bluuebunny/crossref_metadata_2025 huggingface dataset:
Endovascular Repair for a Ruptured AAA due to a Combined Type IIIb and Ia Endoleak
Authors: Avgerinos Konstantinos Ioannis , Melas Nikolaos , Saratzis Athanasios , Tympanidou Marianthi V. , Saratzis Nikolaos , Lazaridis Ioannis
Published: April 2018

We report a case of a ruptured abdominal aortic aneurysm (AAA) caused by a combined type IIIb and Ia endoleak. Also, we propose the mechanism that resulted in this combined endoleak. Specifically, a 71-year old-man, with a previous history of endovascular aneurysm repair (EVAR) for an AAA, was diagnosed with a contained rupture. CT scan depicted a type Ia endoleak and a migrated Talent endograft. A proximal aortic cuff sealed the endoleak, but intraoperative angiography revealed that a type IIIb endoleak coexisted due to fabric tear close to the Talent bifurcation. A second aortic cuff could not seal the fabric tear; so, in-lay parallel limbs were sequentially deployed as a “kissing endograft” technique inside the cuff. Simultaneous treatment of combined type IIIb and Ia endoleaks has not yet been described. Maybe the type IIIb endoleak is the primary entity causing sac enlargement, neck recontouring, proximal migration, and ultimately type Ia endoleak, which leads to huge enlargement and rupture. Placement of an aortic cuff to seal the proximal endoleak/migration and kissing endografts limbs for the fabric tear seems a safe option in such patients.
The Traditional Medicinal Plants Cuphea calophylla, Tibouchina kingii, and Pseudelephantopus spiralis Attenuate Inflammatory and Oxidative Mediators
Authors: Ramírez-Atehortúa Ana María , Morales-Agudelo Lorena , Osorio Edison , Lara-Guzmán Oscar J.
Published: April 2018

Aerial parts of Cuphea calophylla, Tibouchina kingii, and Pseudelephantopus spiralis have been used in Colombian traditional medicine for inflammation. However, the underlying mechanisms that could explain the anti‐inflammatory actions remain unknown. This study aimed to elucidate the anti‐inflammatory and cytoprotective effects of hydroalcoholic extracts from C. calophylla (HECC), T. kingii (HETK), and P. spiralis (HEPS) in LPS‐stimulated THP‐1 macrophages. Reactive oxygen species (ROS), nitric oxide (NO), and malondialdehyde (MDA) were monitored as inflammatory and oxidative markers. The inhibition of lipoxygenase (LOX) and cyclooxygenase (COX) activities in a cell‐free system were also investigated. Antioxidant activities were determined using standard in vitro methods. All extracts inhibited the NO, ROS, and MDA levels. HETK showed the highest ROS production inhibition and the highest antioxidant values, whereas HETK and HEPS significantly decreased the cytotoxicity mediated by LPS. The release of MDA was reduced significantly by all extracts. Moreover, the catalytic activity of LOX was inhibited by HECC and HETK. HECC was a more potent reducer of COX‐2 activity. All extracts effectively suppressed COX‐1 activity. In summary, these results suggest that HECC, HEPS, and HETK possess anti‐inflammatory properties. Therefore, these plants could provide a valuable source of natural bioactive compounds for the treatment of inflammatory‐related diseases.
Optimization of Preparation Conditions of Novel Adsorbent from Sugar Scum Using Response Surface Methodology for Removal of Methylene Blue
Authors: El maguana Y. , Elhadiri N. , Bouchdoug M. , Benchanaa M. , Boussetta A.
Published: April 2018

A novel and inexpensive adsorbent was prepared from sugar scum for the removal of methylene blue as an organic pollutant from aqueous solutions. The response surface methodology was used to study the effects of the calcination temperature and time on the yield and the methylene blue adsorption. In order to determine the optimal conditions of the preparation, the Doehlert design and desirability function were applied. The increase in calcination temperature increases the methylene blue adsorption and induces a reduction in yield. The optimal conditions have been identified to be a calcination temperature of 986°C and calcination time of 61 min. The characteristics of the obtained adsorbent were determined using SEM/EDX, and surface functions were obtained based on FTIR and pHpzc. The produced adsorbent had a porous structure and a pHpzc of 12.5. The results showed that the yield was 49.74% and the adsorption of methylene blue was 24.52 mg·g−1 with a contact time of 10 h determined by kinetic test. The sugar scum was found to be an effective material for the preparation of appropriate adsorbent for dye removal from wastewater.
Different Kinetics of Perioperative CRP after Hip Arthroplasty for Elderly Femoral Neck Fracture with Elevated Preoperative CRP
Authors: Lim Seung-Jae , Choi Kyung-Hwa , Lee Jin Hyuck , Jung Joon Young , Han Woosol , Lee Byung Hoon
Published: April 2018

This study aimed to determine the kinetics of four inflammatory markers and to identify the variables that affect the natural kinetics of inflammatory markers in aged patients having hip fractures with and without elevated preoperative CRP. 240 elderly patients who have been operated on for femoral neck fracture with no infectious complications were divided into two groups on elevated preoperative CRP level (>10 mg/L). The temporal values of four inflammatory markers of WBC, neutrophil count (N) (%), ESR, and CRP were assessed eight times every other day until the 14th postoperative day. At 48–60 h postoperatively, mean CRP was markedly higher in patients with preoperatively elevated CRP than in those with nonelevated CRP (122.1±65.9 and 73.7±35.5, p<0.001). However, the abrupt elevation of CRP in the elevated group was conversely decreased on the 4th-5th postoperative day, demonstrating similar kinetic curves with no significant differences between both groups. For WBC, N (%), and ESR, both groups showed similar patterns of temporal values 14 days after surgery regardless of preoperative CRP level. Our findings could be used as guidelines for patient discharge and during the follow-up period after surgery.
The Activation of the Mirror Neuron System during Action Observation and Action Execution with Mirror Visual Feedback in Stroke: A Systematic Review
Authors: Zhang Jack J. Q. , Fong Kenneth N. K. , Welage Nandana , Liu Karen P. Y.
Published: April 2018

Objective. To evaluate the concurrent and training effects of action observation (AO) and action execution with mirror visual feedback (MVF) on the activation of the mirror neuron system (MNS) and its relationship with the activation of the motor cortex in stroke individuals. Methods. A literature search using CINAHL, PubMed, PsycINFO, Medline, Web of Science, and SCOPUS to find relevant studies was performed. Results. A total of 19 articles were included. Two functional magnetic resonance imaging (fMRI) studies reported that MVF could activate the ipsilesional primary motor cortex as well as the MNS in stroke individuals, whereas two other fMRI studies found that the MNS was not activated by MVF in stroke individuals. Two clinical trials reported that long-term action execution with MVF induced a shift of activation toward the ipsilesional hemisphere. Five fMRI studies showed that AO activated the MNS, of which, three found the activation of movement-related areas. Five electroencephalography (EEG) studies demonstrated that AO or MVF enhanced mu suppression over the sensorimotor cortex. Conclusions. MVF may contribute to stroke recovery by revising the interhemispheric imbalance caused by stroke due to the activation of the MNS. AO may also promote motor relearning in stroke individuals by activating the MNS and motor cortex.
Surface Modification of Sodium Montmorillonite Nanoclay by Plasma Polymerization and Its Effect on the Properties of Polystyrene Nanocomposites
Authors: Narro-Céspedes Rosa Idalia , Neira-Velázquez María Guadalupe , Mora-Cortes Luis Fernando , Hernández-Hernández Ernesto , Castañeda-Facio Adali Oliva , Ibarra-Alonso María Cristina , Reyes-Acosta Yadira Karina , Soria-Arguello Gustavo , Borjas-Ramos José Javier
Published: April 2018

Sodium montmorillonite nanoclay (Na+-MMT) was modified by plasma polymerization with methyl methacrylate (MMA) and styrene (St) as monomers and was denominated as Na+-MMT/MMA and Na+-MMT/St, respectively. This plasma modified nanoclay was used as reinforcement for polystyrene (PS) nanocomposites that were prepared by melt mixing. Pristine and modified Na+-MMT nanoclay were analyzed by the dispersion in various solvents, Fourier transform infrared spectroscopy (FTIR), thermogravimetric analysis (TGA), and scanning electron microscopy (SEM). The results confirmed a change in hydrophilicity of the modified Na+-MMT, as well as the presence of a polymeric material over its surface. The pristine PS/Na+-MMT and modified PS/Na+-MMT/MMA and PS/Na+-MMT/St nanocomposites were studied with X-ray diffraction (XRD), differential scanning calorimetry (DSC), and TGA, as well as mechanical properties. It was found that the PS/Na+-MMT/St nanocomposites presented better thermal properties and an improvement in Young’s modulus (YM) in compared to PS/Na+-MMT/MMA nanocomposites.
3D Comparison of Mandibular Response to Functional Appliances: Balters Bionator versus Sander Bite Jumping
Authors: Gazzani Francesca , Ruellas Antonio Carlos de Oliveira , Faltin Kurt , Franchi Lorenzo , Cozza Paola , Bigliazzi Renato , Cevidanes Lucia Helena Soares , Lione Roberta
Published: April 2018

Aim. To assess the three-dimensional (3D) maxillomandibular and dental response to Balters Bionator (BB) and the Sander Bite Jumping Appliance (SBJA) in growing patients. Materials and Methods. Twenty-seven Class II division 1 patients (13 males, 14 females), consecutively treated with either the BB (9 females, 7 males; 10.1±1.6 years) or SBJA (5 females, 6 males; 11±1.9 years), were collected from a single orthodontic practice. All patients presented overjet ≥5 mm, full Class II or end-to-end molar relationship, mandibular retrusion. CBCT scans were available at T1 and after removal of the functional appliances (T2) with a mean interval of 18 months. The 3D location and direction of skeletal and dental changes with growth and treatment were quantitatively assessed. Statistical analysis was performed by means of Mann–Whitney U test (p<0.05). Results. Patients treated with the SBJA and BB orthopedic appliances presented, respectively, 4.7 mm and 4.5 mm of 3D displacement of the chin, with marked ramus growth of, respectively, 3.7 mm and 2.3 mm. While the mandible and maxilla grew downward and forward, no opening of the mandible plane was observed. Both appliances adequately controlled labial inclination of lower incisors (1.3° and 0.3°, for the SBJA and BB groups, resp.). No significant between-group differences were found for the T2−T1 changes for any of the variables, with the exception of molar displacements (significantly greater in the SBJA group than in the BB group, 1.2 mm and 0.9 mm, resp.). Conclusions. The maxillomandibular and dental growth responses to BB and SBJA therapies are characterized by vertical ramus growth and elongation of mandible that improve the maxillomandibular relationship with adequate control of lower incisor position.
Coastal Fishermen as Lifesavers While Sailing at High Speed: A Crossover Study
Authors: Fungueiriño-Suárez Ramón , Barcala-Furelos Roberto , González-Fermoso Marta , Martínez-Isasi Santiago , Fernández-Méndez Felipe , González-Salvado Violeta , Navarro-Patón Rubén , Rodríguez-Núñez Antonio
Published: April 2018

Purpose. Starting basic cardiopulmonary resuscitation (CPR) early improves survival. Fishermen are the first bystanders while at work. Our objective was to test in a simulated scenario the CPR quality performed by fishermen while at port and while navigating at different speeds. Methods. Twenty coastal fishermen were asked to perform 2 minutes of CPR (chest compressions and mouth-to-mouth ventilations) on a manikin, in three different scenarios: (A) at port on land, (B) on the boat floor sailing at 10 knots, and (C) sailing at 20 knots. Data was recorded using quality CPR software, adjusted to current CPR international guidelines. Results. The quality of CPR (QCPR) was significantly higher at port (43%±10) than sailing at 10 knots (30%±15; p=0.01) or at 20 knots (26%±12; p=0.001). The percentage of ventilation that achieved some lung insufflation was also significantly higher when CPR was done at port (77%±14) than while sailing at 10 knots (59%±18) or 20 knots (57%±21) (p=0.01). Conclusion. In the event of drowning or cardiac arrest on a small boat, fishermen should immediately start basic CPR and navigate at a relatively high speed to the nearest port if the sea conditions are safe.
Epidermal Growth Factor Receptor Mutations and Their Prognostic Value with Carcinoembryonic Antigen in Pathological T1 Lung Adenocarcinoma
Authors: Zhu Wang-Yu , Li Hai-Feng , Fang Ke-Xin , Zhang Bing-Jie , Zhou Shi-Quan , Zhang Yong-Kui , Le Han-Bo , Hu Xiao-Fei
Published: April 2018

Aims. The prognostic value of epidermal growth factor receptor (EGFR) mutations in the context of serum carcinoembryonic antigen levels remains controversial in T1 lung adenocarcinoma. Methods. Clinical and pathological characteristics, preoperational carcinoembryonic antigen levels, EGFR mutations, and disease-free and overall survival were analysed retrospectively in 573 pathological T1 patients in East China. Results. EGFR mutations were detected in 220 of 573 patients (38.4%). Patients with serum carcinoembryonic antigen levels ≥ 2.12 ng/mL had worse disease-free (P<0.001) and overall survival (P<0.001) than had others, although survival was comparable between patients with and without EGFR mutations. However, patients with exon 21 mutations in EGFR had significantly better overall survival than had patients with exon 19 mutations (P=0.016), although disease-free survival was comparable (P=0.424). Among patients with serum carcinoembryonic antigen levels ≥ 2.12 ng/mL, disease-free (P=0.019) and overall survival (P<0.001) was also better than that in those with exon 21 mutations. Finally, the exon 19 deletion was found to be an independent predictor of unfavourable overall survival (P=0.037). Conclusions. EGFR mutations were associated with preoperational serum carcinoembryonic antigen levels ≥ 2.12 ng/mL. In patients with levels above this threshold, those with the exon 19 deletion have less favourable prognosis than have those with the exon 21 mutation.
Experimental Study of Phlebitis Ointment Administration in Acute Superficial Thrombophlebitis
Authors: Li Guangzong , Litscher Gerhard , Pang He , Yang Baozhong , Litscher Daniela , Wang Lu
Published: April 2018

Acute superficial thrombophlebitis is a venous system disease. Animal models with mannitol induced phlebitis were treated with an orally administered “phlebitis ointment.” 24 rabbits were randomly divided into 4 groups. The therapy group was treated with “phlebitis ointment” and a control group received “Mai Luo Shu Tong granules.” Levels of blood TNF‐α, IL‐6, CRP, and IL‐1β were measured. The tissue expression levels of NF‐КBp65 and PKC genes were evaluated. The therapy group showed a better improvement of the clinical status and similar vascular morphology than the control group. A blank group showed no vascular changes through pathological investigation. In contrast, significant vascular changes were seen in the model group. The control group showed slight vascular modifications. Small thrombi could be found in the lumen despite the intact tunica intima. Both control and therapy group showed less inflammatory cells infiltration than the model group and upregulation of NF‐КBp65 and PKC genes. The phlebitis ointment reduced the levels of necrosis factor‐α, interleukin‐6, C‐reactive protein, and interleukin‐1ß. The expressions of NF‐КBp65 and PKC genes, which are the primary mechanisms underlying the development of thrombophlebitis, were improved significantly in tissues of both therapy group and control group.
Infant Exposure to Metals through Consumption of Formula Feeding in Mekelle, Ethiopia
Authors: Eticha Tadele , Afrasa Melat , Kahsay Getu , Gebretsadik Hailekiros
Published: April 2018

This study aimed at determination of heavy metals (cadmium, lead, and zinc) in milk-based infant formulas collected from Mekelle, Ethiopia, and their associated health risks to the infants through consumption of these products. The infant feeding samples were dry-ashed in a muffle furnace followed by digestion in nitric acid and the resulting solutions were analyzed by flame atomic absorption spectrophotometer. Cadmium was not detected in the samples while the levels of lead and zinc ranged from not detected value to 0.103 mg/kg and from 27.888 to 71.553 mg/kg, respectively. The estimated daily intake values and the health risk indices of both metals were below their respective safety limits and the threshold of 1, respectively. These findings show low infant health risk of these metals through consumption of these products. Nevertheless, regular monitoring of infant formula for toxic metals is required since infants are potentially more susceptible to metals.
An Electrochemical Synthesis of Reduced Graphene Oxide/Zinc Nanocomposite Coating through Pulse-Potential Electrodeposition Technique and the Consequent Corrosion Resistance
Authors: Moshgi Asl S. , Afshar A. , Yaghoubinezhad Y.
Published: April 2018

Pulse-potential coelectrodeposition of reduced graphene oxide/zinc (rGO-Zn) nanocomposite coating is directly controlled upon a steel substrate from a one-pot aqueous mixture containing [GO−/Zn2+]δ+nanoclusters. GO nanosheets are synthesized by modified Hummer’s approach while Zn cations are produced in the solution and deposited on GO nanosheets using anodic dissolution technique. Eventually, nanoclusters are reduced to rGO-Zn film through an electrochemical process. Chemical composition, surface morphology, and corrosion resistance of the thin film are characterized. Results show that the corrosion resistance of rGO-Zn coating is approximately 10 times more than the bare steel.
Tunable Inductors Using Integrated Vanadium Dioxide Phase Change Thin Films
Authors: Li Liangyu , Wang Weisong , Shin Eunsung , Subramanyam Guru
Published: April 2018

This paper presents tunable inductors designed with vanadium dioxide (VO2) thin film to implement tunability. Two types of configurations, a single line coil inductor and a dual line coil inductor, are proposed. Tunable inductance is realized by thermally controlling VO2 thin film stub to be an insulator or a conductor. The measurements of inductors are taken in the frequencies range from 0.01 GHz to 10 GHz. The electrical model has been developed to derive the corresponding inductance. The results show that the tuning range is about 69% when the temperature changes from room temperature to above the critical temperature of 68°C.
Modulation of Neuronal Activity on Intercalated Neurons of Amygdala Might Underlie Anxiolytic Activity of a Standardized Extract of Centella asiatica ECa233
Authors: Wanasuntronwong Aree , Wanakhachornkrai Oraphan , Phongphanphanee Penphimon , Isa Tadashi , Tantisira Boonyong , Tantisira Mayuree H.
Published: April 2018

GABAergic intercalated neurons of amygdala (ITCs) have recently been shown to be important in the suppression of fear‐like behavior. Effects of ECa233 (a standardized extract of Centella asiatica), previously demonstrated anxiolytic activity, were then investigated on ITCs. Cluster of GABAergic neurons expressing fluorescence of GFP was identified in GAD67‐GFP knock‐in mice. We found that neurons of medial paracapsular ITC were GABAergic neurons exhibiting certain intrinsic electrophysiological properties similar to those demonstrated by ITC neurons at the same location in C57BL/6J mice. Therefore, we conducted experiments in both C57BL/6J mice and GAD67‐GFP knock‐in mice. Excitatory postsynaptic currents (EPSCs) were evoked by stimulation of the external capsule during the whole cell patch‐clamp recordings from ITC neurons in brain slices. ECa233 was found to increase the EPSC peak amplitude in the ITC neurons by about 120%. The EPSCs in ITC neurons were completely abolished by the application of an AMPA receptor antagonist. Morphological assessment of the ITC neurons with biocytin demonstrated that most axons of the recorded neurons innervated the central nucleus of the amygdala (CeA). Therefore, it is highly likely that anxiolytic activity of ECa233 was mediated by increasing activation, via AMPA receptors, of excitatory synaptic input to the GABAergic ITC leading to depression of CeA neurons.
Hereditary Nonpolyposis Colorectal Cancer and Cancer Syndromes: Recent Basic and Clinical Discoveries
Authors: Chen Erbao , Xu Xiaojing , Liu Tianshu
Published: April 2018

Approximately one-third of individuals diagnosed with colorectal cancer have a family history of cancer, suggesting that CRCs may result from a heritable component. Despite the availability of current gene-identification techniques, only 5% of all CRCs emerge from well-identifiable inherited causes for predisposition, including polyposis and nonpolyposis syndromes. Hereditary nonpolyposis colorectal cancer represents a large proportion of cases, and robustly affected patients are at increased risk for early onset, synchronous, and metachronous colorectal malignancies and extracolonic malignancies. HNPCC encompasses several cancer syndromes, such as Lynch syndrome, Lynch-like syndrome, and familial colorectal cancer type X, which have remarkable clinical presentations and overlapping genetic profiles that make clinical diagnosis a challenging task. Therefore, distinguishing between the HNPCC disorders is crucial for physicians as an approach to tailor different recommendations for patients and their at-risk family members according to the risks for colonic and extracolonic cancer associated with each syndrome. Identification of these potential patients through epidemiological characteristics and new genetic testing can estimate the individual risk, which informs appropriate cancer screening, surveillance, and/or treatment strategies. In the past three years, many appealing and important advances have been made in our understanding of the relationship between HNPCC and CRC-associated syndromes. The knowledge from the genetic profile of cancer syndromes and unique genotype-phenotype profiles in the different syndromes has changed our cognition. Therefore, this review presents and discusses HNPCC and several common nonpolyposis syndromes with respect to molecular phenotype, histopathologic features, and clinical presentation.
Aetiological Features of Elderly Patients with Newly Diagnosed Symptomatic Epilepsy in Western China
Authors: Guo Yi , Yu Liang , He Baoming , Li Suping , Zhu Qiong , Sun Hongbin
Published: April 2018

Aims. Recent epidemiological studies have indicated that the incidence of epilepsy peaks after 60 years old, and epilepsy has become increasingly prevalent in elderly populations. The aim of this study is to identify the aetiologic characteristics of epilepsy in the elderly. Methods. We retrospectively recruited elderly patients with newly diagnosed epilepsy identified in three epilepsy centres in western China; elderly patients were defined as individuals aged 60 years or older. Demographic characteristics, clinical epilepsy data, and the diagnosis and aetiology of epilepsy were recorded. Results. A total of 760 patients with newly diagnosed epilepsy were enrolled in our study. Of these patients, 25% had experienced one or more episodes of status epilepticus, and 62.4% were confirmed as symptomatic. Among the symptomatic cohort, stroke and traumatic brain injury (TBI) were the two most common causes of epilepsy, followed by cerebral tumour, dementia, hippocampal sclerosis (HS), and central nervous system (CNS) infection. When analysed by residence and age, ischaemic stroke was the most common cause of epilepsy in urban patients, whereas traumatic brain injury was the leading cause of epilepsy in rural patients. Conclusion. More than three-fifths of newly diagnosed epilepsy cases in elderly patients were confirmed as symptomatic, and stroke and traumatic brain injury were the primary aetiologies in elderly epileptic patients.
Study on the Effect of Oxygen Defects on the Electrical and Optical Properties of Thin Films
Authors: Jeong Jin
Published: April 2018

SnO2 thin films grown directly on the Si substrate had larger average grain sizes as the power intensity increased, but the average grain size of the SnO2 thin films grown in oxygen atmosphere decreased as the power intensity increased. Hall measurement of pure SnO2 thin films showed that the carrier density increased with increasing power. However, upon annealing the SnO2 thin films, the carrier density decreased with increasing power owing to the formation of oxygen vacancies and the SiO2 layer between the Si substrate and SnO2 thin films. The photoluminescence (PL) of the SnO2 thin film grown in the oxygen atmosphere changed, and it was affected by the oxygen defects at the surface and interfaces of the thin film.
Preparation and Characterization of Polyelectrolyte Complexes of Hibiscus esculentus (Okra) Gum and Chitosan
Authors: Brar Vivekjot , Kaur Gurpreet
Published: April 2018

Polyelectrolyte complexes (PECs) of Okra gum (OKG) extracted from fruits of Hibiscus esculentus (Malvaceae) and chitosan (CH) were prepared using ionic gelation technique. The PECs were insoluble and maximum yield was obtained at weight ratio of 7 : 3. The supernatant obtained after extracting PECs was clearly representing complete conversion of polysaccharides into PECs. Complexation was also evaluated by measuring the viscosity of supernatant after precipitation of PECs. The dried PECs were characterized using FTIR, DSC, zeta potential, water uptake, and SEM studies. Thermal analysis of PECs prepared at all ratios (10 : 90, 20 : 80, 30 : 70, 40 : 60, 50 : 50, 60 : 40, 70 : 30, 80 : 20, and 90 : 10; OKG : CH) depicted an endothermic peak at approximately 240°C representing cleavage of electrostatic bond between OKG and CH. The optimized ratio (7 : 3) exhibited a zeta potential of −0.434 mV and displayed a porous structure in SEM analysis. These OKG-CH PECs can be further employed as promising carrier for drug delivery.
Pattern of Ureteric Pathology Presenting to a Fistula Centre in Western Kenya
Authors: Wanjala Anthony , Mwangi Henry , Mabeya Hillary
Published: April 2018

Background. Ureteric pathology arises from surgical misadventures, trauma, and congenital anomalies. Early detection and treatment is of the essence. Objectives. To determine the types/etiology and outcome of ureteric pathology presenting to Gynocare Fistula Centre, Eldoret, Kenya. Methods. Descriptive retrospective study that evaluated patients presenting with ureteric pathology at Gynocare between 1st January 2012 and 31st December 2016. We pulled out patient charts and extracted and analyzed relevant data using STATA 13E statistical software. Results. We analyzed 33 charts, and their age ranged from 10 to 58 years. Annual proportion for 2012, 2013, 2014, 2015, and 2016 was 2.5%, 2.8%, 1.2%, 1.4%, and 3.0% respectively among all the fistula patients treated in the hospital. All the patients presented with urinary incontinence, and 7 (21.2%) had flank pain. Iatrogenic injuries contributed 84.8% (28), and 3 (9.1%) were congenital while trauma and infection had 1 each. Of those resulting from surgical misadventures, 17 (60.7%) were from obstetric while 11 (39.2%) were from gynecological surgery. All the injuries were in the distal third of the ureter; 5 were bilateral; and 11 were left sided while 17 were right-sided. Repair and/or reimplantation was successful in 31 (93.93%) of the patients. Conclusion. Highest proportion of ureteric pathologies was accounted for by iatrogenic causes and surgical repair and/or reimplantation has a high success rate.
An Analysis of Italian Nurses’ Approach to Patients’ Pain: A Nationwide Online Survey
Authors: Angeletti Chiara , Guetti Cristiana , Paesani Martina , Colavincenzo Silvia , Ciccozzi Alessandra , Angeletti Paolo Matteo
Published: April 2018

Healthcare providers play a fundamental role in evaluating pain. Several issues about how nurses are educated remain unsolved. The aim of our study was to address how Italian nurses manage patients suffering from pain in daily practice. A cross-sectional survey was administered among Italian registered nurses. Data were collected using a 34-item questionnaire that had been previously validated during a pilot study. The lowest level of participation/education/information events was observed in the South (p=0.0001). A significant difference among the four areas was found in the department affiliation of responders (p=0.0001). Pain assessment at patients’ admission was most frequent in the Northeast (32.9%), whereas the lowest frequency was found in the South (15.1%) (p=0.0001). The prevalence of nurses’ knowledge of pain scales and their distribution in usual applications was similar in the Northwest and -east, and Central Italy, but lower in the South (p=0.0001). This study underlines the need for change in the clinical approach to pain treatment in healthcare. Pain assessment is a fundamental step for preparing individualized therapeutic plans, and nurses play a crucial role in improving the quality of life of suffering patients.
Acceptance of Driverless Vehicles: Results from a Large Cross-National Questionnaire Study
Authors: Nordhoff Sina , de Winter Joost , Kyriakidis Miltos , van Arem Bart , Happee Riender
Published: April 2018

Shuttles that operate without an onboard driver are currently being developed and tested in various projects worldwide. However, there is a paucity of knowledge on the determinants of acceptance of driverless shuttles in large cross-national samples. In the present study, we surveyed 10,000 respondents on the acceptance of driverless vehicles and sociodemographic characteristics, using a 94-item online questionnaire. After data filtering, data of 7,755 respondents from 116 countries were retained. Respondents reported that they would enjoy taking a ride in a driverless vehicle (mean = 4.90 on a scale from 1 = disagree strongly to 6 = agree strongly). We further found that the scores on the questionnaire items were most appropriately explained through a general acceptance component, which had loadings of about 0.7 for items pertaining to the usefulness of driverless vehicles and loadings between 0.5 and 0.6 for items concerning the intention to use, ease of use, pleasure, and trust in driverless vehicles, as well as knowledge of mobility-related developments. Additional components were identified as thrill seeking, wanting to be in control manually, supporting a car-free environment, and being comfortable with technology. Correlations between sociodemographic characteristics and general acceptance scores were small (<0.20), yet interpretable (e.g., people who reported difficulty with finding a parking space were more accepting towards driverless vehicles). Finally, we found that the GDP per capita of the respondents’ country was predictive of countries’ mean general acceptance score (ρ=-0.48 across 43 countries with 25 or more respondents). In conclusion, self-reported acceptance of driverless vehicles is more strongly determined by domain-specific attitudes than by sociodemographic characteristics. We recommend further research, using objective measures, into the hypothesis that national characteristics are a predictor of the acceptance of driverless vehicles.
Production of Biosurfactants by Soil Fungi Isolated from the Amazon Forest
Authors: Sena Hellen Holanda , Sanches Michele Alves , Rocha Diego Fernando Silva , Segundo Walter Oliva Pinto Filho , de Souza Érica Simplício , de Souza João Vicente Braga
Published: April 2018

Biosurfactants are surface-active compounds that have sparked interest in recent years because of their environmental advantages over conventional surfactants. The aim of this study was to investigate the production of biosurfactants by soil fungi isolated from the Amazon forest. Fungi colonies were isolated from soil samples and screened for biosurfactant production in submerged fermentation. In addition, the influences of bioprocess factors (carbon source, nitrogen source, pH, and fermentation time) were investigated. Finally, the biosurfactant produced was semipurified and submitted to stability tests. One hundred fungal cultures were obtained from the soil samples, identified by micromorphology, and submitted to screening for biosurfactant production. Sixty-one strains produced biosurfactants. The strainPenicillium8CC2 showed the highest emulsification index (54.2%). The optimized bioprocess conditions for biosurfactant production byPenicillium8CC2 were as follows: soybean oil, 20 g/L; yeast extract, 30 g/L; pH 9; duration of 9 days. The semipurified biosurfactant showed stability after heating at 100°C for 60 min and after the addition of 30% NaCl (w/v). Tween 80 (0.2% w/v), a conventional surfactant, was used as the control.
Colorectal Adenoma Risk Is Increased among Recently Diagnosed Adult Celiac Disease Patients
Authors: Lasa Juan , Rausch Astrid , Bracho Luis Florez , Altamirano Josefina , Speisky Daniela , de Dávila María Teresa García , Iotti Alejandro , Zubiaurre Ignacio
Published: April 2018

Background. The association between celiac disease and colorectal neoplasia has been previously studied, but the question whether recently diagnosed celiac patients show an increased colorectal adenoma prevalence remains unanswered. Aims. To compare the prevalence of colorectal adenomas between adult patients with a recent diagnosis of celiac disease versus healthy controls. Materials and Methods. A retrospective case-control study was undertaken. Patients with a diagnosis of celiac disease at an age of 45 years or more who undertook colonoscopy six months before or six months after the initiation of a gluten-free diet were enrolled as cases. Asymptomatic subjects undertaking screening colonoscopy were recruited as controls in a 2 : 1 fashion. The prevalence of colorectal adenomas and the prevalence of advanced adenomas were compared between groups. Results. 57 celiac disease patients and 118 controls were enrolled. There was a greater prevalence of female patients among the celiac group, with no significant differences in terms of age. There were more obese patients among controls and a higher proportion of tabaquism among celiac patients. Adenoma prevalence was significantly higher among celiac patients (47.37% versus 27.97%, p=0.01). Advanced adenoma detection was not different between groups. Conclusion. Adult patients with a recent diagnosis of celiac disease have an increased prevalence of colorectal adenomas.
Clinical Efficacy of Jinshuibao Capsules Combined with Angiotensin Receptor Blockers in Patients with Early Diabetic Nephropathy: A Meta‐Analysis of Randomized Controlled Trials
Authors: Lu Qiang , Li Cailan , Chen Weiwen , Shi Zhongfeng , Zhan Ruoting , He Rui
Published: April 2018

Background. Jinshuibao capsules (JSB) have been widely used to treat early diabetic nephropathy (DN), but the specific effects are still inconsistent. A meta‐analysis of randomized controlled trials (RCTs) was conducted to evaluate the clinical efficacy of JSB for early DN. Methods. Four international databases and four Chinese databases were searched from publication dates to March 1, 2018. The RCTs reporting the results of JSB’s specific effects were included, and comparisons were between JSB combined with Angiotensin Receptor Blockers (ARBs) as experimental intervention and ARBs as the control. Included studies’ quality was evaluated and the extracted data were analyzed with RevMan 5.3 software. Results. Twenty‐six RCTs including 2198 early DN participants were adopted in the meta‐analysis. The results showed that, compared with the ARBs alone, JSB could remarkably improve the ORR (OR = 3.84; 95% CI: 2.37~6.24; P < 0.00001) and decrease 24 h UTP (MD = −93.32; 95% CI: −128.60
~−58.04; P < 0.00001), UAER (MD = −24.02; 95% CI: −30.93
~−17.11; P < 0.00001), BUN (MD = −0.26; 95%: −0.44
~−0.08; P = 0.005), Scr (MD = −9.07; 95% CI: −14.26
~−3.88; P = 0.0006), ACR (MD = −17.55; 95% CI: −22.81
~−12.29; P < 0.00001), Cys‐C (MD = −0.60; 95% CI: −0.88
~−0.32; P < 0.00001), SBP (MD = −3.08; 95% CI: −4.65
~−1.52; P = 0.0001), DBP (MD = −2.09; 95% CI: −4.00
~−0.19; P = 0.03), and TG (MD = −0.36; 95% CI: −0.50
~−0.21; P < 0.00001). However, it showed no significant differences in TC (MD = −0.32; 95% CI: −0.69~0.04; P = 0.08), FBG (MD = 0.04; 95% CI: −0.39~0.47; P = 0.87), HbA1c (MD = −0.26; 95% CI: −0.59~0.06; P = 0.11), and β2‐MG (MD = −15.61; 95% CI: −32.95~1.73; P = 0.08). Conclusions. This study indicates that JSB is an effective accessory therapeutic medicine for patients with early DN. It contributes to decreasing blood pressure and the content of triglyceride and improving the renal function of early DN patients. However, there is still a need to further verify the auxiliary therapeutic effect of JSB with more strictly designed RCTs with large sample and multiple centers in the future.
Biomarkers of Sepsis-Induced Acute Kidney Injury
Authors: Wang Kaifei , Xie Sheling , Xiao Kun , Yan Peng , He Wanxue , Xie Lixin
Published: April 2018

Sepsis, an infection-induced systemic disease, leads to pathological, physiological, and biochemical abnormalities in the body. Organ dysfunction is caused by a dysregulated host response to infection during sepsis which is a major contributing factor to acute kidney injury (AKI) and the mortality rate for sepsis doubles due to coincidence of AKI. Sepsis-induced AKI is strongly associated with increased mortality and other adverse outcomes. More timely diagnosis would allow for earlier intervention and could improve patient outcomes. Sepsis-induced AKI is characterized by a distinct pathophysiology compared with other diseases and may also have unique patterns of plasma and urinary biomarkers. This concise review summarizes properties and perspectives of the biomarkers for their individual clinical utilization.
Maternal Nutrition during Early Pregnancy and Cardiometabolic Status of Neonates at Birth
Authors: Riaz Musarrat , Shaikh Fareeha , Fawwad Asher , Hakeem Rubina , Shera A. Samad , Hitman Graham A. , Bhowmik Bishwajit , do Vale Moreira Nayla Christina , Basit Abdul , Hussain Akhtar
Published: April 2018

Objective. To explore the impact of maternal body weight on maternal nutrition and micronutrient status in early pregnancy and potential impact on metabolic status in newborns.Methodology. The EU FP7 project GIFTS was conducted from Jan 2012 to May 2014. Demographic details and anthropometric measurements of women in the first trimester of pregnancy were obtained. Blood samples were collected for OGTT, insulin, lipid profile, serum folate, ferritin, vitamin D, vitamin B12, and red cell folate. Newborn anthropometric characteristics were observed. Cord blood samples were collected after delivery for glucose, insulin, and lipid profile of newborns.Results. A total of 301 pregnant mothers, 108 overweight, 63 underweight, and 130 normal weight were included. Prevalence of vitamin D deficiency (<30 ng/mL) and low vitamin B12 (<190 ng/l) were high, 44% and 42%, respectively, in the first trimester. Anemic women (due to B12 or iron deficiency) were 79%, while 72% had low ferritin levels. Gestational diabetes was 16%. Differences were observed between underweight and overweight mothers (P<0.05) for fasting blood glucose, insulin levels, and serum ferritin were observed. No significant difference was observed between vitamin D, serum B12, and red cell folate levels.Conclusion. Prevalence of multiple micronutrient deficiencies was common among Pakistani women during early pregnancy despite the nonvegetarian diet that has important implications for pregnancy care in Pakistan and potentially in expatriate communities living abroad. This trial is registered with ISRCTN number83599025.
Hypersonic Flow Field Reconfiguration and Drag Reduction of Blunt Body with Spikes and Sideward Jets
Authors: Han Guilai , Jiang Zonglin
Published: April 2018

Flow field reconfiguration and drag reduction have been investigated by numerically solving Navier-Stokes equations, with the 2nd order dispersion controlled dissipative scheme adopted for the convective term discretion and the 2nd order central difference scheme for viscous term. Spikes and sideward jets nearby the spike noses were set up in the front of the blunt body to reconfigure the flow field and reduce drag during hypersonic flight. The spikes and the sideward jets led to the formation of the conical shock, the reattached shock, and the circumfluence, instead of a bow shock. According to the quantitative analysis, the reconfiguration of the flow field played a dominant role in drag reduction. Basing on the locations of the reattached shock and its interaction with the conical shock, a combined parameter was proposed for a primary criterion to design the spiked bodies with sideward jets for the purpose of drag reduction.
A New Approach to Diagnose Parkinson’s Disease Using a Structural Cooccurrence Matrix for a Similarity Analysis
Authors: Souza João W. M. de , Alves Shara S. A. , Rebouças Elizângela de S. , Almeida Jefferson S. , Rebouças Filho Pedro P.
Published: April 2018

Parkinson’s disease affects millions of people around the world and consequently various approaches have emerged to help diagnose this disease, among which we can highlight handwriting exams. Extracting features from handwriting exams is an important contribution of the computational field for the diagnosis of this disease. In this paper, we propose an approach that measures the similarity between the exam template and the handwritten trace of the patient following the exam template. This similarity was measured using the Structural Cooccurrence Matrix to calculate how close the handwritten trace of the patient is to the exam template. The proposed approach was evaluated using various exam templates and the handwritten traces of the patient. Each of these variations was used together with the Naïve Bayes, OPF, and SVM classifiers. In conclusion the proposed approach was proven to be better than the existing methods found in the literature and is therefore a promising tool for the diagnosis of Parkinson’s disease.
Analysis of Dynamic Stiffness of Bridge Cap‐Pile System
Authors: Chu Jinhui , Ma Meng , Liu Jinbo
Published: April 2018

In order to investigate the applicability of dynamic stiffness for bridge cap‐pile system, a laboratory test was performed. A numerical model was also built for this type of system. The impact load was applied on the cap top and the dynamic stiffness was analysed. Then, the effect of the effective friction area between pile and soil was also considered. Finally, the dynamic stiffness relationship between the single pile and the cap‐pile system was also compared. The results show that the dynamic stiffness is a sensitive index and can well reflect the static characteristics of the pile at the elastic stage. There is a significant positive correlation between the vertical dynamic stiffness index and bearing capacity of the cap‐pile system in the similar formation environment. For the cap‐pile system with four piles, the dynamic stiffness is about four times as large as the single pile between 10 and 20 Hz.
Pore-Scale Imaging of the Oil Cluster Dynamic during Drainage and Imbibition Using In Situ X-Ray Microtomography
Authors: Li Junjian , Gao Yajun , Jiang Hanqiao , Liu Yang , Dong Hu
Published: April 2018

We imaged water-wet and oil-wet sandstones under two-phase flow conditions for different flooding states by means of X-ray computed microtomography (μCT) with a spatial resolution of 2.1 μm/pixel. We systematically study pore-scale trapping of the nonwetting phase as well as size and distribution of its connected clusters and disconnected globules. We found a lower Sor, 19.8%, for the oil-wet plug than for water-wet plug (25.2%). Approximate power-law distributions of the water and oil cluster sizes were observed in the pore space. Besides, the τ value of the wetting phase gradually decreased and the nonwetting phase gradually increased during the core-flood experiment. The remaining oil has been divided into five categories; we explored the pore fluid occupancies and studied size and distribution of the five types of trapped oil clusters during different drainage stage. The result shows that only the relative volume of the clustered oil is reduced, and the other four types of remaining oil all increased. Pore structure, wettability, and its connectivity have a significant effect on the trapped oil distribution. In the water sandstone, the trapped oil tends to occupy the center of the larger pores during the water imbibition process, leading to a stable specific surface area and a gradually decreasing oil capillary pressure. Meanwhile, in oil-wet sandstone, the trapped oil blobs that tend to occupy the pores corner and attach to the walls of the pores have a large specific surface area, and the change of the oil capillary pressure was not obvious. These results have revealed the well-known complexity of multiphase flow in rocks and preliminarily show the pore-level displacement physics of the process.
A Systematic Review of the Causes and Management of Nonthrombotic Embolic Stroke of Tissue Origin
Authors: Mello Sarah , Judge Ciaran , Kelly Roisin , Bradley David , Harbison Joseph
Published: April 2018

Introduction. Various bodily tissues have been reported to enter the arterial circulation and embolize to the brain resulting in ischemic stroke. Most frequently nonthrombotic embolic stroke (NTES) of tissue origin is iatrogenic or related to an underlying disease process. With the increase in elective surgery and intravascular procedures, NTES may increase in prevalence.Aim. To compile a summary of the background, incidence, presentation, and treatment of NTES of tissue origin, by conducting a systematic review of the current literature.Summary of Review. We searched EMBASE and MEDLINE for articles on NTES of tissue origin published in English with no restriction on publication date (search date June 2017). 800 articles were identified and screened and 159 articles were ultimately reviewed in full text and included in qualitative analysis. Articles deemed relevant were assessed by a second reviewer to confirm compatibility with the inclusion criteria. References of included articles were reviewed for relevant publications. We categorized the pathology of the emboli into the following groups: amniotic fluid (4 publications), tumour (60 publications), fat (43 publications), cholesterol (19 publications), and intravascular debris (12 publications). We then summarized the available literature on each cause of NTES.Conclusions. NTES of tissue origin is an uncommon but important diagnosis to consider particularly in younger stroke patients and in certain clinical settings. Treatment for NTES is currently anecdotal and based on small case series. Embolectomy may emerge as the therapy of choice due to the longer treatment timeframe and heterogeneity of the emboli.
Development of Small Bowel Volvulus on Barbed V-Loc™ Suture: A Rare Complication after Laparoscopic Ventral Rectopexy
Authors: Terrosu Giovanni , Cherchi Vittorio , Baccarani Umberto , Adani Gian Luigi , Lorenzin Dario , Pravisani Riccardo , Bertozzi Serena , Calandra Sergio , Noce Luigino , Zuliani Antonia Lavinia , Risaliti Andrea
Published: April 2018

In this case report, we share our experience with an emerging complication in laparoscopic surgery caused by the use of barbed sutures for an off-label indication. We describe a postoperative volvulus caused by the adhesion of the small bowel and V-Loc suture after a ventral laparoscopic rectopexy in a 48-year-old female patient. We also suggest cutting flush the end of the V-Loc and extending the follow-up of these patients.