bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of Organ Dysfunction as a Primary Outcome Variable Following Cecal Ligation and Puncture: Recommendations for Future Studies
Authors: Abraham Mabel N. , Kelly Alexander P. , Brandwein Ariel B. , Fernandes Tiago D. , Leisman Daniel E. , Taylor Matthew D. , Brewer Mariana R. , Capone Christine A. , Deutschman Clifford S.
Published: November 2019

Outcomes variables for research on sepsis have centered on mortality and changes in the host immune response. However, a recent task force (Sepsis-3) revised the definition of sepsis to “life-threatening organ dysfunction caused by a dysregulated host response to infection.” This new definition suggests that human studies should focus on organ dysfunction. The appropriate criteria for organ dysfunction in either human sepsis or animal models are, however, poorly delineated, limiting the potential for translation. Further, in many systems, the difference between “dysfunction” and “injury” may not be clear. In this review, we identify criteria for organ dysfunction and/or injury in human sepsis and in rodents subjected to cecal ligation and puncture (CLP), the most commonly used animal model of sepsis. We further examine instances where overlap between human sepsis and CLP is sufficient to identify translational endpoints. Additional verification may demonstrate that these endpoints are applicable to other animals and to other sepsis models, for example, pneumonia. We believe that the use of these proposed measures of organ dysfunction will facilitate mechanistic studies on the pathobiology of sepsis and enhance our ability to develop animal model platforms to evaluate therapeutic approaches to human sepsis.
Suppression of DSB Formation by Polβ in Active DNA Demethylation is Required for Postnatal Hippocampal Development
Authors: Uyeda Akiko , Onishi Kohei , Hirayama Teruyoshi , Hattori Satoko , Miyakawa Tsuyoshi , Yagi Takeshi , Yamamoto Nobuhiko , Sugo Noriyuki
Published: November 2019

Genome stability is essential for brain development and function. However, the contribution of DNA repair to genome stability in neurons remains elusive. Here, we demonstrate that the base excision repair protein Polβ is involved in hippocampal neuronal differentiation via a TET-mediated active DNA demethylation during early postnatal stages. Polβ deficiency induced extensive DNA double-strand breaks (DSBs) in hippocampal neurons, and a lesser extent in cortical neurons, during a period in which decreased levels of 5-methylcytosine were observed in genomic DNA. Inhibition of the hydroxylation of 5-methylcytosine by microRNAs miR29a/b-1 expression diminished DSB formation. Conversely, its induction by TET1 overexpression increased DSBs. The damaged hippocampal neurons exhibited aberrant neuronal gene expression profiles and dendrite formation. Behavioral analyses revealed impaired spatial learning and memory in adulthood. Thus, Polβ maintains genome stability in the active DNA demethylation that occurs during postnatal neuronal development, thereby contributing to differentiation and subsequent behavior.
The structure of gold nanoparticles: molecular dynamics modeling and its verification by X-ray diffraction
Authors: Kamiński Michał , Jurkiewicz Karolina , Burian Andrzej , Bródka Aleksander
Published: November 2019

Noble metal nanoparticles exhibit unique physical, chemical, biomedical, catalytic and optical properties. Understanding these properties and further development of production methods entail detailed knowledge of the structure at the atomic scale. Gold nanoparticles with multimodal size distribution were synthesized on porous silica and their atomic scale structure was studied by X-ray diffraction. The obtained experimental data are compared with molecular dynamics simulations. Spherical models of the Au nanoparticles, defined by ensembles of the Cartesian coordinates of constituent atoms, were generated and their geometry was optimized by applying the LAMMPS software. The comparison was performed in both reciprocal and real space. A good agreement is achieved for the models with disorder that can be related to surface relaxation effects and vacancy defects. The approach adopted here may have wider applications for further structural studies of other nanomaterials, offering direct verification of simulation results by experiment.
A systematic review of Green Business Process Management
Authors: Couckuyt Dries , Van Looy Amy
Published: November 2019

Purpose

Green Business Process Management (BPM) focusses on the ecological impact of business processes. Although it is an emerging field, different attitudes exist towards the discipline’s name, the objectives and the approaches to realise them. By means of a systematic literature review, the purpose of this paper is to arrive at a common understanding of the discipline for successful development.

Design/methodology/approach

The review methodology relies on a hermeneutic framework which integrates the search, analysis and interpretation of the literature. The sample is used in a text analysis to find an appropriate definition (RQ1), a bibliometric analysis to give insights in current Green BPM contributions (RQ2) and a content analysis to present differences with conventional BPM (RQ3).

Findings

Green BPM follows a similar development as conventional BPM, namely from a more technical perspective to also including the managerial perspective. More research is required that goes beyond the traditional business process lifecycle.

Originality/value

The research questions generated a comprehensive overview about application domains and research topics, which in turn can deliver benefits for both research and practitioner-related communities. Researchers identify future research avenues, while practitioners find appropriate Green BPM techniques for their domain.
Analyzing the startup ecosystem of India: a Twitter analytics perspective
Authors: Singh Shiwangi , Chauhan Akshay , Dhir Sanjay
Published: November 2019

Purpose

The purpose of this paper is to use Twitter analytics for analyzing the startup ecosystem of India.

Design/methodology/approach

The paper uses descriptive analysis and content analytics techniques of social media analytics to examine 53,115 tweets from 15 Indian startups across different industries. The study also employs techniques such as Naïve Bayes Algorithm for sentiment analysis and Latent Dirichlet allocation algorithm for topic modeling of Twitter feeds to generate insights for the startup ecosystem in India.

Findings

The Indian startup ecosystem is inclined toward digital technologies, concerned with people, planet and profit, with resource availability and information as the key to success. The study categorizes the emotions of tweets as positive, neutral and negative. It was found that the Indian startup ecosystem has more positive sentiments than negative sentiments. Topic modeling enables the categorization of the identified keywords into clusters. Also, the study concludes on the note that the future of the Indian startup ecosystem is Digital India.

Research limitations/implications

The analysis provides a methodology that future researchers can use to extract relevant information from Twitter to investigate any issue.

Originality/value

Any attempt to analyze the startup ecosystem of India through social media analysis is limited. This research aims to bridge such a gap and tries to analyze the startup ecosystem of India from the lens of social media platforms like Twitter.
Enhancing competitiveness in the tourism industry through the use of business intelligence: a literature review
Authors: Nyanga Christopher , Pansiri Jaloni , Chatibura Delly
Published: November 2019

Purpose

The purpose of this paper is to demonstrate the relevance of business intelligence (BI) in businesses in general and tourism firms in particular. BI has been hailed as an innovation that can propel businesses that adopt the system to high productivity and efficiency. This paper confirms that view but further adds that BI also enhances a business’s competitiveness.

Design/methodology/approach

This paper reviews literature on the use of BI in tourism. Although current literature is largely fragmented, focusing on BI, the tourism industry and the notion of competitiveness separately, this paper makes an attempt to bring the three sub-themes in the same study and highlights their interconnectedness. The study adopts two environmental analysis models to better analyze this matter. First is the environmental analysis model as based on Downes’s modification of Porter’s five forces framework. The second model used is the resource-based view approach to business environmental analysis.

Findings

This paper affirms that the tourism industry is one of those industries that continue to benefit from the advantages that come with the adoption of a BI system. Literature shows that the tourism industry was one of those that first adopted BI in order to benefit from the benefits that come with its adoption. Such advantages include flexible and user friendly tourists’ data capture, storage, retrieval, processing and analytical capabilities.

Research limitations/implications

This was a largely literature review-based study. There is, therefore, room for strengthening its findings by conducting field work and mixed methods research for more robust results.

Practical implications

This study will surely benefit the tourism industry and business in general from its highly favorable conclusions to the benefits that come with the adoption of a BI system. It can also be used as a reference in to the tourism field, especially aggregating important concepts and literature that can help future practical studies.

Social implications

Society will also benefit from this study in terms of the new knowledge that has been generated. Members of society will then be in a position to demand products and services that are a result of innovation and informed decision making.

Originality/value

Although this paper is largely based on literature, the conclusions reached are those of the authors. A close assessment of the literature in BI and the tourism industry was done, resulting in the conclusions reached by the authors.
B(u)y the book: evaluation of a university initiative to provide students with funds to buy books
Authors: Porritt Frances , Murphy Linda , Wells Gemma , Burns Emma
Published: November 2019

Purpose

In the era of high student fees and intense market competition, many universities now buy books for their new students, and recently have incorporated student choice into the offer, enabling students to choose how to spend funds. Teesside University has successfully piloted such an approach with one academic School, the School of Social Sciences, Humanities and Law. The pilot has now been extended to all academic Schools, with all students receiving £100 per academic year to spend on reading list books. The scheme covers new full-time undergraduate students at the University, and is operated in collaboration with an external company, John Smiths. The purpose of this paper is to evaluate the Teesside University Advance scheme against baseline data of book borrowing and reservation patterns of reading list titles. The paper explores the impact upon the student experience and student perceptions of the Library.

Design/methodology/approach

The project used a mixed methods approach. The quantitative strand analysed book borrowing and reservation patterns data from library systems and from book purchasing patterns data provided by the online store supporting the scheme. Students were also surveyed about the scheme. The qualitative strand, via one-to-one interviews conducted by the student researcher, gained an insight into why students select certain titles to purchase; and what their expectations of the university library are for the supply of reading list titles.

Findings

Analysis revealed an overall decline in book borrowing from the library of the titles selected for purchase by students via the scheme. Student perceptions of the library were positive and demonstrated a strategic use of library resources alongside book purchases and open web resources. At early stages of university undergraduate study, students need guidance on most appropriate resources to use and why, from either reading lists or book bundles.

Originality/value

Teesside University scheme is unique in the UK in covering all new full-time undergraduates and letting them choose which reading list titles to buy with the university funds provided.
Effect of travel distance and rurality of residence on initial surveillance for hepatocellular carcinoma in VA primary care patient with cirrhosis
Authors: Rodriguez Villalvazo Yolanda , McDanel Jennifer S. , Beste Lauren A. , Sanchez Antonio J. , Vaughan‐Sarrazin Mary , Katz David A.
Published: November 2019

Objective

To determine the relationship between travel distance and surveillance for hepatocellular carcinoma among veterans with cirrhosis.

Data Sources

Veterans Health Administration (VHA) inpatient and outpatient administrative data were linked to geocoded enrollee files. CMS‐VHA merged data were used to assess receipt of Medicare‐financed non‐VA imaging.

Study Design

A retrospective cohort of US veterans diagnosed with cirrhosis between 2009 and 2015 was examined. First available abdominal imaging following the diagnosis of cirrhosis was analyzed separately as a function of travel distance to the nearest VA medical center (VAMC) and to the patient's assigned VA primary care provider. Veterans with dual use of Medicare and VA services were also examined for receipt of imaging outside of the VA.

Principal Findings

Veterans who resided more than 30 miles from the nearest VAMC were less likely to receive any imaging for HCC surveillance. Among dual users, increased travel distance between the patient's residence and nearest VAMC was associated with an increased likelihood of receiving any abdominal imaging at non‐VA facilities.

Conclusion

Increased travel distance to the nearest VA medical center reduces the likelihood of receiving imaging for HCC surveillance in cirrhotic veterans. Future efforts should focus on reducing geographic barriers to HCC surveillance.
Authentication of Tokaj Wine (Hungaricum) with the Electronic Tongue and Near Infrared Spectroscopy
Authors: Zaukuu John‐Lewis Z. , Soós János , Bodor Zsanett , Felföldi József , Magyar Ildikó , Kovacs Zoltan
Published: November 2019

Tokaj wines (Hungaricum) are botrytized wines acknowledged for the unique organoleptic properties bestowed by botrytized grape berries during production. Excluding these berries during wine production or manipulating the sugar content of low‐grade wines to imitate high‐grade wines are some recent suspicious activities that threaten the wine quality. Advanced methods such as spectroscopy and sensor‐based devices have been lauded for rapid, reliable, and cost‐effective analysis, but there has been no report of their application to monitor grape must concentrate adulteration in botrytized wines. The study aimed to develop models to rapidly discriminate lower grade Tokaj wines, “Forditas I” and “Forditas II,” that were artificially adulterated with grape must concentrate to match the sugar content of high‐grade Tokaj wines using an electronic tongue (e‐tongue) and two near infrared spectrometers (NIRS). Data were evaluated with the following chemometrics: principal component analysis (PCA), discriminant analysis (LDA), partial least square regression (PLSR), and aquaphotomics (a novel approach). There was a noticeable pattern of separation in PCA for all three instruments and 100% classification of adulterated and nonadulterated wines in LDA using the e‐tongue. Aquagrams from the aquaphotomics approach showed important water absorption bands capable of being markers of Tokaj wine quality. PLSR models showed coefficient of determination (R2CV) of 0.98 (e‐tongue), 0.97 (benchtop NIRS), 0.87 (handheld NIRS), and low root mean squared errors of cross‐validation. All three instruments could discriminate, classify, and predict grape must concentrate adulteration in Tokaj with a high accuracy and low error. The methods can be applied for routine quality checks of botrytized wines.

Practical Application

Tokaj wines (Hungaricum) are botrytized wines acknowledged for the unique organoleptic properties bestowed by botrytized grape berries during production. Excluding these berries during wine production or manipulating the sugar content of low‐grade wines to imitate high‐grade wines are some recent suspicious activities that threaten the wine quality. Using advanced instruments, the electronic tongue, benchtop near infrared spectroscopy, and a handheld near infrared spectroscopy, we could discriminate, classify, and predict grape must concentrate adulteration in Tokaj with a high accuracy and low error. The models in our study can be applied for routine quality checks of botrytized wines.
Prevalence, correlates, and impact of sleep disturbance in Chinese patients with primary Sjögren’s syndrome
Authors: Cui Yafei , Li Jing , Li Lin , Zhao Qian , Chen Shengnan , Xia Ling , Fu Ting , Ji Juan , Gu Zhifeng
Published: November 2019

Aim

Sleep disturbances are common in primary Sjögren's syndrome (pSS) patients and may lead to disease aggravation and decreased health‐related quality of life (HRQoL). There are currently no known reported studies related to the prevalence, correlates, and impact of sleep disturbance in pSS patients from China. Therefore, this study aims to assess the sleep quality in Chinese pSS patients and evaluate its relationship with the disease activity, quality of life and mood disorders.

Methods

A self‐report survey was administered to 221 pSS patients and 198 healthy individuals using the Pittsburgh Sleep Quality Index (PSQI) for sleep quality. Disease activity and damage were evaluated with the European League Against Rheumatism Sjögren's syndrome disease activity index (ESSDAI). Independent samples t tests, Chi‐square analysis, logistic regression were used to analyze these data.

Results

Our results found that the prevalence of poor sleep (PSQI ≥ 6) was 57.5% and the mean global score of PSQI was 6.57 (SD 3.19) in patients, which were significantly higher than the controls (32.3% and 4.93 [SD 2.86], respectively). When trying to fall asleep, patients with pSS had some sleep disturbances, reduced sleep efficiency, increased number of awakenings than controls. There were significant correlations among dryness, ocular surface disease, HRQoL, pain, disease activity, anxiety/depression and sleep quality in pSS patients. Meanwhile, logistic regression models identified depression and Short Form‐36 mental composite score as predictors of poor sleep quality.

Conclusions

Sleep disturbances are commonly reported in pSS patients and sleep quality is lower in pSS patients than in healthy controls. The data suggested the need for holistic assessment and management of pSS patients.
The Mesopotamian frontier of the Arabian Neolithic: A cultural borderland of the sixth–fifth millennia BC
Authors: Carter Robert
Published: November 2019

The material culture of coastal Arabian Neolithic sites of the sixth–fifth millennia BC contains a range of small Mesopotamian‐style objects, in addition to Ubaid pottery. There is a significant concentration of such objects at the Kuwaiti sites, H3 and Bahra 1, with lesser amounts in the Central Gulf region and virtually none in the Lower Gulf. The combination of material and symbolic culture at the Kuwaiti sites indicates that their inhabitants could communicate with both Ubaid and Neolithic peoples with equal facility, implying a key role in the region’s earliest experiments in maritime trade. Moreover, the presence in southern Iraq and at Susa of distinctive arrowheads, and possibly Arabian Coarse Ware ceramics, suggests that the range of eastern Arabian Neolithic peoples extended all along the ancient shoreline to the vicinity of the Mesopotamian Ubaid settlements, and even Susiana. The bifacial pressure‐flaked arrowheads are of two different types that are well attested in eastern Arabia, though one type is more common in southern Iraq and Susiana, hinting at a local population related to the Arabian Neolithic. These finds are quantified and illustrated in this paper, and indicate a cultural borderland stretching for around 300 km north of Kuwait.
The short‐term effects of angiotensin II receptor blockers on albuminuria and renal function in Korean patients
Authors: Shin Juyoung , Kim Hun‐Sung , Min Kim Tong , Kim Hyunah , Lee Seung‐Hwan , Hyoung Cho Jae , Lee Hyunyong , Woo Yim Hyeon , Yoon Kun‐Ho
Published: November 2019

Each angiotensin II receptor blocker (ARB) asserts independent molecular effects. No study has compared the renoprotective potency of different types of ARBs in Korea. This study evaluated the differences among medications for treating albuminuria. Data were obtained from electronic medical records of adult patients who underwent albuminuria test and received treatment with either angiotensin‐converting enzyme inhibitors (ACEIs) or ARBs between January 2009 and June 2016. Patients' albuminuria and renal function data were observed for three months after treatment initiation. In total, 1475 patients were included. Patients treated with ACEIs had no significant changes in albuminuria (from 127.7 ± 55.1 mg/g to 46.7 ± 18.7 mg/g, P = .127), but those treated with ARBs showed significant improvement (from 491.2 ± 33.2 mg/g to 372.0 ± 28.0 mg/g, P < .001). The ARB group had significantly more patients with normal albuminuria after treatment (from 55.8% to 59.3% for normal albuminuria, from 16.7% to 18.5% for moderately increased albuminuria and from 27.5% to 22.2% for severely increased albuminuria, P = .005), but renal function did not change significantly. Subgroup analysis of ARB types showed that candesartan (from 712.5 ± 71.1 to 489.8 ± 57.8 mg/g, P < .001) and irbesartan (from 522.6 ± 65.7 to 352.6 ± 54.3 mg/g, P < .001) had significant effects. Candesartan improved albuminuria in patients older than 60 years (from 506.9 ± 84.2 to 371.9 ± 70.6 mg/g, P = .004) and irbesartan improved albuminuria in patients with glomerular filtration rate <60 (from 551.6 ± 100.0 to 392.4 ± 76.2, P = .007). Only irbesartan and candesartan could reduce albuminuria, suggesting that all ARBs do not have the same outcome. This indicates the importance of optimizing ARB selection, considering both patient condition and organ‐specific characteristics of medications.
Compromised endothelial function in transgender men taking testosterone
Authors: Gulanski Barbara I. , Flannery Clare A. , Peter Patricia R. , Leone Cheryl A. , Stachenfeld Nina S.
Published: November 2019

Context

Transgender men (TGM) are persons assigned female gender at birth with a male gender identity and are routinely treated with testosterone. Androgen excess is associated with endothelial dysfunction among cisgender females (CGF) and is an early sign of atherosclerosis and hypertension.

Objective

To determine the effect of testosterone treatment on endothelial function in TGM.

Setting

The John B. Pierce Laboratory and Yale School of Medicine.

Subjects

Eleven TGM (age 27 ± 5 years; BMI 24.4 ± 3.7 kg/m2) receiving testosterone (T) and 20 CGF (28 ± 5 years; BMI 26.0 ± 5.1 kg/m2) during the early follicular phase of their menstrual cycle.

Design and Outcome Measures

We evaluated brachial vasodilatory responses following stimuli designed to elicit shear stress using 5‐minute occlusion to determine endothelial function (flow‐mediated vasodilation, FMD).

Results

Total T was greater in the TGM compared to CGF (484.6 ± 122.5 vs 1.5 ± 0.7 ng/dL), as was free T (83.9 ± 32.4 vs 1.9 ± 0.8 pg/dL). FMD was markedly lower in the TGM (4.5 ± 2.7%) compared to the CGF (8.1 ± 2.9%, P = .002) indicating significantly diminished endothelial function in TGM.

Conclusions

We have shown for the first time that in TGM the androgen‐dominant hormonal milieu was associated with impaired endothelial function. Endothelial dysfunction precedes clinically detectable atherosclerotic plaque in the coronary arteries, so is an important marker for clinical cardiovascular risk. Therefore, attention to cardiovascular risk factors should be integral to the care of transgender men.
Capturing smart service systems: Development of a domain‐specific modelling language
Authors: Huber Rocco Xaver Richard , Püschel Louis Christian , Röglinger Maximilian
Published: November 2019

Over the last years, the nature of service has changed owing to conceptual advances and developments in information technology. These developments have given rise to novel types of service and smart service systems (SSS), ie, resource configurations capable of learning, dynamic adaptation, and decision making. Currently, the internet of things (IoT) is turning physical objects into active smart things, bridging the gap between the physical and the digital world. Smart things advance SSS as they observe the physical environment, access local data, immerse into individuals' everyday lives and organizational routines. In line with the emergent nature of both phenomena, the impact of the IoT on SSS yet needs to be explored. Building the basis for explanatory and design‐led research and for the analysis and design of SSS, a means for the conceptual modelling of SSS that accounts for novel IoT‐enabled concepts is in high need. Hence, we designed, demonstrated, and evaluated a domain‐specific modelling language (DSML) for SSS. We evaluated the DSML by using it in the modelling of real‐world scenarios from all functional IoT domains, by submitting it to the scrutiny of industry experts, by discussing it against generic DSML requirements, and by analysing to what extent it meets domain‐specific design objectives compared with competing artefacts. To demonstrate the DSML, we included a complex real‐world scenario centred around the Nest Learning Thermostat.
Periodontal pathogens and their role in cardiovascular outcome
Authors: Schulz Susanne , Schlitt Axel , Hofmann Britt , Schaller Hans‐Günter , Reichert Stefan
Published: November 2019

Aim

Periodontitis has been identified as a moderate but independent risk factor for cardiovascular (CV) disease and progression. The objective of this study (ClinicalTrials.gov Identifier: NCT01045070) was to assess subgingival colonization with selected periodontal pathogens on the occurrence of further adverse CV events in a cohort of CV patients.

Methods

The prevalence of severe periodontitis including the detection of 11 periodontal pathogens (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, Treponema denticola, P. intermdia, Peptostreptococcus micros, Fusobacterium nucleatum, Campylobacter rectus, Eubacterium nodatum, Eikenella corrodens, Capnocytophaga sputigena, Capnocytophaga gingivalis, Capnocytophaga ochracea; HAIN‐Diagnostica®) was analysed in 1,002 CV patients The prognostic impact of periodontal pathogens for combined CV endpoint (stroke/TIA, myocardial infarction, CV death, death from stroke) was evaluated after a 3‐year follow‐up period. Hazard ratios (HRs) were adjusted for established CV risk factors applying Cox regression.

Results

In the Kaplan–Meier analysis (log‐rank test: p < .001) and Cox regression (HR: 0.545, 95%‐CI: 0.387–0.773; p = .001), the decreased occurrence of E. corrodens was shown to be an independent predictor for adverse CV events after 3 years of follow‐up.

Conclusions

The detection of E. corrodens was associated with a reduced risk of adverse CV events in patients with CV disease. The pathophysiological background underlying this association should be investigated in further studies.
Retrospective study of complications associated with surgically‐placed gastrostomy tubes in 43 dogs with septic peritonitis
Authors: Elmenhorst K. , Pérez López P. , Belch A. , Demetriou J. L.
Published: November 2019

Objectives

To determine the safety of surgically‐placed gastrostomy feeding tubes in dogs with septic peritonitis.

Materials and Methods

Retrospective analysis of 43 dogs with septic peritonitis that had undergone surgical exploration and gastrostomy tube (de Pezzer or Foley) placement as part of the surgical procedure. Postoperative recovery times, hospitalisation times, complication rates and overall survival times were documented.

Results

The most common cause of septic peritonitis was dehiscence of an enterotomy or enterectomy site. Fifteen dogs had a Foley gastrostomy tube placed and 28 had a de Pezzer gastrostomy tube placed. The median time from surgery to the start of enteral nutrition was 16 hours (range 3 to 28 hours). There were no major complications relating to the gastrostomy tube; minor complications occurred in 11 (26%) patients. The overall median time spent in hospital was 5 days (range 3 to 29 days) for patients surviving to discharge and 22 (51%) dogs survived overall.

Clinical Significance

Gastrostomy feeding tubes provide a safe way to provide enteral nutrition to dogs with septic peritonitis; they are associated with a low complication rate in these patients.
Influence of dialysate Ca concentrations on the therapeutic effects of etelcalcetide with concomitant drugs in patients with secondary hyperparathyroidism
Authors: Shigematsu Takashi , Fukagawa Masafumi , Yokoyama Keitaro , Akiba Takashi , Fujii Akifumi , Shinoda Atsushi , Akizawa Tadao
Published: November 2019

Aim

Secondary hyperparathyroidism (SHPT), a complication of haemodialysis, is commonly treated with calcimimetics. The impact of dialysates containing different calcium (Ca) concentrations on clinical efficacy of calcimimetics are unclear. We examined whether dialysate Ca concentrations influence the efficacy and dosing of etelcalcetide with concomitant drugs.

Methods

We performed post hoc analyses of a 52‐week, open‐label, multicentre study of etelcalcetide in Japanese SHPT patients to determine whether dialysate Ca influences the therapeutic effects of etelcalcetide with concomitant drugs. We evaluated the differences in serum intact parathyroid hormone (iPTH), corrected Ca (cCa) and phosphate levels among three dialysate Ca concentration groups (2.5, 2.75 or 3.0 mEq/L Ca). Tartrate‐resistant acid phosphatase 5b (TRACP‐5b) and bone alkaline phosphatase (BAP) levels were also compared. Since the dialysate Ca concentration may influence dose adjustment, we assessed the etelcalcetide and concomitant drug doses.

Results

There were no clinically meaningful differences in iPTH, cCa and phosphate levels among the 2.5, 2.75 and 3.0 mEq/L groups (n = 34, 64 and 35, respectively) over 52 weeks. At Week 52, more than 82%, 71% and 67% of patients had iPTH, cCa and phosphate levels within target ranges (60‐240 pg/mL, 8.4‐10.0 mg/dL and 3.5‐6.0 mg/dL, respectively) across the three groups. TRACP‐5b and BAP levels decreased by Week 52 regardless of dialysate Ca. Changes in etelcalcetide and concomitant drug doses were generally similar in each group.

Conclusion

The efficacy and dosing of etelcalcetide with concomitant drugs were essentially unaffected by the dialysate Ca concentration. Patients showed improvements in bone hypermetabolism during treatment.
A case of diffuse midline glioma, H3 K27M mutant mimicking a hemispheric malignant glioma in an elderly patient
Authors: Fujioka Yutaka , Hata Nobuhiro , Hatae Ryusuke , Suzuki Satoshi O. , Sangatsuda Yuhei , Nakahara Yukiko , Mizoguchi Masahiro , Iihara Koji
Published: November 2019

Diffuse midline glioma, H3 K27M mutant arises from midline structures of the central nervous system and predominately affects pediatric patients. However, this disease entity was only recently established, and the clinical phenotypic spectrum remains largely unclear. We herein report a rare case of diffuse midline glioma, H3 K27M mutant with an unusual distribution in an elderly woman who presented with a diffuse glioma that invaded both sides of the thalami, and left hippocampus and frontoparietal lobes, thus mimicking a hemispheric malignant glioma. A biopsy of the lobular lesion led to a molecular diagnostic confirmation of diffuse midline glioma, H3 K27M mutant. The patient received concurrent bevacizumab and temozolomide therapy with radiation therapy and survived for 30 months. This case highlights the possibility that a glioma with cerebral hemispheric spread in an elderly patient may harbor the H3 K27M mutation.
Short‐term Preoperative Denosumab With Surgery in Unresectable or Recurrent Giant Cell Tumor of Bone
Authors: Zhang Run‐zi , Ma Tian‐xiao , Qi Dian‐wen , Zhao Ming , Hu Tongyu , Zhang Guo‐chuan
Published: November 2019

Objective

The purpose of this retrospective study was to evaluate the clinical and oncological results of combination treatment of short‐term preoperative denosumab (the receptor activator of nuclear factor kappa‐B ligand inhibitor) with surgery in unresectable or recurrent cases of giant cell tumor of the bone (GCTB).

Methods

Between 2016 and 2018, 11 eligible patients (1 man, 10 women, mean age 38.1 years) with grade 3 GCTB were treated with a combination of short‐term (six doses) preoperative denosumab and surgery in a single institution. The clinical, radiological, and pathological alteration after the denosumab treatment were compared. The oncological results of the combination therapy were also recorded. Meanwhile, adverse effects or complications of denosumab, if any, were reported.

Results

The median follow‐up time after surgical procedure was 30 months (range 13–45 months). After 3–4 denosumab injections, pain relief was observed in all patients. In two spine patients, the neurological status improved after four doses of treatment. Intraoperatively, the margin of the tumor became clear and the intensity of the tumor increased while the blood supply around and within the lesion decreased. Within the lesion, the typically soft and loose tissue were replaced by the tough and dense fibro‐osseous tissue. The mean diameter of the lesion before and after treatment was 61.55 ± 22.49 mm and 51.81 ± 21.12 mm, respectively, and the T‐score was 1.02 (P = 0.32). Variable calcification was observed at the periphery and within the lesion. A total of three patients experienced local recurrence in this study. In the resection group, only one extremity patient had soft tissue recurrence that was treated with en‐bloc excision. In the curettage group, two of three sacral tumor patients had local occurrence. Both refused re‐operation and restarted the monthly denosumab injection thereafter, and the lesions remained stable at the final follow up. Finally, no adverse effects or complications related to denosumab treatment were found.

Conclusion

For the unresectable or recurrent GCTB cases, short‐term (six doses) preoperative use of denosumab improved clinical symptoms, decreased the tumor size, and increased the tumor density. The changes in tumors, in turn, simplified the tumor removal manipulation and, subsequently, decreased the local recurrence for the resection surgery. For the curettage, the denosumab‐induced changes had mixed impacts, and shorter term (fewer than six doses) usage may be more appropriate. Our six‐dose regime was deemed safe, while the safety of long‐term use remains unknown.
Increased melanocytic nevi and lentigines in two patients with harlequin ichthyosis
Authors: McKenzie Shanice , Arzeno Julia , Lonowski Sarah , Cheng Carol E. , Hogeling Marcia
Published: November 2019

An increased number of melanocytic nevi and lentigines have been reported in patients with two types of autosomal recessive congenital ichthyosis (ARCI): lamellar ichthyosis and nonbullous congenital ichthyosiform erythroderma. These melanocytic lesions may have clinical and dermoscopic features of atypia, necessitating close surveillance. Here, we report two interesting cases of pediatric patients with harlequin ichthyosis (HI) who developed increased melanocytic nevi and lentigines. These cases are unique in that the patients presented at a younger age and one patient had a darker skin phototype than previously described in the literature.
Effectiveness of nCPAP for moderate preterm infants compared to BiPAP: A Randomized, Controlled Non‐Inferiority Trial
Authors: Lee Mi‐Ji , Choi Eui Kyung , Park Kyu Hee , Shin Jeonghee , Choi Byung Min
Published: November 2019

Background

Bilevel positive airway pressure (BiPAP) has recently been used in preterm infants with respiratory distress as an alternative to nasal continuous positive airway pressure (nCPAP) because, theoretically, BiPAP is thought to be more effective than nCPAP. However, the results of some studies comparing nCPAP with BiPAP as the initial respiratory support were controversial. The aim of this study is to compare the clinical effectiveness and safety of nCPAP with BiPAP at gestational ages of 30+0 to 34+6 weeks.

Methods

A total of 93 infants with gestational ages of 30+0 to 34+6 weeks, who presented with respiratory distress within 24 h after birth, were randomized to the nCPAP group or the BiPAP group. The primary outcome was the incidence of treatment failure with these two non‐invasive respiratory support devices. Criteria for treatment failure included any of the following: respiratory acidosis (PaCO2 >65 mmHg with pH <7.2), hypoxia (FiO2 >0.4), or apnea (>2–3 episodes of apnea/h).

Results

There was no statistically significant difference in treatment failure between the two groups (P = 0.576). The risk difference comparing treatment failure rate between nCPAP and BiPAP groups was −4.7% (95% CI: −21.5–11.9).

Conclusions

Nasal continuous positive airway pressure is not inferior to BiPAP as an initial management of respiratory distress in these premature infants. We therefore conclude that nCPAP can be used as an initial management for preterm infants at gestational age of between 30 and 35 weeks as a substitute for BiPAP.
Concavity and Unimodality of Expected Revenue Under Discrete Willingness to Pay Distributions
Authors: Ninh Anh , Shen Zuo‐Jun Max , Lariviere Martin A.
Published: November 2019

Most pricing and revenue management models have at their core an optimization problem; one needs to determine the optimal price or quantity to maximize a profit or revenue function. To ensure tractability, conditions that assure the objective function has a unique solution are enormously helpful. So far, several technical assumptions have been proposed for the continuous case, but comparatively little attention has been given to the discrete counterpart despite its prevalence in practice. Thus, this study aims to develop new technical assumptions, built upon relevant economic concepts, to guarantee the tractability of revenue management models in discrete settings. In particular, we present two sufficient conditions for the revenue function to be concave, in terms of quantity or price and propose a condition for the revenue function to be unimodal, called discrete increasing generalized failure rate (IGFR). Our definition has an appropriate economic interpretation and offers comparable properties to those of the continuous version. Finally, we show the discrete IGFR property holds for several discrete distributions.
Tattoo pigment agglomerates measured in commercial ink stock products by computerised light microscopy
Authors: Hutton Carlsen Katrina , Larsen Georg , Serup Jørgen
Published: November 2019

Background

The incidence of clinical complications such as granuloma formation and sarcoidosis is often seen in black tattoos and may be associated with agglomeration of black pigment.

Aim

To measure count and dimensions of agglomerates in black tattoo inks vs red inks and to compare old inks and new inks of identical brands.

Method

Examination was performed by light microscopy (Olympus BX51™) with magnification 40X, immersion oil. Photographs (Jenoptik Gryphax RGB camera) were taken of each ink sample and analysed by ImageJ software; count, area, width, height, circumference and circularity index were measured. Agglomerates were defined as width and height of objects above 800 nm. Twenty‐one new unopened black inks and 17 new unopened red inks were compared. Furthermore, five old black inks and five old red inks, that had been opened and stocked for over 2 years, were compared with new products of the same brands.

Results

Black agglomerates were area wise and with respect to width, height and circumference significantly larger compared with red agglomerates and more circularly shaped. Count of agglomerates was lower in black inks than in red inks, in accordance with bigger dimensions of black agglomerates. Comparison of old and new inks indicated old inks have larger agglomerates but variable bottle size and storage conditions may have confounded results.

Conclusion

Pigment agglomerates in black tattoo ink stock products were sized larger than agglomerates in red inks. Agglomerates found directly in black inks may predispose to granuloma formation in black tattoos causing sarcoid reaction.
Old Oil Rigs Never Die
Authors: Zeldovich Lina
Published: November 2019

Offshore oil and gas platforms are among the largest structures humanity has ever built. There are more than 7,500 of them towering up from seas all over the world, according to some recent estimates. As wells dry up and pumping equipment wears down, those structures are likely to become obsolete in the upcoming decades. Those oil wells will have be decommissioned and capped off and the platforms taken down. But taking down an offshore oil platform and the tower that supports it is no simple assignment. It is a massive engineering project that requires state-of-the-art equipment.
Modeling and Simulations of Deteriorated Turbulent Heat Transfer in Wall-Heated Cylindrical Tube
Authors: Vegendla Prasad , Hu Rui
Published: November 2019

This paper discusses the modeling and simulations of deteriorated turbulent heat transfer (DTHT) for a wall-heated fluid flows, which can be observed in gas-cooled nuclear power reactors during pressurized conduction cooldown (PCC) event due to loss of force circulation flow. The DTHT regime is defined as the deterioration of normal turbulent heat transport due to increase of acceleration and buoyancy forces. The computational fluid dynamics (CFD) tools such as Nek5000 and STAR-CCM+ can help to analyze the DTHT phenomena in reactors for efficient thermal-fluid designs. Three-dimensional (3D) CFD nonisothermal modeling and simulations were performed in a wall-heated circular tube. The simulation results were validated with two different CFD tools, Nek5000 and STAR-CCM+, and validated with an experimental data. The predicted bulk temperatures were identical in both CFD tools, as expected. Good agreement between simulated results and measured data were obtained for wall temperatures along the tube axis using Nek5000. In STAR-CCM+, the under-predicted wall temperatures were mainly due to higher turbulence in the wall region. In STAR-CCM+, the predicted DTHT was over 48% at outlet when compared to inlet heat transfer values.
A Numerical Study on Ductile Failure of Porous Ductile Solids With Rate-Dependent Matrix Behavior
Authors: Dæhli Lars Edvard Blystad , Morin David , Børvik Tore , Benallal Ahmed , Hopperstad Odd Sture
Published: November 2019

This work examines the effects of loading rate on the plastic flow and ductile failure of porous solids exhibiting rate-dependent behavior relevant to many structural metals. Two different modeling approaches for ductile failure are employed and numerical analyses are performed over a wide range of strain rates. Finite element unit cell simulations are carried out to evaluate the macroscopic mechanical response and ductile failure by void coalescence for various macroscopic strain rates. The unit cell results are then used to assess the accuracy of a rate-dependent porous plasticity model, which is subsequently used in strain localization analyses based on the imperfection band approach. Strain localization analyses are conducted for (i) proportional loading paths and (ii) non-proportional loading paths obtained from finite element simulations of axisymmetric and flat tensile specimens. The effects of strain rate are most apparent on the stress–strain response, whereas the effects of strain rate on ductile failure is found to be small for the adopted rate-dependent constitutive model. However, the rate-dependent constitutive formulation tends to regularize the plastic strain field when the strain rate increases. In the unit cell simulations, this slightly increases the strain at coalescence with increasing strain rate compared to a rate-independent constitutive formulation. When the strain rate is sufficiently high, the strain at coalescence becomes constant. The strain localization analyses show a negligible effect of strain rate under proportional loading, while the effect of strain rate is more pronounced when non-proportional loading paths are assigned.
Nonlinear Response of an Inextensible, Free–Free Beam Subjected to a Nonconservative Follower Force
Authors: McHugh Kevin A. , Dowell Earl H.
Published: November 2019

A free–free beam with a compressive follower force applied to one end exhibits interesting flutter and limit cycle oscillation (LCO) responses. Here, the derivation from Lagrange's equations is given for the nonlinear inextensible beam with such a force applied. The inextensibility constraint is met with a Lagrange multiplier added to the Lagrangian, and the beam allowed three rigid body modes in planar motion in addition to its elastic deformation. The Rayleigh–Ritz modal expansion method and the Runge–Kutta method are used to calculate time histories of the forced beam response. This new model is validated against classical results for the stability boundary and new LCO bifurcation diagrams are computed.
Effects of Rectangular Column Flanges in Steel Structures on Motion-Induced Vortex Vibration
Authors: Matsuda Kazutoshi , Kato Kusuo , Ejiri Kazufumi , Cao Nade
Published: November 2019

A spring-supported test for a rectangular cross section with the side ratio of B/D = 1.18 (B: along-wind length, D: cross-wind length) was conducted to simulate the phenomenon in a closed circuit wind tunnel at Kyushu Institute of Technology. A new finding was that vibrations were confirmed in the neighborhoods of reduced wind speeds Vr = V/fD = 2 and Vr = 8 (V: wind speed (m/s), f: natural frequency (Hz)). Because the reduced wind speed in motion-induced vortex vibration is calculated as Vr = 1.67 × B/D = 1.67 × 1.18 = 2.0, vibrations around Vr = 2 were considered to be motion-induced vortex vibration. On the other hand, vibrations around Vr = 8 were considered to be Kármán vortex-induced vibrations, because Vr = 1/St = 8.1. St has a Strouhal number of 0.124 measured by wind tunnel test using a rectangular cross section of B/D = 1.18.

In this paper, the authors focused on the wind tunnel model configuration. Rectangular column flanges in steel structures have not usually been taken into account when manufacturing wind tunnel test models. Wind tunnel tests were carried out in order to clarify the effects of rectangular column flanges in steel structures on motion-induced vortex vibration. Spring-supported tests, smoke flow visualizations and measurements of Strouhal number and unsteady aerodynamic lift were performed with or without flanges changing angle of attack. Models were forced-oscillating in smoke flow visualizations and unsteady aerodynamic lift measurements. All wind tunnel tests were conducted in a smooth flow. As a result, it was found that it could be very important to model rectangular column flanges in steel structures for wind tunnel tests, especially bracing members of long-spanned truss bridges from a wind engineering point of view.