bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Fetal Lung Maturity by Quantitative Analysis (quantusFLM) in Women with Gestational Diabetes Mellitus
Authors: López Sánchez Francisco , Delgado Sánchez Elsa , Duyos Mateo Inmaculada , González Álvarez María de la Cruz , Antolín Alvarado Eugenia , Bartha José Luis
Published: September 2018

Objectives: The aim of the present study was to evaluate fetal lung maturity using the noninvasive method of quantitative ultrasound analysis of fetal lung texture (quantusFLM) in women with gestational diabetes mellitus (GDM). Methods: A total of 96 women at 36–38 weeks of gestation were enrolled. They were classified as follows: 33 GDM cases treated with diet, 30 GDM cases treated with diet plus insulin, and 33 normoglycemic women (control group). A quantitative analysis of lung texture was performed. Results: There were significant differences in the lung maturity results among groups (p = 0.004). These differences were established between the insulin-treated group of patients and both the control (p = 0.006) and diet-only (p = 0.003) groups. While none of the women in the control group or in the diet group had a high risk of immaturity, 16.7% of those treated with insulin (5/30) did (p = 0.003). There was no statistically significant correlation between HbA1c and the result of the test. Conclusions: Quantitative ultrasound study of fetal lung texture suggests that a significant percentage of pregnant women with GDM treated with insulin had fetal lung immaturity in the late preterm to early term.
The Predictive Value of the Hydrogen Breath Test in the Diagnosis of Fructose Malabsorption
Authors: Helwig Ulf , Koch Anna K. , Koppka Nadine , Holtmann Sylvia , Langhorst Jost
Published: September 2018

Background: Fructose malabsorption is commonly diagnosed by the hydrogen fructose (H2) breath test. However, the mechanisms behind fructose malabsorption in humans are not well understood and the clinical relevance of this test is considered controversial. Hence, the main aim of this study is to evaluate the predictive value of the H2 breath test. Methods: Regarding exclusion criteria, the study enrolled 562 consecutive patients, enlisted to a gastroenterology clinic between 2009 and 2011 for testing malabsorption. In the final data analysis, 246 patients were included. Ecotrophologists used 3 categories to rate dietary success: complete response, partial response and no response to the diet. They also rated the occurrence of abdominal pain, diarrhoea and bloating during the H2 breath test. Ordinal regression analysis using SPSS was performed to evaluate whether H2 breath test results – measured as the maximum H2 level, the maximum increase in H2, and the area under the curve (AUC) – predicted dietary success or failure. Correlation analyses were applied to test whether symptoms of fructose malabsorption correlated with the H2 breath test measures. Finally, we evaluated whether cut-off-values of 40 or 60 parts per million (ppm) serve better than the test measure of 20 ppm to diagnose fructose malabsorption. Results: When a fructose-free diet was administered it was found that 103 patients (41.9%) were complete responders, 116 (47.2%) were partial responders and 27 (11%) were non-responders. The H2 breath test with the 20 ppm cut-off-value, that is, the maximum H2 level, the maximum increase in H2, and the AUC did not predict dietary response (all 95% CI ns). This was also the case when using 40 or 60 ppm as cut-off-values (all 95% CI ns). Abdominal pain during the test correlated significantly with the AUC. Diarrhoea and bloating correlated significantly with the AUC, the maximum H2 level and the maximum increase in H2 (p < 0.05). Conclusions: The H2 breath test produced no predictive value for the fructose-free diet outcomes; its value as a predictive test is therefore questionable. However, the symptoms of fructose malabsorption correlated significantly with the H2 breath test measures, and this is an indication that there is at least a degree of validity of the H2 breath test beyond the simple detection or exclusion of fructose malabsorption.
Treatment Adherence in Patients with Ulcerative Colitis Is Dependent on the Formulation of 5-Aminosalicylic Acid
Authors: Nakagawa Shoko , Okaniwa Noriko , Mizuno Mari , Sugiyama Tomoya , Yamaguchi Yoshiharu , Tamura Yasuhiro , Izawa Shinya , Hijikata Yasutaka , Ebi Masahide , Ogasawara Naotaka , Funaki Yasushi , Sasaki Makoto , Kasugai Kunio
Published: September 2018

Background/Aims: It is unclear whether 5-aminosalicylic acid (5-ASA) formulation is associated with treatment adherence in ulcerative colitis (UC). Thus, we aimed to investigate the adherence rate after switching from 5-ASA tablets to granules. Methods: This prospective study included 121 UC outpatients treated using 5-ASA tablets. They were grouped based on choice: Group 1 (continued with tablets) and Group 2 (switched to granules without regimen change). Group 2 was further divided into Group 3 (returned to tablets) and Group 4 (continued with granules). The patients completed a self-administered questionnaire regarding the treatment. The primary endpoint was change in adherence after switching to granules. Results: Seventy-nine patients continued with tablets, while 42 patients switched to granules. The adherence rate to the tablet was not significantly different between Group 1 and 2 before switching. In Group 2, switching to granules did not affect adherence. However, in Group 4, adherence significantly improved after switching to granules. Group 3 showed no significant change in adherence before and after switching from tablets. Full-time work and difficulty taking tablets were significant predictors of continuing with granules in Group 4. Conclusion: Patients who continued with 5-ASA granules showed significantly increased adherence, suggesting that patient-tailored drug formulations improved treatment adherence.
Sleep Disturbance and Its Association with Gastrointestinal Symptoms/Diseases and Psychological Comorbidity
Authors: Lei Wei-Yi , Chang Wei-Chuan , Wong Ming-Wun , Hung Jui-Sheng , Wen Shu-Hui , Yi Chih-Hsun , Liu Tso-Tsai , Chen Jiann-Hwa , Hsu Ching-Sheng , Hsieh Tsung-Cheng , Chen Chien-Lin
Published: September 2018

Background/Aims: We aimed to investigate gastrointestinal symptoms, clinical characteristics, and psychological factors in subjects with and without sleep disturbance (SD) in a health screening cohort. Methods: We enrolled 2,752 consecutive subjects during their health checkups. All participants underwent an evaluation with questionnaires. Demographic characteristics and biochemical data were recorded. SD was confirmed when Pittsburgh Sleep Quality Index score was greater than 5. Results: Among the study population (n = 2,674), 956 (36%) individuals had SD. SD was associated with female gender, older age, lower level of education, higher systolic blood pressure, higher serum high-density lipoprotein levels and higher prevalence of functional dyspepsia and irritable bowel syndrome (IBS). SD subjects also had more depression, more anxiety, more severe gastrointestinal reflux disease symptoms and higher prevalence of non-erosive reflux disease (NERD; p < 0.001). SD was ­independently associated with female gender (OR 1.75, p < 0.001), older age (OR 1.03, p < 0.001), NERD (OR 1.88, p = 0.004), IBS (OR 1.51, p = 0.043), and depression (OR 1.16, p < 0.001) by multivariate analysis. Conclusions: Future studies will be needed to clarify the interrelationships among SD, psychological stress, and functional gastrointestinal disorders.
In a Nutshell: Findings from the Bruneck Study
Authors: Kiechl Stefan , Willeit Johann
Published: September 2018

The Bruneck Study is a prospective community-based study enrolling an age- and sex-stratified random sample of 1,000 men and women. It achieved an extraordinary participation rate of 93.4% and a near-complete long-term follow-up exceeding a quarter of a century (1990–2018). High-quality ascertainment of most common human diseases enables reliable evaluation of: disease epidemiology, overlaps between age-related diseases, and risk factors, and discovery of novel biomarkers. Research priorities include atherosclerosis, cardiovascular disease, aging and longevity, neurological diseases, disorders of the bone, and cancer. This review summarizes the main scientific contributions of the Bruneck Study over the past decades, outlines recent highlights, and gives an outlook of what is planned next.
КЛІНІЧНІ ОСОБЛИВОСТІ ГАСТРОЕЗОФАГЕАЛЬНОЇ РЕФЛЮКСНОЇ ХВОРОБИ У ХВОРИХ НА ЦУКРВИЙ ДІАБЕТ ІІ ТИПУ
Authors: Sirchak E. S. , Boldijar O. O. , Stan M. P.
Published: September 2018

Мета – вивчити клінічні особливості ГЕРХ у хворих на ЦД 2 типу.Матеріал і методи. На базі кафедри пропедевтики внутрішніх хвороб медичного факультету ДВНЗ «УжНУ» (гастроентерологічне та ендокринологіне відділення ЗОКЛ імені А. Новака) за 2016–2017 рр. обстежено 84 хворих на ЦД 2 типу з супутньою гастроентерологічною патологією (гастроезофагеальна рефлюксна хвороба (ГЕРХ)). Усі обстежені пацієнти підлягали антропометричним, загальноклінічним, лабораторним та інструментальним мето­дам дослідження. Діагноз цукровий діабет (ЦД) 2 типу встановлено згідно з рекомендаціями International Diabetes Federation (IDF, 2005 р.). Діагноз ГЕРХ встановлювали згідно з критеріями уніфікованого клінічного протоколу (наказ МОЗ України від 31.10.2013 № 943). Результати. Групу обстежених склали хворі на ЦД 2 типу середнього ступеня тяжкості. Аналіз показників антропометричного дослідження свідчить, що у всіх обстежених хворих на ЦД ІІ типу є надмірна вага тіла або ожиріння різного ступеня, а саме – надмірна вага тіла встановлена у 46 (54,7 %) хворих, а ожиріння різного ступе­ня – у 38 (45,3 %) обстежених хворих на ЦД 2 типу.Скарги з боку органів травлення, характерні для ГЕРХ, встановлено у 56 (66,7 %) обстежених хворих на ЦД 2 типу. Провідними клінічними проявами ГЕРХ у хворих була відрижка кислим, печія, відчуття грудки у горлі, а також дисфагія. У 13,1 % пацієнтів виявлені першіння у горлі, осиплість голосу, а також скарги на сухий гавкаючий кашель. У 20,2 % обстежених хворих, які також отримували консультацію кардіолога, додатково ми визначили наявність загруднинного болю за ходом стравоходу та порушення в роботі серця. Ендоскопічне дослідження у всіх обстежених 84 хворих на ЦД 2 типу підтвердило діагноз ГЕРХ.Висновки. 1. У 66,7 % хворих на ЦД 2 типу ГЕРХ проявляється стравохідними клінічними ознаками, а у 33,3 % пацієнтів – позастравохідною симптоматикою. 2. Стравохідні прояви ГЕРХ частіше спостерігаються у хворих на ЦД ІІ типу з ожирінням, а позастравохідні прояви – у пацієнтів з надмірною вагою тіла.
РАДІОЗАХИСНІ ВЛАСТИВОСТІ 2-МЕРКАПТОБЕНЗОТІАЗОЛУ НА КЛІТИНИ IN VITRO
Authors: Litvinchuk K. M. , Lavrenchuk H. Yo. , Gurando V. R. , Klishch I. M. , Kovalchuk A. O.
Published: September 2018

Метою роботи було дослідження радіопротекторних властивостей 2-меркаптобензотіазолу у тест-системах первинної та перещеплюваної культур проліферуючих клітин.Матеріал і методи. Використовували цитологічні і статистичні методи.Результати. При інкубації перещеплюваних клітин лінії L929 з 2-меркаптобензотіазолом у діапазоні концент­рацій 0,03–3,00 мкг/м не було виявлено статистично достовірної зміни (р≤0,05) щільності клітинної популяції у моношарових культурах. Водночас спостерігали для усіх застосованих концентрацій реагенту стимуляцію мітотичної активності на термінальній (5 доба) стадії культивування. Опромінення клітин гамма-квантами 60Со в дозах 1, 5 та 10 Гр призвело до дозозалежних морфофункціональних змін у культурі клітин. Опромінення клітин у присутності 2-меркаптобензотіазолу істотно зменшило негативний вплив радіації на показники життєздатності клітин та їх диференціацію в культурі.Висновки. Кількісна оцінка радіопротекторних властивостей 2-меркаптобензотіазолу у тест-системах культури міогенних клітин та лінії L929 (фібробластоподібні клітини) показала, що найвищі показники коефіцієнта захисту (0,31–0,36) реагент показав при концентрації 3 мкг/мл при опроміненні в дозі 1 Гр, а фактор зменшення дози був максимальний – 4, за концентрації 3,00 мкг/мл. За сукупністю даних літератури та результатів власних досліджень можна вважати 2-меркаптобензотіазол реагентом із радіопротекторними властивостями для клітин in vitro.
ПОЛІМОРФІЗМ ГЕНА PRO12ALA PPAR-γ2 У ХВОРИХ НА НЕАЛКОГОЛЬНУ ЖИРОВУ ХВОРОБУ ПЕЧІНКИ, АРТЕРІАЛЬНУ ГІПЕРТЕНЗІЮ ТА ОЖИРІННЯ
Authors: Yarynych Yu. M.
Published: September 2018

На сьогодні є багато суперечливих відомостей про роль поліморфізму генів сімейства PPAR-γ2 у розвитку метаболічного синдрому, дисліпідемій, артеріальної гіпертензії (АГ) та ожиріння.Мета – проаналізувати частоту алелів і генотипів Pro12Ala поліморфізму гена PPAR-γ2 у структурі хворих на НАЖХП із есенціальною АГ, обтяженою абдомінальним ожирінням (АО).Матеріал і методи. У 96 хворих на НАЖХП у поєднанні із есенціальною АГ II стадії та АО 1–2 ступенів викона­ли дослідження Pro12Ala поліморфізму гена PPAR-γ2 методом ПРЛ. Чоловіків було 41,67 %, жінок – 58,33 %. Серед­ній вік хворих становив (53,70±5,34) років. Групу контролю склали 50 практично здорових осіб, зіставних за віком (47,99±8,46 років) та статевим розподілом (60 % жінок, 40 % чоловіків), які не були у родинних стосунках із хвори­ми.Результати. Серед обстежених стеатогепатит із мінімальною активністю мезенхімально-запального проце­су реєстрували у 16,67 % (16) хворих, у 83,33 % (80) випадків виявили стеатогепатоз. 27,08 % (26) осіб мали АО І ступеня, 58,33 % (56) осіб – АО II ступеня, 14,58 % (14) пацієнтів – АО III ступеня.Загалом, як серед осіб групи контролю, так і cеред хворих, переважав Pro-алель у 6,14 і 3,85 раза (р<0,001) відповідно, без вірогідної різниці у частоті окремих генотипів. Однак у осіб групи контролю вірогідно частіше реє­стрували дикий Pro-алель, рідше Ala-алель, ніж у хворих на НАЖХП із есенціальною АГ, АО І ступеня на 16,77% (χ2=5,06, р=0,024). Частота алелів та генотипів гена PPAR-γ2 (rs1801282) між хворими на стеатогепатит і стеатогепа­тоз вірогідно не відрізнялась. Однак відносна частота осіб із AlaAla- і ProAla-генотипами і, відповідно, із Ala-алелем була вірогідно більшою у хворих на стеатогепатит, ніж у контролі – на 30,25 % (χ2=4,99; р=0,025) і 17,25 % (χ2=4,85; р=0,028). Натомість, відносна частота осіб із ProPro-генотипом та Pro-алелем, навпаки, була меншою, ніж у контролі, на 30,25 % (р=0,025) і 17,25 % (р=0,028).Висновки. Ala-алель гена PPAR-γ2 (Pro12Ala) асоціюється із більшою частотою стеатогепатиту у хворих на АГ та АО.
Whole-Blood miRNA Sequencing Profiling for Vasospasm in Patients With Aneurysmal Subarachnoid Hemorrhage
Authors: Pulcrano-Nicolas Anne-Sophie , Proust Carole , Clarençon Frédéric , Jacquens Alice , Perret Claire , Roux Maguelonne , Shotar Eimad , Thibord Florian , Puybasset Louis , Garnier Sophie , Degos Vincent , Trégouët David-Alexandre
Published: September 2018

Background and Purpose—

Arterial vasospasm is a well-known delayed complication of aneurysmal subarachnoid hemorrhage (aSAH). However, no validated biomarker exists to help clinicians discriminating patients with aSAH who will develop vasospasm (VSP
+
) and identifying those who then deserve aggressive preventive therapy. We hypothesized that whole-blood miRNAs could be a source of candidate biomarkers for vasospasm.

Methods—

Using a next-generation sequencing approach, we performed whole-blood miRNA profiling between VSP
+
patients with aSAH and patients who did not develop vasospasm (VSP
−
) in a prospective cohort of 32 patients. Profiling was performed on the admission day and 3 days before vasospasm.

Results—

Four hundred forty-two miRNAs were highly expressed in whole blood of patients with aSAH. Among them, hsa-miR-3177-3p demonstrated significant (
P
=5.9×10
−5
;
P
Bonferroni
corrected
=0.03) lower levels in VSP
−
compared with VSP
+
patients. Looking for whole-blood mRNA correlates of hsa-miR-3177-3p, we observed some evidence that the decrease in hsa-miR-3177-3p levels after aSAH was associated with an increase in
LDHA
mRNA levels in VSP
−
(
P
<10
–3
) but not in VSP
+
(
P
=0.66) patients.

Conclusions—

Whole-blood miRNA levels of hsa-miR-3177-3p could serve as a biomarker for vasospasm.

Clinical Trial Registration—

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01779713.
Number of Stent Retriever Passes Associated With Futile Recanalization in Acute Stroke
Authors: Baek Jang-Hyun , Kim Byung Moon , Heo Ji Hoe , Nam Hyo Suk , Kim Young Dae , Park Hyungjong , Bang Oh Young , Yoo Joonsang , Kim Dong Joon , Jeon Pyoung , Baik Seung Kug , Suh Sang Hyun , Lee Kyung-Yul , Kwak Hyo Sung , Roh Hong Gee , Lee Young-Jun , Kim Sang Heum , Ryu Chang Woo , Ihn Yon-Kwon , Kim Byungjun , Jeon Hong-Jun , Kim Jin Woo , Byun Jun Soo , Suh Sangil , Park Jeong Jin , Lee Woong Jae , Roh Jieun , Shin Byoung-Soo
Published: September 2018

Background and Purpose—

Stent retriever (SR) thrombectomy has become the mainstay of treatment of acute intracranial large artery occlusion. However, it is still not much known about the optimal limit of SR attempts for favorable outcome. We evaluated whether a specific number of SR passes for futile recanalization can be determined.

Methods—

Patients who were treated with a SR as the first endovascular modality for their intracranial large artery occlusion in anterior circulation were retrospectively reviewed. The recanalization rate for each SR pass was calculated. The association between the number of SR passes and a patient’s functional outcome was analyzed.

Results—

A total of 467 patients were included. Successful recanalization by SR alone was achieved in 82.2% of patients. Recanalization rates got sequentially lower as the number of passes increased, and the recanalization rate achievable by ≥5 passes of the SR was 5.5%. In a multivariable analysis, functional outcomes were more favorable in patients with 1 to 4 passes of the SR than in patients without recanalization (odds ratio [OR] was 8.06 for 1 pass; OR 7.78 for 2 passes; OR 6.10 for 3 passes; OR 6.57 for 4 passes; all
P
<0.001). However, the functional outcomes of patients with ≥5 passes were not significantly more favorable than found among patients without recanalization (OR 1.70 with 95% CI, 0.42–6.90 for 5 passes,
P
=0.455; OR 0.33 with 0.02–5.70,
P
=0.445 for ≥6 passes).

Conclusions—

The likelihood of successful recanalization got sequentially lower as the number of SR passes increased. Five or more passes of the SR became futile in terms of the recanalization rate and functional outcomes.
Long-Term Premorbid Blood Pressure and Cerebral Small Vessel Disease Burden on Imaging in Transient Ischemic Attack and Ischemic Stroke
Authors: Lau Kui Kai , Li Linxin , Simoni Michela , Mehta Ziyah , Küker Wilhelm , Rothwell Peter M. ,   for the Oxford Vascular Study
Published: September 2018

Background and Purpose—

Studies of causes of cerebral small vessel disease (SVD) should fully adjust for blood pressure (BP), but most etiological studies use a single BP measurement or history of hypertension, which might underestimate the role of hypertension. In patients with transient ischemic attack and ischemic stroke, we therefore compared the associations of baseline and long-term premorbid BP with measures of SVD on magnetic resonance imaging brain.

Methods—

We studied 1009 transient ischemic attack/ischemic stroke patients who had a brain magnetic resonance imaging, in the population-based OXVASC (Oxford Vascular Study), and related baseline and 20-year premorbid BP (median: 15 readings/patient) to the total SVD score on imaging.

Results—

SVD score was associated with increasing mean baseline systolic BP (SBP; odds ratio of top versus bottom BP quartile: 2.28; [95% CI, 1.62–3.21];
P
<0.0001) and with prior hypertension (2.53; [95% CI, 2.01–3.20];
P
<0.0001), but the association was much stronger with mean premorbid SBP (6.09; [95% CI, 4.34–8.55];
P
<0.0001). Mean diastolic BP at baseline was negatively associated with SVD score (0.71; [95% CI, 0.51–1.00];
P
=0.050), and a positive association was only evident for diastolic BP 10 to 20 years previously (3.35; [95% CI, 2.33–4.84]; both
P
<0.0001). Relationships between overall mean premorbid BP and SVD burden were strongest in patients age <70 (SBP: 6.99; 4.11–11.86; diastolic BP: 3.13; 1.95–5.07; both
P
<0.0001) versus ≥70 years (2.37; 1.42–3.94;
P
=0.001; and 1.16; 0.74–1.84;
P
=0.52).

Conclusions—

Mean premorbid SBP is more strongly associated with SVD burden than baseline SBP or history of hypertension, and baseline diastolic BP yields a misleading estimate of the likely etiological importance of midlife hypertension for the subsequent development of SVD. Studies of novel potential etiological factors for SVD should aim to adjust for long-term prior BP, and trials of BP lowering with only a few years of follow-up may underestimate the overall impact on SVD.
Integration of Computed Tomographic Angiography Spot Sign and Noncontrast Computed Tomographic Hypodensities to Predict Hematoma Expansion
Authors: Morotti Andrea , Boulouis Gregoire , Charidimou Andreas , Schwab Kristin , Kourkoulis Christina , Anderson Christopher D. , Gurol M. Edip , Viswanathan Anand , Romero Javier M. , Greenberg Steven M. , Rosand Jonathan , Goldstein Joshua N.
Published: September 2018

Background and Purpose—

Noncontrast computed tomographic (CT) hypodensities represent an alternative to the CT angiography spot sign (SS) to predict intracerebral hemorrhage (ICH) expansion. However, previous studies suggested that these markers predicted hematoma expansion independently from each other. We investigated whether the integration of SS and hypodensity (HD) improved the stratification of ICH expansion risk.

Methods—

A single-center cohort of consecutive patients with ICH was retrospectively analyzed. Patients with available CT angiography, baseline, and follow-up noncontrast CT images available were included. Trained readers reviewed all the images for SS and HD presence, and the study population was classified into 4 groups: SS and HD negative (SS−HD−), SS positive only (SS+HD−), HD positive only (SS−HD+), and SS and HD positive (SS+HD+). ICH expansion was defined as hematoma growth >33% or >6 mL. The association between SS and HD presence and ICH expansion was investigated with multivariable logistic regression.

Results—

A total of 745 subjects qualified for the analysis (median age, 73 years; 54.1% men). The rates of ICH expansion were 9.3% in SS−HD−, 25.8% in SS+HD−, 27.4% in SS−HD+, and 55.6% in SS+HD+ patients (
P
<0.001). After adjustment for potential confounders and keeping SS−HD− subjects as reference, the risk of ICH expansion was increased in SS+HD− and SS−HD+ patients (odds ratio, 2.93,
P
=0.002 and odds ratio, 3.02,
P
<0.001, respectively). SS+HD+ subjects had the highest risk of hematoma growth (odds ratio, 9.50;
P
<0.001).

Conclusions—

Integration of SS and HD improves the stratification of hematoma growth risk and may help the selection of patients with ICH for antiexpansion treatment in clinical trials.
Iodine Sign as a Novel Predictor of Hematoma Expansion and Poor Outcomes in Primary Intracerebral Hemorrhage Patients
Authors: Fu Fan , Sun Shengjun , Liu Liping , Gu Hongqiu , Su Yaping , Li Yingying
Published: September 2018

Background and Purpose—

The aim of the study was to investigate the utility of iodine contrast agent leakage (the iodine sign) analyzed by Gemstone spectral imaging in early hematoma formation compared with that of the spot sign for predicting early hematoma expansion (HE) and poor functional outcomes.

Methods—

From 2014 to 2017, 91 patients with spontaneous intracerebral hemorrhage who underwent spectral computed tomography angiography within 6 hours of spontaneous intracerebral hemorrhage onset were prospectively included in our study. We defined a positive iodine sign as tiny enhancing foci within the hematoma on Gemstone spectral imaging and an iodine concentration inside the foci of >7.82 (100 µg/mL). Univariate and multivariate logistical regression analyses were performed to assess risk factors for HE, and the predictive value of HE was analyzed.

Results—

Positive spot and iodine signs were present in 38.5% (35/91) and 57.1% (52/91) of the patients, respectively. Using multivariate analysis, the iodine sign independently predicted HE (odds ratio, 53.67; 95% CI, 11.88–242.42;
P
<0.001) and had a higher sensitivity (91.5% versus 63.8%), negative predictive value (89.7% versus 69.9%), and accuracy (85.7% versus 75.8%) for detecting HE than the spot sign. The iodine sign, but not the spot sign, was significantly related to poor functional outcomes (severely disabled and vegetative state) in all patients (χ
2
=29.97;
P
<0.001).

Conclusions—

The iodine sign is a reliable and sensitive marker for predicting HE and poor functional outcomes.

Clinical Trial Registration—

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02625948.
Emergent Large Vessel Occlusion Screen Is an Ideal Prehospital Scale to Avoid Missing Endovascular Therapy in Acute Stroke
Authors: Suzuki Kentaro , Nakajima Nobuhito , Kunimoto Kenta , Hatake Seira , Sakamoto Yuki , Hokama Hiroyuki , Nomura Koichi , Hayashi Toshiyuki , Aoki Junya , Suda Satoshi , Nishiyama Yasuhiro , Kimura Kazumi
Published: September 2018

Background and Purpose—

The strong evidence of endovascular therapy in acute ischemic stroke patients with large vessel occlusion (LVO) is revealed. Such patients are required to direct transport to the hospital capable of endovascular therapy. There are several prehospital scales available for paramedics to predict LVO. However, they are time consuming, and several of them include factors caused by other types than LVO. Therefore, we need a fast, simple, and reliable prehospital scale for LVO.

Methods—

We developed a new prehospital stroke scale, emergent large vessel occlusion (ELVO) screen, for paramedics to predict LVO. The study was prospectively performed by multistroke centers. When paramedics referred to stroke center to accept suspected stroke patients, we obtain the following information over the telephone. ELVO screen was designed focusing on cortical symptoms: 1 observation; presence of eye deviation and 2 questions; paramedics show glasses, what is this? and paramedics show 4 fingers, how many fingers are there? If the presence of eye deviation or ≥1 of the 2 items were incorrect, ELVO screen was identified as positive. We evaluated between results of ELVO screen and presence of LVO on magnetic resonance angiography at hospital arrival.

Results—

A total of 413 patients (age, 74±13 years; men, 234 [57%]) were enrolled. Diagnosis was ischemic stroke, 271 (66%); brain hemorrhage 73 (18%); subarachnoid hemorrhage, 7 (2%); and not stroke, 62 (15%). One hundred fourteen patients had LVO (internal carotid artery, 33 [29%]; M1, 52 [46%]; M2, 21 [18%]; basilar artery, 5 [4%]; P1, 3 [3%]). Sensitively, specificity, positive predictive value, negative predictive value, and accuracy for ELVO screen to predict LVO were 85%, 72%, 54%, 93% and 76%, respectively. Among 233 patients with negative ELVO screen, only 17 (7%) had LVO, which indicated to be an ideal scale to avoid missing endovascular therapy.

Conclusions—

The ELVO screen is a simple, fast, and reliable prehospital scale for paramedics to identify stroke patients with LVO for whom endovascular therapy is an effective treatment.
Effect of Intrathecal Baclofen on Pain and Quality of Life in Poststroke Spasticity
Authors: Creamer Michael , Cloud Geoffrey , Kossmehl Peter , Yochelson Michael , Francisco Gerard E. , Ward Anthony B. , Wissel Jörg , Zampolini Mauro , Abouihia Abdallah , Calabrese Alessandra , Saltuari Leopold , Van der Looven R. , Bouche K. , Rubin B. , Khurana S. , Moraleda S. , Bender A. , Ruijgrok J. , Shilt J. , Lejeune T. , Ebke M. , Molteni F. , Lawson M. , Grabljevec K. , Dalton C. , Matzak H.
Published: September 2018

Background and Purpose—

Intrathecal baclofen (ITB) is an effective treatment for managing patients with severe poststroke spasticity, who can experience continued pain and decline in their quality of life (QoL). SISTERS (Spasticity In Stroke–Randomized Study) was a randomized, controlled, open-label, multicenter, phase 4 study to evaluate ITB therapy versus conventional medical management (CMM) with oral antispastic medications for treatment of poststroke spasticity.

Methods—

Poststroke patients with spasticity in ≥2 extremities and an Ashworth Scale score of ≥3 in ≥2 affected lower extremity muscle groups were randomized (1:1) to ITB (N=31) or CMM (N=29). Both treatment arms received physiotherapy throughout. The primary outcome was the change in average Ashworth Scale score in the lower extremities of the affected side from baseline to month 6. Here, we report results for secondary outcomes: pain via the Numeric Pain Rating Scale, health-related QoL by the EuroQol–5 dimensional 3 level utility score and health status visual analog scale score, stroke-specific QoL, and patient satisfaction. Analyses were performed on an intention-to-treat basis.

Results—

We observed significant treatment effects in favor of ITB over CMM for changes from baseline to month 6 in Numeric Pain Rating Scale scores for actual pain (ITB versus CMM: mean, −1.17 [SD, 3.17] versus 0.00 [3.29]; median, −1.00 versus 0.00;
P
=0.0380) and least pain (mean, −1.61 [2.29] versus 0.24 [3.07]; median, −1.00 versus 0.00;
P
=0.0136), and EuroQol–5 dimensional 3 level utility scores (mean, +0.09 [0.26] versus +0.01 [0.16]; median, +0.07 versus 0.00;
P
=0.0197). Between-group differences were not statistically significant for EuroQol–5 dimensional 3 level visual analog scale, stroke-specific QoL summary, or Numeric Pain Rating Scale worst pain scores, although ITB patients showed greater numeric improvements from baseline during follow-up. More ITB patients than CMM patients (73% versus 48%) were satisfied with the spasticity reduction at month 6.

Conclusions—

These data support that ITB therapy is associated with improvements in pain and QoL in poststroke patients.

Clinical Trial Registration—

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01032239.
Circulating Vascular Growth Factors and Magnetic Resonance Imaging Markers of Small Vessel Disease and Atrophy in Middle-Aged Adults
Authors: Raman Mekala R. , Himali Jayandra J. , Conner Sarah C. , DeCarli Charles , Vasan Ramachandran S. , Beiser Alexa S. , Seshadri Sudha , Maillard Pauline , Satizabal Claudia L.
Published: September 2018

Background and Purpose—

Little is known about associations between vascular growth factors and magnetic resonance imaging (MRI) markers in midlife. We investigated the association of serum VEGF (vascular endothelial growth factor), Ang2 (angiopoietin 2), sTie2 (soluble tyrosine kinase with immunoglobulin-like and EGF-like domains 2), and HGF (hepatocyte growth factor) concentrations with MRI markers of brain aging in middle-aged adults.

Methods—

We evaluated 1853 participants (mean age, 46±9 years; 46% men) from the Framingham Heart Study. Serum growth factor concentrations were measured using standardized immunoassays. Outcomes included total brain, cortical and subcortical gray matter, white matter, cerebrospinal fluid, and white matter hyperintensity volumes derived from MRI; as well as fractional anisotropy in white matter tracts from diffusion tensor imaging. We related VEGF, Ang2, sTie2, and HGF to MRI measures using multivariable regression models adjusting for vascular risk factors. We tested for interactions with
APOE
(apolipoprotein E) genotype and CRP (C-reactive protein). Results were corrected for multiple comparisons.

Results—

Higher sTie2 was associated with smaller total brain (estimate by SD unit±SE=−0.08±0.02,
P
=0.002) and larger white matter hyperintensity (0.08±0.02,
P
=0.002) volumes. Furthermore, higher Ang2 (0.06±0.02,
P
=0.049) and HGF (0.09±0.02,
P
=0.001) were associated with larger cerebrospinal fluid volumes. Finally, higher Ang2 was associated with decreased fractional anisotropy, in
APOE-ε4
carriers only.

Conclusions—

Vascular growth factors are associated with early MRI markers of small vessel disease and neurodegeneration in middle-aged adults.
Phylogeny and revised classification of the tribe Elachipterini (Diptera: Chloropidae)
Authors: MLYNAREK JULIA J. , WHEELER TERRY A.
Published: September 2018

The phylogenetic relationships of the chloropid tribe Elachipterini were analysed. Sixty-eight exemplar species and seven outgroup species were included in a cladistic analysis based on 76 morphological characters of adult specimens in order to test existing, non-phylogenetic, classifications of the tribe. Nine genera are recognized in the Elachipterini: Allomedeia Mlynarek & Wheeler, Alombus Becker, Anatrichus Loew, Ceratobarys Coquillett, Disciphus Becker, Elachiptera Macquart, Goniaspis Duda, Melanochaeta Bezzi and Sepsidoscinis Hendel. Myrmecosepsis Kertesz is synonymised with Anatrichus, and Togeciphus Nishijima and Cyrtomomyia Becker are synonymised with Elachiptera. Ceratobarys is removed from synonymy with Elachiptera and all Neotropical species and two Nearctic species previously assigned to Elachiptera are transferred to Ceratobarys. Melanochaeta is a valid genus; the type species Melanochaeta capreolus clusters with other species of Melanochaeta and not Oscinella. New combinations include Anatrichus hystrix (Kertesz, 1914) (Myrmecosepsis); Anatrichus taprobane (Andersson, 1977) (Myrmecosepsis), Ceratobarys attenuata (Adams, 1908) (Elachiptera); Ceratobarys cultrata (Wheeler & Forrest, 2002) (Elachiptera); Ceratobarys flavida (Williston, 1896) (Elachiptera); Ceratobarys melinifrons (Mlynarek & Wheeler, 2008) (Elachiptera); Ceratobarys fucosa (Mlynarek & Wheeler, 2008) (Elachiptera); Ceratobarys queposana (Mlynarek & Wheeler, 2008) (Elachiptera); Ceratobarys rubida (Becker, 1912) (Elachiptera); Ceratobarys sacculicornis (Enderlein, 1911) (Elachiptera); Ceratobarys willistoni (Sabrosky, 1948)  (Elachiptera), Elachiptera ensifer (Sabrosky, 1951) (Cyrtomomyia); Elachiptera ericius (Kanmiya, 1983) (Togeciphus); Elachiptera katoi (Nishijima, 1955) (Togeciphus); Elachiptera maculinervis (Becker, 1910) (Cyrtomomyia); Elachiptera punctulata (Becker, 1912) (Cyrtomomyia); Elachiptera subelongata (Kanmiya, 1983) (Disciphus); Elachiptera truncatus (Liu & Yang, 2012) (Togeciphus); Elachiptera tuberculata (Adams, 1905) (Cyrtomomyia) and all the species that were placed in Lasiochaeta are returned to Melanochaeta. A key to genera of the tribe Elachipterini is provided and diagnoses are provided for all genera. The tribe is divided into two geographically distinct clades: the Anatrichus clade includes the Old World tropical genera Allomedeia, Alombus, Anatrichus, Disciphus and Sepsidoscinis; the Elachiptera clade includes the primarily Neotropical genera Goniaspis and Ceratobarys and the widespread, but primarily Holarctic, genera Elachiptera and Melanochaeta.
The first Philippine species of Loeblites Franz (Coleoptera: Staphylinidae: Scydmaeninae)
Authors: JAŁOSZYŃSKI PAWEŁ
Published: September 2018

Loeblites Franz, 1986 is a genus of Glandulariini with adults sharing a very similar body form and most taxonomically important structures with Syndicus Motschulsky, 1851. One of the most conspicuous differences between these genera is the antennal structure. In Syndicus, the antennomere XI is strongly reduced, much shorter than X and lacks the basal stalk, so that the two terminal antennomeres are compactly assembled. They either form one oval structure that appears as a single antennomere because the base of subconical antennomere XI is as broad as apex of X (Syndicus s. str.) or the antennomere XI forms a distinct small 'papilla' on top of X (subgen. Semisyndicus Jałoszyński, 2004) because the base of antennomere XI is much narrower than apex of X. Adults of Loeblites have unmodified antennae, with the antennomere XI strongly elongate and with a narrow basal stalk; additionally the antennae are strikingly slender, nearly filiform. Morphological structures of both genera were described and illustrated by Jałoszyński (2004, 2005). While Syndicus is species-rich, often abundant in leaf litter and under bark in subtropical forests (Jałoszyński 2004, 2006, 2008, 2009, 2011, 2014; Jałoszyński & Nomura 2006; Yin & Li 2015; Yin et al. 2014; Yin & Zhou 2016; Zhou & Yin 2017), and broadly distributed from southeastern Australia, through Southeast Asia, Yunnan (China) and Ryukyus (Japan), up to Sri Lanka, India and the Himalayas, Loeblites comprises merely four species known to occur in Malaysia, Thailand and China (Jałoszyński 2005; Zhou & Li 2015). Loeblites mastigicornis Franz, 1986 is known to occur in Chiang Mai (northern Thailand), L. sabahensis Franz, 1992 and L. minor Jałoszyński, 2005 in Sabah (northern Borneo), and L. chinensis Zhou & Li, 2015 in Yunnan (southwest China). Two females representing an undescribed species were also recorded from Yunnan by Zhou & Li (2015). Specimens of this interesting genus are found rarely, in small numbers and they are typically sifted from leaf litter in subtropical forests.
A new species and new records of the genus Oideterus Thomson, 1857 (Coleoptera: Cerambycidae: Prioninae: Anacolini) from Colombia
Authors: ASCUNTAR-OSNAS OSCAR
Published: September 2018

Oideterus farallonensis sp. nov. is described from Colombia and a detailed photographic record is presented. New locality records for O. andrarius (Galileo, 1987) are provided and a distribution map of the genus Oideterus is presented for the country.
Schistura alboguttata, a new loach species of the family Nemacheilidae (Pisces: Cypriniformes) from the Pearl River basin in Guangxi, South China
Authors: CAO LIANG , ZHANG E.
Published: September 2018

Schistura alboguttata, a new species of nemacheilid loach, is herein described from the Leli-He, a tributary flowing to the You-Jiang of the Pearl River basin (Zhu-Jiang in Chinese) at Tianlin County, Guangxi, South China. This new species can be readily distinguished from all other Chinese species of Schistura by its striking body coloration consisting of irregular white spots scattered over the dorsal and lateral regions of the body, with occasional irregular bars with narrow interspaces on the predorsal region.
Design Roadmapping in an Uncertain World: Implementing a Customer-Experience-Focused Strategy
Authors: Kim Euiyoung , Beckman Sara L. , Agogino Alice
Published: September 2018

Technology is rapidly changing, and customers are seeking not just products and services but experiences. Traditional approaches to strategic planning using product and technology roadmaps are no longer sufficient. This article describes the emergence of what the authors call “design roadmapping” approaches that are grounded in the creation of customer experiences, and which drive the choices of features, functionality, and technology. Design roadmapping provides stability for the future, even as technologies are changing, and keeps organizations more focused on the customers they are serving.
Ideological Attempts to Build a Sustainable Program of Ecodomical Decommunistization in Post-1989 Romania by Promoting the Notion of National Identity
Authors: Simuț Corneliu C.
Published: September 2018

In December 1989, Communism died in Romania—if not as mentality, it surely met its demise as a political system which had dominated almost every aspect of life in the country for over four decades. Thus, at least in theory, an ideological vacuum was created and concrete steps towards filling it with different values and convictions were supposed to be taken as early as possible. The Romanian Eastern Orthodox Church seized the opportunity and initiated a series of measures which eventually created a distinct perception about what culture, ethnicity, and religion were supposed to mean for whoever identified himself as Romanian. This paper investigates these ideological attempts to decontaminate Romania of its former Communist mentalities by resorting to the concept of ecodomy seen as ‘constructive process’ and the way it can be applied to how the Romanian Eastern Orthodox Church dealt with culture, ethnicity, and religion. In the end, it will be demonstrated that while decommunistization was supposed to be constructive and positive, it proved to be so only for the Romanians whose national identity was defined by their adherence to the Romanian Eastern Orthodox Church and its perspective on culture, ethnicity, and religion. For all other Romanian citizens, however, decommunistization was a process of ‘negative ecodomy’ because their cultural ideas, ethnic origin, or religious convictions were perceived as non-Romanian and non-Orthodox. In attempting to reach decommunistization therefore, the Romanian majority still tends to be xenophobic and even anti-Muslim, as plainly demonstrated by the Bucharest mosque scandal which rocked the country in the summer of 2015.
Independent Regulatory Authorities as Mechanisms of Political Monitoring
Authors: Lancaster Thomas D. , Abdalla Reem
Published: September 2018

This article argues that the study of political monitoring can be used to help situate the study of independent regulatory authorities (IRAs). Building upon previous work on the management of common pool resources and other literature on monitoring as a component of governance in larger systems, it looks broadly at liberal democracies’ use of IRAs as monitoring mechanisms. Identifying fundamental concepts and theoretical components in the study of political monitoring, this article argues that they can be used as a lens through which policy analysts can observe and compare IRAs, and thus move beyond descriptive analysis. While focusing on monitoring, as one of the functions of IRAs, it highlights theoretical concerns about how to best institutionalise policy-implementation mechanisms, especially in the area of market interventions and the governance of public goods.
Dynamics of Nuclear Energy Policies in India: A Case Study on the Emergence of Nuclear Safety Regulatory Authority
Authors: Rabbi Md. Fazle , Sabharwal Meghna
Published: September 2018

This study analyses the dynamics of nuclear energy policies in India by using Punctuated Equilibrium Theory (PET) and examines the emergence of India’s Nuclear Safety Regulatory Authority (NSRA) bill as an outcome of punctuation of policy equilibrium. In doing so, the initial part of the study focuses on origin, diffusion and antecedents of independent regulatory agencies (IRAs) to position PET as a theoretical framework, and in the latter part, we analyse the phenomenon of the emergence of the NSRA bill in light of PET. The study finds that the dynamics of nuclear energy policies in India follow a pattern inscribed in the PET and the emergence of NSRA bill can be ascribed to the punctuation of a long sustaining policy equilibrium maintained from 1948 to 2010. The active engagement of multiple policy venues such as the Parliament and the judiciary, an unprecedented level of public protest and increased media attention triggered by the Fukushima Dai-ichi nuclear accident in 2011 catalysed the end of an equilibrium and compelled the policymakers to introduce a bill for establishing an independent regulatory agency, that is, NSRA, to oversee nuclear safety in India.
Characterization of bi-stable pure and hybrid composite laminates – An experimental investigation of the static and dynamic responses
Authors: Firouzian-Nejad A , Mustapha S , Ziaei-Rad S , Ghayour M
Published: September 2018

In this study, the static and dynamic responses of bi-stable hybrid composite laminates [0/AL/90]T and [02/AL/902]T were scrutinized, and their behavior was compared to bi-stable pure composite laminates including [0/90]T and [02/902]T. The work consisted of an analytical study that was validated experimentally. An analytical method based on Hamilton’s principle was developed to investigate the static and vibration characteristics of the laminates. Experimentally, curvatures and out-of plane-displacement, and snap-through load were measured using a quasi-static loading on a universal testing machine. Further experimental analysis was performed to characterize the damping viscous ratio, natural frequency, and critical base excitation that cause the snapping between the two different stable shapes. The results show that the hybridization of bi-stable pure composite laminates has the potential to increase the stable curvatures and enhance the static load-carrying capability up to five times when compared to a pure bi-stable composite laminate of the same thickness. It was also observed that the hybridization of bi-stable pure composite laminates may result in a dramatic change in the dynamic response. The natural frequencies of bi-stable hybrid composite laminates are increased in comparison with bi-stable pure composite laminates. The critical base excitation required for snapping has increased significantly for the hybrid composite laminate. The qualitative and quantitative comparisons between the analytical and experimental results were very promising and they agreed well.
Developing a Prototype to Translate Text and Speech to Pakistan Sign Language With Bilingual Subtitles: A Framework
Authors: Abbas Ali , Sarfraz Summaira
Published: September 2018

The purpose of the study is to provide a literature review of the work done on sign language (SL) around the world and in Pakistan and to develop a translation tool of speech and text to Pakistan Sign Language (PSL) with bilingual subtitles. Information and communication technology and tools development for teaching and learning purposes improve the learning process and facilitate both teachers and students. In Pakistan, unimpaired people face a lot of problems to communicate with deaf people due to the lack of SL understanding, learning resources, and interpreters. This problem is faced by the teachers who communicate with deaf students in the classrooms. The communication gap is filled with the development of a translation tool as Haseeb and Illyas concluded in their study that using this kind of tool, deaf people will have more opportunities to communicate with other members of society at every level. Different components of technology such as Python programming language, Natural Language Tool Kit, prerecorded PSL videos, Linux-based server, and databases are used to develop the prototype of PSL translation tool. This study provides a literature review to highlight the existing technological work done around the world and in Pakistan and also provides an architectural framework of the PSL translation tool which is developed by the researchers to facilitate the people who face difficulty to communicate with deaf people.
Best Practice Approach for Assessment of Microchip-associated Tumors in Preclinical Safety Studies: Position of the Registry of Industrial Toxicology Animal-data (RITA)
Authors: Lapp Stefanie , Bube Axel , Colbatzky Florian A. , Ernst Heinrich , Kellner Rupert , Nolte Thomas , Rinke Matthias
Published: September 2018

Microchip (passive radio-frequency identification device) implantation is a common and widely employed means of animal identification in laboratory animal facilities. However, these devices have been associated with tumors of the skin and subcutis in rodents. While microchip-associated tumors are rare, they pose a challenge for accurate diagnosis and documentation in preclinical toxicity studies. Documentation of these tumors should differentiate microchip-associated lesions with spontaneously occurring or test article–induced tumors. Standardizing criteria for microchip-associated lesions will aid the diagnostic process and allow for preclinical regulatory standardization. To this end, the Registry of Industrial Toxicology Animal-data have developed clear recommendations for diagnosis and documentation of microchip-associated lesions.