bluuebunny/crossref_metadata_2025 huggingface dataset:
360-degree suture trabeculotomy ab interno with phacoemulsification in open-angle glaucoma and coexisting cataract: a pilot study
Authors: Sato Tomoki , Kawaji Takahiro , Hirata Akira , Mizoguchi Takanori
Published: October 2018

Objective

We performed a pilot trial to evaluate the 24-month safety and efficacy of 360-degree suture trabeculotomy ab interno with phacoemulsification used to treat mild to moderate open-angle glaucoma coexisting with cataract.

Methods and analysis

We randomly assigned 18 eyes with open-angle glaucoma and coexisting cataract to undergo 360-degree suture trabeculotomy ab interno with phacoemulsification (combined) or phacoemulsification alone (control) (1:1 ratio) and followed up patients for 24 months. Main outcome measures were mean postoperative intraocular pressure (IOP) and success probabilities based on Kaplan-Meier life table analyses. Surgical success was defined as follows: criterion A: IOP value ≥6  mm Hg and ≤15  mm Hg, with ≥20 % reduction without medication; criterion B: IOP value ≥6  mm Hg and ≤12  mm Hg, with ≥30% reduction without medication. Secondary outcome measures included the number of medications, complications and best-corrected visual acuity.

Results

Mean IOP values (number of medications), which were 18.4  mm Hg (0.9) and 17.1  mm Hg (1.3) at baseline, showed significant reductions to 11.8  mm Hg (1.0) and 14.6  mm Hg (1.5) at 24 months postoperatively in the combined and control groups, respectively (p=0.0003  and 0.0192, respectively). Success rates for criterion A in the combined and control groups were 77.8% and 11.1%, respectively (p=0.0110) and those for criterion B in the combined and control groups were 46.7% and 0%, respectively (p=0.0036). Both groups had a similar overall occurrence of postoperative complications.

Conclusion

Using 360-degree suture trabeculotomy ab interno with phacoemulsification appeared to be a more beneficial option for mild to moderate open-angle glaucoma with coexisting cataract than phacoemulsification alone.

Trial registration number

UMIN000021170, date of registration: 2016/03/01.
A comparison of hospital-acquired pressure injuries in intensive care and non-intensive care units: a multifaceted quality improvement initiative
Authors: Goodman Laurie , Khemani Ekta , Cacao Francis , Yoon Jennifer , Burkoski Vanessa , Jarrett Scott , Collins Barbara , Hall Trevor N T
Published: October 2018

Hospital-acquired pressure injuries (HAPI) are a significant cause of morbidity and mortality, and represent a major health concern worldwide. Patients suffering from HAPI report a poor quality of life on several dimensions of health. Moreover, HAPI is reported to lengthen in-hospital stay in the acute setting, posing significant healthcare resource utilisations and costs. Given the clinical and economic burden of HAPI, recent best practice guidelines provide recommendations to reduce the prevalence of pressure injuries. Humber River Hospital (HRH), a large community hospital in Toronto, Canada, has a daily census of approximately 500 patients. The aim of this project was to reduce the prevalence of HAPI within the intensive care unit (ICU) and non-ICU setting at HRH within a 1-year period. Using the International Pressure Injury/Ulcer Prevalence (IPUP) Survey we established a baseline prevalence of HAPI of 27.6% (n=315) for non-ICU and 30% for ICU (n=33) patients at our institution in 2015. Using the Plan-Do-Study-Act (PDSA) method for quality improvement, we implemented a multifaceted approach aimed at improving equipment, digital documentation and education on risk assessment, prevention and treatment strategies. Over multiple PDSA cycles, our prevalence of HAPI reduced to 16% for non-ICU patients with no changes to the HAPI prevalence in ICU patients in 2016. Sustainability continues with HAPI prevalence currently at 10% in 2017 for non-ICU patients, which outperforms the Canadian prevalence (13.7%) by census size for 2017. However, the prevalence of HAPI in the ICU increased to 45% in 2017 despite multiple quality improvement initiatives, suggesting critically ill patients represent a unique challenge for reducing HAPI for these patients at our institution.
Study investigating the generalisability of a COPD trial based in primary care (Salford Lung Study) and the presence of a Hawthorne effect
Authors: Pate Alexander , Barrowman Michael , Webb David , Pimenta Jeanne M , Davis Kourtney J , Williams Rachael , Van Staa Tjeerd , Sperrin Matthew
Published: October 2018

Introduction

Traditional phase IIIb randomised trials may not reflect routine clinical practice. The Salford Lung Study in chronic obstructive pulmonary disease (SLS COPD) allowed broad inclusion criteria and followed patients in routine practice. We assessed whether SLS COPD approximated the England COPD population and evidence for a Hawthorne effect.

Methods

This observational cohort study compared patients with COPD in the usual care arm of SLS COPD (2012–2014) with matched non-trial patients with COPD in England from the Clinical Practice Research Datalink database. Generalisability was explored with baseline demographics, clinical and treatment variables; outcomes included COPD exacerbations in adjusted models and pretrial versus peritrial comparisons.

Results

Trial participants were younger (mean, 66.7 vs 71.1 years), more deprived (most deprived quintile, 51.5% vs 21.4%), more current smokers (47.5% vs 32.1%), with more severe Global initiative for chronic Obstructive Lung Disease stages but less comorbidity than non-trial patients. There were no material differences in other characteristics. Acute COPD exacerbation rates were high in the trial population (98.37th percentile).

Conclusion

The trial population was similar to the non-trial COPD population. We observed some evidence of a Hawthorne effect, with more exacerbations recorded in trial patients; however, the largest effect was observed through behavioural changes in patients and general practitioner coding practices.
Monitoring tuberculosis contact tracing outcomes in Western Sydney, Australia
Authors: Parvaresh Laila , Bag Shopna K , Cho Jin-Gun , Heron Neil , Assareh Hassan , Norton Sophie , Corbett Stephen , Marais Ben J
Published: October 2018

Treatment of latent tuberculosis infection (LTBI) is an important component of strategies to achieve global tuberculosis (TB) elimination, but implementation is rarely monitored. This is a retrospective review of TB contact tracing outcomes at one of the busiest TB clinics in Australia, measured against the Centre for Disease Control and Prevention performance indicators. In total, 45 of 53 (85%) pulmonary TB cases had 171 close contacts, of whom 139 (81%) were evaluated with a tuberculin skin test (TST); 58 of 139 (42%) were positive at baseline. Among 57 close contacts of 16 sputum smear-positive TB cases, the elicitation, evaluation, initiation of LTBI treatment and completion rates were 93%, 86%, 14% and 100%, and among 114 close contacts of 37 sputum smear-negative pulmonary TB cases 81%, 83%, 16% and 89%, respectively. Of 79 contacts with an initial negative TST, 19 of 47 (40%) demonstrated TST conversion when retested; 5 of 19 (26%) were offered LTBI treatment. Four secondary TB cases were identified. One incident TB case developed a pleural effusion 5 months after TST conversion, despite LTBI treatment. Apart from young children, LTBI treatment was inconsistently initiated in household TB contacts. Safe and pragmatic treatment options, as well as functional monitoring frameworks, are essential to improve LTBI treatment implementation.
Myocardial remodelling and tissue characterisation by cardiovascular magnetic resonance (CMR) in endurance athletes
Authors: Pujadas Sandra , Doñate Maite , Li Chi-Hion , Merchan Soraya , Cabanillas Ana , Alomar Xavier , Pons-Llado Guillem , Serra-Grima Ricard , Carreras Francesc
Published: October 2018

There is still some controversy about the benignity of structural changes observed in athlete’s heart, especially regarding the observation of increased biomarkers and the presence of myocardial fibrosis (MF).

Aim

Our purpose was to evaluate by cardiovascular magnetic resonance (CMR) the presence of diffuse as well as focal MF in a series of high-performance veteran endurance athletes.

Methods

Thirty-four veteran healthy male endurance athletes, still being in regular training, with more than 10 years of training underwent a CMR. A cardiopulmonary exercise test was also performed to assess their maximal physical performance. The control group consisted in 12 non-trained normal individuals.

Results

We found an increase in both, right and left ventricular (LV) volumes in the athlete’s group when compared with controls. There was no increase in indexed LV myocardial mass despite of a significantly increased maximal myocardial wall thickness in comparison to controls. Native T1 values and extracellular volume (ECV) were normal in all cases. We did not find differences in native T1 values and ECV between both groups. In three athletes (9%), non-ischaemic late gadolinium enhancement (LGE) was observed. We did not find a correlation between total training volume and presence of LGE or with the ECV value.

Conclusions

Our results show that the majority of veteran endurance athletes present with myocardial remodelling without MF as a physiological adaptive phenomenon. In the only three athletes with focal MF, the LGE pattern observed suggests an intercurrent event not related with the remodelling phenomenon.
Cancer antigen-125 and outcomes in acute heart failure: a systematic review and meta-analysis
Authors: Li Ka Hou Christien , Gong Mengqi , Li Guangping , Baranchuk Adrian , Liu Tong , Wong Martin C S , Jesuthasan Aaron , Lai Rachel W C , Lai Jenny Chi Ling , Lee Alex Pui Wai , Bayés-Genis Antoni , de la Espriella Rafael , Sanchis Juan , Wu William K K , Tse Gary , Nuñez Julio ,   On behalf of International Health Informatics Study (IHIS) Network
Published: October 2018

Background

Carbohydrate antigen-125 (CA125) is an ovarian cancer marker, but recent work has examined its role in risk stratification in heart failure. A recent meta-analysis examined its prognostic value in heart failure generally. However, there has been no systematic evaluation of its role specifically in acute heart failure (AHF).

Methods

PubMed and EMBASE databases were searched until 11 May 2018 for studies that evaluated the prognostic value of CA125 in AHF.

Results

A total of 129 and 179 entries were retrieved from PubMed and EMBASE. Sixteen studies (15 cohort studies, 1 randomised trial) including 8401 subjects with AHF (mean age 71 years old, 52% male, mean follow-up 13 months, range of patients 525.1±598.2) were included. High CA125 levels were associated with a 68% increase in all-cause mortality (8 studies, HRs: 1.68, 95% CI 1.36 to 2.07; p<0.0001; I2: 74%) and 77% increase in heart failure-related readmissions (5 studies, HRs: 1.77, 95% CI 1.22 to 2.59; p<0.01; I2: 73%). CA125 levels were higher in patients with fluid overload symptoms and signs compared with those without them, with a mean difference of 54.8 U/mL (5 studies, SE: 13.2 U/mL; p<0.0001; I2: 78%).

Conclusion

Our meta-analysis found that high CA125 levels are associated with AHF symptoms, heart failure-related hospital readmissions and all-cause mortality. Therefore, CA125 emerges as a useful risk stratification tool for identifying high-risk patients with more severe fluid overload, as well as for monitoring following an AHF episode.
Case series of non-freezing cold injury: epidemiology and risk factors
Authors: Kuht James A , Woods D , Hollis S
Published: October 2018

Background

Non-freezing cold injury (NFCI) occurs when the peripheral tissue is cooled sufficiently that damage occurs, but not to the point of tissue freezing. Historically, the phenotype of the injuries studied was often severe, and it is unclear whether knowledge gained from these cases is entirely relevant to the frequently subtle injuries seen today.

Methods

We therefore sought to characterise a recent case series of 100 patients referred with suspected NFCI to a military UK NFCI clinic. Their demographics, medical history and situational risk factors leading to their injuries were analysed, and comparison was made between those subsequently diagnosed with NFCI (n=76) and those receiving alternate diagnoses (n=24).

Results

Statistically significant predisposing factors for NFCI in the UK service personnel (SP) were being of African-Caribbean ethnicity and having a short duration of service in the Armed Forces. Past or current smoking was not identified as a risk factor. Injuries were almost always suffered on training exercises (most commonly in the UK); being generally cold and being on static duties were statistically significant situational risk factors. Non-significant trends of risk were also found for having wet clothing, wet boots and immersion. Self-reported dehydration was not found to be a risk factor for NFCI.

Conclusions

Our demographic findings are in general agreement with those of previous studies. Our situational risk factor findings, however, highlight a pattern of NFCI risk factors to the modern UK SP: winter training exercises, when troops are generally cold and extremities often wet, with static duties frequently implicated in the disease mechanism.
Too much medicine: not enough trust?
Authors: Fritz Zoë , Holton Richard
Published: October 2018

As many studies around the theme of ‘too much medicine’ attest, investigations are being ordered with increasing frequency; similarly the threshold for providing treatment has lowered. Our contention is that trust (or lack of it) is a significant factor in influencing this, and that understanding the relationship between trust and investigations and treatments will help clinicians and policymakers ensure ethical decisions are more consistently made. Drawing on the philosophical literature, we investigate the nature of trust in the patient–doctor relationship, arguing that at its core it involves a transfer of discretion. We show that there is substantial empirical support for the idea that more trust will reduce the problem of too much medicine. We then investigate ways in which trust can be built, concentrating on issues of questioning, of acknowledging uncertainty and of shouldering responsibility for it. We argue that offering investigations or treatments as a way of generating trust may itself be an untrustworthy way of proceeding, and that healthcare systems should provide the institutional support for facilitating continuity, questioning and the entrusting of uncertainty.
Lamin mutation location predicts cardiac phenotype severity: combined analysis of the published literature
Authors: Captur Gabriella , Arbustini Eloisa , Syrris Petros , Radenkovic Dina , O'Brien Ben , Mckenna William J , Moon James C
Published: October 2018

Objective

TwoLMNAgenotype–phenotype cardiac correlations are reported: first, that cardiac involvement in multisystem laminopathies prevails with mutations upstream of the nuclear localisation signal (NLS); second, that worse outcomes occur with non-missense (compared with missense) mutations. We tested whetherLMNAmutation DNA location and mutation subtype can predict phenotype severity in patients with lamin heart disease.

Methods

We used a semantic workflow platform and manual electronic literature search to identify publishedLMNAmutations with cardiac-predominant phenotype. Hierarchical cluster analysis (HCA) assembled lamin heart disease into classes based on phenotype severity. 176 reported causative mutations were classified and any relationships to mutation location/subtype assessed by contingency analysis.

Results

More adverse phenotype was associated with mutation location upstream of the NLS (p=0.014, OR 2.38, 95% CI 1.19 to 4.80) but not with non-missense mutations (p=0.337, OR 1.36, 95% CI 0.72 to 2.57), although an association with non-missense mutations was identified in a subcluster with malignant ventricular arrhythmia (p=0.005, OR 2.64, 95% CI 0.76 to 9.21). HCA limited to the 65 mutations described on ClinVar as pathogenic/likely pathogenic showed similar findings (upstream of NLS, p=0.030, OR 4.78, 95% CI 1.28 to 17.83; non-missense, p=0.121, OR 2.64, 95% CI 0.76 to 9.21) as did analysis limited to pathogenic/likely pathogenic variants according to the American College of Medical Genetics and Genomics standards.

Conclusion

Cardiac patients with anLMNAmutation located upstream versus downstream of the NLS have a more adverse cardiac phenotype, and some missense mutations can be as harmful as non-missense ones.
Gene correlation network analysis to identify regulatory factors in idiopathic pulmonary fibrosis
Authors: McDonough John E , Kaminski Naftali , Thienpont Bernard , Hogg James C , Vanaudenaerde Bart M , Wuyts Wim A
Published: October 2018

Background

Idiopathic pulmonary fibrosis (IPF) is a severe lung disease characterised by extensive pathological changes. The objective for this study was to identify the gene network and regulators underlying disease pathology in IPF and its association with lung function.

Methods

Lung Tissue Research Consortium dataset with 262 IPF and control subjects (GSE47460) was randomly divided into two non-overlapping groups for cross-validated differential gene expression analysis. Consensus weighted gene coexpression network analysis identified overlapping coexpressed gene modules between both IPF groups. Modules were correlated with lung function (diffusion capacity, DLCO; forced expiratory volume in 1 s, FEV1; forced vital capacity, FVC) and enrichment analyses used to identify biological function and transcription factors. Module correlation with miRNA data (GSE72967) identified associated regulators. Clinical relevance in IPF was assessed in a peripheral blood gene expression dataset (GSE93606) to identify modules related to survival.

Results

Correlation network analysis identified 16 modules in IPF. Upregulated modules were associated with cilia, DNA replication and repair, contractile fibres, B-cell and unfolded protein response, and extracellular matrix. Downregulated modules were associated with blood vessels, T-cell and interferon responses, leucocyte activation and degranulation, surfactant metabolism, and cellular metabolic and catabolic processes. Lung function correlated with nine modules (eight with DLCO, five with FVC). Intermodular network of transcription factors and miRNA showed clustering of fibrosis, immune response and contractile modules. The cilia-associated module was able to predict survival (p=0.0097) in an independent peripheral blood IPF cohort.

Conclusions

We identified a correlation gene expression network with associated regulators in IPF that provides novel insight into the pathological process of this disease.
EMHD flow through microchannels with corrugated walls in the presence of nanofluid
Authors: Rashid M. , Nadeem S.
Published: October 2018

The present examination deals with the effects of nanofluids on corrugated walls under the influence of electromagnetohydrodynamic (EMHD) forces. Investigation is carried out using water-based nanofluid with copper nanoparticles. Consider incompressible and electrically conducting Jeffrey fluid between microparallel plates. The governing equations are solved by applying the perturbation method, and we have evaluated analytical solutions for the velocity, temperature, and volume flow rates. For the corrugations of the two walls, periodic sine waves are described for small amplitude either in phase or out of phase. By using numerical calculations we analyzed the corrugation effects on the velocity and temperature for EMHD flow. We graphically explained the velocity and temperature profiles and their dependences on all parameters. The important conclusion is that small values of amplitude ratio parameter reduce the unobvious wave effect on the velocity and temperature.
A quantum method for dynamic nonlinear programming technique using Schrödinger equation and Monte Carlo approach
Authors: Kaur Amandeep , Kaur Satnam , Dhiman Gaurav
Published: October 2018

The power of quantum computing may allow for solving the problems which are not practically feasible on classical computers and suggest a considerable speed up to the best known classical approaches. In this paper, we present the contemporary quantum behaved approach which is based on Schrödinger equation and Monte Carlo method. The three basic steps of proposed technique are also mathematically modeled and discussed for effective movement of particles. The performance of the proposed approach is tested for solving the dynamic nonlinear problem. Experimental results reveal the supremacy of proposed approach for solving the nonlinear problem as compared to other approaches.
The dynamics of tripartite quantum correlations under Ornstein–Uhlenbeck noise
Authors: Yang Jing , Mu Qi-Xiong , Huang Yan-Xia
Published: October 2018

The dynamics of the tripartite thermal entanglement measured by Negativity (N) and the tripartite quantum correlation described by measurement-induced disturbance (MID) under Ornstein–Uhlenbeck noise are investigated. This study has found that the tripartite N and MID can be preserved more effectively in the non-Markovian environment than in the short-time limit and the Markov limit cases. The short-time limit is a better approximation than the Markov limit. MID vanishes only in the asymptotic limit, while entanglement sudden death may occur, and the decreasing duration of MID far outweighs entanglement. This implies that MID is more robust than Negativity. As the noise bandwidth increases, the disentanglement time and the decay time of MID are significantly shorter. The increase of XZX[Formula: see text]+[Formula: see text]YZY three-site interaction is more effective than XZY−YZX three-site interaction to enhance Negativity and MID as well as the disentanglement time. The magnetic field diminishes Negativity and MID, but has no significant influence on the decreasing durations of both Negativity and MID.
On homogeneous locally nilpotent derivations of trinomial algebras
Authors: Gaifullin Sergey , Zaitseva Yulia
Published: October 2018

We provide an explicit description of homogeneous locally nilpotent derivations of the algebra of regular functions on affine trinomial hypersurfaces. As an application, we describe the set of roots of trinomial algebras.
On semi-σ-nilpotent finite groups
Authors: Zhang Chi , Skiba Alexander N.
Published: October 2018

Let [Formula: see text] be a partition of the set [Formula: see text] of all primes and [Formula: see text] a finite group. A chief factor [Formula: see text] of [Formula: see text] is said to be [Formula: see text]-central if the semidirect product [Formula: see text] is a [Formula: see text]-group for some [Formula: see text]. [Formula: see text] is called [Formula: see text]-nilpotent if every chief factor of [Formula: see text] is [Formula: see text]-central. We say that [Formula: see text] is semi-[Formula: see text]-nilpotent (respectively, weakly semi-[Formula: see text]-nilpotent) if the normalizer [Formula: see text] of every non-normal (respectively, every non-subnormal) [Formula: see text]-nilpotent subgroup [Formula: see text] of [Formula: see text] is [Formula: see text]-nilpotent. In this paper we determine the structure of finite semi-[Formula: see text]-nilpotent and weakly semi-[Formula: see text]-nilpotent groups.
Modules with minimal copure-injectivity domain
Authors: Toksoy Sultan Eylem
Published: October 2018

In this paper, copure-injectively poor modules are introduced as modules whose copure-injectivity domains are minimal. Rings over which every module is copure-injectively poor are CDS rings. Examples showing the relations between poor and copi-poor modules are given. It is shown that over a commutative (co-)noetherian ring copi-poor modules coincide with pi-poor modules. Also, some properties of copure-split modules are given.
Zariski compactness of minimal spectrum and flat compactness of maximal spectrum
Authors: Tarizadeh Abolfazl
Published: October 2018

In this paper, Zariski compactness of the minimal spectrum and flat compactness of the maximal spectrum are characterized.
Spectral collocation method for solving continuous population models for single and interacting species by means of exponential Chebyshev approximation
Authors: Ramadan M. A. , Abd El Salam M. A.
Published: October 2018

In this paper, an efficient and accurate method is presented to solve continuous population models for single and interacting species using spectral collocation method with exponential Chebyshev (EC) functions. The first problem is a logistic growth model in a population, while the second problem is a prey–predator model: Lotka–Volterra system, the third is a simple 2-species Lotka–Volterra competition model, and the final one is a prey–predator model with limit cycle periodic behavior. The high accuracy of this method is verified through some numerical examples. The obtained numerical results are compared with other methods, showing that the proposed method gives higher accuracy.
Adjacency matrix comparison for stochastic block models
Authors: Yang Guangren , Yang Songshan , Zhou Wang
Published: October 2018

In this paper, we study whether two networks arising from two stochastic block models have the same connection structures by comparing their adjacency matrices. We conduct Monte Carlo simulations study to examine the finite sample performance of the proposed method. A real data example is used to illustrate the proposed methodology.
Quantitative source apportionment of groundwater pollution: a case study of alluvial fan groundwater in the Hun river region, NE China
Authors: Meng Li , Zuo Rui , Wang Jin-sheng , Guo Xue-ru , Yang Jie , Teng Yan-guo , Lin Yuan-hui , Shi Rong-tao
Published: October 2018

Groundwater pollution is controlled by many anthropogenic processes, and source apportionment is particularly difficult in cases with multiple superimposed anthropogenic influences. Forty-three shallow groundwater samples in the Hun River alluvial fan were collected and 15 parameters comprising Ca
2+
, Mg
2+
, Fe
2+
, Mn
2+
, NH
4
+
, NO
3
−
, NO
2
−
, F
−
, SO
4
2−
, PO
4
3−
, Cl
−
, COD, TDS, CN
−
and HCO
3
−
were studied using principal component analysis (PCA) and factor analysis (FA), coupled with the absolute principal-component-score multiple-linear-regression (APCS-MLR) receptor model. The relationship among land-use types, hydrochemical composition and change of the groundwater quality from natural and anthropogenic sources was demonstrated. The results show that the four major potential pollution sources were water–rock interaction, agricultural fertilizer pollution, geological background and domestic and industrial wastewater; the contribution was 36.4%, 24.1%, 14.7% and 11.8%, respectively. The high-concentration areas were mainly located in the western and northwestern areas, especially in the downstream portion of the Hun River. Rapid economic development and the acceleration of urbanization led to an increase in industrial sewage effluent with complex and changeable composition. The variation of land-use type and evolution of the spatial distribution of the pollution sources in the groundwater show good consistency, which demonstrate that PCA/FA coupled with APCS-MLR is a versatile tool for comprehensive source apportionment of groundwater.
A look at the design of Lua
Authors: Ierusalimschy Roberto , De Figueiredo Luiz Henrique , Celes Waldemar
Published: October 2018

Simplicity, small size, portability, and embeddability set Lua apart from other scripting languages.
Modern debugging
Authors: Spinellis Diomidis
Published: October 2018

Systematic use of proven debugging approaches and tools lets programmers address even apparently intractable bugs.
Software challenges for the changing storage landscape
Authors: Waddington Daniel , Harris Jim
Published: October 2018

Conventional storage software stacks are unable to meet the needs of high-performance Storage-Class Memory technology. It is time to rethink 50-year-old architectures.
Good Clinical Approach: Delphi Consensus for the Use of Betahistine in Menière’s Disease
Authors: Casani Augusto Pietro , Navari Elena , Guidetti Giorgio , Lacour Michel
Published: October 2018

Menière’s disease is a disorder of the inner ear that causes vertigo, tinnitus, fullness, and hearing loss. Several pharmacological treatments are available, but none of them has shown significant results. Betahistine has been largely used but its effect on the main symptoms of Menière’s disease remains unclear. In order to improve clinical appropriateness and to reduce the heterogeneity of the therapeutic approaches for Menière’s disease, we proposed a European Consensus Conference on Betahistine’s prescription. A group of European experts in vestibular disorders completed a questionnaire, prepared by opinion leaders, on the use of betahistine in Menière’s disease. The Delphi method was used as an iterative investigation method in order to increase and establish the consensus. While betahistine was considered useful to reduce the number of the vertigo attacks during the intercritical phase of the disease, its use during attacks was considered helpful only when associated with other drugs. Betahistine was not considered useful for preventing hearing loss. The experts support the use of betahistine during the intercritical phase of the disease to reduce the number and severity of vertigo episodes. They also defined the parameters for a good clinical approach to evaluate the efficacy of betahistine treatment for Menière’s disease.
Immunomodulatory Effects of Drugs for Effective Cancer Immunotherapy
Authors: Matsushita Maiko , Kawaguchi Mai
Published: October 2018

Recent advances in cancer immunotherapy, including immune checkpoint inhibitors or adoptive T cell therapies, have contributed to better outcomes in cancer patients. However, there are still many cancers with no cure. Therefore, combinations of several treatment strategies are being explored, and enhancing anticancer immunity will play an important role to combat the disease. There have been several reports on the immune-modulatory effects of commonly used drugs, namely, statin, metformin, and angiotensin receptor blockers (ARBs), which suggest that these drugs could enhance immunity against cancer cells. Other anticancer drugs, such as anthracyclines, thalidomides, lenalidomides, and hypomethylating drugs, could also strengthen the immune system to attack cancer cells at a relatively low dose. Hence, these drugs might contribute to better outcomes in cancer patients.
Reliability Analysis on Structures Based on a Modified Iterative Response Surface Method
Authors: Wei Yanxu , Bai Guangchen , Wang Bowei , Bai Bin
Published: October 2018

In order to improve the computational accuracy and efficiency of response surface method for reliability analysis on structures, a modified iterative response surface method (called as NDIRSM) is proposed. Firstly, a new starting center point, which is closer to design point, is calculated out as the starting center point instead of the point at mean values of input variables and a dynamic factor vectorf1, which is inversely proportional to the change rate of performance function with respect to variance, is calculated out for the first iteration. Then the arbitrary factorsfkare determined according to the design matrix condition number for the subsequent iteration. Thus the sample points are close to limit state function and the response surface function can approximate the limit state function accurately and efficiently. Two examples are employed to validate the advantages of NDIRSM and the results show that NDIRSM improves the computational accuracy and efficiency of response surface method. At last, NDIRSM is applied to the reliability analysis on low cycle fatigue life of a gas turbine disc, which provides a useful reference for reliability analysis on low cycle fatigue life of gas turbine disc and demonstrates the high computational accuracy and efficiency of NDIRSM.
Social‐Aware Cooperative Video Distribution via SVC Streaming Multicast
Authors: Zhao Lindong , Wang Lei , Zhang Xuguang , Kang Bin
Published: October 2018

Scalable Video Coding (SVC) streaming multicast is considered as a promising solution to cope with video traffic overload and multicast channel differences. To solve the challenge of delivering high‐definition SVC streaming over burst‐loss prone channels, we propose a social‐aware cooperative SVC streaming multicast scheme. The proposed scheme is the first attempt to enable D2D cooperation for SVC streaming multicast to conquer the burst‐loss, and one salient feature of it is that it takes fully into account the hierarchical encoding structure of SVC in scheduling cooperation. By using our scheme, users form groups to share video packets among each other to restore incomplete enhancement layers. Specifically, a cooperative group formation method is designed to stimulate effective cooperation, based on coalitional game theory; and an optimal D2D links scheduling scheme is devised to maximize the total decoded enhancement layers, based on potential game theory. Extensive simulations using real video traces corroborate that the proposed scheme leads to a significant gain on the received video quality.
Novel Nonstationarity Assessment Method for Hypersonic Flutter Flight Tests
Authors: Zheng Hua , Liu Junhao , Duan Shiqiang
Published: October 2018

Hypersonic aircraft have been rapidly developed in recent years both theoretically and experimentally. Aerothermoelastic simulation is very challenging due to its inherent complexity, but physical tests are a workable approach. Flutter tests with variable speed are a popular alternative to hypersonic tests which provide nonstationary structural response data. This paper proposes a nonstationarity assessment method based on energy distribution in the time-frequency domain. The proposed method reveals the nonstationarity level corresponding to the appropriate modal identification algorithm or flutter boundary prediction (FBP) method. Several classic flutter criteria are utilized to build a hypersonic aircraft FBP framework. Numerical simulation and experimental applications demonstrate the effectiveness and feasibility of the proposed method, which facilitates accurate flutter predictions for the subcritical turbulence response during hypersonic flutter flight.
Single Nucleotide Polymorphism in SMAD7 and CHI3L1 and Colorectal Cancer Risk
Authors: Abd El-Fattah Amal Ahmed , Sadik Nermin Abdel Hamid , Shaker Olfat Gamil , Mohamed Kamal Amal
Published: October 2018

Colorectal cancer (CRC) is one of the leading cancers throughout the world. It represents the third most common cancer and the fourth in mortality. Most of CRC are sporadic, arise with no known high-penetrant genetic variation and with no previous family history. The etiology of sporadic CRC is considered to be multifactorial and arises from the interaction of genetic variants of low-penetrant genes and environmental risk factors. The most common well-studied genetic variation is single nucleotide polymorphisms (SNPs). SNP arises as a point mutation. If the frequency of the sequence variation reaches 1% or more in the population, it is referred to as polymorphism, but if it is lower than 1%, the allele is typically considered as a mutation. Lots of SNPs have been associated with CRC development and progression, for example, genes of TGF-β1 and CHI3L1 pathways. TGF-β1 is a pleiotropic cytokine with a dual role in cancer development and progression. TGF-β1 mediates its actions through canonical and noncanonical pathways. The most important negative regulatory protein for TGF-β1 activity is termed SMAD7. The production of TGF-βcan be controlled by another protein called YKL-40. YKL-40 is a glycoprotein with an important role in cancer initiation and metastasis. YKL-40 is encoded by the CHI3L1 gene. The aim of the present review is to give a brief introduction of CRC, SNP, and examples of some SNPs that have been documented to be associated with CRC. We also discuss two important signaling pathways TGF-β1 and CHI3L1 that influence the incidence and progression of CRC.
Identifying Recurrent Malignant Glioma after Treatment Using Amide Proton Transfer-Weighted MR Imaging: A Validation Study with Image-Guided Stereotactic Biopsy
Authors: Jiang Shanshan , Eberhart Charles G. , Lim Michael , Heo Hye-Young , Zhang Yi , Blair Lindsay , Wen Zhibo , Holdhoff Matthias , Lin Doris , Huang Peng , Qin Huamin , Quinones-Hinojosa Alfredo , Weingart Jon D. , Barker Peter B. , Pomper Martin G. , Laterra John , van Zijl Peter C.M. , Blakeley Jaishri O. , Zhou Jinyuan
Published: October 2018

Purpose:

To quantify the accuracy of amide proton transfer-weighted (APTw) MRI for identifying active glioma after treatment via radiographically guided stereotactic tissue validation.

Experimental Design: Twenty-one patients who were referred for surgery for MRI features concerning for tumor progression versus treatment effect underwent preoperative APTw imaging. Stereotactic biopsy samples were taken from regions of interest with varying APTw signal intensities. The relationship between final clinical pathology and the histopathology of each of the 64 specimens was analyzed relative to APTw results. Analysis of confirmed recurrent tumor or treatment effect tissue was used to perform ROC analysis.

Results:

Eighteen of 21 patients had recurrent tumor, and 3 had treatment effect on clinical pathology. In 12 patients, there were multiple histopathologic assignments confirmed within the same tumor. Of the 64 total specimens, 20 specimens were active glioma, 27 mixed active and quiescent glioma, and 17 quiescent/no identifiable tumor. APTw signal intensity and histopathologic assignment, cellularity, and proliferation index had significant positive correlations (R = 0.651, 0.580, and 0.458, respectively; all P < 0.001). ROC analysis with a 1.79% APTw intensity cutoff differentiated active from nonactive tumor (AUC of 0.881) with 85.1% sensitivity and 94.1% specificity. Analysis of clinical pathology showed the mean APTw intensity for each patient had 94.4% sensitivity and 100% positive predictive value for identifying recurrent glioma at this cutoff.

Conclusions:

APTw imaging hyperintensity may be a marker of active malignant glioma. It is able to distinguish between regions of heterogeneous abnormality on anatomic brain MRI with high sensitivity and specificity.
Single versus Dual Antiplatelet Therapy after Transcatheter Aortic Valve Implantation: A Systematic Review and Meta-Analysis
Authors: Hu Xu , Yang Fu-Yao , Wang Yan , Zhang Yi , Chen Mao
Published: October 2018

Objectives: Although dual antiplatelet therapy (DAPT) with aspirin and clopidogrel is currently recommended in patients after transcatheter aortic valve implantation (TAVI), this practice is not supported by sufficient evidence. This study was performed to compare DAPT to single antiplatelet therapy (SAPT). Methods: An electronic search was completed of PubMed, Embase, Ovid Medline, Web of Science, and Cochrane Central Register of Controlled Trials. Studies comparing DAPT versus SAPT in patients undergoing TAVI were included. Results: Seven studies incorporating 1,445 patients were eligible for the present meta-analysis. There were no significant differences on 30-day all-cause mortality (OR 1.19, 95% CI 0.63–2.25, p = 0.593), 6-month all-cause mortality (OR 1.11, 95% CI 0.49–2.53, p = 0.796), or 1-year all-cause mortality (OR 1.19, 95% CI 0.63- 2.25, p = 0.593). DAPT was associated with an increased risk for 30-day (OR 2.91, 95% CI 1.85–4.58, p < 0.01), 6-month (OR 2.54, 95% CI 1.26–5.10, p < 0.001), and 1-year major and lethal bleeding (OR 2.65, 95% CI 1.04–6.77, p = 0.041) based on 896, 337, and 583 patients, respectively, compared to SAPT. Conclusion: Compared to SAPT, DAPT was not shown to be superior in reducing thrombotic events, but presented an increased risk of major/life-threatening bleeding. More randomized controlled trials are needed to provide further evidence.
Co-Inheritance of Autosomal Dominant Polycystic Kidney Disease and Naevoid Basal Cell Carcinoma Syndrome: Effects on Renal Progression
Authors: Martínez Maria Florencia , Mazzuoccolo Luis Daniel , Oddo Elisabet Mónica , Iscoff Paula Virginia , Muchnik Carolina , Neumann Hartmut P.H. , Martin Rodolfo Santiago , Fraga Adriana Raquel , Azurmendi Pablo Javier
Published: October 2018

The calcium signalling and hedgehog (HH) signalling pathways operate in the primary cilium. Abnormalities in these pathways cause autosomal dominant polycystic kidney disease (ADPKD) and naevoid basal cell carcinoma syndrome (NBCCS) respectively. Several reports have proposed that hyperactivation of the HH pathway in animal models of polycystic kidney disease affects normal renal development and renal cyst phenotype. A family with 2 cases (a proband and her sister) of ADPKD and NBCCS coinheritance led us to investigate whether interactions may be present in the 2 pathways. The effect of HH pathway hyperactivation (due to c.573C>G mutation on PTCH1 gene that cause NBCCS) on renal ADPKD progression in the proband was compared to 18 age- and sex-matched ADPKD patients in a 9-year, prospective, follow-up study. Blood pressure, total kidney volume, estimated glomerular filtration rate, plasma copeptin, urine excretion of albumin, total protein and monocyte chemoattractant protein-1 (MCP-1) were analysed. Data for the sibling was not available. In the ADPKD group, blood pressure and estimated glomerular filtration rate were within normal values, and total kidney volume and MCP-1 increased (p < 0.01) throughout the study. In comparison, during the 9-year follow-up, the proband showed persistent hypertension (from 125/85 to 140/95 mm Hg), low total kidney volume (75 and 61% of median ADPKD), and a ninefold increase in urine MCP-1. We found no differences in urine excretion of albumin or plasma copeptin values. These results suggest that HH hyperactivation may play a minimal role in ADPKD progression. These observations can help to clarify the clinical impact of affected pathways in renal development and cystogenesis in humans.
Vastly Different Exercise Programs Similarly Improve Parkinsonian Symptoms: A Randomized Clinical Trial
Authors: Tollár József , Nagy Ferenc , Hortobágyi Tibor
Published: October 2018

Objectives: To directly compare the effects of agility exergaming (EXE) and stationary cycling (CYC) exercise training on Parkinson’s disease (PD) patients’ mobility and clinical symptoms. Design: Randomized clinical trial. Setting: Outpatient physiotherapy clinic in a hospital. Participants: Seventy-four stage 2–3, nondemented PD patients were included in this study. Intervention: The groups were as follows: EXE (n = 25), CYC (n = 25), and a wait-listed control group (CON; n = 24). The EXE and CYC groups exercised 5×/week for 5 weeks, matched at 80% of the age-predicted maximal heart rate. Main Outcomes: The primary outcome was the Movement Disorders Society Unified Parkinson’s Disease Rating Scale (UPDRS-II) score. Secondary outcomes were Parkinson’s Disease Quastionnaire-39 (PDQ-39), the Beck Depression Inventory (BDI), the Schwab and England Activities of Daily Living (SE-ADL) scale, Euro-Quality of Life-5 Dimensions (EQ-5D) questionnaire, the Berg Balance Scale (BBS), the Balance Evaluation Systems Test (BESTest), the Tinetti Assessment Tool (TAT), the Dynamic Gait Index, the 6-min walk test (6MWT), and standing posturography. Results: After treatment, UPDRS-II scores improved (mean change: EXE, –4.5 points; CYC, –3.2 points). The results for the other outcomes (EXE and CYC, respectively) were: PDQ, 13 and 17%; BDI, –2.5 and –2.1 points; 6MWT, 129.6 and 141.6 m; and EQ-5D, 12 and 9% (all p < 0.05, but there was no difference between groups). EXE vs. CYC resulted in improved SE-ADL (8.4 and 4.0 points, effect size [ES]: 0.12), BBS (8.8 and 4.2 points, ES: 0.44), and 2 measures of posturography (ES: 0.11 and 0.21) (p < 0.05). BESTtest, TAT, the Dynamic Gait Index, and 4 out of 6 posturography measures did not change (p > 0.05). Conclusion: Two highly different exercise programs resulted in similar improvement of most motor and clinical symptoms in PD patients.
Closure of Bronchopleural Fistula with Mesenchymal Stem Cells: Case Report and Brief Literature Review
Authors: Zeng Yiming , Gao Hong-Zhi , Zhang Xiao-Bin , Lin Hui-Huang
Published: October 2018

Closure of bronchopleural fistula remains a difficult challenge for clinicians. Although several therapeutic approaches have been proposed, the clinical results are commonly unsatisfactory. Previous reports have indicated that autologous mesenchymal stem cells (MSCs) are useful for aiding treatment of bronchopleural fistula. We report here the use of umbilical cord MSCs to effect the successful closure of a bronchopleural fistula (5 mm) in a 33-year-old woman 6 months after a lobectomy. A review of the relevant literature is included. The use of MSCs may be a promising therapeutic method for the closure of bronchopleural fistula. Randomized controlled trials with larger samples are required.
The Chinese Linguistic Validation of the Ureteral Stent Symptom Questionnaire
Authors: Zhu Changming , Qu Jianglei , Yang Lei , Feng Xiaodi
Published: October 2018

Objective: We validated the Chinese version of the Ureteral Stent Symptoms Questionnaire (USSQ) in patients with an indwelling ureteric stent. Patients and Methods: The English version of the USSQ was translated into Chinese using a multi-step process by 3 urologists and 2 independent translators. The Chinese version was validated by asking 50 patients with temporary unilateral ureteral stent to complete the questionnaire at weeks 1 and 4 after stent placement. Thirty healthy individuals without a ureteral stent were also asked to complete the Chinese USSQ once. The psychometric properties of the questionnaire were analyzed. Results: After revision of the initial 2 drafts after translation, back translation, and pilot testing, a final draft was developed that underwent field testing. Psychometric analyses revealed satisfactory internal consistencies and test-retest reliability for all domains except for sexual matters. Most USSQ domains showed moderate correlations with each other. It demonstrated satisfactory discriminant validity (sensitivity to change, p < 0.05) and test-retest reliability. Analysis of the domains of the sexual matters was limited because of the small proportion of the study population for whom it was applicable. Conclusion: The Chinese version of the USSQ is a reliable and valid instrument to evaluate symptoms and health-related quality of life in Chinese patients with ureteric stents.