bluuebunny/crossref_metadata_2025 huggingface dataset:
Protocols for the Treatment of Essential Hypertension and Type II Diabetes Mellitus by Pharmacists in Ambulatory Care Clinics
Authors: Tiggelaar John M.
Published: February 2017

During the last several years, the pharmacist has acted as a primary-care provider for patients with selected chronic illnesses at an urban county health department. The pharmacist's responsibilities include examining patients, ordering laboratory tests and X-rays, and adjusting or prescribing medication.

In order to comply with health department regulations requiring the use of protocols by non-physician practitioners, and to better define the pharmacist's role, pharmacy protocols for the treatment of essential hypertension and type II diabetes mellitus have been developed. The protocols provide specific guidelines for the pharmacist involved in primary patient care. In addition, they describe a procedure for the selection and referral of patients.

These protocols can serve as a sound foundation by which other pharmacists involved with primary patient care treat essential hypertension and type II diabetes mellitus. They can easily be modified to suit a pharmacist's particular needs and situation.
Evaluation of a Therapeutic Drug Monitoring Program for Theophylline in a Teaching Hospital
Authors: Robinson J. Daniel , Taylor William J. , Wing David S. , Duff Henry J.
Published: February 2017

Studies concerning the value of therapeutic drug monitoring programs for theophylline have yielded contradictory findings. This study employed a prospective, single-blind, randomized, crossover design to evaluate the effect of a therapeutic drug monitoring program for theophylline. There were 410 serum theophylline assays performed in 169 patients. The average number of assays drawn incorrectly and the average number of assays used inappropriately were significantly reduced (from 1.87 to 1.32 and from 2.07 to 1.45, respectively) with therapeutic drug monitoring. When the program was withdrawn, no statistically significant change resulted, and when the program was reinstituted, there was improvement in audit criteria performance but the change was not statistically significant. Although the savings from the program would equal the cost in the first year, cost savings would be anticipated in the future.
Evaluation of Temazepam and Diphenhydramine as Hypnotics in a Nursing-Home Population
Authors: Stewart Ronald B. , Meuleman John R. , Nelson Richard C. , Clark R. Lee
Published: February 2017

Seventeen nursing home residents with sleeping problems were enrolled in a randomized, double-blind, crossover trial of temazepam 15 mg, diphenhydramine (DPH) 50 mg, and placebo. Each drug was given for five consecutive nights with a 72-hour washout period between drugs. Subjects were assessed three times weekly with tests of psychomotor and cognitive function and four times weekly with observer sleep diaries and morning sleep questionnaires. Three subjects failed to complete the study.

By report of the subjects, DPH resulted in shorter sleep latency than did placebo (t = 2.77, p < 0.05). On the fifth night, use of DPH was associated with longer duration of sleep than temazepam (t = 2.88, p < 0.05). No significant difference in tests of neurologic function was noted although, compared with placebo, subjects performed more poorly on seven of eight tests while taking temazepam and five of eight tests while taking DPH. Several instances of daytime hypersomnolence were noted in subjects taking temazepam and DPH, but none in subjects given placebo.
Iodinated Glycerol-Induced Hypothyroidism
Authors: Gomolin Irving H.
Published: February 2017

This report describes an adverse reaction to iodinated glycerol, an organic form of iodine prescribed as a mucolytic-expectorant. In a patient with a previous history of severe potassium iodide-induced hypothyroidism, administration of iodinated glycerol resulted in mild subclinical hypothyroidism. There is one report in the literature of goiter resulting from iodinated glycerol and physicians should be aware of the potential for hypothyroidism with this agent. Iodinated glycerol should be added to the list of iodine-containing organic compounds that interfere with thyroid function.
Antibiotic Prophylaxis in Open-Heart Surgery Patients: Comparison of Cefamandole and Cefuroxime
Authors: Peterson Charles D. , Lake Kathleen D. , Arom Kit V. , Love Kathryn R.
Published: February 2017

The efficacy of cefamandole and cefuroxime in preventing postoperative wound infections was compared in 3037 patients undergoing open-heart surgery. Antibiotic prophylaxis in 1467 patients having coronary artery bypass and valve replacement surgery was cefamandole 2 g iv preoperatively followed by 2 g q6h for five days postoperatively; 1570 patients received cefuroxime 1.5 g iv preoperatively then 1.5 g iv q12h for threedays postoperatively. Postoperative wound infections (sternal and leg wounds) were studied in each treatment group. In the cefamandole study group, 27 patients (1.8 percent) developed postoperative wound infections (9 sternal and 18 leg wounds). In the cefuroxime treatment group, 19 patients (1.2 percent) developed postoperative wound infections (9 sternal and 10 leg wounds). Overall, no statistical difference was found between the two antibiotics in preventing postoperative wound infections. However, in patients having valve replacement surgery, cefuroxime was found statistically more effective than cefamandole prophylaxis in preventing sternal wound infections (no infections in 284 patients compared with five infections in 205 patients, respectively, p = 0.01). The most common organism isolated from infected wounds with cefamandole was Staphylococcus aureus followed by S. epidermidis compared with cefuroxime which had S. epidermidis followed by S. aureus.

Cefuroxime was found to be as effective as cefamandole and considerably less expensive in preventing postoperative wound infections in patients undergoing open-heart surgery.
Effect of Ranitidine on Chloroquine Disposition
Authors: Ette Ene I. , Brown-Awala Esther A. , Essien Ettiene E.
Published: February 2017

Ten healthy, male volunteers (aged 19–27 yr; weight 62–67 kg) were randomly distributed into control and test groups of five subjects each in a controlled study on the effect of ranitidine on chloroquine disposition. The control group subjects received two tablets of chloroquine sulfate (300-mg base) only. The test group subjects received ranitidine 250 mg hs for four days prior to the administration of chloroquine sulfate and throughout the sample collection period. Blood samples (5 ml) were collected from the time of the chloroquine administration to the seventh day after drug administration. The samples were analyzed for chloroquine content by a combination of thin-layer chromatography and ultraviolet spectrophotometry. The Wilcoxon test at 0.05 significance level was used to compare the disposition parameters between control and test groups.

Ranitidine therapy was associated with no significant alterations in chloroquine oral clearance rate, elimination rate constant, and apparent volume of distribution.

Unlike cimetidine, ranitidine does not interact pharmacokinetically with chloroquine. Ranitidine, therefore, may be the H2-receptor antagonist of choice for ulcer patients receiving chloroquine.
The Contribution of Epidemiology to the Study of Drugs
Authors: Porta Miquel S. , Hartzema Abraham G.
Published: February 2017

Epidemiology is concerned with the distribution of disease and health in human populations. Drugs are one of the factors that influence such a distribution. Pharmacoepidemiology can be defined as the application of epidemiologic knowledge, methods, and reasoning to the study of the effects (beneficial and adverse) and uses of drugs in human populations.

Pharmacoepidemiology aims to describe, explain, control, and predict the effects and uses of pharmacologic treatment modalities in a defined time, space, and population. The present article is an introduction to the contributions of epidemiology to the study of drugs.
A Comparison of Sublingual Nifedipine Versus Nitroglycerin in the Treatment of Acute Angina Pectoris
Authors: Mooss Aryan N. , Mohiuddin Syed M. , Hilleman Daniel E. , Sketch Michael H.
Published: February 2017

The administration of nifedipine by the sublingual rather than the oral route has been suggested to provide a more rapid onset of effect. We compared the safety and efficacy of sl nifedipine to sl nitroglycerin in patients who developed anginal chest pain during diagnostic exercise stress testing. Consecutive patients undergoing diagnostic Bruce treadmill exercise who had not had a recent myocardial infarction or undergone coronary bypass graft surgery and who were not taking nitrates, beta-blockers, digoxin, or calcium antagonists were eligible. Seventy-eight patients meeting the inclusion/exclusion criteria consented to participate. Of these 78, 13 developed chest pain necessitating exercise cessation and were randomized to either nitroglycerin or nifedipine. Nitroglycerin was initially given to seven patients and nifedipine to six patients. Complete pain relief was observed in five of seven (71 percent) nitroglycerin patients at two minutes postdose. At four minutes postdose, the remaining two nitroglycerin patients were essentially pain-free. At two minutes postdose, no patient receiving nifedipine had complete pain resolution, and only one patient (17 percent) had partial (> 50 percent) pain relief. At four minutes postdose, four of the nifedipine patients were crossed over to nitroglycerin. At two minutes after the nitroglycerin dose, all four patients had total pain relief. The remaining two nifedipine patients had partial pain relief and were not crossed over to nitroglycerin. Subjective side effects and changes in heart rate and blood pressure were not significantly different between nitroglycerin and nifedipine. A 10 mg dose of sl nifedipine is not as effective as a 0.4 mg dose of sl nitroglycerin in terminating acute exercise-induced anginal attacks within four minutes of administration, and therefore, nitroglycerin remains the drug of choice.
Relative Bioavailability of Rectally Administered Phenobarbital Sodium Parenteral Solution
Authors: Graves Nina M. , Holmes Gregory B. , Kriel Robert L. , Jones-Saete Carolyn , Ong Betty , Ehresman David J.
Published: February 2017

Rectal administration of antiepileptic drugs may be a useful alternative route when oral administration is not possible due to illness, surgery, or status epilepticus. Although parenteral administration often replaces oral administration in these circumstances, there is not always a desirable intravenous line available or repeated intramuscular injections may not be practical. The purpose of this study was to determine the relative bioavailability and time course of absorption of the commercially available parenteral phenobarbital sodium solution administered rectally in comparison with the same preparation given intramuscularly. Seven healthy adult volunteers were given phenobarbital 5 mg/kg intramuscularly and rectally five weeks apart. Eighteen blood samples were drawn over 288 hours. Pharmacokinetic parameters following intramuscular versus rectal administration were the following: area under the curve 5916 vs. 5253 μmol⋅h/L; half-life 112 vs. 113 h; time to maximum concentration 2.1 vs. 4.4 h; and maximum serum concentration 36.2 vs. 31.4 μmol/L. Mean relative bioavailability for rectal phenobarbital was 90 percent. Therefore, the parenteral phenobarbital sodium solution given rectally is well absorbed and provides a useful alternative route of administration.
Relief of Diabetic Neuropathy with Fluoxetine
Authors: Theesen Karen A. , Marsh William R.
Published: February 2017

A 31-year-old woman with advanced diabetes mellitus with secondary autonomic and peripheral neuropathy was admitted for treatment of major depression. Previous therapy with desipramine resulted in exacerbation of the patient's orthostatic hypotension. After admission to the psychiatric facility she was initially stabilized medically and treated with psychotherapy. Subsequent treatment with low-dose fluoxetine 5 mg resulted in a decrease of the patient's diabetic neuropathy pain. Further increases in the fluoxetine dosage resulted in improvement of her depression and increased pain relief. Therapy with fluoxetine did not result in exacerbation of the orthostatic hypotension. This preliminary case report indicates that fluoxetine may be an alternative to the tricyclic antidepressants and trazodone in the treatment of diabetic peripheral neuropathy.
Stability of Intravenous Famotidine Stored in Polyvinyl Chloride Syringes
Authors: Bullock Linda S. , Fitzgerald Joseph F. , Mazur Helen I.
Published: February 2017

The stability of intravenous famotidine in dextrose 5% injection (D5W), NaCl 0.9% injection (NS), and sterile water for injection stored in polyvinyl chloride (PVC) syringes at 4°C for 14 days was studied. The concentration of famotidine samples was determined at time 0, 7 days, and 14 days by reverse-phase high-performance liquid chromatography. Samples were inspected for visual changes and tested for changes in pH. Results of the HPLC analysis indicated that the famotidine samples remained within 94-100 percent and 99-103 percent of the time 0 concentrations at 7 and 14 days, respectively. Repeated measures analysis of variance demonstrated a significant time effect on famotidine concentration as concentrations changed over time (p<0.01). This change was small in magnitude, however, and concentrations decreased at 7 days and increased at 14 days. Famotidine is stable at a concentration of 2 mg/mL in D5W, NS, and sterile water for injection stored in PVC syringes at 4°C for 14 days.
Choosing Cephalosporins for the Formulary
Authors: Tartaglione Teresa A.
Published: February 2017

Proper selection of antibiotics for any formulary requires cooperation and communication with members of the pharmacy and therapeutics (P&T) committee and departments of infectious diseases, microbiology, and epidemiology. Ideally, P&T members need to know their institution's incidence and sources of infection (hospital- or community-acquired), antibiotic cure rates, and the adverse effects profiles of antimicrobial agents used. In addition, members need to be briefed on the findings of antibiotic utilization reviews performed. In vitro activity should be compared among similar classes of antibiotics and, when possible, local resistance rates should be considered. The pharmacokinetic properties of an antibiotic, such as peak concentration, protein binding, distribution characteristics, and elimination half-life, should be evaluated during the selection process, as should total cost of the drug, including costs associated with monitoring therapy. The three generations of cephalosporins are used as examples here to delineate differences in potency, pharmacokinetics, efficacy, and potential for causing adverse reactions during the ideal formulary evaluation process.
Social Class and Voter Turnout in China
Authors: Wang Zhengxu , Sun Long
Published: February 2017

In research on China’s state-controlled elections, whether pro-democratic and politically efficacious citizens vote or abstain more has dominated the debate. Analyzing an up-to-date data set, we find class status and citizens’ institutional environment command overwhelming power in determining voter turnout, while psychological and motivational variables show no significant impacts. Specifically, members of the middle class employed in the state sector are more likely to vote than other social groups, while their counterparts in the private and foreign sectors are far less inclined to vote. While in general, citizens show relatively high level of support for the regime, except among the state-employed middle class, this support is not translated into a higher turnout rate. Electoral behaviors of Chinese citizens, therefore, are heavily conditioned by an individual social group’s particular relation with the state. Members of the Communist Party turn out to vote no more than other members of the society, revealing a critical institutional failure the system faces.
The Effect of Achilles Tendon Lengthening on Ankle Dorsiflexion: A Cadaver Study
Authors: Costa Matthew L. , Logan Karl , Heylings David , Donell Simon T. , Tucker Keith
Published: February 2017

Background: Tendon lengthening is an important cause of morbidity after Achilles tendon rupture. However, direct measurement of the tendon length is difficult. Ankle dorsiflexion has, therefore, been used as a surrogate measure on the assumption that it is the Achilles tendon that limits this movement. The aim of this investigation was to assess the relationship between Achilles tendon length and ankle dorsiflexion. The primary question was whether or not the Achilles tendon is the structure that limits ankle dorsiflexion. The secondary purpose was to quantify the relationship between Achilles tendon lengthening and dorsiflexion at the ankle joint. Methods: Five cadaver specimens were dissected to expose the tendons and capsular tissue of the leg and hindfoot. Fixed bony reference points were used as markers for the measurements. In the first specimen, the Achilles tendon was intact and the other structures that may limit ankle dorsiflexion were sequentially divided. In the other specimens the Achilles tendon was lengthened by 1 cm intervals and the effect upon ankle dorsiflexion movement was recorded. Results: Division of the other tendons and the capsular tissue around the ankle joint did not affect the range of ankle dorsiflexion. When the Achilles was divided the foot could be dorsiflexed until the talar neck impinged upon the anterior aspect of the distal tibia. There was a mean increase of 12 degrees of dorsiflexion for each centimeter increase in tendon length. Conclusion: The Achilles tendon is the anatomical structure that limits ankle dorsiflexion, even when the tendon is lengthened. There was a linear relationship between the length of the Achilles tendon and the range of ankle dorsiflexion in this cadaver model. Ankle dorsiflexion would appear to be a clinically useful indicator of tendon length.
Comparison of Endoscopic and Open Resection for Haglund Tuberosity in a Cadaver Study
Authors: Lohrer Heinz , Nauck Tanja , Dorn Nadja V. , Konerding Moritz A.
Published: February 2017

Background: About half of patients who have Haglund disease may require treatment by surgical resection of the superior portion of the calcaneal tuberosity. Endoscopic techniques have been described as alternatives to open surgery, but only results of uncontrolled retrospective clinical investigations have been reported. Up to now no research is available which compares these different procedures. Methods: A controlled laboratory study was done to evaluate the morphologic appearance of the superior portion of the calcaneal tuberosity after endoscopic or open resection. The tuberosity was resected in 15 isolated fresh-frozen human cadaver lower limb specimens with either open (nine) or endoscopic (six) technique. Outcome was measured radiographically. Iatrogenic soft-tissue lesions of the distal Achilles tendon, plantaris tendon and sural nerve caused by the surgical procedure were evaluated by direct observation after anatomic dissection. Results: Radiographs revealed that the slope of the resection line (osteotomy angle) was steeper ( p = 0.017) and the resected protruberance was larger ( p = 0.003), while the remaining posterior rim was smaller ( p = 0.048) after open resection than after endoscopic resection. Macroscopic analysis indicated that both approaches may damage soft tissues particularly the medial Achilles tendon column and in the plantaris tendon (relative risk = 0.5 in either group). Iatrogenic sural nerve injuries were found after both techniques (relative risk = 0.2 for endoscopic and 0.1 for open resection). Residual bursa tissue was detected only after endoscopy (relative risk = 0.3), while loose bony fragments were present only after open surgery (relative risk = 0.4). Conclusions and clinical relevance: The medial column of the Achilles tendon, the plantaris tendon, and the sural nerve are at risk in both open and endoscopic resection for Haglund disease.
Tax Evasion Indices and Profiles
Authors: Rizzi Dino
Published: February 2017

The aim of this article is to adapt definitions and tools currently used in the economic literature on poverty to individual data on tax evasion. The article presents composite indices and profiles of tax evasion based on the three I’s of tax evasion: incidence, intensity, and inequality, following the approach of Shorrocks’s study and Jenkins and Lambert’s study that proposed the three I’s of poverty. In the field of tax evasion, one stream of literature produces a potentially large amount of individual microdata using tax benefit and agent-based models: the article enriches the analysis offered by these models with indices that take into account the entire distribution of taxpayer evasion rates. Particularly, the article presents a new composite index of tax evasion that incorporates a concentration index of individual tax evasion rates. A final section shows a sensitivity analysis of tax evasion indices and profiles through numerical simulations.
Are SMEs in the hospitality industry less likely to experience credit constraint than other industries in the service sector? Evidence from Latin America
Authors: Motta Victor
Published: February 2017

Small- and medium-sized enterprises (SMEs) in the service and hospitality industries are critical for economic development in Latin America. However, due to information asymmetries, access to capital is a major obstacle for SMEs to expand their activities. Drawing from agency theory, the purpose of this study was to examine the financial constraints of SMEs in the service sector, particularly the case of hospitality firms in Latin America, due to requirements associated with mitigating information asymmetries. Using a logit model, we investigated whether financial requirements acting as mechanisms to mitigate information asymmetries, such as fixed asset collateral requirements and financial statement audits, would be associated with credit constraints for small- and medium-sized firms. We further investigated whether, due to their unique financing characteristics, SMEs in the hospitality industry would be less credit constrained than other industries in the service sector. Results suggest that SMEs subjected to collateralized fixed assets and auditing requirements, separately, were more likely to be credit constrained. However, our findings indicate that both financial requirements, when used together, decreased the likelihood of credit constraint for SMEs in the hospitality industry.
Reach and effectiveness of the HeartBeat Connections telemedicine pilot program
Authors: Benson Gretchen A , Sidebottom Abbey , Sillah Arthur , Boucher Jackie L , Miedema Michael D , Knickelbine Thomas , VanWormer Jeffrey J
Published: February 2017

Introduction

Innovative care delivery programs that support primary care providers are needed to reduce the burden of cardiovascular disease (CVD). HeartBeat Connections (HBC) is a primary prevention telemedicine program utilizing registered dietitian nutritionists (RDNs) and registered nurses (RNs) to deliver health coaching and medication therapy protocols for dyslipidaemia and hypertension among patients at high risk for developing CVD.

Methods

This retrospective cohort study documents the reach and six-month effectiveness of the HBC program for improving CVD risk factors. The sample included 1028 high-risk individuals aged 40–79 (without CVD or diabetes) served between 2010 and 2013 (326 participants, 702 eligible non-participants). Mixed-model analyses of variance were used to compare changes in outcome measures between baseline and six-month follow-up for participants and non-participants. Outcomes were also examined for three groups: non-participants, participants with 1–4 encounters, and participants with > 5 encounters.

Results

Nearly one-third of all eligible patients participated. There were no significant differences over time between HBC participants and non-participants in blood pressure or body mass. A higher proportion of HBC participants quit using tobacco (7.0 vs. 3.2%, p = 0.004) and achieved the low-density lipoprotein (LDL) program goal of < 100 mg/dL (8.9 vs. –1.1%, p = 0.009). Also, more favourable improvements in total and LDL cholesterol were observed among HBC participants with higher program engagement ( p < 0.05).

Discussion

The HBC telemedicine program resulted in significant improvement in some, but not all, CVD risk factors over six months. HBC reached many high-CVD-risk patients in the target region, which may confer population-level health benefits if this program can be scaled and sustained. Innovative, collaborative care delivery models like HBC can serve as a platform to systematically target and proactively engage at-risk populations, perhaps reducing patients’ CVD risk.
Program experiences of adults with autism, their families, and providers: Findings from a focus group study
Authors: Koffer Miller Kaitlin H , Mathew Mary , Nonnemacher Stacy L , Shea Lindsay L
Published: February 2017

A growing number of individuals with autism spectrum disorder are aging into adulthood. In the United States, Medicaid is the primary payer for services for adults with autism spectrum disorder, yet there are few funded programs that provide dedicated supports to this population. This study examined the experiences of adults with autism spectrum disorder in two Medicaid-funded programs in Pennsylvania through focus groups. Researchers conducted 20 focus groups with a total of 36 adults with autism spectrum disorder, 32 family members, 32 direct care staff, and 20 program administrators. Using thematic analysis, we identified three themes: training needs, community engagement and socialization, and employment. There was a need for additional training to meet the varying needs of program participants including co-occurring diagnoses, sexuality, and long-term planning. Adults with autism spectrum disorder prioritized more individualized community activities based on their interests. Finally, barriers to and strategies for successful employment were discussed. It will be crucial for policy makers to utilize the findings to inform program improvement and development based on the experiences of individuals impacted by these services and systems directly. Additionally, researchers should use the findings from this study to design interventions for adults with autism spectrum disorder as it includes their voices.
Popular journalism in China: A study of China Youth Daily
Authors: Wang Haiyan , Sparks Colin , Yu Huang
Published: February 2017

It is commonly stated that the press in China can be divided into two main categories, the party-oriented official press and the market-oriented commercial press. This article examines an official paper, China Youth Daily, which is a central organ of the Communist Youth League of China. The findings of a content analysis demonstrate that this title differs significantly from other central official titles, like People’s Daily, but also from commercial papers, like Southern Metropolis Daily. While China Youth Daily’s journalism is close to the official pole in the amount of propaganda-related material it covers, it also has a greater emphasis on watchdog journalism than does People’s Daily. It places a much greater emphasis on infotainment than do either of the official and commercial poles. It is more likely to use journalistic techniques like sensationalism and the revelation of personal details than are the other titles analysed. These findings lead to the conclusion that the bi-polar characterization of the Chinese press requires modification. At least one prominent national title is best described as ‘popular official’ media. One of the main features of this kind of journalism is that it presents the party and business elite in a human light and thus constitutes a renewal of the repertoire of hegemonic devices at the party’s disposal. What is certainly the case is that the frequent claim that there is a contradiction between popular journalism responding to audience tastes and official journalism constrained by the propaganda needs of the party is mistaken.
An Exploratory Study on the Anti-inflammatory Effects of Fucoidan in Relation to Quality of Life in Advanced Cancer Patients
Authors: Takahashi Hidenori , Kawaguchi Mitsuhiko , Kitamura Kunihiro , Narumiya Seiji , Kawamura Munenori , Tengan Isamu , Nishimoto Shinji , Hanamure Yasuo , Majima Yasuo , Tsubura Shuichi , Teruya Kiichiro , Shirahata Sanetaka
Published: February 2017

Background. Conventional anticancer therapies still cause difficulties with selective eradication and accompanying side effects that reduce patients’ quality of life (QOL). Fucoidan is extracted from seaweeds and has already exhibited broad bioactivities, including anticancer and anti-inflammatory properties, in basic studies. It is expected to enhance therapeutic efficacy and minimize side effects in cancer patients; however, despite its potential benefits, there are very few clinical trials using fucoidans. Therefore, we performed an exploratory clinical study for advanced cancer patients to examine the efficacy of fucoidans, especially focusing on inflammation in relation to QOL scores. Methods. We conducted a prospective, open-label clinical study for advanced cancer patients using fucoidans via oral administration; 20 advanced cancer patients with metastases were recruited and were given 400 mL/d fucoidan (10 mg/mL) for at least 4 weeks. Inflammatory biomarkers, including high-sensitivity C-reactive protein and various cytokines, and QOL scores were monitored before treatment, after 2 weeks, and after 4 weeks of fucoidan ingestion. Results. The main proinflammatory cytokines, including interleukin-1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α) were significantly reduced after 2 weeks of fucoidan ingestion. QOL scores, including fatigue, stayed almost stable without significant changes during the study period. The univariate and multivariate analyses revealed that the responsiveness of IL-1β was a significant independent prognostic factor. Conclusion. This is the first study providing evidence of the anti-inflammatory effects of fucoidans for advanced cancer patients. In future studies, larger blinded, controlled trials are required to establish the efficacy of fucoidan as supportive care for cancer patients, especially those undergoing chemotherapy.
Intra-abdominal Trocar-Free Vacuum Liver Retractor for Upper-Gastrointestinal Surgery
Authors: Benzing Christian , Weiss Helmut , Krenzien Felix , Biebl Matthias , Pratschke Johann , Zorron Ricardo
Published: February 2017

Background. In laparoscopic upper-gastrointestinal (GI) surgery, an adequate retraction of the liver is crucial. Especially in single-port surgery and obese patients, problems may occur during liver retraction. The current study seeks to evaluate the efficacy and safety of the LiVac trocar-free liver retractor in laparoscopic upper-GI surgery. Methods. The present study is a nonrandomized dual-center clinical series describing our preliminary results using the LiVac system for liver retraction. The primary end points of the present study included the effectiveness and safety of the LiVac device as well as complications and documentation of problems with the device during surgery. Results. The device was used in 11 patients for simple and complex laparoscopic procedures. The mean age of the study population was 59.6 years (SD = 20.6; range = 30-84). There were 6 female and 5 male patients with a mean body mass index (BMI) of 31.9 kg/m2 (SD = 8.1; range = 26.0-45.3). The efficacy of the device was excellent in all cases, reducing the number of trocars needed. There were no device-related complications. Conclusion. The LiVac liver retractor is easy to use and provides a good exposure of the operative field in upper-GI laparoscopic surgery, even in obese patients with a high BMI.
Experimental Procedure of Compression Anastomosis Using Fragmented Rings: A Porcine Model
Authors: Vanbrugghe Charles , Birnbaum David Jérémie , Berdah Stéphane Victor
Published: February 2017

Background. Compression anastomosis has been recently abandoned because of a nonsuperiority compared to stapling anastomosis. Nonremoval of the rings has frequently been reported and this technique does not support a routine use. The aim of this experimental study was to assess the feasibility of anastomosis using compression with a device consisting of fragmented rings. Methods. A new compression device, the “Anastocom,” was compared to standard double-stapled colocolonic anastomosis in 2 groups of 8 pigs. In each group, colocolonic anastomosis was performed with a circular stapler (DST Series EEA Staplers) in 4 pigs and with the Anastocom device for the other 4 pigs. Results. The anastomotic rings were expelled between postoperative day 7 and day 13 from the 4 animals sacrificed at day 30. The anastomosis was clean and intact in all pigs. After sacrifice, there was no difference in the bursting pressure at day 7 ( P = .226) or at day 30 ( P = .885) between the 2 types of anastomosis. After sacrifice at day 7, the mean bursting pressure values for the Anastocom and EEA anastomoses were 128.6 mm Hg (range 119-143 mm Hg) and 218.9 mm Hg (range 84-240 mm Hg), respectively. After sacrifice at day 30, the mean bursting pressure values for the Anastocom and EEA anastomoses were 111 mm Hg (range 59-234 mm Hg) and 105 mm Hg (range 81-130 mmHg), respectively. Conclusion. No bowel obstruction was observed with Anastocom. This fragmentation mechanism should better prevent nonexpulsion compared to basic compression anastomosis.
Applying the Business of Lifestyle Medicine
Authors: Raphael Joe
Published: February 2017

Lifestyle medicine improves health outcomes by educating and equipping evidence-based interventions to treat and prevent non-communicable disease. The Business of Lifestyle Medicine offers tools and a framework that enables organizations, corporations, healthcare systems, and providers to operationalize the practice of Lifestyle Medicine. The Business of Lifestyle Medicine is the application of an intensive induction phase, followed by tapered consolidation and ongoing sustainability utilizing risk stratification and often demonstrating cost-savings. The purpose of this article was to outline some of my experiences with the Business of Lifestyle Medicine, highlight pivotal considerations when creating a Lifestyle Medicine practice, and illustrate a Lifestyle as Medicine Business Model.
WI-USHER: A grid-based parallel algorithm for particle insertion in hybrid atomistic-continuum method
Authors: Wang Qian , Xu Xin-Hai , Ye Shuai , Li Chao , Ren Xiao-Guang , Yang Xue-Jun
Published: February 2017

The hybrid atomistic-continuum coupling method based on domain decomposition serves as an important tool for the micro-fluid simulation. There exists a certain degree of parallelism load imbalance when directly using the USHER algorithm in the domain decomposition–based hybrid atomistic-continuum coupling method. In this article, we propose a grid-based parallel algorithm for particle insertion, named WI-USHER, to improve the efficiency of the particle insertion operation when restricting the size of the region to be inserted or with higher number density. The WI-USHER algorithm slices the region to be inserted into finer grids with proper spacing scale, marks parts of finer grids in black according to three exclusive rules, that is, Single Particle Occupation (SPO), Single Particle Coverage (SPC), and Multi-Particles Coverage (MPC), and finds the target insertion point in the remained white grids. We use two test cases to show the superiority of our WI-USHER algorithm over the USHER algorithm. The WI-USHER algorithm performs lower averaged force evaluation times, which decreases from [Formula: see text] to [Formula: see text] compared to the USHER algorithm when the number density of slightly high to high value. The percentage of the total parallel simulation time processed by the particle insertion operation decreases from 23.5% to 3% compared to the USHER algorithm.
Online prediction of the piston maximum temperature in dual-fuel engine
Authors: Fu Youyao , Xiao Bing
Published: February 2017

Diesel–natural gas dual-fuel engine has become a hot research topic in recent years because of its excellent power and economy. However, the reliability of the dual-fuel engine does not meet the requirements of practical application. The piston maximum temperature of dual-fuel engine easily exceeds the security border. Toward this, this article presents a relational model to real-timely predict the piston maximum temperature of dual-fuel engine. Specifically, some easy-measured engine indirect signals, including NOx emission, excess air coefficient, and engine speed, are employed as the model inputs. The piston maximum temperatures, as the only output, are acquired offline by finite element analysis in ANSYS. Support vector regression is employed to solve the prediction model parameters. Cross-validation is introduced to determine some intermediate variables formed in the process of building model. Experiments revealed that the proposed model produces satisfying predictions with deviations less than 7°C. Thus, this study provides an effective method to monitor the piston maximum temperature state of dual-fuel engine in real time.
Random sampling and model competition for guaranteed multiple consensus sets estimation
Authors: Li Jing , Yang Tao , Yu Jingyi
Published: February 2017

Robust extraction of consensus sets from noisy data is a fundamental problem in robot vision. Existing multimodel estimation algorithms have shown success on large consensus sets estimations. One remaining challenge is to extract small consensus sets in cluttered multimodel data set. In this article, we present an effective multimodel extraction method to solve this challenge. Our technique is based on smallest consensus set random sampling, which we prove can guarantee to extract all consensus sets larger than the smallest set from input data. We then develop an efficient model competition scheme that iteratively removes redundant and incorrect model samplings. Extensive experiments on both synthetic data and real data with high percentage of outliers and multimodel intersections demonstrate the superiority of our method.
Tree-based indexing for real-time ConvNet landmark-based visual place recognition
Authors: Hou Yi , Zhang Hong , Zhou Shilin
Published: February 2017

Recent impressive studies on using ConvNet landmarks for visual place recognition take an approach that involves three steps: (a) detection of landmarks, (b) description of the landmarks by ConvNet features using a convolutional neural network, and (c) matching of the landmarks in the current view with those in the database views. Such an approach has been shown to achieve the state-of-the-art accuracy even under significant viewpoint and environmental changes. However, the computational burden in step (c) significantly prevents this approach from being applied in practice, due to the complexity of linear search in high-dimensional space of the ConvNet features. In this article, we propose two simple and efficient search methods to tackle this issue. Both methods are built upon tree-based indexing. Given a set of ConvNet features of a query image, the first method directly searches the features’ approximate nearest neighbors in a tree structure that is constructed from ConvNet features of database images. The database images are voted on by features in the query image, according to a lookup table which maps each ConvNet feature to its corresponding database image. The database image with the highest vote is considered the solution. Our second method uses a coarse-to-fine procedure: the coarse step uses the first method to coarsely find the top- N database images, and the fine step performs a linear search in Hamming space of the hash codes of the ConvNet features to determine the best match. Experimental results demonstrate that our methods achieve real-time search performance on five data sets with different sizes and various conditions. Most notably, by achieving an average search time of 0.035 seconds/query, our second method improves the matching efficiency by the three orders of magnitude over a linear search baseline on a database with 20,688 images, with negligible loss in place recognition accuracy.
Collision avoidance for multiple Lagrangian dynamical systems with gyroscopic forces
Authors: Sabattini Lorenzo , Secchi Cristian , Fantuzzi Cesare
Published: February 2017

This article introduces a novel methodology for dealing with collision avoidance for groups of mobile robots. In particular, full dynamics are considered, since each robot is modeled as a Lagrangian dynamical system moving in a three-dimensional environment. Gyroscopic forces are utilized for defining the collision avoidance control strategy: This kind of forces leads to avoiding collisions, without interfering with the convergence properties of the multi-robot system’s desired control law. Collision avoidance introduces, in fact, a perturbation on the nominal behavior of the system: We define a method for choosing the direction of the gyroscopic force in an optimal manner, in such a way that perturbation is minimized. Collision avoidance and convergence properties are analytically demonstrated, and simulation results are provided for validation purpose.
The random exploration graph for optimal exploration of unknown environments
Authors: Palacios Alfredo Toriz , Sánchez L Abraham , Bedolla Cordero Jose María Enrique
Published: February 2017

The exploration of an unknown environment by a robot system is a well-studied problem in robotics; however, although many of the proposals made in this field represent efficient tools in terms of exploration paradigm, most of them are not efficient for time critical applications since the robot may visit the same place more than once during backtracking. In this way and considering these limitations, this article presents a novel approach called the random exploration graph, which addresses the problem of exploring unknown environments by building a graph structure created incrementally by the random choice of the free frontier in the observation range of the robot. In addition, the random exploration graph algorithm uses a new concept called “frontier control” introduced in this work, used to store nodes left behind in the graph structure that have not been fully explored and that will be used to guide the exploration process in an efficient way, when the algorithm needs to go back to previously visited areas to continue exploration. The frontier control concept next to the versatility of the graph structure used for the exploration process is the main contribution of this work.
Esmya® and the PEARL studies: A review
Authors: Powell Martin , Dutta Deborata
Published: February 2017

Ulipristal acetate was investigated in four phase 3 trials. In PEARL I, ulipristal produced significant normalisation of blood loss within 1 week and decreased fibroid volume. In PEARL II, ulipristal produced faster and more consistent control of bleeding than leuprorelin acetate and had a more favourable side-effect profile. Ulipristal-induced decreases in fibroid volume persisted for 6 months, whereas fibroids regrew after leuprorelin was stopped. PEARL III showed that ulipristal was effective during long-term treatment, with norethisterone further reducing the magnitude of bleeding in the off-treatment period. PEARL IV investigated ulipristal over four cycles, finding little difference between 5 and 10 mg ulipristal, further changes in menstruation and fibroid volume with repeat courses, and no increase in side effects.
Analytical considerations for the biochemical assessment of vitamin D status
Authors: Couchman Lewis , Moniz Cajetan F
Published: February 2017

The most widely used and clinically accepted biochemical marker for assessing vitamin D status is the total serum 25-hydroxyvitamin D [25(OH)D] concentration. Despite the analysis of 25(OH)D dating back to the early 1970s, modern analytical techniques still exhibit significant interassay variability due to varying concentrations of other related vitamin D metabolites and sample-to-sample matrix differences. It is important for clinicians requesting 25(OH)D analyses to understand these issues and limitations, and where necessary to confront laboratories for details of analytical methods used. The availability of reference measurement procedures for 25(OH)D based on liquid chromatography and tandem mass spectrometry, whilst not intended for routine clinical sample analysis, should be utilized to improve assay harmonization and reduce interlaboratory variability. Laboratories should also be forthcoming with details of subscriptions to external quality assessment schemes and assay traceability. As well as discussing the reasons for ongoing assay variability for 25(OH)D, this short review will also briefly discuss other assays related to the assessment of vitamin D status, including parathyroid hormone, 24,25-dihydroxyvitamin D, 1,25-dihydroxyvitamin D and vitamin D binding proteins.
Neuroimaging of ocular involvement in patients with sickle cell disease and review of the literature
Authors: Vallejo Diaz José Fernando , Glikstein Rafael , Dos Santos Marlise Peruzzo , Torres Carlos
Published: February 2017

Endophthalmitis is a rare cause of ocular infection that can be associated with immunocompromising conditions and, more rarely, with sickle cell disease. In this case report and review of the literature, we present a case of a young male with sickle cell disease who presented with rapidly progressive ocular pain, edema, erythema, and decreased visual acuity. The key radiological findings to suggest endophthalmitis were demonstrated using computed tomography and magnetic resonance imaging.
Point-of-care ultrasonography (POCUS) in hemophilia A: a commentary on current status and its potential role for improving prophylaxis management in severe hemophilia A
Authors: Acharya Suchitra S. , Rule Brittny , McMillan Omar , Humphries Thomas J.
Published: February 2017

In patients with severe hemophilia A, recurrent bleeding into joints results in increased morbidity and reduced quality of life. Prophylaxis using replacement factor products, especially when initiated early, has established benefits in terms of reducing joint bleeds and preserving joint function. Poor adherence to prophylactic regimens is a common cause for breakthrough bleeds and resultant arthropathy. Improving prophylaxis management, especially in the transitional age group, is a challenge. Here, we discuss the current status of ultrasonography (US) in hemophilia A, challenges in its wider implementation, and the potential for use of point-of-care US (POCUS) as an adjunct in the routine management of patients with hemophilia following prophylaxis regimens. Using POCUS, in which US is performed by trained hematologists and nonphysician operators (rather than comprehensive US performed by imaging specialists), specific clinical questions can be addressed in a time-efficient, user-friendly manner to promote adherence to prophylaxis and guide or modify treatment approaches. This review also discusses barriers to acceptance of POCUS as a part of routine management of patients with hemophilia, including questions related to its diagnostic accuracy, dependence on trained operators, agreement on appropriate scoring systems, and potential usefulness in patient management.