapat Alka
Published: September 2018

Interdisciplinary research can help address complex issues such as community resilience and climate change. However, transcending disciplinary borders to provide better understandings of these cross‐cutting issues is not an easy task. While there has been a greater focus on improving integration across disciplines, less attention has been paid to the particular challenges in the inclusion and integration of policy praxis into interdisciplinary research. This article argues that to effectively integrate policy‐relevant goals, researchers need to understand the obstacles to transcending disciplinary borders to incorporate the perspectives of policy practitioners. Researchers also need to understand problems in integration when it takes place within research groups or entities comprised of a variety of scholars from diverse disciplines working with a set of practitioners from different agencies or levels of government. Impediments to integration include epistemological, disciplinary, and attitudinal barriers, differences in terminologies and timescales, the role of organizational culture, institutional barriers, data issues, and issues related to risk communication and liability. This article explores these challenges and how they affect the translation of interdisciplinary and transdisciplinary research. It concludes with recommendations to help overcome challenges in synthesizing disaster research and policy practices and to enrich interdisciplinary disaster research approaches and designs.
Aberrant IL‐35 levels in patients with primary Sjogren's syndrome
Authors: Guo Jie , Gu Mingli , Zhang Weiwei , Liu Yun , Qian Cheng , Deng Ammei
Published: September 2018

Objective

IL‐35 is a newly discovered immunoregulatory cytokine that possesses the ability to inhibit CD4 + effector T cells and alleviate autoimmune diseases. The objective of this study was to investigate IL‐35 levels in patients with primary Sjogren's syndrome (pSS) and explore the roles of IL‐35 in the pathogenesis of pSS.

Methods

Thirty‐four hospitalized patients with pSS were recruited, and 34 volunteers were enrolled as healthy controls. An ELISA was adopted to measure plasma IL‐35 levels. The levels of P35 and EBI3 mRNAs in peripheral blood mononuclear cells (PBMCs) were determined using real‐time quantitative PCR. The percentage of CD4 + EBI3 + T cells and CD19 + EBI3 + B cells was analysed using flow cytometry. Correlations between IL‐35 levels, P35 and EBI3 mRNAs, numbers of CD4 + EBI3 + T cells, CD19 + EBI3 + B cells and clinical parameters were analysed.

Results

Significantly lower plasma IL‐35 levels, P35 and EBI3 mRNA levels, and percentages of CD4 + EBI3 + T cells but increased percentages of CD19 + EBI3 + B cells were observed in patients with pSS than in healthy controls. IL‐35 levels, EBI3 mRNA expression and the percentage of CD4 + EBI3 + T cells exhibited negative correlations with the ESSDAI score, whereas levels of the IL‐35 protein and EBI3 mRNA were negatively correlated with the ESR. Patients who were positive for anti‐SSB antibodies presented with lower IL‐35 levels and percentages of CD4 + EBI3 + T cells.

Conclusions

Based on these results, a decrease in the IL‐35 levels may play an important role in the pathogenesis of pSS. IL‐35 may act as a potential therapeutic agent against inflammation in patients with pSS.
Interactions between fascicles and tendinous tissues in gastrocnemius medialis and vastus lateralis during drop landing
Authors: Hollville Enzo , Nordez Antoine , Guilhem Gaël , Lecompte Jennyfer , Rabita Giuseppe
Published: September 2018

Animal tendons have been shown to act as shock absorbers to protect muscle fascicles from exercise‐induced damage during landing tasks. Meanwhile, the contribution of tendinous tissues to damping activities such as landing has been less explored in humans. The aim of this study was to analyze in vivo fascicle‐tendon interactions during drop landing to better understand their role in energy dissipation. Ultrafast ultrasound images of the gastrocnemius medialis (GM) and vastus lateralis (VL), lower limb electromyographic activity, 2‐D kinematics, and ground reaction forces were collected from twelve participants during single‐ and double‐leg drop landings from various heights. For both muscles, length changes were higher in tendinous tissues than in fascicles, demonstrating their key role in protecting fascicles from rapid active lengthening. Increasing landing height increased lengthening and peak lengthening velocity of VL fascicle and GM architectural gear ratio, whereas GM fascicle displayed similar length and velocity patterns. Single‐leg landing lengthens the tendinous tissues of GM and, to a greater degree, VL muscles, without affecting the fascicles. These findings demonstrate the adjustment in fascicle‐tendon interactions to withstand mechanical demand through the tendon buffer action and fascicle rotation. The higher VL fascicle contribution to negative work as the drop height increases would suggest muscle‐specific damping responses during drop landing. This can originate from the distal‐to‐proximal sequence of joint kinetics, from differences in muscle and tendon functions (one‐ and two‐joint muscles), architectural and morphological properties (eg, tendon stiffness), as well as from the muscle activity of the GM and VL muscles.
Designing Popular Vote Processes for Democratic Systems: Counter‐Proposals, Recurring Referendums, and Iterated Popular Votes
Authors: McKay Spencer
Published: September 2018

Normative evaluations of popular vote processes, such as referendums and initiatives, often pay attention to specific aspects of institutional design, such as whether a popular vote process is binding or advisory. While it is necessary to analyze these specific features, I contend that we need to do so in the context of the broader democratic system in which popular vote processes are situated because these specific design features may have distinct consequences depending on the context. I contend that taking this systemic view also makes it possible to understand the circumstances in which democratic innovations could address democratic deficits that are commonly associated with particular types of ballot measures.
The Institutional Design of Referendums: Bottom‐Up and Binding
Authors: Cheneval Francis , el‐Wakil Alice
Published: September 2018

Democratic theorists generally ignore that the institutional design of popular vote processes varies in important ways. However, these differences in design influence the kind of role that these processes play in and their impact on democratic systems. We intend to remedy this situation by launching a normative discussion about the institutional design of popular vote processes in the Debate “Do Referendums Enhance or Threaten Democracy?” In this introductory essay, we first insist on the necessity to adopt a differentiated conception of popular vote processes. We then highlight some aspects of our normative approach to the institutional design of popular vote processes. We finally argue that referendum processes can positively contribute to democratic systems when they are 1) launched bottom‐up and 2) legally binding.
A Spatial Perspective on Access to Knowledge and Mobile Phone Use
Authors: Krone Madlen , Dannenberg Peter
Published: September 2018

Small‐scale farmers in rural areas in the Global South often lack access to crucial business knowledge due to, among others, spatial constraints, for example, peripheral locations and poor transport infrastructure. Studies on information and communication technology for development (ICT4D) argue that the use of ICTs like mobile phones, supports farmers by overcoming these constraints. Combining concepts about knowledge with relational and spatial proximity, this paper aims to contribute to the current debate on ICT4D studies. Based on a survey and qualitative interviews with horticultural small‐scale farmers in the Mwanza region, Tanzania, we analyse the potential and limitations of mobile phone use to reduce spatial constraints in order to access different types of knowledge. Our results show the benefits of phone use to access particularly external knowledge can only fully take place if the users already possess external contacts that are, however, usually based on personal relationships in close spatial proximity.
A banana R2R3‐MYB transcription factor MaMYB3 is involved in fruit ripening through modulation of starch degradation by repressing starch degradation‐related genes and MabHLH6
Authors: Fan Zhong‐Qi , Ba Liang‐Jie , Shan Wei , Xiao Yun‐Yi , Lu Wang‐Jin , Kuang Jian‐Fei , Chen Jian‐Ye
Published: September 2018

Starch degradation is a necessary process determining banana fruit quality during ripening. Many starch degradation‐related genes are well studied. However, the transcriptional regulation of starch degradation during banana fruit ripening remains poorly understood. In this study, we identified a MYB transcription factor (TF) termed MaMYB3, as a putative protein binding the promoter of MaGWD1, a member of glucan water dikinase (GWD) family which has been demonstrated as an important enzyme of starch degradation. MaMYB3 was ripening‐ and ethylene‐repressible, and its expression was negatively correlated with starch degradation. Acting as a nucleus‐localized transcriptional repressor, MaMYB3 repressed the transcription of 10 starch degradation‐related genes, including MaGWD1, MaSEX4, MaBAM7‐MaBAM8, MaAMY2B, MaAMY3, MaAMY3A, MaAMY3C, MaMEX1, and MapGlcT2‐1, by directly binding to their promoters. Interestingly, a previously identified activator of starch degradation‐related genes, MabHLH6, was also suppressed by MaMYB3. The ectopic overexpression of MaMYB3 in tomato down‐regulated the expression of starch degradation‐related genes, inhibited starch degradation and delayed fruit ripening. Based on these findings, we conclude that MaMYB3 negatively impacts starch degradation by directly repressing starch degradation‐related genes and MabHLH6, and thereby delays banana fruit ripening. Collectively, our study expands our understanding of the complex transcriptional regulatory hierarchy modulating starch degradation during fruit ripening.
Fibular osteotomy to facilitate proximal tibial rotation during tibial plateau leveling osteotomy
Authors: Zuckerman Joshua S. , Dyce Jonathan , Arruda Andréia G. , Kramer Caroline M. , Ben‐Amotz Ron
Published: September 2018

Objective

To identify factors that restrict proximal tibial rotation during tibial plateau leveling osteotomy (TPLO) and report on the outcome of concurrent fibular osteotomy (TPLO‐FO).

Study design

Retrospective case‐control study.

Animals

Dogs undergoing TPLO‐FO (n = 23) and dogs undergoing routine TPLO (n = 49).

Methods

Medical records and radiographs of dogs that had undergone TPLO‐FO were reviewed. Data that were collected included signalment, preoperative tibial plateau angle (TPA), mechanical medial proximal tibial angle (mMPTA), postoperative and recheck TPA and mMPTA, ratio of fibular width to tibial width (FW:TW), presence of tibiofibular synostosis, tibial osteotomy location, and use of additional implants.

Results

The odds of exhibiting rotational constraints requiring FO during TPLO were 62‐fold greater in dogs with tibiofibular synostosis than in dogs without synostosis. Dogs with FW:TW greater than 0.24 were 7.8‐fold more likely to exhibit rotational constraints. After TPLO‐FO, the postoperative increase in TPA was greater after single‐plate fixation (mean, 5.4 ° ± 4.5 °) compared with fixation with 2 plates (mean, 1.4 ° ± 0.6 °).

Conclusion

Proximal tibiofibular synostosis and a relatively wide fibula restricted tibial plateau rotation. In these dogs, concurrent fibular osteotomy allowed adequate rotation. Adjunct plate fixation limited loss of rotation after TPLO‐FO.

Clinical significance

Successful TPLO relies on adequate rotation of the proximal tibial segment. Fibular osteotomy and adjunct plate fixation are recommended to achieve and maintain adequate rotation of the osteotomized tibia in dogs with rotational constraints.
Hemipelvic and proximal femoral limb salvage endoprosthesis with tendon ongrowth in a dog
Authors: Fitzpatrick Noel , Guthrie James W.
Published: September 2018

Objective

To report the clinical application of a hemipelvic and proximal femoral endoprosthesis for limb salvage.

Study design

Retrospective case report.

Animal

One 5‐year‐old, neutered female, flat coated retriever with a malignant neoplasia of the left coxofemoral joint.

Methods

An invasive soft tissue mass (histiocytic sarcoma) with bone lysis of the femoral head and acetabulum was noted on radiographs, computed tomography (CT), and MRI. Custom‐designed hemipelvic and proximal femoral endoprostheses were produced from CT images and manufactured with hydroxyapatite coated surfaces to allow tissue integration. The proximal femoral implant allowed tendon ongrowth and muscle attachment. The pelvic implant was anchored to the ilium and ischium with screws, and the femoral implant was cemented. Chemotherapy consisted of lomustine (CCNU).

Results

No evidence of implant loosening or local/thoracic metastases was noted on radiographs or CT at 6 weeks and at 3, 6, 9, and 12 months after surgery. A neurapraxia resolved 14 weeks postoperatively. Intensive rehabilitation was performed. At 12 months, activity was unrestricted with minimal residual lameness. The dog was euthanized at 14 months for metastatic disease.

Conclusion

Limb salvage with a hemipelvic and proximal femoral endoprosthesis resulted in limb function and survival for 14 months.

Clinical significance

Neoplasia involving the bones of the coxofemoral joint traditionally requires hemipelvic resection and pelvic limb amputation. This report provides evidence that limb salvage can result in satisfactory levels of activity.
Genioglossus muscle activity during sniff and reverse sniff in healthy men
Authors: Ichikawa Tsuyoshi , Yokoba Masanori , Kimura Masahiko , Shibuya Manaka , Easton Paul A. , Katagiri Masato
Published: September 2018

New Findings

What is the central question of this study?

Maximal sniff nasal inspiratory and reverse sniff nasal expiratory pressures are measured as inspiratory and expiratory muscle strength, respectively. Is the genioglossus muscle activated during short maximal inspiratory and expiratory efforts through the nose?

What is the main finding and its importance?

Genioglossus muscle activity occurred with inspiratory muscle activity during a maximal sniff and with expiratory muscle activity during a maximal reverse sniff. These results indicate that genioglossus muscle activity is closely related to the generation of maximal sniff nasal inspiratory and reverse sniff nasal expiratory pressures.

Maximal sniff nasal inspiratory pressure (SNIPmax) is widely used to assess inspiratory muscle strength. The sniff nasal inspiratory pressure (SNIP) is lower in patients with neuromuscular disease with bulbar involvement compared with those without, possibly owing to impaired upper airway muscle function. However, the degree to which the genioglossus (GG) muscle, one of the upper airway muscles, is activated during inspiratory and expiratory efforts through the nose remains unclear. Therefore, we examined GG activity during short and sharp inspiratory and expiratory efforts through the nose, i.e. sniff and reverse sniff manoeuvres. In eight normal young subjects, we inserted fine wire electrodes into the GG muscle, parasternal intercostal and scalene (inspiratory) muscles and transversus abdominis (expiratory) muscle. We assessed EMG activity of each muscle and measured SNIP and reverse sniff nasal expiratory pressure (RSNEP) during sniffs and reverse sniffs from low to high intensities in the sitting position. The highest SNIP and RSNEP were analysed as SNIPmax and maximal RSNEP (RSNEPmax), respectively. In each subject, GG EMG activity increased linearly with increasing SNIP and RSNEP. The SNIPmax and RSNEPmax were −85.1 ± 15.9 and 83.2 ± 24.2 cmH2O, respectively. Genioglossus EMG activity varied with EMG activity of the parasternal intercostal and scalene muscles during generation of SNIPmax and with EMG activity of the transversus abdominis muscle during RSNEPmax. Genioglossus EMG activity during generation of SNIPmax was higher than during RSNEPmax (62.9 ± 31.1% EMG of SNIPmax, P = 0.012). These results suggested that GG activity was closely related to the generation of both SNIPmax and RSNEPmax.
Differential expression of heat shock proteins and activation of mitogen‐activated protein kinases in A549 alveolar epithelial cells exposed to cigarette smoke extract
Authors: Somborac‐Bačura Anita , Rumora Lada , Novak Ruđer , Rašić Dubravka , Dumić Jerka , Čepelak Ivana , Žanić‐Grubišić Tihana
Published: September 2018

New Findings

What is the central question of this study?

What is the effect of cigarette smoke on cell death, oxidative damage, expression of heat shock proteins (HSPs) and activation of mitogen‐activated protein kinases (MAPKs) in A549 alveolar epithelial cells?

What is the main finding and its importance?

Cigarette smoke induces cytotoxicity and oxidative damage to A549 cells, increases expression of different HSPs and activates MAPK signalling pathways. This could be related to inflammatory response and apoptosis observed in lungs of patients with smoking‐related diseases.

Cigarette smoking is one of the main risk factors for development of chronic obstructive pulmonary disease (COPD). We previously reported that cigarette smoke (CS) induces damage to proteins and their ineffective degradation. Here, we hypothesize that CS could induce oxidative stress and cytotoxicity in lung epithelial cells through alterations of heat shock protein (HSP) expression and mitogen‐activated protein kinase (MAPK) signalling pathways. We exposed A549 alveolar epithelial cells to various concentrations of cigarette smoke extract (CSE). Higher concentrations of CSE caused apoptosis of A549 cells after 4 h, while after 24 h cell viability was decreased, and lactate dehydrogenase in cell culture medium was increased as well as the number of necrotic cells. Concentrations of malondialdehyde (MDA) were elevated, while total thiol groups were decreased. Changes in the expression of HSPs (HSP70, HSP32 and HSP27) were time‐dependent. After 6 h, CSE caused an increase in the expression of HSP70 and HSP32, while after 8 h all examined HSPs were up‐regulated and remained increased up to 48 h. Treatment of A549 cells with CSE stimulated phosphorylation of extracellular signal‐regulated kinase and p38 in a dose‐dependent manner, while c‐Jun N‐terminal kinase activation was not detected. By using specific inhibitors, we demonstrated that MAPKs and HSPs interplay in CSE effects. In conclusion, our results show that MAPKs and HSPs are involved in the mechanism underlying CSE‐induced cytotoxicity and oxidative damage to A549 alveolar epithelial cells. These processes could be related to inflammatory response and apoptosis observed in lungs of patients with smoking‐related diseases, such as COPD.
Case of colonic mucosal Schwann cell hamartoma and review of literature on unusual colonic polyps
Authors: Chintanaboina JayaKrishna , Clarke Kofi
Published: September 2018

Mucosal Schwann cell hamartomas (MSCH) are benign mesenchymal tumours rarely seen in the gastrointestinal tract. They occasionally present as incidental sessile polyps during colonoscopy. A 55-year-old asymptomatic female patient with a medical history of multiple sclerosis presented for a screening colonoscopy. A 5 mm low-risk tubular adenoma was noted in the caecum, and a second 5 mm polyp was found in the ascending colon. Histopathology of the ascending colon polyp showed proliferation of spindle cells without ganglion cells in the lamina propria. Immunohistochemical findings are compatible with an MSCH. Surveillance colonoscopy was scheduled in 5 years based on the presence of a single low-risk tubular adenoma.
Primary renal angiosarcoma: a diagnostic and therapeutic challenge
Authors: Lodhi Hanan Tahir , Inayat Faisal , Munir Ahmed , Ilyas Ghulam
Published: September 2018

Primary renal angiosarcoma is an exceedingly rare and aggressive neoplasm. Although it may occur in youth, this tumour is frequently reported in the sixth and seventh decades of life. The clinical presentation is frequently varied. Pathogenesis remains largely unknown and it has overlapping features with other tumours of the kidney. Current treatment options include variable combinations of surgery, chemotherapy and radiotherapy. Reports regarding the disease prognosis and natural history are limited. In this article, we chronicle the case of a patient with primary renal angiosarcoma presenting at an advanced stage as a widely metastasised tumour. Additionally, we undertake here a brief literature review highlighting the rarity and aggressiveness of this condition, its poor prognosis, and the lack of specific management guidelines.
Intestinal obstruction with a twist: a rare case of congenital portal vein aneurysm causing intestinal obstruction
Authors: Chandran Shanu , Kumar Manish , Jacob Tarun John K , Mohamed Ferzine
Published: September 2018

Bilious vomiting is often a presenting feature of upper intestinal obstruction in newborn. We present a case of intestinal obstruction in a newborn baby caused by abnormal vascular band arising from portal vein aneurysm in association with a midgut volvulus. Congenital anomalies of portovenous system are very rare, and it usually presents with portal hypertension in late infancy or childhood. In this particular child, the portal vein aneurysm contributed to intestinal obstruction due to both a failure of intestinal rotation and a mechanical band over the transverse colon.
Primary retroperitoneal filariasis: a common disease of tropics with uncommon presentation and review of literature
Authors: Diwakar Deepak Kumar , Wadhwani Nikita , Prasad Nikhil , Gupta Ashwani
Published: September 2018

Lymphatic filariasis is caused by nematode filariaeWuchereria bancrofti,Brugia malayiorBrugia timori.It is commonly seen in tropical and subtropical regions of the world and affects the lymphatic system of humans, who are the definitive host while mosquito is the intermediate host. The most common manifestation of the disease is hydrocele followed by lower limb lymphoedema and elephantiasis. Although filariasis is much more common entity in north India, its presentation as retroperitoneal cyst is very rare with reported incidence rate of 1/105 000. We present a case of primary retroperitoneal filariasis in a 52-year-old man, without any classic signsandsymptoms, diagnosed postoperatively after surgical resection following diagnostic uncertaintyandfailure of other medical therapies.
Hypertrophic pyloric stenosis following repair of oesophageal atresia and tracheo-oesophageal fistula in a neonate
Authors: Ilhan Ozkan , Bor Meltem , Gunendi Tansel , Dorterler Mustafa Erman
Published: September 2018

Development of hypertrophic pyloric stenosis (HPS) after a few weeks of repair of an oesophageal atresia (OA) and tracheo-oesophageal fistula (TOF) is a rare condition in early infancy. Although vomiting or feeding intolerance in operated cases of OA+TOF are attributed to oesophageal stricture, gastro-oesophageal reflux and oesophageal dysmotility, it may also be caused by HPS. Herein, we report a newborn infant who had OA and TOF operation on day 2 of life and diagnosed to have HPS at 15th day of age. Even though it is a rare anomaly, HPS should be kept on mind in the presence of persistent vomiting following repair of OA.
Post-traumatic bilateral vesicocutaneous fistula of thighs treated with buccal mucosa graft urethroplasty and cyanoacrylate glue instillation: a novel treatment for management of a complicated fistula
Authors: Agarwal Samarth , Sharma Ashish , Gupta Akansha , Sankwar Satya Narayan
Published: September 2018

Post-traumatic vesicocutaneous fistula (VCF) is a rare variant of urinary fistulas. These fistulas may externally communicate to abdomen, perineum, buttocks, scrotum or very rarely thigh. These fistulas usually develop at a variable time duration after trauma and are usually preceded with thigh swelling or abscess formation followed by spontaneous rupture. We, hereby, report a case of VCF of bilateral thighs with associated penobulbar urethral stricture after road traffic accident which was managed with dual modality of buccal mucosa graft urethroplasty surgery and cyanoacrylate glue injection in the fistulous tracts. To the best of our knowledge, this is first report of bilateral VCFs communicating externally to thighs. In literature, very few cases of VCFs of thigh are reported and are rarely managed with adhesive glue application.
Cushing’s reflex secondary to neck haematoma following thyroidectomy
Authors: Devaraja K , Nayak Dipak Ranjan , Kordcal Abhishek Rao , Malapure Sumeet Suresh
Published: September 2018

Neck haematoma following thyroid surgery can present with respiratory distress which is generally attributed to airway obstruction. We recently had a 63-year-old female patient who underwent total thyroidectomy for toxic nodular goitre. However, within 4 hours of surgery, she developed sudden respiratory distress which was managed by prompt evacuation of the neck haematoma. Just before the haematoma evacuation, the patient had hypertension and bradycardia along with the distress. The arterial blood gas analysis sampled at that time was normal. Intraoperatively, the tracheal framework was found rigid and non-pliable. Considering the various clinical–biochemical findings observed, we think that the cause of the respiratory distress in the index case was transiently elevated intracranial pressure, secondary to bilateral internal jugular veins' compression. We hypothesise that in many patients with immediate postoperative neck haematoma, the Cushing’s reflex would at least contribute partly, if not solely to the respiratory distress.
Increased risk of aortic aneurysm and dissection in patients with Sjögren’s syndrome: a nationwide population-based cohort study in Taiwan
Authors: Tsai Yi-Da , Chien Wu-Chien , Tsai Shih-Hung , Chung Chi-Hsiang , Chu Shi-Jye , Chen Sy-Jou , Liao Wen-I , Yang Chih-Jen , Liao Min-Tser , Wang Jen-Chun
Published: September 2018

Objectives

Sjögren’s syndrome (SS) is a systemic autoimmune disorder. Several molecular pathways and the activation of matrix metalloproteinases associated with the pathogenesis of SS participate in the initiation and progression of aortic aneurysm (AA) and aortic dissection (AD). In this study, we aimed to evaluate whether patients with SS exhibit an increased risk of AA or AD.

Methods

We conducted a retrospective cohort study using a database extracted from Taiwan’s National Health Insurance Research Database. All medical conditions for each case and control were categorised using the International Classification of Diseases, Ninth Revision. HRs and 95% CIs for associations between SS and AA/AD were estimated using Cox regression and adjusted for comorbidities.

Results

Our analyses included 10 941 SS cases and 43 764 propensity score-matched controls. Compared with the controls, the patients with SS exhibited a significantly increased risk of developing an AA or AD (adjusted HR=3.642, p<0.001). Subgroup analysis revealed that compared with patients without SS, patients with primary and secondary SS both exhibited a significantly increased risk of developing AA or AD (adjusted HR=1.753, p=0.042; adjusted HR=3.693, p<0.001).

Conclusion

Patients with SS exhibit increased risks of developing AA or AD, and healthcare professionals should be aware of this risk when treating patients with SS. Increased aortic surveillance may be required for patients with SS.
Multicentred randomised controlled trial of an augmented exercise referral scheme using web-based behavioural support in individuals with metabolic, musculoskeletal and mental health conditions: protocol for the e-coachER trial
Authors: Ingram Wendy , Webb Douglas , Taylor Rod S , Anokye Nana , Yardley Lucy , Jolly Kate , Mutrie Nanette , Campbell John L , Dean Sarah Gerard , Greaves Colin , Steele Mary , Lambert Jeffrey D , McAdam Chloe , Jane Ben , King Jennie , Jones Ray B , Little Paul , Woolf Anthony , Erwin Jo , Charles Nigel , Terry Rohini H , Taylor Adrian H
Published: September 2018

Introduction

Physical activity is recommended for improving health among people with common chronic conditions such as obesity, diabetes, hypertension, osteoarthritis and low mood. One approach to promote physical activity is via primary care exercise referral schemes (ERS). However, there is limited support for the effectiveness of ERS for increasing long-term physical activity and additional interventions are needed to help patients overcome barriers to ERS uptake and adherence.

This study aims to determine whether augmenting usual ERS with web-based behavioural support, based on the LifeGuide platform, will increase long-term physical activity for patients with chronic physical and mental health conditions, and is cost-effective.

Methods and analysis

A multicentre parallel two-group randomised controlled trial with 1:1 individual allocation to usual ERS alone (control) or usual ERS plus web-based behavioural support (intervention) with parallel economic and mixed methods process evaluations. Participants are low active adults with obesity, diabetes, hypertension, osteoarthritis or a history of depression, referred to an ERS from primary care in the UK.

The primary outcome measure is the number of minutes of moderate-to-vigorous physical activity (MVPA) in ≥10 min bouts measured by accelerometer over 1 week at 12 months.

We plan to recruit 413 participants, with 88% power at a two-sided alpha of 5%, assuming 20% attrition, to demonstrate a between-group difference of 36–39 min of MVPA per week at 12 months. An improvement of this magnitude represents an important change in physical activity, particularly for inactive participants with chronic conditions.

Ethics and dissemination

Approved by North West Preston NHS Research Ethics Committee (15/NW/0347). Dissemination will include publication of findings for the stated outcomes, parallel process evaluation and economic evaluation in peer-reviewed journals.

Results will be disseminated to ERS services, primary healthcare providers and trial participants.

Trial registration number

ISRCTN15644451; Pre-results.
Cu(I)–PNF, an organic-based nanocatalyst, catalyzed C–O and C–S cross-coupling reactions
Authors: Taherinia Zahra , Ghorbani-Choghamarani Arash
Published: September 2018

Peptide nanofiber has been prepared via a self-assembly protocol and decorated with Cu(I) to prepare a nanostructural catalyst. The catalytic activity of this prepared nanomaterial (Cu(I)–PNF) was examined in C–O and C–S cross-coupling reactions. Compared with conventional copper–ligand catalytic systems, CuNP–PNF has unique advantages such as water solubility, high efficiency, and low cost, which makes it a highly efficient and beneficial catalyst to reuse in cross-coupling reactions.
Evaluation of factors affecting tack coat bond strength
Authors: Biglari Moein , Asgharzadeh Seyed Mohammad , Sharif Tehrani Saleh
Published: September 2018

Different types of distress occur in asphalt concrete pavements due to lack of bonding between existing old layer and overlay. Therefore, this paper evaluates the bonding strength between sand asphalt mixture as overlay and roller compacted concrete (RCC) as the existing layer. Four types of tack coat including crumb rubber modified (CRM), grade 60/70 binder, cationic slow-setting (CSS), and cationic rapid-setting (CRS) emulsion were considered, with 200, 400, and 600 g/m2 dosages. Different RCC surface temperatures including 0, 25, and 60 °C were chosen to evaluate the effect of ambient temperature on the bonding strength. Results showed that CRM and 60/70 binders have higher bonding strength in comparison to emulsions. The bonding strength at 0 °C for all types of tack coat was significantly lower than other temperatures. The optimum application rates of 200 g/m2 and 400 g/m2 were selected for the CSS and CRS emulsified binders respectively. The optimum application rate for the 60/70 and CRM binders was selected as 600 g/m2.
Formally verified software in the real world
Authors: Klein Gerwin , Andronick June , Fernandez Matthew , Kuz Ihor , Murray Toby , Heiser Gernot
Published: September 2018

Verified software secures the Unmanned Little Bird autonomous helicopter against mid-flight cyber attacks.
Maternal separation enhances anticontractile perivascular adipose tissue function in male rats on a high-fat diet
Authors: Loria Analia S. , Spradley Frank T. , Obi Ijeoma E. , Becker Bryan K. , De Miguel Carmen , Speed Joshua S. , Pollock David M. , Pollock Jennifer S.
Published: September 2018

Clinical studies have shown that obesity negatively impacts large arteries’ function. We reported that rats exposed to maternal separation (MatSep), a model of early life stress, display enhanced angiotensin II (ANG II)-induced vasoconstriction in aortic rings cleaned of perivascular adipose tissue (PVAT) under normal diet (ND) conditions. We hypothesized that exposure to MatSep promotes a greater loss of PVAT-mediated protective effects on vascular function and loss of blood pressure (BP) rhythm in rats fed a high-fat diet (HFD) when compared with controls. MatSep was performed in male Wistar-Kyoto rats from days 2 to 14 of life. Normally reared littermates served as controls. On ND, aortic rings from MatSep rats with PVAT removed showed increased ANG II-mediated vasoconstriction versus controls; however, rings from MatSep rats with intact PVAT displayed blunted constriction. This effect was exacerbated by an HFD in both groups; however, the anticontractile effect of PVAT was greater in MatSep rats. Acetylcholine-induced relaxation was similar in MatSep and control rats fed an ND, regardless of the presence of PVAT. HFD impaired aortic relaxation in rings without PVAT from MatSep rats, whereas the presence of PVAT improved relaxation in both groups. On an HFD, immunolocalization of vascular smooth muscle-derived ANG-(1–7) and PVAT-derived adiponectin abundances were increased in MatSep. In rats fed an HFD, 24-h BP and BP rhythms were similar between groups. In summary, MatSep enhanced the ability of PVAT to blunt the heightened ANG II-induced vasoconstriction and endothelial dysfunction in rats fed an HFD. This protective effect may be mediated via the upregulation of vasoprotective factors within the adipovascular axis.
A novel device for real-time measurement and manipulation of licking behavior in head-fixed mice
Authors: Williams Brice , Speed Anderson , Haider Bilal
Published: September 2018

The mouse has become an influential model system for investigating the mammalian nervous system. Technologies in mice enable recording and manipulation of neural circuits during tasks where they respond to sensory stimuli by licking for liquid rewards. Precise monitoring of licking during these tasks provides an accessible metric of sensory-motor processing, particularly when combined with simultaneous neural recordings. There are several challenges in designing and implementing lick detectors during head-fixed neurophysiological experiments in mice. First, mice are small, and licking behaviors are easily perturbed or biased by large sensors. Second, neural recordings during licking are highly sensitive to electrical contact artifacts. Third, submillisecond lick detection latencies are required to generate control signals that manipulate neural activity at appropriate time scales. Here we designed, characterized, and implemented a contactless dual-port device that precisely measures directional licking in head-fixed mice performing visual behavior. We first determined the optimal characteristics of our detector through design iteration and then quantified device performance under ideal conditions. We then tested performance during head-fixed mouse behavior with simultaneous neural recordings in vivo. We finally demonstrate our device’s ability to detect directional licks and generate appropriate control signals in real time to rapidly suppress licking behavior via closed-loop inhibition of neural activity. Our dual-port detector is cost effective and easily replicable, and it should enable a wide variety of applications probing the neural circuit basis of sensory perception, motor action, and learning in normal and transgenic mouse models.

NEW & NOTEWORTHY Mice readily learn tasks in which they respond to sensory cues by licking for liquid rewards; tasks that involve multiple licking responses allow study of neural circuits underlying decision making and sensory-motor integration. Here we design, characterize, and implement a novel dual-port lick detector that precisely measures directional licking in head-fixed mice performing visual behavior, enabling simultaneous neural recording and closed-loop manipulation of licking.
Effect of Functionalized Carbon Nanotubes in the Detection of Benzene at Room Temperature
Authors: Janudin Nurjahirah , Abdullah Norli , Wan Yunus Wan Md Zin , Yasin Faizah Md , Yaacob Mohd Hanif , Mohamad Saidi Norshafiqah , Mohd Kasim Noor Azilah
Published: September 2018

In this paper, carbon nanotubes (CNTs) were functionalized by acid treatment and further functionalized with dodecylamine and were designated as CNT-carboxylic and CNT-amide, respectively. Then, functionalized CNTs produced were characterized with various methods to verify the attachment of a functional group. Performance of the functionalized CNTs in the detection of benzene gas was monitored at room temperature. The sample was dropped cast on the interdigitated transducer (IDT), and the changes in resistivity were recorded by a digital multimeter in a customized chamber under controlled humidity (∼55%) environment. Based on the findings, it showed that the functionalized CNTs provide an extra active area for interaction between the gas analyte and CNTs, thus increasing their response and improving the sensitivity of the sensing material.
A Meta‐Analysis of the Clinical Efficacy of TCM Decoctions Made from Formulas in the Liuwei Dihuang Wan Categorized Formulas in Treating Diabetic Nephropathy Proteinuria
Authors: Gao Xue , Shang Jianwei , Liu Hongfang , Yu Borui
Published: September 2018

Objective. Diabetic nephropathy (DN) is one of the microvascular complications of diabetes mellitus. Proteinuria is the most important clinical characteristics of DN and an independent risk factor for disease progression of DN; reducing urine protein is the primary target of treatment strategies for DN. Liuwei Dihuang Wan Categorized Formulas (LDWCFs), a group of classic traditional Chinese medicine (TCM) formulas aiming at “kidney ‐tonifying”, have been widely used in the treatment of DN. This study aimed to obtain a comprehensive understanding of the TCM method “kidney‐tonifying” in the treatment of DN by conducting a meta‐analysis to analyze the clinical efficacy of decoctions made from the LDWCFs in the treatment of DN proteinuria. Methods. CNKI, Wanfang, Weipu, CBM, PubMed, Embase, and the Cochrane Library were searched; 14 studies were included in the meta‐analysis. Results. The results showed that the overall efficacy of the LDWCFs in treating DN was significantly better than that of the comparators (OR 2.87, 95% CI 1.98–4.15, P<0.00001). These formulas showed better efficacy than the comparators in reducing 24‐hour urinary protein level (MD 0.12, 95% CI 0.06–0.17, P<0.0001) and in reducing urine microalbumin excretion rate (SMD 0.87, 95% CI 0.41–1.32, P<0.0002). No serious adverse reactions were reported. Conclusions. TCM formulas included in the LDWCFs are safe and effective in the treatment of DN proteinuria. These findings suggested that the TCM therapeutic principle of “kidney‐tonifying” is a valuable addition to the treatment strategies for DN.
Acupoint Embedding of Polyglactin 910 Sutures in Patients with Chronic Pain due to Cervical Spondylotic Radiculopathy: A Multicenter, Randomized, Controlled Clinical Trial
Authors: Chu Yu-Xia , Cui Wen-Qiang , Xu Fei , Pan Yuan-Yuan , Ma Yan-Hua , Chen Teng , Wang Si-Jing , Sun Hong-Bo , Wang Yan-Qing , Sun Wen-Shan
Published: September 2018

Objective. We aimed to investigate the effectiveness of acupoint polyglactin 910 (PGLA) embedding in patients with cervical spondylotic radiculopathy (CSR). Methods. A total of 102 CSR patients with neck and shoulder pain were recruited and assigned randomly into three groups: the sham acupoint embedding (SAE) group, the middle‐layer acupoint PGLA embedding (MAPE) group, and the deep‐layer acupoint PGLA embedding (DAPE) group. The primary outcomes were Visual Analog Scale (VAS) scores showing the analgesic effects of treatment. Secondary outcomes included clinical symptoms (evaluated by the Yasuhisa Tanaka 20 (YT‐20) score and the neck disability index (NDI)) and patient health status (evaluated by the 36‐item short‐form survey (SF‐36)) as reported in the trial. Results. Compared with the SAE group, VAS scores were significantly reduced at 1, 2, 3, 4, and 10 weeks after the first treatment in both the DAPE and MAPE groups (P < 0.001). Moreover, there were statistically significant increases in the weekly YT‐20 scores and significant reductions of the weekly NDI scores compared with baseline values in both the DAPE and MAPE groups (P < 0.001). Compared with baseline values, both the physical component summary (PCS) and the mental component summary scores of the SF‐36 at 2, 3, 4, and 10 weeks were significantly higher in the DAPE and MAPE groups (P < 0.001). There were significant lower VAS scores (P < 0.01), higher PCS scores (P < 0.05) at 3 weeks, and lower NDI scores (P < 0.05) at 4 weeks in the DAPE group compared with the MAPE group. Conclusions. Both DAPE and MAPE showed significant and long‐lasting effects on alleviating pain and improving clinical symptoms as well as quality of life in CSR patients with neck and shoulder pain. A more intense effect was seen in the DAPE group compared with the MAPE group.