bluuebunny/crossref_metadata_2025 huggingface dataset:
Interventional Pain Treatments in the Management of Oncologic Patients With Thoracic Spinal Tumor–Related Pain: A Case Series
Authors: Rispoli Leia , Rakesh Neal , Shah Rita , Gulati Amitabh
Published: July 2019

Background

Advanced tumors of the thoracic spine are difficult to treat and can lead to complex pain syndromes. Following conventional oncologic treatments, pharmacologic therapy may be insufficient to manage pain. Minimally invasive interventional procedures offer alternatives to treat malignant thoracic spinal pain.

Methods

Thirteen patients with metastatic disease and poorly controlled thoracic axial and/or radicular pain were identified via a retrospective chart review. Patients were either treated with radiation, surgery, chemotherapy, or a combination of these. Then, the patients were organized into groups based on their diagnoses, anatomical disease locations, symptoms, prior treatments, and interventional pain procedures offered.

Results

All cases of intercostal nerve, costotransverse junction, erector spinae plane, and paravertebral blocks resulted in pain relief without any reported complications. A patient who received a thoracic epidural injection had a complete resolution of pain when combined with radiation therapy 2 weeks after the injection. One patient who underwent repeat thoracic epidural injections eventually had an intrathecal pump placement, resulting in reduced opioid usage. Finally, 1 patient who received a thoracic medial branch block with a relief of thoracic axial pain reported greater pain relief with a medial branch nerve cryoablation.

Conclusion

We propose a treatment algorithm to manage patients with thoracic spinal tumor–related pain. Interventional thoracic axial procedures may be safe and efficacious pain treatments for patients with cancer.
A dynamic yet vulnerable pipeline: Integration and coordination of hydraulic traits across whole plants
Authors: McCulloh Katherine A. , Domec Jean‐Christophe , Johnson Daniel M. , Smith Duncan D. , Meinzer Frederick C.
Published: July 2019

The vast majority of measurements in the field of plant hydraulics have been on small‐diameter branches from woody species. These measurements have provided considerable insight into plant functioning, but our understanding of plant physiology and ecology would benefit from a broader view, because branch hydraulic properties are influenced by many factors. Here, we discuss the influence that other components of the hydraulic network have on branch vulnerability to embolism propagation. We also modelled the impact of changes in the ratio of root‐to‐leaf areas and soil texture on vulnerability to hydraulic failure along the soil‐to‐leaf continuum and showed that hydraulic function is better maintained through changes in root vulnerability and root‐to‐leaf area ratio than in branch vulnerability. Differences among species in the stringency with which they regulate leaf water potential and in reliance on stored water to buffer changes in water potential also affect the need to construct embolism resistant branches. Many approaches, such as measurements on fine roots, small individuals, combining sap flow and psychrometry techniques, and modelling efforts, could vastly improve our understanding of whole‐plant hydraulic functioning. A better understanding of how traits are coordinated across the whole plant will improve predictions for plant function under future climate conditions.
Examining the item response process to personality measures in high‐stakes situations: Issues of measurement validity and predictive validity
Authors: Zhang Bo , Cao Mengyang , Tay Louis , Luo Jing , Drasgow Fritz
Published: July 2019

We conducted two experimental studies with between‐subjects and within‐subjects designs to investigate the item response process for personality measures administered in high‐ versus low‐stakes situations. Apart from assessing measurement validity of the item response process, we examined predictive validity; that is, whether or not different response models entail differential selection outcomes. We found that ideal point response models fit slightly better than dominance response models across high‐ versus low‐stakes situations in both studies. Additionally, fitting ideal point models to the data led to fewer items displaying differential item functioning compared to fitting dominance models. We also identified several items that functioned as intermediate items in both the faking and honest conditions when ideal point models were fitted, suggesting that ideal point model is “theoretically” more suitable across these contexts for personality inventories. However, the use of different response models (dominance vs. ideal point) did not have any substantial impact on the validity of personality measures in high‐stakes situations, or the effectiveness of selection decisions such as mean performance or percent of fakers selected. These findings are significant in that although prior research supports the importance and use of ideal point models for measuring personality, we find that in the case of personality faking, though ideal point models seem to have slightly better measurement validity, the use of dominance models may be adequate with no loss to predictive validity.
Paediatric donation after circulatory determined death heart transplantation using donor normothermic regional perfusion and ex situ heart perfusion: A case report
Authors: Khushnood Abbas , Butt Tanveer A. , Jungschleger Jerome , Henderson Paul , Smith Jonathan H. , De Rita Fabrizio , Nassar Mohamed , Page Aravinda , Messer Simon , Large Stephen , Dark John H. , Parry Gareth , Reinhardt Zdenka , Hasan Asif
Published: July 2019

This is a report of a unique DCD paediatric heart transplant whereby normothermic regional perfusion was used to assess DCD heart function after death followed by ex situ heart perfusion of the graft during transportation from donor to recipient hospitals. The DCD donor was a 9‐year‐old boy weighing 84 kg. The recipient was 7‐year‐old boy with failing Fontan circulation and weighed 23 kg. It was an ABO‐compatible heart transplantation. The DCD heart was reperfused and assessed using normothermic regional perfusion followed by portable ex situ heart perfusion during transportation. The orthotopic heart transplantation was successful with good graft function and no evidence of rejection on endomyocardial biopsy at 30 days post‐transplant. At 1‐year follow‐up, excellent graft function is maintained, and he is attending school with a good quality of life. DCD heart transplantation in children is a promising solution to reducing paediatric waiting times. The case demonstrates the feasibility of using normothermic regional perfusion in the donor and ex situ heart perfusion during graft transportation. This combination allowed a functional assessment whilst minimizing warm ischaemia resulting in a successful outcome. More research and long‐term follow‐up are needed in order to benefit from the huge potential that paediatric DCD heart transplantation has to offer.
A case report of cutaneous melanocytoma with CRTC1‐TRIM11 fusion: Is CMCT distinct from clear cell sarcoma of soft tissue?
Authors: Kashima Jumpei , Motoi Toru , Nishimaki Miyuki , Hayashi Yukiko , Ogawa Masumi , Kato Ikuma , Yamada Rin , Tonooka Akiko , Horiguchi Shin‐ichiro , Funata Nobuaki , Hishima Tsunekazu , Yoshino Koji
Published: July 2019

Pathological diagnosis of dermal melanocytic tumors is often problematic owing to histological resemblance. Recently, cutaneous melanocytoma with CRTC1‐TRIM11 (CMCT) was added to this category. However, only six cases have been reported so far. We herein present a case of a 77‐year‐old Japanese man with CMCT. The patient presented a nodule in the right thigh and underwent surgical resection. Histological examination indicated a well‐demarcated 6 × 5 mm‐sized tumor nodule in the dermis and subcutis. The tumor was amelanotic, consisting of uniform nests and fascicles of spindled, or epithelioid cells. The melanocytic nature was evident by immunohistochemistry. The
CRTC1‐TRIM11 fusion was detected by TRIM11 immunostaining, chromogenic in situ hybridization, and RT‐PCR/direct sequencing. He has been free from the tumor for 1 year after additional resection. The main differential diagnosis of CMCT includes primary and metastatic dermal malignant melanomas (MM) and dermal/subcutaneous clear cell sarcoma (CCS). Additionally, histological overlap with paraganglioma‐like dermal melanocytic tumor was considered. Although some investigators argue that CMCT is a variant of CCS, we think it should be separated from CCS, and subcutaneous/dermal CCS should be confined to tumors with
EWSR1‐ATF1/ CREB1 fusion. However, longer follow‐up and more case studies are needed for revealing the true prognosis of CMCT.
Lower‐lobe predominant pleuroparenchymal fibroelastosis
Authors: Kinoshita Yoshiaki , Watanabe Kentaro , Ishii Hiroshi , Kushima Hisako , Nabeshima Kazuki
Published: July 2019

Upper‐lobe predominance of elastofibrosis is agreed upon for the diagnosis of clinical pleuroparenchymal fibroelastosis (PPFE). We herein describe a patient with dermatomyositis‐related interstitial pneumonia with a histology of lower‐lobe predominant PPFE. A 71‐year‐old woman who had been diagnosed with dermatomyositis‐related interstitial pneumonia died of respiratory failure. The computed tomography patterns of the lower lobes showed reticular and ground‐glass opacities with traction bronchiectasis. An autopsy revealed that the bilateral lower lobes were sclerotic with decreased air volume. A microscopic examination of the lower lobes showed pleural fibrosis and subpleural elastofibrosis without the structural destruction, indicative of histological PPFE. PPFE histology was also evident in the upper lobes but relatively modest compared to that of the lower lobes. In addition, because the computed tomography images of the patient were suggestive of non‐PPFE‐type fibrosis, lower‐lobe dominant PPFE might be overlooked in daily practice.
The significance of lipid accumulation in breast carcinoma cells through perilipin 2 and its clinicopathological significance
Authors: Kuniyoshi Shimpei , Miki Yasuhiro , Sasaki Akari , Iwabuchi Erina , Ono Katsuhiko , Onodera Yoshiaki , Hirakawa Hisashi , Ishida Takanori , Yoshimi Naoki , Sasano Hironobu
Published: July 2019

Both systemic and intratumoral lipid metabolism have been recently reported to play pivotal roles in both tumor development and progression in various human malignancies including breast cancer. However, its details have remained largely unknown in breast cancer patients. Therefore, in this study, we focused on perilipin 2, which is involved in constituting the intracellular lipid composition. Perilipin 2 was first immunolocalized in 105 cases of breast cancer. The status of perilipin 2 immunoreactivity was significantly positively associated with histological grade, Ki‐67 labeling index and HER2 status and negatively with estrogen receptor status of these patients. Subsequent in vitro study also revealed that its mRNA expression in triple negative breast carcinoma cells was higher than cells of other subtypes. We then examined the correlation between perilipin 2 immunoreactivity and intracellular lipid droplet evaluated by Oil‐red O stating in 13 cases of breast carcinoma tissues. A significantly positive correlation was detected between the status of perilipin 2 and Oil‐red O staining. These findings above did indicate that perilipin 2 could represent the status of intracellular lipid droplets in surgical pathology specimens of breast cancer and perilipin 2 was also associated with its more aggressive biological phenotypes.
Pollination and fruit set in two rewardless slipper orchids and their hybrids (Cypripedium, Orchidaceae): large yellow flowers outperform small white flowers in the northern tall grass prairie
Authors: Grantham M. A. , Ford B. A. , Worley A. C.
Published: July 2019

Species with rewardless flowers often have low fruit to flower ratios, although wide temporal and spatial variation in fruiting success can occur. We compared floral phenotypes, insect visitors and fruiting success in four populations of the small white (Cypripedium candidum) and yellow (C. parviflorum) lady’s slipper orchids and their hybrids near the northern extent of North America’s tall grass prairie.

Flower and fruit numbers were observed for two seasons on marked individuals (n = 1811). Floral traits were measured on 82–140 individuals per taxon and analysed in relation to fruiting success. All insects found inside flowers were collected, inspected for pollen smears and measured for comparison to floral features.

Among orchid taxa,C. candidumhad the smallest flowers, lowest number and variety of insect visitors, and lowest fruit to flower ratios. These measures were intermediate in hybrids and highest inC. parviflorum, despite low flower numbers in the latter. Within orchid taxa, fruit number was positively related to flower number, but fruit to flower ratios decreased slightly, as would be expected if pollinators left unrewarding patches. Potential pollinators included the dipteranOdontomyia pubescensand hymenopteransAndrenaspp.,Apis melliferaandLasioglossum zonulum.

Cypripedium parviflorumhad a reproductive advantage overC. candidumacross multiple populations and years. Hybrids showed segregation for floral traits, and hybrid fruiting success increased with a deeper intensity of yellow pigment and larger escape routes for floral visitors. These same attributes likely contributed to the relatively high fruit set inC. parviflorumin the study region.
Polls and Elections: Presidential Referendum Effects in the 2018 Midterm Election: An Initial Analysis
Authors: Cohen Jeffrey E.
Published: July 2019

Using the recently released American National Election Studies (ANES) 2018 Pilot Study, this article tests for presidential referendum effects in House, Senate, and gubernatorial contests during that election cycle. Results find strong presidential referendum effects in spite of the considerable correlation between presidential approval and several political predispositions, notably partisan and ideological identification. Weak electoral performance of Republican candidates was due to President Donald Trump's overall low approval ratings. However, Trump approvers appeared more inclined to turn out to vote than disapprovers, which softened the negative effect of Trump's weak approval polls on Republican candidate vote totals. The conclusion discusses the potential implications of these findings for the upcoming 2020 presidential elections, especially if Trump approvers continue their turnout advantage over disapprovers.
Factors Influencing Undergraduate Students’ Intention to Use Evidence‐Based Practice After Graduation: Development and Validation of a Theory‐Based Prediction Model
Authors: Ramis Mary‐Anne , Chang Anne , Nissen Lisa
Published: July 2019

Background

Despite curriculum requirements for evidence‐based practice (EBP) to be a key component of undergraduate health students’ training, few studies have investigated factors influential to students’ intention to use EBP after graduation. Self‐efficacy is known to mediate and motivate behavior; therefore, it may be a crucial factor linking undergraduate students’ EBP education and adoption of positive EBP behaviors.

Aims

To develop, test, and validate a multivariate, theory‐based prediction model with the outcome of students’ intention to use EBP after graduation.

Methods

A correlational study with structural equation modeling was conducted. Model factors were determined from Bandura's self‐efficacy theory and previous literature. An online survey comprised of seven validated scales and a demographic tool was distributed to a sample of undergraduate nursing and paramedic students. Two episodes of data collection were conducted to test and validate the model.

Results

Evidence‐based practice beliefs directly and significantly influenced student intention to use EBP in both models. Sources of EBP self‐efficacy also had significant but indirect influence on the outcome variable. Overall variance for intention to use EBP was 25% for the initial model and 18% for the validated model.

Linking Evidence to Action

Evidence‐based practice curriculum that supports positive EBP beliefs and integrates Bandura's sources of self‐efficacy has potential to positively influence students’ intention to use EBP after graduation.
Adding intestinal insult to skin injury
Authors: Gowthaman Uthaman , Eisenbarth Stephanie C.
Published: July 2019

Mechanical skin injury promotes food allergy.
Human CD4
+
CD103
+
cutaneous resident memory T cells are found in the circulation of healthy individuals
Authors: Klicznik Maria M. , Morawski Peter A. , Höllbacher Barbara , Varkhande Suraj R. , Motley Samantha J. , Kuri-Cervantes Leticia , Goodwin Eileen , Rosenblum Michael D. , Long S. Alice , Brachtl Gabriele , Duhen Thomas , Betts Michael R. , Campbell Daniel J. , Gratz Iris K.
Published: July 2019

Human blood and lymph contain circulating CD4
+
CD103
+
cutaneous resident memory T cells that can seed distant skin sites. See the related Focus by
Carbone and Gebhardt
.
Should I stay or should I go—Reconciling clashing perspectives on CD4
+
tissue-resident memory T cells
Authors: Carbone Francis R. , Gebhardt Thomas
Published: July 2019

Two recent studies on CD4
+
T cells in nonlymphoid tissues reveal a combination of memory cell retention and emigration. See the related Research Article by

Klicznik
et al
.
Binding is not enough; autoantibodies do more to garner complements
Authors: Ruff William E. , O’Connor Kevin C.
Published: July 2019

Pathogenic autoantibodies in neuromyelitis optica require antigen array assembly and a specific epitope to initiate robust complement activation.
Insights into past ocean proxies from micron-scale mapping of sulfur species in carbonates
Authors: Rose Catherine V. , Webb Samuel M. , Newville Matthew , Lanzirotti Antonio , Richardson Jocelyn A. , Tosca Nicholas J. , Catalano Jeffrey G. , Bradley Alexander S. , Fike David A.
Published: July 2019

Geological reconstructions of global ocean chemistry and atmospheric oxygen concentrations over Earth history commonly rely on the abundance and stable isotopic composition (δ34S) of sulfur-bearing compounds. Carbonate-associated sulfate (CAS), sulfate bound within a calcium carbonate mineral matrix, is among the most commonly interrogated sulfur mineral phases. However, recent work has revealed variability in δ34SCAS values that cannot be explained by evolution of the marine sulfate reservoir, challenging the common interpretation that CAS is inherently a high-fidelity record of seawater sulfate. To investigate the source of this inconsistency, we used X-ray spectromicroscopy to map the micron-scale distribution of S-bearing sedimentary phases in Ordovician-aged (ca. 444 Ma) shallow marine carbonates from Anticosti Island, Québec, Canada. Clear differences in the abundance of CAS are observed between cements and fossils, suggesting that variance in bulk-rock data could be a consequence of component mixing and that coupled synchrotron-petrographic screening can identify the carbonate components that are most likely to retain primary CAS. Furthermore, we observe multiple, distinct forms of sulfate (both inorganic and organic). Differences in these forms among fossil clades could provide new insights into biomineralization mechanisms in extinct organisms.
Fifteen-minute consultation: Assessing the child with a Blalock-Taussig shunt who is unwell in a district general hospital
Authors: McVea Steven , McGettrick Anne
Published: July 2019

Univentricular heart disease accounts for ~1.25% of all congenital heart disease. Such cases remain among the most challenging to manage, typically requiring a three-staged palliation. The first stage involves placement of a systemic to pulmonary shunt. While a variety of shunt types, including ductal stenting, can be used to manage univentricular conditions, the archetype remains the Blalock-Taussig (BT) shunt. While waiting future palliative intervention at home, intercurrent illness may necessitate presentation to a district general hospital where subspecialist advice and assessment is remote. This review aims to present the general paediatrician with a straightforward BT shunt physiology overview highlighting unique complications which may complicate intercurrent illness.
Helping Babies Breathe and its effects on intrapartum-related stillbirths and neonatal mortality in low-resource settings: a systematic review
Authors: Versantvoort Jorien M D , Kleinhout Mirjam Y , Ockhuijsen Henrietta D L , Bloemenkamp Kitty , de Vries Willem B , van den Hoogen Agnes
Published: July 2019

Background

An important factor in worldwide neonatal mortality is the deficiency in neonatal resuscitation skills among trained professionals. ‘Helping Babies Breathe’ (HBB) is a simulation-based training course designed to train healthcare professionals in the initial steps of neonatal resuscitation in low-resource areas. The aim of this systematic review is to provide an overview of the available evidence regarding intrapartum-related stillbirths and neonatal mortality related to the HBB training and resuscitation method.

Data sources

Cochrane, CINAHL, Embase, PubMed and Scopus.

Study eligibility criteria

Conducted in low-resource settings focusing on the effects of HBB on intrapartum-related stillbirths and neonatal mortality.

Study appraisal

Included studies were reviewed independently by two researchers in terms of methodological quality.

Data extraction

Data were extracted by two independent reviewers and crosschecked by one additional reviewer.

Results

Seven studies were included in this systematic review; the selected studies included a total of 230.797 neonates. Significant decreases were found after the implementation of HBB in one of two studies describing perinatal mortality (n=25 108, rate ratio (RR) 0.75; p<0.001), four out of six studies related to intrapartum-related stillbirths (n=125.720, RR 0.31–0.76), in four out of five studies focusing on 1 day neonatal mortality (n=111.289, RR 0.37–0.67), and one out of three studies regarding 7 day neonatal mortality (n=4.390, RR 0.32). No changes were seen in late neonatal mortality after HBB training and resuscitation method.

Limitations

Included studies in were predominantly of moderate quality, therefore no strong recommendations can be made.

Conclusions and implications of key findings

Due to the heterogeneous quality of the studies, this systematic review showed moderate evidence for a decrease in intrapartum-related stillbirth and 1-day neonatal mortality rate after implementing the ‘Helping Babies Breathe’ training and resuscitation method. Further research is required to address the effects of simulation-based team training on morbidity and mortality beyond the initial neonatal period.

PROSPERO registration number

CRD42018081141.
Multiple pipeline twists encountered during treatment of a symptomatic fusiform ICA aneurysm
Authors: Young Robert W , Bender Matthew T , Colby Geoffrey P , Coon Alexander L
Published: July 2019

Pipeline embolisation device (PED) ‘twisting’ is an intra-operative complication that manifests with the appearance of a ‘figure-8’ in perpendicular planes on digital subtraction angiography. A twisted PED causes narrowing and/or complete occlusion of the vessel lumen and poses significant risks for thrombus formation and downstream ischaemia. Here, we present a case in which three unique PED implants become twisted during pipeline embolisation of a large fusiform internal carotid artery aneurysm. The twists were remediated by balloon angioplasty and a combination of techniques that allowed the PED to rotate and restore its original axis. Six-month and twelve-month follow-up angiography demonstrated complete aneurysm occlusion with preservation of the parent vessel, proving that proper remediation of PED twisting can still result in successful long-term outcomes.
Simulating vascular leakage on optical coherence tomography angiography using an overlay technique with corresponding thickness maps
Authors: de Carlo Talisa E , Zahid Sarwar , Bohm Kelley J , Chan R V Paul , Lim Jennifer I , Mieler William F
Published: July 2019

Background

To demonstrate a technique for using optical coherence tomography angiography (OCTA) to simulate leakage in eyes with diabetic macular oedema and determine the sensitivity and positive predictive value of detecting leaking microvasculature on OCTA using fluorescein angiography (FA) as the comparative norm.

Methods

6×6 mm OCT angiograms were overlaid with the corresponding OCT thickness maps. Microvascular abnormalities on the OCT angiogram underlying areas of thickening on the OCT thickness map were assumed to be leaking. Two independent readers blindly read the OCTA overlay images then the FA images cropped to the same approximate region to delineate areas of leaking microvasculature. The results were compared to determine the sensitivity and positive predictive value of OCTA for detection of leaking vessels.

Results

28 eyes of 19 diabetic patients were included. Each eye demonstrated an average of seven leaking microvascular abnormalities on the OCTA images and 22 leaking abnormalities on the FA images. Sensitivity of leaking microvasculature detection by OCTA was 26.1% and positive predictive value was 68.4%. The correlation coefficient of the two readers’ detection of leaking microvasculature was 0.605 for OCTA reads compared with 0.916 for FA.

Conclusion

OCTA as a whole can be used to simulate leakage, but currently, sensitivity of the technique is low. Further understanding of the OCTA technology may yield novel means of detecting retinal pathology.
Neurodevelopmental delay in normocephalic children with in utero exposure to Zika virus
Authors: Faiçal Adriana Virginia , de Oliveira Juliana Cabral , Oliveira João Vitor Vieira , de Almeida Breno Lima , Agra Iluska Andrade , Alcantara Luiz Carlos Junior , Acosta Angelina Xavier , de Siqueira Isadora Cristina
Published: July 2019

Neurodevelopment in 29 normocephalic children with in utero exposure to Zika virus (ZIKV) was evaluated by the Bayley Scales of Infant and Toddler Development-Third Edition. Ten (35%) infants presented neurodevelopment delay. Language, cognitive and motor delays were identified in 9 (31%), 4 (14%) and 1 (3%) infants, respectively. Children exposed to ZIKV in utero must undergo careful evaluations for the early detection of any neurodevelopment delays in order to implement prompt intervention.
British Society of Gastroenterology guidelines on the diagnosis and management of patients at risk of gastric adenocarcinoma
Authors: Banks Matthew , Graham David , Jansen Marnix , Gotoda Takuji , Coda Sergio , di Pietro Massimiliano , Uedo Noriya , Bhandari Pradeep , Pritchard D Mark , Kuipers Ernst J , Rodriguez-Justo Manuel , Novelli Marco R , Ragunath Krish , Shepherd Neil , Dinis-Ribeiro Mario
Published: July 2019

Gastric adenocarcinoma carries a poor prognosis, in part due to the late stage of diagnosis. Risk factors includeHelicobacter pyloriinfection, family history of gastric cancer—in particular, hereditary diffuse gastric cancer and pernicious anaemia. The stages in the progression to cancer include chronic gastritis, gastric atrophy (GA), gastric intestinal metaplasia (GIM) and dysplasia. The key to early detection of cancer and improved survival is to non-invasively identify those at risk before endoscopy. However, although biomarkers may help in the detection of patients with chronic atrophic gastritis, there is insufficient evidence to support their use for population screening. High-quality endoscopy with full mucosal visualisation is an important part of improving early detection. Image-enhanced endoscopy combined with biopsy sampling for histopathology is the best approach to detect and accurately risk-stratify GA and GIM. Biopsies following the Sydney protocol from the antrum, incisura, lesser and greater curvature allow both diagnostic confirmation and risk stratification for progression to cancer. Ideally biopsies should be directed to areas of GA or GIM visualised by high-quality endoscopy. There is insufficient evidence to support screening in a low-risk population (undergoing routine diagnostic oesophagogastroduodenoscopy) such as the UK, but endoscopic surveillance every 3 years should be offered to patients with extensive GA or GIM. Endoscopic mucosal resection or endoscopic submucosal dissection of visible gastric dysplasia and early cancer has been shown to be efficacious with a high success rate and low rate of recurrence, providing that specific quality criteria are met.
Phenotypic features of patients with complex regional pain syndrome compared with those with neuropathic pain
Authors: Alam Osman H , Zaidi Bilal , Pierce Jennifer , Moser Stephanie E , Hilliard Paul E , Golmirzaie Goodarz , Brummett Chad M
Published: July 2019

Introduction

We hypothesized that patients with complex regional pain syndrome (CRPS) would describe a more negative pain phenotype including higher pain severity, more neuropathic pain descriptors, more centralized pain symptoms, poorer physical function, and more affective distress when compared with patients with neuropathic pain of the extremities not meeting CRPS criteria.

Materials and methods

This was a retrospective cross-sectional study conducted at a tertiary pain center. The sample included 212 patients who met Budapest Criteria for CRPS and 175 patients with neuropathic pain of the extremities who did not meet criteria. All patients completed a packet of questionnaires before their initial visit containing validated outcome measures assessing pain severity, pain interference, physical functioning, depression, anxiety, and catastrophizing.

Results

Patients with CRPS reported higher physical disability (p=0.022) and more neuropathic pain symptoms (p=0.002) than patients not meeting CRPS criteria, but the groups did not otherwise differ significantly. There were no significant differences in pain severity or affective distress, despite power analyses suggesting the ability to detect small to medium effect sizes (d=0.29; w=0.14). Subanalyses of differences in neuropathic pain symptoms revealed that patients with CRPS, compared with patients not meeting CRPS criteria, were more likely to report pain with light touch (p=0.003), sudden pain attacks (p=0.003), pain with cold or heat (p=0.002), sensation of numbness (p=0.042), and pain with slight pressure (p=0.018).

Discussion

Counter to our hypothesis, the present study suggests that patients with CRPS do not have a worse clinical phenotype compared with patients not meeting CRPS criteria, with the exception of higher physical disability and more neuropathic pain symptoms. This corresponds to recent evidence that patients with CRPS are similar to other patient populations with chronic pain.
Home versus outpatient pulmonary rehabilitation in COPD: a propensity-matched cohort study
Authors: Nolan Claire Marie , Kaliaraju Djeya , Jones Sarah Elizabeth , Patel Suhani , Barker Ruth , Walsh Jessica A , Wynne Stephanie , Man William
Published: July 2019

Home-based exercise has been proposed as an equivalent treatment strategy to supervised outpatient pulmonary rehabilitation (PR), but it is not known whether its implementation into clinical practice produces similar benefits to those observed in trials. We compared the real-world responses of 154 patients with COPD undergoing home-based exercise with a matched group attending supervised PR. We observed smaller improvements in exercise capacity with home-based exercise compared with PR, but similar improvements in quality of life. We propose that supervised PR remains the standard of care, with home-based exercise a less effective alternative for those unable to attend PR.
Osteogenesis and dentinogenesis imperfecta in a four‐month‐old English mastiff
Authors: Gold Randi , Pool Roy R , Edwards Erin E
Published: July 2019

Osteogenesis imperfecta, also known as ‘brittle bone disease’, is an inherited connective tissue disorder caused by defects in type 1 collagen. The disease results in low bone mass and reduced bone strength, often manifesting as multiple intrauterine fractures, skeletal abnormalities and death before adulthood. A four‐month‐old, female entire, English mastiff was presented for multiple limb fractures. Due to a poor prognosis, euthanasia was elected. Gross examination revealed diffuse osteopenia with multiple chronic and acute skeletal fractures. All adult teeth were undersized and opalescent, and multiple deciduous incisors were retained. Histopathology of the long bones demonstrated severe, diffuse osteopenia with retention of non‐ossified cartilage spicules in the secondary spongiosa. The incisor teeth had multifocal disorganisation of odontoblasts and ameloblasts that exhibited piling (dysplasia) and hypoplasia of the dentin. Diagnoses of osteogenesis imperfecta and dentinogenesis imperfecta were made. Osteogenesis imperfecta should be considered as a cause of diffuse osteopenia in young dogs.
Size of free groups in varieties generated by finite groups
Authors: Cocke William
Published: July 2019

The number of distinct [Formula: see text]-variable word maps on a finite group [Formula: see text] is the order of the rank [Formula: see text] free group in the variety generated by [Formula: see text]. For a group [Formula: see text], the number of word maps on just two variables can be quite large. We improve upon previous bounds for the number of word maps over a finite group [Formula: see text]. Moreover, we show that our bound is sharp for the number of 2-variable word maps over the affine group over fields of prime order and over the alternating group on five symbols.
A measure for quantum paths, gravity and spacetime microstructure
Authors: Padmanabhan T.
Published: July 2019

The number of classical paths of a given length, connecting any two events in a (pseudo) Riemannian spacetime is, of course, infinite. It is, however, possible to define a useful, finite, measure [Formula: see text] for the effective number of quantum paths [of length [Formula: see text] connecting two events [Formula: see text]] in an arbitrary spacetime. When [Formula: see text], this reduces to [Formula: see text] giving the measure for closed quantum loops of length [Formula: see text] containing an event [Formula: see text]. Both [Formula: see text] and [Formula: see text] are well-defined and depend only on the geometry of the spacetime. Various other physical quantities like, for e.g. the effective Lagrangian, can be expressed in terms of [Formula: see text]. The corresponding measure for the total path length contributed by the closed loops, in a spacetime region [Formula: see text], is given by the integral of [Formula: see text] over [Formula: see text]. Remarkably enough [Formula: see text], the Ricci scalar; i.e. the measure for the total length contributed by infinitesimal closed loops in a region of spacetime gives us the Einstein–Hilbert action. Its variation, when we vary the metric, can provide a new route towards induced/emergent gravity descriptions. In the presence of a background electromagnetic field, the corresponding expressions for [Formula: see text] and [Formula: see text] can be related to the holonomies of the field. The measure [Formula: see text] can also be used to evaluate a wide class of path integrals for which the action and the measure are arbitrary functions of the path length. As an example, I compute a modified path integral which incorporates the zero-point-length in the spacetime. I also describe several other properties of [Formula: see text] and outline a few simple applications.
Cosmological implications of Tsallis dark energy in modified Brans–Dicke theory
Authors: Jawad Abdul , Aslam Asma , Rani Shamaila
Published: July 2019

Tsallis entropy has been widely applied to analyze the gravitational and cosmological setups. We discuss the dark energy (DE) model by its cosmological consequences using Tsallis holographic entropy in the framework of modified Brans–Dicke (BD) gravity. We consider the Hubble horizon as infrared cutoff to study the nature of DE that is responsible for current cosmic acceleration. We focus on flat FRW universe in interacting and noninteracting scenarios between DE and dark matter (DM). In this framework, we discuss the cosmological parameters like equation of state parameter, deceleration parameter, Om-diagnostic, squared speed of sound and planes like evolving equation of state parameter and statefinders. We discuss graphical presentation of these parameters and planes. We compare the results with observation data to check the consistency of results.
FRACTAL-BASED ANALYSIS OF THE RELATION BETWEEN THE FRACTAL STRUCTURES OF MACHINED SURFACE AND TOOL WEAR IN TURNING OPERATION
Authors: KIEW CHAI LIP , BRAHMANANDA AKSHAYEN , ISLAM KH TAUHID , LEE HAO NAM , VENIER SAMUEL ANTHONY , SARAAR ASHIR , NAMAZI HAMIDREZA
Published: July 2019

Obtaining the optimum surface finish is one of the key factors in machining operations. For this purpose, engineers apply a set of machining parameters to obtain the desired surface quality. On the other hand, tool faces wear during machining operation that itself affects the surface quality of machined surface. Therefore, tool wear and surface finish of machined workpiece should be related to each other. In this research, we employ fractal analysis in order to investigate the correlation between variations of complex structure of machined surface and tool wear in turning operation. In fact, we changed the machining parameters between different experiments and investigated how the machined surface is correlated with the tool wear. Based on the obtained results, we can see the correlation between the complexity of machined surface and tool wear by increasing the depth of cut, spindle speed and feed rate in different experiments. The method of analysis employed in this research can be widely applied to other machining operations in order to find the correlation between the surface quality of machined surface and tool wear.
AVERAGE DISTANCE OF SUBSTITUTION NETWORKS
Authors: YE QIANQIAN , XI LIFENG
Published: July 2019

The substitution network is a deterministic model of evolving self-similar networks. For normalized substitution networks, the limit of metric spaces with respect to networks is a self-similar fractal and the limit of average distances on networks is the integral of geodesic distance of the fractal on the self-similar measure. After some technical handles, we establish the finiteness of integrals and obtain a linear equation set to solve the average distance on the fractal.
ANALYSIS ON THE TIME-FREQUENCY CHARACTERISTICS OF ULTRASONIC WAVEFORM OF COAL UNDER UNIAXIAL LOADING
Authors: ZHANG ZHIBO , WANG ENYUAN , ZHANG YINGHUA , YANG SHUAI , LIU XIANAN , ALI MUHAMMAD , QI GUANSHENG
Published: July 2019

Ultrasonic receiving wave can reflect physical properties and damage degree of coal samples. Therefore, it is of great significance to deeply study the parameters of ultrasonic. In this paper, time-domain characteristics of receiving wave are analyzed systematically, which present good correlation with stress. The frequency spectrum of receiving wave is obtained using Fast Fourier Transform (FFT), and peak frequency and centroid frequency are calculated. During the entire loading process, peak frequency fluctuates around 110[Formula: see text]kHz, but corresponding centroid frequency decreases obviously at the end stage of loading. According to multifractal theory, the multifractal spectrum of wavelet packet energy characteristics is calculated. The results show that wavelet packet energy distribution has obvious multifractal characteristics, and multifractal parameter [Formula: see text] presents downward trend before coal samples buckling failure. Based on damage process of the coal samples, the reason of change in [Formula: see text] value is related to damage degree of coal samples. This research is of great significance for understanding the deformation and failure process of coal samples using ultrasonic technology.
TWO-DIMENSIONAL FRACTAL MODEL FOR ULTIMATE CRUSHING STATE OF COARSE AGGREGATES
Authors: YU QIANMI , LIU JIANKUN , PATIL UJWALKUMAR D. , CONGRESS SURYA S. C. , PUPPALA ANAND J.
Published: July 2019

The research on the ultimate crushing state of coarse aggregates is beneficial to analyze and predict the evolutionary process of crushing. The Growing Path method uses the two-dimensional fractal geometry structure to simulate the size variation of particle size fraction during the particle breakage of coarse aggregates and it serves to investigate the ultimate fractal dimension corresponding to the ultimate crushing state of coarse aggregates. This method manifests the self-growing characteristics of particle size distribution in the process of particle crushing. This study found that the two-dimensional image of ultimate fractal model was precisely similar to that of the Sierpinski gasket of fractal theory when the ultimate crushing state was reached. The results from the model analysis show that the theoretically ultimate fractal dimension is about 2.585, which is consistent with the existing results calculated from the three-dimensional ultimate fragmentation model of cataclastic rock located in the fault zones. The relationship between two fractal models was analyzed. Furthermore, the application of fractal geometry presented in this study will also serve as a reference for the analysis of the other chaos phenomena observed in geotechnical engineering.
Distributed Drone Traffic Coordination Using Triggered Communication
Authors: Zaini Abdul Hanif , Xie Lihua
Published: July 2019

This paper proposes a low complexity distributed multi-agent coordination algorithm for agents to reach their target positions in dense traffic under limited communication. Each single-integrator agent is limited to communicating with only one other agent at a time in consideration of limited bandwidth. We adapt the Velocity Obstacle collision avoidance method from literature to the limited communication problem by incorporating Voronoi Cells and repulsion in our hybrid algorithm. We also introduce a priority system for distributed coordination to avoid deadlocks and livelocks by having agent pairs make mutual decisions based on each agent’s conditional priority. An event trigger-based communication protocol is designed to determine when and to whom to communicate. Our method’s effectiveness is demonstrated in simulations including 100 randomized scenarios of 50 agents. The simulations show that our proposed algorithm enables agents to reach their assigned target positions without deadlock and collision while requiring an average communication rate that is significantly lower than the control frequency.
Clinical Usefulness of HLA-B∗58:01 Genotyping in Gouty Arthritis
Authors: Yu Carrel Ka Lung , Mok Chi Chiu
Published: July 2019

Allopurinol is an effective urate lowering agent but may lead to rare but life-threatening severe cutaneous adverse reactions (SCAR). Genetic predisposition, age, sex, renal function, dosage and concomitant diuretic use are known risk factors of allopurinol related SCAR. Among these factors, HLA-B[Formula: see text]58:01 confers the highest risk. Frequency of the HLA-B[Formula: see text]58:01 allele varies significantly across different ethnic groups. Although the usefulness of HLA-5801 genotyping before initiation of allopurinol has been confirmed by clinical studies, its positive predictive value for SCAR is low because of the low prevalence of HLA-5801 in some localities. Thus, health economic analysis does not consistently show cost-effectiveness of universal screening of HLA-5801 before initiation of allopurinol. However, screening of this genotype in high-risk subjects, including those with renal impairment or advanced age, should be considered on individual basis.
Exacerbated effects of prorenin on hypothalamic magnocellular neuronal activity and vasopressin plasma levels during salt-sensitive hypertension
Authors: Pitra Soledad , Worker Caleb J. , Feng Yumei , Stern Javier E.
Published: July 2019

Accumulating evidence supports that the brain renin-angiotensin system (RAS), including prorenin (PR) and its receptor (PRR), two newly discovered RAS players, contribute to sympathoexcitation in salt-sensitive hypertension. Still, whether PR also contributed to elevated circulating levels of neurohormones such as vasopressin (VP) during salt-sensitive hypertension, and if so, what are the precise underlying mechanisms, remains to be determined. To address these questions, we obtained patch-clamp recordings from hypothalamic magnocellular neurosecretory neurons (MNNs) that synthesize the neurohormones oxytocin and VP in acute hypothalamic slices obtained from sham and deoxycorticosterone acetate (DOCA)-salt-treated hypertensive rats. We found that focal application of PR markedly increased membrane excitability and firing responses in MNNs of DOCA-salt, compared with sham rats. This effect included a shorter latency to spike initiation and increased numbers of spikes in response to depolarizing stimuli and was mediated by a more robust inhibition of A-type K+ channels in DOCA-salt compared with sham rats. On the other hand, the afterhyperpolarizing potential mediated by the activation of Ca2+-dependent K+ channel was not affected by PR. mRNA expression of PRR, VP, and the Kv4.3 K+ channel subunit in the supraoptic nucleus of DOCA-salt hypertensive rats was increased compared with sham rats. Finally, we report a significant decrease of plasma VP levels in neuron-selective PRR knockdown mice treated with DOCA-salt, compared with wild-type DOCA-salt-treated mice. Together, these results support that activation of PRR contributes to increased excitability and firing discharge of MNNs and increased plasma levels of VP in DOCA-salt hypertension.

NEW & NOTEWORTHY Our studies support that prorenin (PR) and its receptor (PRR) within the hypothalamus contribute to elevated plasma vasopressin levels in deoxycorticosterone acetate-salt hypertension, in part because of an exacerbated effect of PR on magnocellular neurosecretory neuron excitability; Moreover, our study implicates A-type K+ channels as key underlying molecular targets mediating these effects. Thus, PR/PRR stands as a novel therapeutic target for the treatment of neurohumoral activation in salt-sensitive hypertension.
Correlation of gene expression and clinical parameters identifies a set of genes reflecting LV systolic dysfunction and morphological alterations
Authors: Witt Eric , Hammer Elke , Dörr Marcus , Weitmann Kerstin , Beug Daniel , Lehnert Kristin , Nauck Matthias , Völker Uwe , Felix Stephan B. , Ameling Sabine
Published: July 2019

To gain new insights into the complex pathophysiology of dilated cardiomyopathy (DCM) we performed a quantitative approach to identify genes with expression patterns that linearly correlate with parameters of cardiac morphology (left ventricular end-diastolic diameter indexed by body surface are (LVEDDI), systolic function [LV ejection fraction (LVEF)], and serum levels of cardiac peptide hormone NH2-terminal probrain natriuretic peptide (NT-proBNP) in human endomyocardial biopsies of 47 DCM patients and eight individuals with normal LVEF. A set of genes was identified as common heart failure markers characterized by correlation of their expression with cardiac morphology, systolic function, and NT-proBNP. Among them are already known genes encoding e.g., the natriuretic peptide hormones NPPA and NPPB and its converting enzyme corin, but also potential new heart failure markers like EP300 antisense RNA1 and dimethylarginine dimethylaminohydrolase 1 (DDAH1) along with other genes with so far unknown relation to heart function. In contrast, the expression of other genes including the Ca2+ flux regulating genes phospholamban (PLN), sarcoplasmic/endoplasmic reticulum calcium ATPase 2 (SERCA), and extracellular matrix proteins showed significant correlation with LVEF and LVEDDI only. Those genes seem to reflect more specifically pathological alterations of systolic function and morphology in DCM hearts.