bluuebunny/crossref_metadata_2025 huggingface dataset:
Misplaced incus: an unusual complication of a temporal bone fracture
Authors: Pollaers Katherine , Broadbent Christopher , Kuthubutheen Jafri
Published: March 2019

A 24-year-old man sustained significant injuries as a result of a motor bicycle accident. CT scans demonstrated multiple intracranial injuries including bilateral temporal bone fractures. On emergence from sedation, the patient reported right-sided hearing loss which was attributed to ossicular chain disruption after the incus was found to be in the external auditory canal. Unexpectedly, the initial conductive hearing loss resolved with conservative management and an ossicular chain reconstruction was not required. This is an unusual case of impressive long-term good hearing outcomes following complete dislocation of the incus and extrusion from the middle ear.
Bilateral leiomyosarcoma of kidneys with pericardial metastases: a double whammy
Authors: Kumar Santosh , Narain Tushar Aditya , Sharma Gopal , Tyagi Shantanu
Published: March 2019

Renal sarcoma is a rare but lethal malignancy affecting the kidneys. Literature regarding this rare tumour has been limited to case reports and case series. In this paper, we report a very rare case of bilateral renal leiomyosarcoma with pericardial metastasis. Disease status and dearth of our knowledge in treating this particular type of case prompted us to review our experience of managing such case, which has never been reported previously in literature to our knowledge.
Unusual finding in the karyotype of a neonate with glandular hypospadias with chordee
Authors: Ramaswamy Viraraghavan Vadakkencherry , Rao Gajanan Venkat , Suryanarayana Nori , Gummadapu Sanghamitra
Published: March 2019

A 37-week, 2700 g vaginally delivered baby was admitted for respiratory distress which was attributed to transient tachypnoea of newborn. A clinical finding of glandular hypospadias with ventral chordee was detected. The penis was normal in size, and gonads were palpable bilaterally in the scrotal sac. The parents were informed of the good prognosis associated with this milder variety of hypospadias. In view of parental concerns, a fluorescent in situ hybridisation (FISH) for X and Y chromosome was performed. Surprisingly, FISH revealed the presence of 46, XY in 90% of cells and 46, XX in 10% of the remainder cells suggesting a diagnosis of chimerism.
Giant posterior fossa meningioma: the importance of early diagnosis and challenges concerning treatment
Authors: Antunes Cristiano , Ramos Rui , Machado Maria João , Filipe Miguel Afonso
Published: March 2019

Posterior fossa lesions may present with behavioural changes and/or progressive neurological deficit. Patients may have symptoms for long periods which may be attributed to other causes such as psychiatric diseases. We report a case of a 44-year-old woman with behavioural changes lasting for 5 years who lost her job, marriage and the guard of her sons. Latterly, she developed neurological deficit, hydrocephalus and intracranial hypertension. A giant left pontocerebellar angle mass was diagnosed. A retrosigmoid craniotomy was performed with total removal and cranial nerve function’s preservation. Histology revealed a grade I meningioma. The surgical approach for such huge lesions on pontocerebellar angle is controversial concerning patient’s positioning and surgical route. A brief revision is made. Since nowadays medical imaging is more easily accessible, it is mandatory to have a brain image in patients with behavioural changes and/or neurological deficit to exclude potential structural and curable causes such as in this case.
Recurrence of a complex anterior skull base tumour managed with an uncommon surgical approach
Authors: Alvi Muhammad Ibaad ur Rehman , Pathmanaban Omar , Bhalla Raj , Mani Navin
Published: March 2019

A well 74 -year-old woman presented to routine ophthalmology clinic instituted following treatment of a frontoethmoidal sarcoma initially excised in 1989 and diagnosed then as a sinus mucosal melanoma. At review in ophthalmology clinic, a reduction in right visual fields was noted. CT scan showed recurrence of a mass now involving the frontoethmoidal region, frontal sinus and abutting the cribiform plate. Endoscopic biopsy confirmed the recurrence as a low-grade biphenotypic sarcoma. This was discussed at the sarcoma multidisciplinary meeting. Using a three-dimensional printed model of the patients skull for planning, primary surgery with craniofacial resection combining intracranial and transfacial approaches with reconstruction was decided on. The implications of no treatment would be tumour involvement of the dura and brain as well as the right only-seeing eye. Craniofacial surgery would involve otolaryngolical, neurosurgical and maxillofacial multispecialty involvement and close teamwork. The goal was en bloc excision with negative surgical margins.
Simultaneous parotitis and ipsilateral herpes zoster ophthalmicus: coincidence?
Authors: Banno Fady , Riccelli Tori , Banno Mark
Published: March 2019

A 43-year-old previously healthy man presented to the primary care clinic with concurrent ipsilateral viral parotitis and herpes zoster ophthalmicus. The patient experienced painful swelling below the right ear as well as painful vesicles on the right forehead, eyelid and cheek in the V1 dermatomal region. There were no lesions in the oral cavity or nose. Antibody titres confirmed active varicella zoster virus in the absence of mumps or herpes simplex virus 1 and 2 and unilateral parotitis were confirmed to be non-suppurative by the patient’s primary care physician and the neurologist. Both conditions resolved within 3 weeks with appropriate treatment.
‘I decided not to go into surgery due to dress code’: a cross-sectional study within the UK investigating experiences of female Muslim medical health professionals on bare below the elbows (BBE) policy and wearing headscarves (hijabs) in theatre
Authors: Malik Abida , Qureshi Hafsah , Abdul-Razakq Humayra , Yaqoob Zahra , Javaid Fatima Zahra , Esmail Faatima , Wiley Emma , Latif Asam
Published: March 2019

Objectives

The objective of this study is to explore the impact of workplace dress code policies and guidance that may influence inclusivity and opportunities in the workplace.

Design

Quantitative, self-completion cross-sectional survey.

Setting

British Islamic Medical Association conference.

Participants

Eighty-four female medical healthcare professionals with a range of ethnicities and wide geographical coverage.

Primary and secondary outcome measures

The study reports on the experiences of female Muslim healthcare professions wearing the headscarf in theatre and their views of the bare below the elbows (BBE) policy. Percentage of positive answers and their respective 95% CIs are calculated.

Results

The majority of participants agreed that wearing the headscarf was important for themselves and their religious beliefs (94.1%), yet over half (51.5%) experienced problems trying to wear a headscarf in theatre; some women felt embarrassed (23.4%), anxious (37.1%) and bullied (36.5%). A variety of different methods in head covering in operating theatres were identified. The majority of respondents (56.3%) felt their religious requirement to cover their arms was not respected by their trust, with nearly three-quarters (74.1%) of respondents not happy with their trust’s BBE uniform policy alternative. Dissatisfaction with the current practice of headscarves in theatre and BBE policy was highlighted, with some respondents preferring to specialise as GPs rather than in hospital medicine because of dress code matters. The hijab prototype proposed by the research team also received a positive response (98.7%).

Conclusions

Our study suggests that female Muslims working in the National Health Service (NHS) reported experiencing challenges when wearing the headscarf in theatre and with BBE policy. The NHS needs to make its position clear to avoid variations in individual trust interpretation of dress code policies. This illustrates a wider issue of how policies can be at odds with personal beliefs which may contribute to a reduction in workforce diversity.
Qualitative, exploratory pilot study to investigate how people living with posterior cortical atrophy, their carers and clinicians experience tests used to assess vision
Authors: Bowen Michael , Zutshi Harry , Cordiner Martin , Crutch Sebastian , Shakespeare Tim
Published: March 2019

Objectives

To investigate the experiences and views of people living with posterior cortical atrophy (PCA), their family carers and healthcare professionals of vision assessment tests.

Design

A qualitative investigation using video recordings of vision assessments, semistructured interviews and audio recordings of a focus group. Interviews and focus group used broad, open questions around the topic to prompt and guide discussion. Video and audio recordings were transcribed, manually coded and analysed using framework analysis.

Setting

University College, London’s Queen Square neurology centre provided the venues for all stages of the research.

Participants

Participants living with PCA were one male and two females (age range 67–78 years). Health professional participants were a neurologist (male), two ophthalmologists (male) and an optometrist (female).

Primary and secondary outcomes

(1) Experiences and attitudes of people living with PCA and health professionals to vision assessment tests, (2) views of health professionals and people living with PCA of whether some tests are more effective at discriminating between cortical vision problems and vision problems related to optical or ocular causes.

Results

Patients were able to engage with and complete a number of tests. Their partners played a vital role in the process. Participants reported that simple, short tests were more effective than more subjective tests. Examples of tests that appeared to be more problematic for the patient participants were the Amsler Grid and visual field analysis.

Conclusions

Although limited in scope and execution, the project suggests that some vision assessment tests are likely to support health professionals to discriminate between cortical and optical/ocular causes of visual impairment. It supports existing evidence that there are vision assessments that people with dementia can engage with and complete. We identify areas of importance for future research and make tentative suggestions for clinical practice.
Opinion leader empowered patients about the era of digital health: a qualitative study
Authors: Meskó Bertalan , Radó Nóra , Győrffy Zsuzsa
Published: March 2019

Objectives

We aimed to explore the opinion leader empowered patients’ relationship with their medical professionals, their experiences and beliefs about technologies, and how they see the future. We also attempted to determine whether technologies, the access to it or patient empowerment are the main driving forces behind these changes.

Design

A qualitative interview study analysed with interpretative phenomenological analysis.

Setting

All interviews were conducted and recorded individually with the same trained interviewer via a Skype call.

Participants

The study is based on qualitative, semistructured interviews with 11 opinion leader empowered patients from six countries including UK, USA, Australia, Sweden, South Africa and Ireland.

Results

We identified four superordinate themes emerging from e-patients’ experiences: (1) impact of technology, (2) the meaning of empowerment, (3) the changing physician–patient relationship and (4) expectations for the future. The relationship e-patients have with their physicians is based on efficient communication, proactivity, the desire for asking questions and the use of technologies. The interviews have shown that the rapid development of technology has fundamentally changed the lives of these e-patients, and technology eventually is transforming the physician–patient relationship into a partnership. Regarding the future of the physician–patient partnership, e-patients emphasised that change will rather be cultural than technological.

Conclusions

The interviews have shown that cooperation between technology and healthcare is not enough on its own: the most decisive factor is the return of the human touch and reciprocal communication. All of these suggest that technology is an important ally in the ‘renaissance of medicine’ that starts to treat patients as it should have always had.
Hydroxychloroquine for prevention of recurrent miscarriage: study protocol for a multicentre randomised placebo-controlled trial BBQ study
Authors: Pasquier Elisabeth , de Saint-Martin Luc , Marhic Gisèle , Chauleur Celine , Bohec Caroline , Bretelle Florence , Lejeune-Saada Véronique , Hannigsberg Jacob , Plu-Bureau Geneviève , Cogulet Virginie , Merviel Philippe , Mottier Dominique
Published: March 2019

Introduction

Recurrent miscarriage (RM), defined by three or more consecutive losses during the first trimester of pregnancy, affects 1%–2% of fertile couples. Standard investigations fail to reveal any apparent cause in ~50% of couples. However, on the basis of animal models and clinical studies, several hypotheses have been put forward concerning underlying mechanisms of RM: altered ovarian reserve, progesterone defect, thrombotic and/or endothelial dysfunction and immunological disturbances. Nonetheless, no study has yet reached conclusive beneficial clinical evidence for a potential treatment in unexplained RM. Hydroxychloroquine (HCQ) is a molecule with extensive safety data during pregnancy. The pharmacological properties of HCQ (eg, antithrombotic, vascular protective, immunomodulatory, improved glucose tolerance, lipidlowering and anti-infectious) could be effective against some mechanisms of unexplained RM. Furthermore, eventhough clinical benefit of HCQ is suggested in prevention of thrombotic and late obstetric events in antiphospholipid (APL) syndrome, there are no data suggesting the benefit of HCQ in RM in the presence of APL antibodies.

Methods and analysis

Taken all together and given the low cost of HCQ, the aim of this multicentre, randomised, placebo-controlled, double-blind study is to investigate whether HCQ would improve the live birth rate in women with RM, irrespective of maternal thrombophilic status: (1) no known thrombophilia, (2) inherited thrombophilia or (3) APL antibodies. The primary end point is a live and viable birth. After confirming eligibility and obtaining consent, 300 non-pregnant women will be randomised into two parallel groups for a daily oral treatment (HCQ 400 mg or placebo), initiated before conception and stopped at 10 weeks’ gestation. If pregnancy does not occur after 1 year, the treatment will be stopped.

Ethics and dissemination

Agreement from the French National Public Health and Drug Security Agency (160765A-22) and ethical approval from the Committee for the Protection of Persons of NORD-OUEST I (2016-001330-97) have been obtained.

Trial registration numbers

NCT0316513; Pre-results.
Phase III, multicentre, randomised, double-blind, placebo-controlled, 104-week study of subcutaneous belimumab administered in combination with rituximab in adults with systemic lupus erythematosus (SLE): BLISS-BELIEVE study protocol
Authors: Teng Y K Onno , Bruce Ian N , Diamond Betty , Furie Richard A , van Vollenhoven Ronald F , Gordon David , Groark James , Henderson Robert B , Oldham Mary , Tak Paul P
Published: March 2019

Introduction

Belimumab, an anti-B-lymphocyte-stimulator antibody, is approved for the treatment of active, autoantibody-positive systemic lupus erythematosus (SLE). Rituximab, a B cell-depleting anti-CD20 antibody, remains in the SLE treatment armamentarium despite failed trials in lupus nephritis and extrarenal lupus. These biologics, which operate through complementary mechanisms, might result in an enhanced depletion of circulating and tissue-resident autoreactive B lymphocytes when administered together. Thus, belimumab and rituximab combination may be a highly effective treatment of SLE. This study aims to evaluate and compare the efficacy, safety and tolerability of subcutaneous (SC) belimumab and a single cycle of rituximab in patients with SLE with belimumab alone.

Methods and analysis

BLISS-BELIEVE is a three-arm, randomised, double-blind, placebo-controlled, 104-week superiority study. Two hundred adults with SLE will be randomised 1:2:1 to arm A, belimumab SC 200 mg/week for 52 weeks plus placebo at weeks 4 and 6; arm B, belimumab SC 200 mg/week for 52 weeks plus rituximab 1000 mg at weeks 4 and 6; arm C, belimumab SC 200 mg/week plus standard of care for 104 weeks. The 52-week treatment period (arms A and B) is followed by a 52-week observational phase. The primary efficacy endpoint is the proportion of patients with disease control (SLE Disease Activity Index (SLEDAI)−2K≤2, without immunosuppressants and with a prednisone-equivalent dose of ≤5 mg/day) at week 52. Major secondary efficacy endpoints are the proportion of patients in clinical remission (defined as SLEDAI-2K=0, without immunosuppressants and corticosteroids) at week 64, and the proportion of patients with disease control at week 104. Safety endpoints include the incidence of adverse events (AEs), serious AEs and AEs of special interest.

Ethics and dissemination

Within 6 months of the study’s primary manuscript publication, anonymised individual participant data and study documents can be requested for further research fromwww.clinicalstudydatarequest.com.

Trial registration number

NCT03312907; Pre-results.
Enhancing the public health impact of latent tuberculosis infection diagnosis and treatment (ACT4): protocol for a cluster randomised trial
Authors: Oxlade Olivia , Trajman Anete , Benedetti Andrea , Adjobimey Mênonli , Cook Victoria J , Fisher Dina , Fox Gregory James , Fregonese Federica , Hadisoemarto Panji , Hill Philip C , Johnston James , Long Richard , Obeng Joseph , Ruslami Rovina , Valiquette Chantal , Menzies Dick
Published: March 2019

Introduction

Treatment of latent tuberculosis (TB) infection (LTBI) is an important component of the End-TB strategy. However, the number of individuals who successfully complete LTBI treatment remains low as there are losses at all steps in the LTBI ‘cascade-of-care’. The reasons for these losses are variable and highly dependent on the setting. We have planned a trial of a standardised public health approach to strengthen the management of household contacts (HHCs) of newly diagnosed patients with pulmonary TB. Assessing costs related to approach is a secondary objective of the study.

Methods and analysis

A cluster randomised trial will be conducted in 24 randomisation units (health facilities or groups of health facilities) in five countries. In Phase 1, at intervention sites, we will conduct a standardised assessment of the current LTBI programme, with a focus on cascade-of-care endpoints. Standardised open-ended questionnaires on practices, knowledge, attitudes and beliefs regarding TB prevention are then administered to key patient groups and healthcare workers. At each site, local stake-holders will review study findings and select solutions based on their acceptability, cost and effectiveness. In Phase 2, intervention clinics will implement the selected solutions, along with contact measurement registries and regular in-service LTBI management training. Control sites will continue their usual LTBI care with no explicit evaluation, strengthening or training activities. The primary study outcome is the number of HHC initiating LTBI treatment per newly diagnosed active TB patient, within 3 months of diagnosis of the index patient. An intention-to-treat analysis will be performed, using a Poisson regression approach.

Ethics and dissemination

Ethics approval from the MUHC ethical review board (ERB) was obtained in November 2015. During the study standardised tools will be developed and made publicly available. Key study findings and novel methodologic contributions will be detailed in publications and other dissemination activities.

Trial registration number

NCT02810678; Pre-Results.
Supervised exercise delivered via telehealth in real time to manage chronic conditions in adults: a protocol for a scoping review to inform future research in stroke survivors
Authors: Ramage Emily R , Fini Natalie A , Lynch Elizabeth A , Patterson Amanda , Said Catherine M , English Coralie
Published: March 2019

Introduction

Increasing physical activity reduces secondary stroke risk factors, but many stroke survivors have low levels of physical activity. Supervised exercise delivered via telehealth has the potential to overcome barriers to increased physical activity in stroke survivors. Our scoping review will examine the emerging field of supervised exercise delivered via telehealth to map the available evidence in relation to its efficacy, acceptability, safety and feasibility in chronic conditions to inform future research into its ability to increase physical activity.

Methods and analysis

The methodological framework of Arksey and O’Malley will be applied to our scoping review. A systematic search of Medline, CINAHL, Scopus, Cochrane, Pedro and Embase; hand searching of pertinent studies’ reference lists; and consultation with experts in the field will identify relevant papers. Studies involving participants with a chronic condition who undertake supervised exercise delivered by a health professional via telehealth targeted at improving secondary stroke risk factors or involving lower limb weight-bearing exercise will be included. Study selection and critical appraisal of individual studies will be carried out independently by two authors with discrepancies resolved by a third author. Quantitative and qualitative data will be charted using a standardised form. Results will be tabulated and narratively summarised to highlight findings relevant to the review’s research questions and to inform recommendations for future research.

Ethics and dissemination

Our review will significantly contribute to the knowledge base of exercise and rehabilitation delivered via telehealth and its application in chronic conditions, including stroke. Findings will be relevant to researchers, healthcare workers and policy-makers and will be disseminated through publication and presentations. Only secondary deidentified data will be included, therefore ethics approval will not be sought. This protocol is not registered as PROSPERO currently excludes scoping reviews.
Reporting of data monitoring committees and adverse events in paediatric trials: a descriptive analysis
Authors: Gates Allison , Caldwell Patrina , Curtis Sarah , Dans Leonila , Fernandes Ricardo M , Hartling Lisa , Kelly Lauren E , Vandermeer Ben , Williams Katrina , Woolfall Kerry , Dyson Michele P
Published: March 2019

Objectives

For 300 paediatric trials, we evaluated the reporting of: a data monitoring committee (DMC); interim analyses, stopping rules and early stopping; and adverse events and harm-related endpoints.

Methods

For this cross-sectional evaluation, we randomly selected 300 paediatric trials published in 2012 from the Cochrane Central Register of Controlled Trials. We collected data on the reporting of a DMC; interim analyses, stopping rules and early stopping; and adverse events and harm-related endpoints. We reported the findings descriptively and stratified by trial characteristics.

Results

Eighty-five (28%) of the trials investigated drugs, and 18% (n=55/300) reported a DMC. The reporting of a DMC was more common among multicentre than single centre trials (n=41/132, 31% vs n=14/139, 10%, p<0.001) and industry-sponsored trials compared with those sponsored by other sources (n=16/50, 32% vs n=39/250, 16%, p=0.009). Trials that reported a DMC enrolled more participants than those that did not (median [range]): 224 (10–60480) vs 91 (10–9528) (p<0.001). Only 25% of these trials reported interim analyses, and 42% reported stopping rules. Less than half (n=143/300, 48%) of trials reported on adverse events, and 72% (n=215/300) reported on harm-related endpoints. Trials that reported a DMC compared with those that did not were more likely to report adverse events (n=43/55, 78% vs 100/245, 41%, p<0.001) and harm-related endpoints (n=52/55, 95% vs. 163/245, 67%, p<0.001). Only 32% of drug trials reported a DMC; 18% and 19% did not report on adverse events or harm-related endpoints, respectively.

Conclusions

The reporting of a DMC was infrequent, even among drug trials. Few trials reported stopping rules or interim analyses. Reporting of adverse events and harm-related endpoints was suboptimal.
External validation and recalibration of the Brock model to predict probability of cancer in pulmonary nodules using NLST data
Authors: Winter Audrey , Aberle Denise R , Hsu William
Published: March 2019

Introduction

We performed an external validation of the Brock model using the National Lung Screening Trial (NLST) data set, following strict guidelines set forth by the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis statement. We report how external validation results can be interpreted and highlight the role of recalibration and model updating.

Materials and methods

We assessed model discrimination and calibration using the NLST data set. Adhering to the inclusion/exclusion criteria reported by McWilliamset al, we identified 7879 non-calcified nodules discovered at the baseline low-dose CT screen with 2 years of follow-up. We characterised differences between Pan-Canadian Early Detection of Lung Cancer Study and NLST cohorts. We calculated the slope on the prognostic index and the intercept coefficient by fitting the original Brock model to NLST. We also assessed the impact of model recalibration and the addition of new covariates such as body mass index, smoking status, pack-years and asbestos.

Results

While the area under the curve (AUC) of the model was good, 0.905 (95% CI 0.882 to 0.928), a histogram plot showed that the model poorly differentiated between benign and malignant cases. The calibration plot showed that the model overestimated the probability of cancer. In recalibrating the model, the coefficients for emphysema, spiculation and nodule count were updated. The updated model had an improved calibration and achieved an optimism-corrected AUC of 0.912 (95% CI 0.891 to 0.932). Only pack-year history was found to be significant (p<0.01) among the new covariates evaluated.

Conclusion

While the Brock model achieved a high AUC when validated on the NLST data set, the model benefited from updating and recalibration. Nevertheless, covariates used in the model appear to be insufficient to adequately discriminate malignant cases.
PinPinKorori or NenNenKorori: the historical and socioeconomic background of geriatric trauma care in Japan
Authors: Fujita Takashi
Published: March 2019

Introduction

Aging is one of the most serious social issues, not only in Japan. A country’s socioeconomic conditions must be taken into account when considering the issue of rapid aging. The purpose of this review was to introduce the historical and socioeconomic background of geriatric trauma care in Japan.

Method

Literature review regarding the trauma care for the elderly written in Japanese and English.

Results

“PinPinKorori” is a Japanese word which symbolizes an ideal, healthy life. “NenNenkorori” is the opposite of PinPinKorori. The Japanese elderly desire to live a healthy, active life and die (PinPinKorori) rather than being bedridden and dying in agony. A bedridden individual (NenNenKorori) is a candidate for receiving end-of-life care. End-of-life care is a form of trauma care for the elderly that ensures quality of death for those in need.

Conclusions

I encourage the elderly to document their advance care preferences with decision-making capacity in order to avoid futile care. Healthcare providers should strive to provide optimum care to the patients in their best interest and ensure not to provide treatment that is not desired by the patients.

Level of evidence

Level IV.
4-Index theory of gravity and its relation with the violation of the energy–momentum conservation law
Authors: Moradpour H. , Licata I. , Corda C. , Salako Ines G.
Published: March 2019

Recently, a 4-index generalization of the Einstein theory has been proposed by Moulin [F. Moulin, Eur. Phys. J. C 77, 878 (2017)]. Using this method, we find the most general 2-index field equations derivable from the Einstein–Hilbert action. The application of Newtonian limit, the role of gravitational coupling constant and the effects of the properties of ordinary energy–momentum tensor in obtaining a 4-index gravity theory have been studied. We also address the results of building Weyl free 4-index gravity theory. Our study displays that both the Einstein and Rastall theories can be obtained as the subclasses of a 4-index gravity theory which shows the power of 4-index method in unifying various gravitational theories. It is also obtained that the violation of the energy–momentum conservation law may be allowed in 4-index gravity theory, and moreover, the contraction of 4-index theory generally admits a non-minimal coupling between geometry and matter field in the Rastall way. This study also shows that, unlike the Einstein case, the gravitational coupling constant of 4-index Rastall theory generally differs from that of the ordinary 2-index Rastall theory.
Various dark energy models for variables G and Λ in f(R, T) modified theory
Authors: Aktaş Can
Published: March 2019

In this paper, we have researched tachyon field, k-essence and quintessence dark energy (DE) models for Friedmann–Robertson–Walker (FRW) universe with varying G and [Formula: see text] in f(R, T) gravitation theory. The theory of f(R, T) is proposed by Harko et al. [Phys. Rev. D 84, 024020, 2011]. In this theory, R is the Ricci scalar and T is the trace of energy–momentum tensor. For the solutions of field equations, we have used linearly varying deceleration parameter (LVDP), the equation of state (EoS) and the ratio between [Formula: see text] and Hubble parameter. Also, we have discussed some physical behavior of the models with various graphics.
Grammian solutions for a (2+1)-dimensional integrable coupled modified Date–Jimbo–Kashiwara–Miwa equation
Authors: Wang Sheng-Nan , Hu Juan
Published: March 2019

In this paper, Grammian solutions to a (2[Formula: see text]+[Formula: see text]1)-dimensional modified Date–Jimbo–Kashiwara–Miwa (mDJKM) equation are presented by using Hirota bilinear method and perturbation expansion. Starting from the Grammian solutions, an integrable coupled mDJKM equation is then obtained and the corresponding Grammian solutions are first derived by utilizing the source generation procedure. Besides, we also construct and solve a coupled DJKM equation via source generation procedure. It is interesting that the coupled mDJKM system constitute a bilinear Bäcklund transformation for the coupled DJKM system. This means that the commutativity of source generation procedure and Bäcklund transformation is valid for the (2[Formula: see text]+[Formula: see text]1)-dimensional DJKM equation.
Dispersive traveling wave solutions of nonlinear optical wave dynamical models
Authors: Apeanti Wilson Osafo , Lu Dianchen , Yaro David , Akuamoah Saviour Worianyo
Published: March 2019

In this work, we apply the extended simple equation method to study the dispersive traveling wave solutions of (2+1)-dimensional Nizhnik–Novikov–Vesselov (NNV), Caudrey–Dodd–Gibbon (CDG) and Jaulent–Miodek (JM) hierarchy nonlinear equations. A set of exact, periodic and soliton solutions is obtained for these models confirming the effectiveness of the proposed method. The models studied are important for a number of application areas especially in the field of mathematical physics. Interesting figures are used to illustrate the physical properties of some obtained results. A comparison between obtained solutions and established results in the literature is also given.
Cyber security in the quantum era
Authors: Wallden Petros , Kashefi Elham
Published: March 2019

Quantum systems will significantly affect the field of cyber security research.
Pondering variables and direct instruction
Authors: Hill Robin K. , Guzdial Mark
Published: March 2019

The
Communications
Web site, http://cacm.acm.org, features more than a dozen bloggers in the BLOG@CACM community. In each issue of
Communications
, we'll publish selected posts or excerpts.

twitter

Follow us on Twitter at http://twitter.com/blogCACM

http://cacm.acm.org/blogs/blog-cacm

Robin K. Hill considers the nature of variables, while Mark Guzdial reflects on renewed interest in the "direct instruction model."
The future of data storage
Authors: Greengard Samuel
Published: March 2019

Research into next-generation storage techniques marches forward, yet tape remains the most viable, dependable medium.
Portal milieu and the interplay of multiple antidiabetic effects after gastric bypass surgery
Authors: Pal Atanu , Rhoads David B. , Tavakkoli Ali
Published: March 2019

Diabetes is a worldwide health problem. Roux-en-Y gastric bypass (RYGB) leads to rapid resolution of type 2 diabetes (T2D). Decreased hepatic insulin resistance is key, but underlying mechanisms are poorly understood. We hypothesized that changes in intestinal function and subsequent changes in portal venous milieu drive some of these postoperative benefits. We therefore aimed to evaluate postoperative changes in portal milieu. Two rat strains, healthy [Sprague-Dawley (SD)] and obese diabetic [Zucker diabetic fatty (ZDF)] rats, underwent RYGB or control surgery. After 4 wk, portal and systemic blood was sampled before and during an intestinal glucose bolus to investigate changes in intestinal glucose absorption (Gabsorp) and utilization (Gutil), and intestinal secretion of incretins and glucagon-like peptide-2 (GLP-2). Hepatic activity of dipeptidyl peptidase-4 (DPP4), which degrades incretins, was also measured. RYGB decreased Gabsorp in both rat strains. Gutil increased in SD rats and decreased in ZDF rats. In both strains, there was increased expression of intestinal hexokinase and gluconeogenesis enzymes. Systemic incretin and GLP-2 levels also increased after RYGB. This occurred without an increase in secretion. Hepatic DPP4 activity and expression were unchanged. RYGB perturbs multiple intestinal pathways, leading to decreased intestinal glucose absorption and increased incretin levels in both healthy and diabetic animals. In diabetic rats, intestinal glucose balance shifts toward glucose release. The portal vein as the gut-liver axis may integrate these intestinal changes to contribute to rapid changes in hepatic glucose and hormone handling. This fresh insight into the surgical physiology of RYGB raises the hope of less invasive alternatives.

NEW & NOTEWORTHY Portal milieu after gastric bypass surgery is an underinvestigated area. Roux-en-Y gastric bypass perturbs multiple intestinal pathways, reducing intestinal glucose absorption and increasing incretin levels. In diabetic rats, the intestine becomes a net releaser of glucose, increasing portal glucose levels. The portal vein as the gut-liver axis may integrate these intestinal changes to contribute to changes in hepatic glucose handling. This fresh insight raises the hope of less invasive alternatives.
Impact of exercise-induced hypohydration on gastrointestinal integrity, function, symptoms, and systemic endotoxin and inflammatory profile
Authors: Costa Ricardo J. S. , Camões-Costa Vera , Snipe Rhiannon M. J. , Dixon David , Russo Isabella , Huschtscha Zoya
Published: March 2019

It is commonly believed that gastrointestinal issues during exercise are exacerbated by hypohydration. This study aimed to determine the effect of exercise-induced hypohydration on gastrointestinal integrity, function, symptoms, and systemic endotoxin and inflammatory profiles. In a randomized crossover design, male endurance runners ( n = 11) performed 2 h of running at 70% of maximum oxygen uptake in 25°C ambient temperature with water provision [euhydration (EuH)] and total water restriction [hypohydration (HypoH)] during running, which accounted for 0.6 ± 0.6% and 3.1 ± 0.7% body mass loss, respectively. Blood and fecal samples were collected before and after exercise. Breath samples (H2 determination) were collected and gastrointestinal symptoms (GIS) recorded before, during, and after exercise. HypoH resulted in a higher, yet insignificant, ∆ preexercise to postexercise plasma cortisol concentration (+286 nmol/l vs. +176 nmol/l; P = 0.098) but significantly higher intestinal fatty acid-binding protein (I-FABP) (+539 pg/ml vs. +371 pg/ml; P = 0.047) concentration compared with EuH. A greater breath H2 response ( P = 0.026) was observed on HypoH (1,188 ppm/3 h, peak +12 ppm) vs. EuH (579 ppm/3 h, peak +6 ppm). Despite greater GIS incidence on HypoH (82%) vs. EuH (64%), GIS severity scores were not significant between trials. Exercise-induced leukocytosis (overall pre- to postexercise: 5.9 × 109/l to 12.1 × 109/l) was similar on both trials. Depressed in vitro neutrophil function was observed during recovery on HypoH (−36%) but not on EUH (+6%). A pre- to postexercise increase ( P < 0.05) was observed for circulating cytokine concentrations but not endotoxin values. Hypohydration during 2 h of running modestly perturbs gastrointestinal integrity and function and increases GIS incidence but does not affect systemic endotoxemia and cytokinemia.

NEW & NOTEWORTHY Despite anecdotal beliefs that exercise-induced hypohydration exacerbates perturbations to gastrointestinal status, the present study reports only modest perturbations in gastrointestinal integrity, function, and symptoms compared with euhydration maintenance. Exercise-induced hypohydration does not exacerbate systemic endotoxemia and cytokinemia compared with euhydration maintenance. Programmed water intake to maintain euhydration results in gastrointestinal symptom severity similar to exercise-induced hypohydration. Maintaining euhydration during exertional stress prevents the exercise-associated depression in bacterially stimulated neutrophil function.
Iron Deficiency Anemia among In-School Adolescent Girls in Rural Area of Bahir Dar City Administration, North West Ethiopia
Authors: Mengistu Getachew , Azage Muluken , Gutema Hordofa
Published: March 2019

Background. Anemia is a major public health problem worldwide. Adolescent girls are the most vulnerable group of population due to different reasons. The aim of this study was to assess the prevalence of anemia and associated factors among school adolescent girls in rural towns of Bahir Dar City Administration, North West Ethiopia. Methods. A cross-sectional study was conducted from March 5 to April 15, 2017, on 443 randomly selected school adolescent girls. Data were collected using pretested structured questionnaire and anthropometric measurements. Blood sample was also collected to assess the hemoglobin (Hgb) value of study participants. SPSS version 20 was used to analyze data. Descriptive statistics were used to describe data. Bivariate and multivariable logistic regression models were used to identify the associated factors with the outcome variable. Crude and adjusted odds ratios with 95% confidence interval (CI) were calculated to identify the variables significantly associated with the outcome variable. Result. The prevalence of anemia was 11.1%. Household family size [AOR=3.2, 95%CI (1.29-7.89)], average household monthly income <500 ETB [AOR=10; 95%CI (2.49-41.26)], 501-1000 ETB [AOR=6, 95%CI (2.54-14.33)], history of intestinal parasitic infection [AOR=2.7; 95% CI (1.19-6.21)], duration of menstruation flow [AOR=2.4; 95%CI (1.08- 5.44)], and BMI for age [AOR-3.2; 95% CI (1.43-7.05)] were the predictors of anemia. Conclusion and Recommendation. Anemia was a mild public health problem among school adolescent girls in the study area. Household monthly income, family size, intestinal parasite infections, duration of menstruation, and BMI for age are predictors of anemia. Thus, intervention strategies should focus on prevention and early treatment of intestinal parasite, nutritional education, screening, and iron supplementation programs to prevent anemia among school adolescent girls.
Effects of Olanzapine on Bone Mineral Density, Glucose, and Lipid Metabolism in Schizophrenia Patients
Authors: Liang Mining , Zhang Beibei , Deng Lu , Xu Rong , Wu Haishan , Chen Jindong
Published: March 2019

Aim. To explore whether olanzapine alters bone mineral density (BMD), glucose, and lipid metabolism in schizophrenia patients. Methods. This study enrolled 150 patients diagnosed with schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), including 101 patients who had over 6-month history of olanzapine use (olanzapine-treated group) and 49 patients who had no history of antipsychotic use (first episode drug-naïve group). 71 subjects with age- and gender-matched healthy volunteers (healthy control group) were also enrolled. All study subjects were from the Chinese Han population recruited in the Second Xiangya Hospital from January 2015 to January 2016. Demographic and physical examination data were collected from all subjects. BMD measurements of the radius+ulna, lumbar spine (L1-4), and left hip were performed via a dual-energy X-ray absorptiometry test. Serum lipid, glucose, and insulin levels were analyzed. Psychopathology profiles in all enrolled schizophrenia patients were assessed by the positive and negative syndrome scale (PANSS). Results. There was no significant difference in age, gender, activity intensity, smoking, or drinking among the three groups. In the majority of evaluated bone areas, the BMD values in olanzapine-treated or drug-naïve patients were lower than those in the control group. However, BMD values in the drug-naïve group showed no difference or even decreased as compared with those in the olanzapine-treated group. Among the olanzapine-treated group, although not observed in every tested region, a positive correlation was found of BMI or HOMA-IR with BMD. Stepwise multiple linear regression analysis revealed independent predictive factors associated with BMD in groups/subgroups of schizophrenia patients or healthy controls, including gender, TG, BMI, body weight, HOMA-IR, and FBG. Conclusions. Schizophrenia, but not the long-term use of olanzapine, correlates with BMD loss in schizophrenia patients. Elevated BMI, TG, FBG, and insulin levels might protect these patients against bone degradation. Our work provides new information to improve the understanding, prevention, and treatment of osteoporosis in schizophrenia patients.
pNNS-Conjugated Chitosan Mediated IGF-1 and miR-140 Overexpression in Articular Chondrocytes Improves Cartilage Repair
Authors: Zhao Rong-lan , Zhang Xu-mei , Jia Li-na , Song Wei , Sun Yan-li , Meng Xiang-ying , Peng Xiao-xiang
Published: March 2019

The aim of the present study was to investigate the effects of phosphorylatable nucleus localization signal linked nucleic kinase substrate short peptide (NNSp)-conjugated chitosan (NNSp-CS) mediated miR-140 and IGF-1 in both rabbit chondrocytes and cartilage defects model. NNSp-CS was combined with pBudCE4.1-IGF-1, pBudCE4.1-miR-140, and negative control pBudCE4.1 to form pDNA/NNSp-CS complexes. Then these complexes were transfected into chondrocytes or injected intra-articularly into the knee joints. High levels of IGF-1 and miR-140 expression were detected both in vitro and in vivo. Compared with pBudCE4.1 group, in vitro, the transgenic groups significantly promoted chondrocyte proliferation, increased glycosaminoglycan (GAG) synthesis, and ACAN, COL2A1, and TIMP-1 levels, and reduced the levels of nitric oxide (NO), MMP-13, and ADAMTS-5. In vivo, the exogenous genes enhanced COL2A1, ACAN, and TIMP-1 expression in cartilage and reduced cartilage Mankin score and the contents of NO, IL-1β, TNF-α, and GAG contents in synovial fluid of rabbits, MMP-13, ADAMTS-5, COL1A2, and COL10A1 levels in cartilage. Double gene combination showed better results than single gene. This study indicate that NNSp-CS is a better gene delivery vehicle in gene therapy for cartilage defects and that miR-140 combination IGF-1 transfection has better biologic effects on cartilage defects.
Severe Hypocalcemia and Dramatic Increase in Parathyroid Hormone after Denosumab in a Dialysis Patient: A Case Report and Review of the Literature
Authors: Bhanot Ravinder D. , Kaur Jasleen , Bhat Zeenat
Published: March 2019

Chronic kidney disease-mineral and bone disorder (CKD-MBD) is frequently present in advanced stages of chronic kidney disease (CKD) patients with high risk of fracture and elevated socioeconomic burden. Denosumab, an injectable human monoclonal antibody with affinity for nuclear factor-kappa ligand (RANKL), is an effective treatment for osteoporosis in postmenopausal women and men. Unlike the bisphosphonates, the pharmacokinetics and pharmacodynamics of denosumab are not influenced by the renal function and are being increasingly used for patients having CKD-MBD with low bone mineral density (BMD) to reduce the risk of fragility fractures. Hypocalcemia is a known side effect of this drug along with compensatory increase in parathyroid hormone (PTH). However, limited information is available in the literature regarding this potentially life-threatening side effect with denosumab in end-stage renal disease (ESRD) patients on dialysis. We present a patient with ESRD on peritoneal dialysis who developed severe symptomatic hypocalcemia and dramatic increase in PTH following denosumab therapy. She was conservatively managed with calcium supplementation and appropriate adjustment in calcium dialysate. We have also reviewed the literature on the use of denosumab in dialysis patients and looked at additional factors that may precipitate severe hypocalcemia in these patients. We believe that denosumab should be used with caution in dialysis patients since it may lead to profound hypocalcemia. Clinicians should ensure special attention in recognizing patients at risk of developing this serious adverse effect, so that prompt treatment and preventive strategies can be implemented.
Coating Performance of Water-Based Polyurethane-Acrylate Coating on Bamboo/Bamboo Scrimber Substrates
Authors: Xu Jianfeng , Liu Ru , Wu Huagui , Qiu Hongyun , Yu Yanglun , Long Ling
Published: March 2019

In this paper, a kind of high solid content water-based polyurethane-acrylate (PUA) coating was synthesized in laboratory. Bamboo, bamboo scrimber, and heat-treated bamboo scrimber were selected as substrates and coated with the PUA coating. The coating properties of those materials were investigated. The results showed that PUA coating could well cover the surface of the three kinds of materials. However, the coating performances varied among these substrates due to their different chemical and morphological surfaces. Due to the densified structures, small pores, and improved hydrophobicity of bamboo scrimber, it was difficult for PUA coating to wet and penetrate into the substrate, where the smaller contact angle and penetration depth were obtained compared with bamboo. In contrast, heat-treated one had better hydrophilicity and smaller contact angle with PUA coating than pure bamboo scrimber. Therefore, the coating performance of heat-treated bamboo scrimber was better with lower average roughness value. However, the adhesion classification between the coating and all substrates was 2 (with 5-15% cross-cut area of flaking along the edges).