bluuebunny/crossref_metadata_2025 huggingface dataset:
Preoperative POPQ versus Simulated Apical Support as a Guideline for Anterior or Posterior Repair at the Time of Transvaginal Apical Suspension (PREPARE trial): study protocol for a randomised controlled trial
Authors: Jeon Myung Jae , Kim Chul Hong , Cho Hyun-Hee , Suh Dong Hoon , Kim Soo Rim
Published: January 2020

Introduction

Transvaginal reconstructive surgery is the mainstay of treatment for symptomatic pelvic organ prolapse. Although adequate support for the vaginal apex is considered essential for durable surgical repair, the optimal management of anterior and posterior vaginal wall prolapse in women undergoing transvaginal apical suspension remains unclear. The objective of this trial is to compare surgical outcomes of pelvic organ prolapse quantification (POPQ)-based surgery with outcomes of simulated apical support-based surgery for anterior or posterior vaginal wall prolapse at the time of transvaginal apical suspension.

Methods and analysis

This is a randomised, multicentre, non-inferiority trial. While women who are assigned to the POPQ-based surgery group will undergo anterior or posterior colporrhaphy for all stage 2 or greater anterior or posterior vaginal prolapse, those assigned to simulated apical support-based surgery will receive anterior or posterior colporrhaphy only for the prolapse unresolved under simulated apical support. The primary outcome measure is the composite surgical success, defined as the absence of anatomical (anterior or posterior vaginal descent beyond the hymen or descent of the vaginal apex beyond the half-way point of vagina) or symptomatic (the presence of vaginal bulge symptoms) recurrence or retreatment for prolapse by either surgery or pessary, at 2 years after surgery. Secondary outcomes include the rates of anterior or posterior colporrhaphy, the changes in anatomical outcomes, condition-specific quality of life and sexual function, perioperative outcomes and adverse events.

Ethics and dissemination

This study was approved by the institutional review board of each participating centre (Seoul National University College of Medicine/Seoul National University Hospital, Chonnam National University Hospital, Seoul St. Mary’s Hospital, International St. Mary’s Hospital). The results of the study will be published in peer-reviewed journals, and the findings will be presented at scientific meetings.

Trial registration number

NCT03187054
Targeted and tailored pharmacist-led intervention to improve adherence to antihypertensive drugs among patients with type 2 diabetes in Indonesia: study protocol of a cluster randomised controlled trial
Authors: Alfian Sofa D , Abdulah Rizky , Denig Petra , van Boven Job F M , Hak Eelko
Published: January 2020

Introduction

Current intervention programme to improve drug adherence are either too complex or expensive for implementation and scale-up in low-middle-income countries. The aim of this study is to assess the process and effects of implementing a low-cost, targeted and tailored pharmacist intervention among patients with type 2 diabetes who are non-adherent to antihypertensive drugs in a real-world primary care Indonesian setting.

Methods and analysis

A cluster randomised controlled trial with a 3-month follow-up will be conducted in 10 community health centres (CHCs) in Indonesia. Type 2 diabetes patients aged 18 years and older who reported non-adherence to antihypertensive drugs according to the Medication Adherence Report Scale (MARS) are eligible to participate. Patients in CHCs randomised to the intervention group will receive a tailored intervention based on their personal adherence barriers. Interventions may include reminders, habit-based strategies, family support, counselling to educate and motivate patients, and strategies to address other drug-related problems. Interventions will be provided at baseline and at a 1-month follow-up. Simple question-based flowcharts and an innovative adherence intervention wheel are provided to support the pharmacy staff. Patients in CHCs randomised to the control group will receive usual care based on the Indonesian guideline. The primary outcome is the between-group difference in medication adherence change from baseline to 3-month follow-up assessed by MARS. Secondary outcomes include changes in patients’ blood pressure, their medication beliefs assessed by the Beliefs about Medicines Questionnaire (BMQ)-specific, as well as process characteristics of the intervention programme from a pharmacist and patient perspective.

Ethics and dissemination

Ethical approval was obtained from the Ethical Committee of Universitas Padjadjaran, Indonesia (No. 859/UN6.KEP/EC/2019) and all patients will provide written informed consent prior to participation. The findings of the study will be disseminated through international conferences, one or more peer-reviewed journals and reports to key stakeholders.

Trial registration number

NCT04023734.
Association of postoperative covert stroke and cognitive dysfunction among elderly patients undergoing non-cardiac surgery: protocol for a prospective cohort study (PRECISION study)
Authors: Cui Qianyu , Wang Dexiang , Zeng Min , Dong Jia , Jin Hailong , Hu Zhengfang , Zhang Yuan , Peng Yuming , Han Ruquan
Published: January 2020

Introduction

The incidence of covert stroke and cognitive dysfunction has gradually increased due to an ageing population. Recently, a prospective cohort study reported perioperative covert stroke was associated with an increased risk of postoperative cognitive dysfunction (POCD) 1 year after non-cardiac surgery. However, the mechanism remains unclear.

Methods and analysis

This is a prospective observational trial aiming to investigate the cumulative incidence of perioperative covert stroke and test the hypothesis that perioperative covert stroke associates with POCD in elderly patients undergoing non-cardiac and non-neurological surgery. Data on risk factors, brain MRI, cognitive function evaluation and serum immune-inflammatory cytokines will be collected and analysed.

Ethics and dissemination

Ethical approval has been granted by the Medical Ethics Committee of Beijing Tiantan Hospital, Capital Medical University (reference number: KY2017-027-02). The results of this study will be disseminated through presentations at scientific conferences and publication in scientific journals.

Trial registration number

NCT03081429.
Exploring the influencing factors for non-utilisation of healthcare facilities during childbirth: a special mixed-method study of Bangladesh and 13 other low- and middle-income countries based on Demographic and Health Survey data
Authors: Siddiquee Tanjim , Halder Henry Ratul , Islam Md Akhtarul
Published: January 2020

Objective

To identify the associated factors affecting the decision regarding institutional delivery for pregnant women in 14 low- and middle-income countries (LMICs).

Design

A special mixed-method design was used to combine cross-sectional studies for harmonising data from Bangladesh and 13 other countries to obtain extended viewpoints on non-utilisation of institutional healthcare facilities during childbirth.

Setting

Demographic and Health Survey (DHS) data for 14 LMICs were used for the study.

Participants

There are several kinds of datasets in the DHS. Among them‘IndividualWomen’s Records’was used as this study is based on all ever-married women.

Results

In the binary logistic and meta-analysis models for Bangladesh, ORs for birth order were 0.57 and 0.51 and for respondents’ age were 1.50 and 1.07, respectively. In all 14 LMICs, the most significant factors for not using institutional facilities during childbirth were respondents’ age (OR 0.903, 95% CI 0.790 to 1.032) and birth order (OR 0.371, 95% CI 0.327 to 0.421).

Conclusion

Birth order and respondents’ age were the two most significant factors for non-utilisation of healthcare facilities during childbirth in 14 LMICs.
Study of type 2 diabetes management among patients in a Macau primary care setting
Authors: Wong In
Published: January 2020

Background

In the primary care setting in Macau, type 2 diabetes mellitus (T2DM) is the seventh most common reason for consultation. Inadequate glycaemic control constitutes a major public health problem and is associated with premature death and disability and decreased quality of life. Moreover, this condition substantially increases healthcare expenditures.

Objective

The primary objective was to assess the successful glycaemic control rates, blood pressure (BP) and cholesterol control rates in patients with T2DM in a Macau primary care setting. The secondary objective of this study was to assess the delay of insulin initiation in the Sao Lourence Health Center.

Methods

Patients were stratified according to age (<65 years vs ≥65 years) and sex. Successful glycaemic control was defined as glycated haemoglobin (HbA1c) <7%. Successful cholesterol control was defined as a low-density lipoprotein cholesterol (LDL-C) level <2.6 mmol/L, and BP control was defined as BP <140/90 mm Hg.

Results

Among the 2157 participants included in this study, 1046 (48.5%) patients had HbA1c <7%, 1209 (56.1%) patients had BP <140/90 mm Hg and 1244 (57.7%) patients had LDL-C <2.6 mmol/L. In conclusion, only 403 (18.7%) patients met the targets for all three measures. Of the 235 patients who were on insulin therapy, the mean (±SD) duration from T2DM diagnosis to insulin initiation was 7.47±6.52 years, the mean (±SD) duration from HbA1c not meeting the target (HbA1c ≥7% over 1 year and persistently) to insulin initiation was 3.34±3.66 years and the mean baseline HbA1c was 9.13%. Compared with patients with a longer duration (≥5 years) of HbA1c not meeting the target before insulin initiation, those who started insulin within 1 year of HbA1c not meeting the target had a better glycaemic control rate (40.7% vs 13%).

Conclusions

Nearly half of the patients at Sao Lourence Health Center, a primary care centre in Macau, met the glycaemic control target, but less than one-fifth of patients met all three targets for T2DM control. Moreover, there was a delay in insulin initiation for people with T2DM.
Continuous quality improvement methodology: a case study on multidisciplinary collaboration to improve chlamydia screening
Authors: Ursu Allison , Greenberg Grant , McKee Michael
Published: January 2020

This article illustrates quality improvement (QI) methodology using an example intended to improve chlamydia screening in women. QI projects in healthcare provide great opportunities to improve patient quality and safety in a real-world healthcare setting, yet many academic centres lack training programmes on how to conduct QI projects. The choice of chlamydia screening was based on the significant health burden chlamydia poses despite simple ways to screen and treat. At the University of Michigan, we implemented a multidepartment process to improve the chlamydia screening rates using the plan-do-check-act model. Steps to guide QI projects include the following: (1) assemble a motivated team of stakeholders and leaders; (2) identify the problem that is considered a high priority; (3) prepare for the project including support and resources; (4) set a goal and ways to evaluate outcomes; (5) identify the root cause(s) of the problem and prioritise based on impact and effort to address; (6) develop a countermeasure that addresses the selected root cause effectively; (7) pilot a small-scale project to assess for possible modifications; (8) large-scale roll-out including education on how to implement the project; and (9) assess and modify the process with a feedback mechanism. Using this nine-step process, chlamydia screening rates increased from 29% to 60%. QI projects differ from most clinical research projects by allowing clinicians to directly improve patients’ health while contributing to the medical science body. This may interest clinicians wishing to conduct relevant research that can be disseminated through academic channels.
The Difficulties and Achievements of China’s Ecological Environment Construction: 1949–2019
Authors: PAN Jiahua
Published: January 2020

China’s ecological environment construction has undergone three phases, i.e. the agriculture-based development phase with low productivity not long after the founding of the People’s Republic of China (P.R.C.), the industrial development phase after the adoption of reform and opening-up policy, and the phase toward ecological civilization, each of which has its own features, challenges, responsive measures and achievements. From the year 1949 to the adoption of reform and opening up policy, the Chinese society was characterized by farming culture on the whole, facing problems such as frequent natural disasters, shortage in food production and low urbanization level. To jump out of the Malthusian Trap, the founders of the P.R.C. led people to prevent floods by water control, water conservancy projects and reclamation of wasteland, which alleviated but did not solve the problems because China still suffered poverty and backwardness, and failed to shake off the Malthusian Curse. After the adoption of the reform and opening-up policy, the rapid progress in industrialization and urbanization has liberated farmers from land and greatly improved labor productivity; meanwhile, some lands were released from farmers’ hand, which not only made the value of land resources much higher but also enabled land rehabilitation and ecological self-restoration. Although rapid industrialization and urbanization enormously boosted productive forces and accumulated immense amount of material wealth, but since the beginning of the 21st century, China’s development has been drawn near to the ecological red line, environmental threshold and resources upper limit of industrial development, constantly challenged by sustainable development. After 2010, China has initiated the transformation to ecological civilization, featuring ecological protection, pollution control and resource conservation, aiming to promote the harmonious development between man and nature.
Acoustic Behavior Prediction and Analysis of Resonators in the Presence of Low Mach Number Flow
Authors: Huang Hongpu , Ji Zhenlin , Han Kangjian
Published: January 2020

The frequency-domain linearized Navier–Stokes equations (LNSEs) are used to describe the sound field of Helmholtz resonators and concentric perforated tube resonators in the presence of low Mach number flow. The numerical procedure of LNSEs method is performed in three steps, computational fluid dynamics (CFD) calculation, data transfer and acoustics calculation. The transmission loss predictions of the resonators exhibit good agreement with measurements published in the literature. The results show that the low Mach number flow shifts the resonance frequencies of resonators and changes the acoustic attenuation behavior, which may be attributed to the change of acoustic impedance of the opening and orifices. In order to weaken the effect of flow on the resonance frequency, the modified configurations of resonators are proposed by using the conical tubes to reduce the flow velocity passing the opening and orifices. Numerical results demonstrated that the influence of flow velocity on the resonance frequency of the modified resonators is less sensitive than the original configurations.
Anatol Roshko, 1923–2017
Authors: Papamoschou Dimitri , Gharib Morteza
Published: January 2020

We present a brief account of Anatol Roshko's research and educational contributions to fluid mechanics, focusing on the spirit of his transformative ideas and legacy.
Antiadipogenesis of Oroxylum indicum (L.) Kurz Extract via PPARγ2 in 3T3‐L1 Adipocytes
Authors: Hengpratom Tanaporn , Ngernsoungnern Apichart , Ngernsoungnern Piyada , Lowe Gordon Matthew , Eumkeb Griangsak
Published: January 2020

Oroxylum indicum is regarded as a traditional food with medicinal properties and is used widely throughout Asia. It has previously been demonstrated that O. indicum extract (OIE) was able to suppress the differentiation of 3T3‐L1 preadipocytes to adipocytes. However, the mechanism underlying the antiadipogenesis of this plant has not been fully investigated. The present study aimed to explore the impact of OIE at 50 to 200 μg mL−1 on the molecular mechanism involved in the antiadipogenic activity in 3T3‐L1 cells at day 0 of their differentiation to adipocytes. The morphology and biochemistry of the cells on day 12 were investigated and compared to the relevant controls. Adiponectin was measured using enzyme‐linked immunosorbent assay (ELISA). The mRNA expression of peroxisome proliferator‐activated receptor‐gamma 2 (PPARγ2), sterol regulatory element‐binding proteins 1c (SREBP‐1c), fatty acid synthetase (FAS), glucose transporter (GLUT4), and leptin in adipocytes was determined by real‐time PCR. The results demonstrated that the OIE at 200 μg mL−1 exhibited strongest suppression on intracellular lipid accumulation. The levels of adiponectin were dramatically increased in the untreated adipocytes, whereas significantly decreased in the 200 μg mL−1 OIE‐treated adipocytes (P < 0.05). Expression of the mRNAs revealed that OIE‐treated adipocytes at 200 μg mL−1 significantly inhibited the expression of PPARγ2 and SREBP‐1c and lowered the level of expression of GLUT4, FAS, and leptin compared to the control (P < 0.05). These findings suggest that OIE inhibits adipocyte differentiation along with the downregulation of PPARγ2, SREBP‐1c, and GLUT4, leading to the decrease in the expression of FAS and adipokine (leptin and adiponectin). Thus, OIE might be developed for hyperlipidemia and obesity prevention.
Two Cases of Atraumatic Chylous Ascites Characterized by Hypotriglyceridemia and Partially Managed with an Oral Fat-Free Elemental Diet
Authors: Kamigaki Michihiro , Kunita Satoko , Nakano Makoto , Tanaka Miwako , Aoki Shinya , Tsuga Katsutoshi , Ito Hiroyuki , Matsuura Hideo
Published: January 2020

Most cases of chylous ascites occur after surgery, but it also develops in nonoperative cases, although rarely. Such cases are often difficult to treat. In this study, we treated 2 cases of atraumatic chylous ascites, which were controlled by combining diuretic treatment with an oral fat-free elemental diet (Elental®, EA Pharma Co., Ltd., Tokyo, Japan). Elental can provide oral nutrition compatible with a lipid-restricted diet, which may be useful for control of chylous ascites. We report on these cases, including literature review-based considerations.
Extraskeletal Chondroma: A Rare Cause of Trigger Finger in Children
Authors: Salvatori Giada , Abati Caterina Novella , Bettuzzi Camilla , Buccoliero Anna Maria , Caporalini Chiara , Zanardi Alessandro , Lampasi Manuele
Published: January 2020

Introduction. Trigger finger is ten times less common than trigger thumb in infants and children and, unlike trigger thumb, may arise from a variety of underlying causes. To our knowledge, we describe the first case of pediatric trigger finger secondary to an extraskeletal chondroma. Case Presentation. We report the case of an 11-year-old girl presenting with a typical history of triggering of the fourth finger, in whom a nodule attached to the flexor digitorum superficialis was found; clinical, ultrasound, and operative findings are described. Histological analysis was diagnostic of extraskeletal chondroma, also known as chondroma of soft tissues. Conclusion. This is a very uncommon benign cartilaginous tumor, mostly reported in patients aged 30 to 60 years (just one pediatric extraskeletal chondroma of the hand has been described), and presentation with trigger finger has been reported just once, in a 76-year-old man. This condition should be considered in the differential diagnosis of pediatric trigger finger.
Vanishing Gastroschisis with a Favorable Outcome after a 3-Year Follow-Up: A Case Report and Literature Review
Authors: Abi Rached Elise , Sananes N. , Kauffmann-Chevalier I. , Becmeur F.
Published: January 2020

Vanishing gastroschisis (VG) is a severe complication of gastroschisis with a high mortality rate. We report here a case of VG with a favorable outcome after a 3-year follow-up. A 26-year-old primigravida woman was referred to Strasbourg University Hospital because her fetus was diagnosed with an isolated gastroschisis at 13-week gestation. The ultrasound evolution was marked by a progressive closure of the abdominal wall defect from 19-week gestation and the appearance of dilated intra-abdominal loops. The child was born with a closed abdominal wall except a small remnant at the level of the former gastroschisis orifice. Explorative laparotomy revealed extensive midgut atresia with only 50 cm of remaining midgut. A jejunocolic anastomosis was performed. The child is now 3 years old and has a favorable outcome with only 2 nights a week of parenteral nutrition. A total of 39 cases of VG type D from Perrone et al. classification are described in the literature from 1991 to 2019, among which 19 (48.7%) are alive at the time of publication but only 4 cases are described with a long-term follow-up of 3 years or more. This is the fifth case described with a favorable evolution after 3-year follow-up.
Threshold for Tonic Motor Effects from Random Waveform in a Rat Experimental Model of Frontal Cortex Stimulation
Authors: Leiphart James W. , Ye Zhixing , Lee Michaela , Loew Murray H.
Published: January 2020

Background: Brain stimulation is utilized to treat a variety of neurological disorders. Clinical brain stimulation technologies currently utilize charge-balanced pulse stimulation. The brain may better respond to other stimulation waveforms. This study was designed to evaluate the motor threshold of the brain to stimulation with various waveforms. Methods: Three stimulation waveforms were utilized on rats with surgically implanted brain electrodes: pulses, square waves, and random waveform. The peak-to-peak stimulation voltage was increased in a step-wise manner until motor signs were elicited. Results: The random waveform had the highest motor threshold with brain stimulation compared to the other waveforms. Random waveform stimulation reached maximum voltage without motor side effects while stimulating through both 1 and 8 electrodes. In contrast, the stimulation thresholds for motor side effects of the other two waveforms were on average less than half of the maximum voltage and lower for stimulation through 8 electrodes than stimulation through 1 electrode (p < 0.0005). Conclusion: The random waveform was better tolerated than the other waveforms and may allow for the use of higher stimulation voltage without side effects.
Is the En Bloc Transurethral Resection More Effective than Conventional Transurethral Resection for Non-Muscle-Invasive Bladder Cancer? A Systematic Review and Meta-Analysis
Authors: Yang Han , Lin Jingyu , Gao Pan , He Ziqiu , Kuang Xiayu , Li Xinyu , Fu Haibo , Du Dan
Published: January 2020

Background: En bloc transurethral resection (ERBT) is a major topic of discussion as an alternative to conventional transurethral resection (cTURBT) for the treatment of non-muscle-invasive bladder cancer (NMIBC) addressing the limitations of cTURBT. Methods: We searched through electronic databases including Embase, Cochrane Library, MEDLINE, Web of Science, PubMed, and Google Scholar for articles published up to April 1, 2019; RevMan 5.3 was used to conduct this meta-analysis. Results were expressed as 95% confidence intervals (CI) and risk differences (RD). Results: Nine trials met the inclusion criteria (n = 1,020 patients): 1 study was a randomized controlled trial including a total of 142 participants, 4 studies had a prospective paired design including 605 patients, and 4 studies were retrospective (n = 273 patients). Duration of continuous postoperative bladder irrigation (RD –0.16; 95% CI –3.47 to 0.28; I2 = 97%; p = 0.10) and operation time (RD 0.05; 95% CI –0.23 to 0.32; I2 = 79%; p = 0.74) were not significantly different between ERBT and cTURBT. However, hospitalization time (I2 = 96%; χ2 = 203.16; p = 0.01) and catheterization time (I2 = 95%; χ2 = 163.24; p = 0.02), as well as 24-month recurrence rate (I2 = 0%; χ2 = 0.98; p = 0.008) were significantly better using the ERBT scheme. The incidence of urethral stricture between both schemes (95% CI –0.03 to 0.02; p = 0.50) was not different, but complications such as obturator nerve reflex (95% CI 0.01 to 0.12; p < 0.00001) and bladder perforation (95% CI 0.05 to 0.59; p = 0.50) were less frequent in the ERBT group. Conclusion: ERBT is an effective treatment approach with some advantages for NMIBC. Our meta-analysis revealed that hospitalization time, catheterization time, and 24-month recurrence rate is superior in patients treated with ERBT than cTURBT, and ERBT patients also have a lower complication rate. Furthermore, ERBT improves the quality of tumor specimens and decreases the frequency of repeat transurethral bladder cancer resection. Further randomized controlled trials are needed to confirm our results.
Cardiovascular Comorbidities Are the Main Predictors of Cardiac Reverse Remodeling following Kidney Transplantation
Authors: Kobayashi Masatake , Huttin Olivier , Schikowski Johan , Bozec Erwan , Zohra Lamiral , Frimat Luc , Girerd Nicolas , Girerd Sophie
Published: January 2020

Background: End-stage renal disease is associated with cardiac remodeling, which is partly reversible after kidney transplantation (KT). We aimed to determine the association of cardiovascular comorbidities or kidney-related factors with cardiac reverse remodeling after KT. Methods: We performed echocardiography in 56 patients (aged 48 ± 15 years, mean ± SD) before and 24 months after undergoing their first KT. Echocardiograms were reviewed using a standardized process with blinding for the patient characteristics and evaluation timing. Multivariable linear regression analysis was used to evaluate the association between comorbidities and changes in cardiac structure and systolic/diastolic function. Results: Left ventricular mass index (LVMI) and diastolic parameters did not change significantly, while left ventricular ejection fraction (LVEF) increased from 63.9 to 69.6% (p = 0.046). Multivariable analysis revealed associations of histories of valvular heart disease with a smaller reduction in LVMI (β = –27.3, p = 0.04), of coronary artery disease or heart failure with a smaller increase in LVEF (β = 7.17, p = 0.02), and of diabetes mellitus with less improvement in E wave (β = –0.19, p = 0.05), e’ (β = 4.15, p = 0.046), and E/e’ (β = –5.00, p < 0.01). Conclusion: Cardiovascular comorbidities were ­associated with less improvement in cardiac structure and function following KT. Our findings suggest that patients with CV comorbidities may experience limited “favorable” reverse cardiac remodeling following KT.
Hidradenitis Suppurativa and Bipolar Disorders: A Population-Based Study
Authors: Tzur Bitan Dana , Berzin Daniella , Cohen Arnon
Published: January 2020

Background: Psychological comorbidities have been reported in patients with hidradenitis suppurativa (HS), yet only a few studies have investigated the possible association between HS and severe psychiatric disorders. The current study aimed to assess the association between HS and bipolar disorder, a major, chronic, psychiatric disease. Methods: A nationwide, population-based study was performed utilizing data from the Clalit Health Services (CHS) database in Israel. The study included 4,191 HS patients and 20,941 age- and gender-matched controls. A multivariate binary logistic regression, adjusted for demographic and behavioral risk factors, was performed. Results: A higher proportion of bipolar disorders was found among HS patients compared to controls (0.7 vs. 0.1%, respectively). There was an increased proportion of active smokers among HS patients than among controls (53.4 vs. 13.5%, respectively). In the multivariate analysis, adjusting for age, sex, and smoking, HS was found to be independently and positively associated with bipolar disorders (OR 2.12, 95% CI 1.21–3.27, p < 0.01), yet after controlling for body mass this association became nonsignificant. Conclusions: Bipolar disorders are associated with HS. Future studies should explore whether cardiometabolic deficiencies might account for this association. Healthcare providers should consider this potential co-occurrence as it may impede patient compliance and require appropriate screening and treatment. Results also stress the need for a multidisciplinary approach to optimize management of the disease and its associated comorbidities.
Correlation between High-Resolution Computed Tomography Scan Findings and Histological Findings in Human Vestibular End Organs and Surgical Implications
Authors: Manrique-Huarte Raquel , Zulueta-Santos Cristina , Garaycochea Octavio , Alvarez Linera-Alperi Marta , Manrique Manuel
Published: January 2020

Background: Histological study of vestibular end organs has been challenging due to the difficulty in preserving their structures for histological analysis and due to their complex geometry. Recently, radiology advances have allowed to deepen the study of the membranous labyrinth. Summary: A review and analysis of surgical implications related to the anatomy of the vestibular end organ is performed. Radiological advances are key in the advancement of the knowledge of the anatomy and pathology of the vestibule. Thus, application of such knowledge in the development or improvement of surgical procedures may facilitate the development of novel techniques. Key Messages: During the last few decades, the knowledge of the anatomy of the auditory system through histology and radiology had improved. Technological advances in this field may lead to a better diagnosis and therapeutic approach of most common and important diseases affecting the inner ear.
Azathioprine-Induced Acute Submandibular Sialadenitis in a Crohn’s Disease Patient
Authors: Alves da Silva Joana Inês , Caetano Cidalina , Pedroto Isabel
Published: January 2020

Introduction: Azathioprine (AZA) is a widely used immunosuppressive drug in inflammatory bowel disease (IBD). The occurrence of adverse effects (AEs) is a major downside in the use of this drug, leading to treatment withdrawal in a variable proportion of patients. Case Presentation: We report the case of a Crohn’s disease patient who developed sialadenitis as an AE to AZA. Discussion and Conclusion: To our knowledge this AE has been reported only once in the literature. Sialadenitis is a common disorder and refers to inflammation of a salivary gland. It has many causes, such as bacterial and viral infections, ductal obstruction, and drugs. There are several AEs related to this drug, categorized as dose-dependent and dose-independent. Their knowledge is essential for therapeutic management in IBD, which is already challenging, requiring an individualized approach.
Lupus Nephritis Class IV-Global Is Associated with a Higher Risk of End-Stage Renal Disease than Class IV-Segmental
Authors: Oliveira Camila , Mariz Henrique , Fernandes Gisele , Costa Denise , Cavalcante Maria Alina , Valente Lucila
Published: January 2020

Introduction: The International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification of lupus nephritis (LN) divides class IV into segmental and global (IV-S and IV-G) based on evidence suggesting different renal outcomes. However, subsequent studies have shown conflicting results. Objective: This study was performed to compare long-term renal outcomes between the IV-S and IV-G classes. Methods: This is a retrospective cohort study of adult patients with biopsy-proven class IV LN using the ISN/RPS classification. The primary end point was end-stage renal disease (ESRD). Results: Among the 89 patients, rapidly progressive glomerulonephritis was twice as frequent in the IV-G group (60 vs. 29%; p = 0.005) than that in the IV-S group. Moreover, the IV-G group had a higher rate of biopsy with cellular and fibrocellular crescents (70.9 vs. 47.1%, p = 0.024) and more crescentic glomerulonephritis (34.5 vs. 5.8%, p = 0.007) than the IV-S group. After a mean follow-up of 57 months, the IV-G group had a greater risk of ESRD (RR 3.9; 95% CI 1.2–12.2, p = 0.006) than the IV-S group. Multivariate analysis indicated that class IV-G was an independent predictor of ESRD. Conclusions: Patients with class IV-G have a higher risk of ESRD than patients with class IV-S.
Optimization of efficiency for power system using three phase AC to AC matrix converter with the algorithm of fuzzy controller
Authors: Rashag Hassan Farahan
Published: January 2020

This paper suggested a new contribution of three phase AC to AC matrix converter MC via fuzzy logic controller FLC to enhance the whole system. However, the weakness of matrix converter is that the input- output voltage transfer is control to 87% for input and output waveform. Also, matrix converter is more sensitive to the trouble of input voltage which deteriorates the system performance. To overcome these problems, and to improve the efficiency of system, FLC with matrix converter is proposed to minimize the sensitivity to the load, and to increase voltage transfer. In this paper the currents a,b,c are converted to alpha and beta current via Clarke transformation . In this method two FLC are used. The error (between alpha current and reference current) (e) and the change of this error (de) will apply to first FLC. The output of FLC is actual alpha current. In the other hand, the error of beta current and the change of error are also passes through the second FLC to produce the actual beta current. The actual alpha and beta current is converted to direct and quadrature d-q current by park transformation. The d-q current is converted to (a, b, c) out currents by inverse park transformation, the results of this method express that the matrix converter with FLC is more capable, high accuracy with better efficiency as compared with conventional matrix converter system.
Utilization of the finite element method for the calculation and examination of underground power cable ampacity
Authors: Hadi Mahmood Khalid
Published: January 2020

Currently, the use of underground electric cables is a regular feature of present-day power transmission and distribution schemes. Issues related to economical limitations and the lack of adequate space led to the need for cables with an elevated current carrying capacity (ampacity). In order to achieve this objective, public services around the globe are focusing not only on better designs, but also on improving the level of precision in the context of cable parameter values. Precise parameter values are essential for ensuring that the replicated outcomes correspond sufficiently close to actual circumstances. While the conventional approach to ampacity calculation is through the IEC-60287 procedure, the numerical route is considered more specific and flexible. This endeavour harnesses the finite element method to conceive an innovative process for calculating the thermal field and ampacity of a cable. This process involves the crafting of a temperature field distribution model for scrutinizing temperature distribution in the region of an electric cable, and the deployment of the linear interpolation procedure for computing its ampacity. Subsequent to its formation, the model was put into operation on the underground cable 33KV XLPE.
Neutral point clamped quasi Z source inverter for photovoltaic systems
Authors: Aravindan M. , Balaji V. , Saravanan V. , Arumugam M.
Published: January 2020

Multilevel inverters are becoming popular for power conversion in renewable energy systems, AC-DC hybrid micro grids etc. The voltage stress and inrush current through these inverter leg switches are quite higher as compared to the load ratings which increase the chances of inverter leg switch failure. A three level neutral point clamped quasi Z source inverter topology is discussed in this paper which has the features of lower component count, reduced capacitor voltage stress, and it can be operated at different control strategies to achieve wide range of voltage boosting ability, suited for photovoltaic (PV) systems. It also ensures continuous input current irrespective of the DC supply voltage variations and injects stable and smooth power to the load/grid. The effectiveness of the proposed inverter is verified by simulation results in MATLAB Simulink model as well as performing experiment with the help of a laboratory prototype.
Orai1 Channel Inhibition Preserves Left Ventricular Systolic Function and Normal Ca
2+
Handling After Pressure Overload
Authors: Bartoli Fiona , Bailey Marc A. , Rode Baptiste , Mateo Philippe , Antigny Fabrice , Bedouet Kaveen , Gerbaud Pascale , Gosain Rajendra , Plante Jeffrey , Norman Katherine , Gomez Susana , Lefebvre Florence , Rucker-Martin Catherine , Ainscough Justin F.X. , Kearney Mark T. , Bruns Alexander-Francisco , Shi Jian , Appleby Hollie L. , Young Richard S. , Shawer Heba M. , Debant Marjolaine , Gomez Ana-Maria , Beech David J. , Foster Richard , Benitah Jean-Pierre , Sabourin Jessica
Published: January 2020

Background:

Orai1 is a critical ion channel subunit, best recognized as a mediator of store-operated Ca
2+
entry (SOCE) in nonexcitable cells. SOCE has recently emerged as a key contributor of cardiac hypertrophy and heart failure but the relevance of Orai1 is still unclear.

Methods:

To test the role of these Orai1 channels in the cardiac pathophysiology, a transgenic mouse was generated with cardiomyocyte-specific expression of an ion pore-disruptive Orai1
R91W
mutant (C-dnO1). Synthetic chemistry and channel screening strategies were used to develop 4-(2,5-dimethoxyphenyl)-N-[(pyridin-4-yl)methyl]aniline (hereafter referred to as JPIII), a small-molecule Orai1 channel inhibitor suitable for in vivo delivery.

Results:

Adult mice subjected to transverse aortic constriction (TAC) developed cardiac hypertrophy and reduced ventricular function associated with increased Orai1 expression and Orai1-dependent SOCE (assessed by Mn
2+
influx). C-dnO1 mice displayed normal cardiac electromechanical function and cellular excitation-contraction coupling despite reduced Orai1-dependent SOCE. Five weeks after TAC, C-dnO1 mice were protected from systolic dysfunction (assessed by preserved left ventricular fractional shortening and ejection fraction) even if increased cardiac mass and prohypertrophic markers induction were observed. This is correlated with a protection from TAC-induced cellular Ca
2+
signaling alterations (increased SOCE, decreased [Ca
2+
]
i
transients amplitude and decay rate, lower SR Ca
2+
load and depressed cellular contractility) and SERCA2a downregulation in ventricular cardiomyocytes from C-dnO1 mice, associated with blunted Pyk2 signaling. There was also less fibrosis in heart sections from C-dnO1 mice after TAC. Moreover, 3 weeks treatment with JPIII following 5 weeks of TAC confirmed the translational relevance of an Orai1 inhibition strategy during hypertrophic insult.

Conclusions:

The findings suggest a key role of cardiac Orai1 channels and the potential for Orai1 channel inhibitors as inotropic therapies for maintaining contractility reserve after hypertrophic stress.
Between the Abstract and the Concrete: A Constraint-Based Approach to Navigating Instrumental Space
Authors: Döbereiner Luc
Published: January 2020

This article deals with a way that algorithmic composition systems can be informed by material realities of musical performance. After a general discussion of the relation of abstract algorithms to concrete materiality, the article focuses on the idea of an instrument's space of possibilities. It briefly discusses a number of compositional approaches that seek to derive musical structure from bodily movements and from the physical properties of instruments. The last part describes a new open-source JavaScript library called OboeJS and a Web application based on this library. The system is an experimental exploration of the idea of instrumental space and an attempt to bring together abstract algorithmic processing and the concrete possibilities of a musical instrument. The system implements a flexible constraint-based search algorithm for the generation of oboe fingering sequences. This tool is presented as part of a wider approach to algorithmic composition that aims not to map data output of generative procedures to “sound generators” (e.g., performers, instruments, sound synthesis processes). Instead, I propose to derive structure from the space of possibilities of the instrument itself, which in this case is the oboe.
Robot Opera: Bridging the Anthropocentric and the Mechanized Eccentric
Authors: Sigman Alexander
Published: January 2020

The recent emergence of robot opera, in which robots and robotic entities have served polyvalent and at times ontologically ambiguous roles, has challenged the distinction made by Bauhaus artist László Moholy-Nagy between anthropocentric and mechanized eccentric theater, as is outlined in his 1924 essay “Theater, Circus, Variety.” When incorporated into the context of music theater, is the robot dimension intended to replace human activities and modes of expression; to augment, disembody or dislocate them; or rather to absorb them, such that the robot becomes an ersatz human presence in and of itself? If the latter, does the robot adequately emulate human attributes of musical expression, or does it establish its own artificial expressive mode and set of performance techniques? With Moholy-Nagy's criteria for a so-called Theater of Totality and these leading questions in the background, salient robot opera examples of the past several years will be discussed. Repertoire examples include Tod Machover's pioneering Death and the Powers (2010), the Komische Oper Berlin production My Square Lady (2015), Keiichiro Shibuya's Scary Beauty (2018), and works emerging from the University of Sussex Centre for Research in Opera and Music Theatre Robot Opera Mini Symposium, held in 2017.
Organizing principles of whole-brain functional connectivity in zebrafish larvae
Authors: Betzel Richard F.
Published: January 2020

Network science has begun to reveal the fundamental principles by which large-scale brain networks are organized, including geometric constraints, a balance between segregative and integrative features, and functionally flexible brain areas. However, it remains unknown whether whole-brain networks imaged at the cellular level are organized according to similar principles. Here, we analyze whole-brain functional networks reconstructed from calcium imaging data recorded in larval zebrafish. Our analyses reveal that functional connections are distance-dependent and that networks exhibit hierarchical modular structure and hubs that span module boundaries. We go on to show that spontaneous network structure places constraints on stimulus-evoked reconfigurations of connections and that networks are highly consistent across individuals. Our analyses reveal basic organizing principles of whole-brain functional brain networks at the mesoscale. Our overarching methodological framework provides a blueprint for studying correlated activity at the cellular level using a low-dimensional network representation. Our work forms a conceptual bridge between macro- and mesoscale network neuroscience and opens myriad paths for future studies to investigate network structure of nervous systems at the cellular level.
First record of the genus Phanoperla Banks, 1938 (Plecoptera: Perlidae) from mainland China, with description of a new species
Authors: CHEN ZHI-TENG
Published: January 2020

Phanoperla huanghuye sp. nov., a new species of Phanoperla Banks, 1938 is reported from Fujian Province of South China. This is the first record of Phanoperla from mainland China, and the third species of Phanoperla reported from China. The adult male, female, and egg of P. huanghuye sp. nov. are described and illustrated. The new species is distinctive in the male by the sensilla basiconica patches on abdominal terga 7–9, the uniquely modified hemitergal lobes and aedeagal armature. A key to the males of the three known Chinese species of Phanoperla is provided.
Kudoa ajurutellus n. sp. (Multivalvulida: Kudoidae), a parasite of the skeletal musculature of the Bressou sea catfish, Aspistor quadriscutis, in northeastern of the State of Pará
Authors: NETO JOSÉ POMPEU ARAÚJO , CARDIM JOYCE , DA SILVA DIEHGO T. , HAMOY IGOR , MATOS EDILSON , ABRUNHOSA FERNANDO
Published: January 2020

Kudoa ajurutellus n. sp. (Multivalvulida: Kudoidae) is described as a parasite of the Bressou catfish, Aspistor quadriscutis (Siluriformes) collected at Ajuruteua beach, northeastern Pará, Brazil. The new species is described based on the morphology of the spores and the sequence of the 18S rDNA. This parasite was found only in the skeletal muscular tissue of fish hosts. In the apical view, the spores were pseudo-quadrangular in shape, with rounded borders, and four symmetrical capsules. The spores are 6.63±0.53 μm in length and 8.16±0.75 μm in width. The polar capsules are piriform, 3.45±0.30 μm in length and 1.87±0.15 μm in width. The phylogenetic analysis based on the sequence of the 18S rDNA gene indicated that the new species is clearly distinct from all other Kudoa species, and that the degree of differentiation is constant with the existence of a new species of the genus Kudoa. This is the first marine Kudoa species recorded in northeastern of the State of Pará.
Three new species of the genus Bittacus Latreille, 1805 (Mecoptera: Bittacidae), with a key to the species of Bittacidae in South China
Authors: ZHANG YAN-NA , DU WEI , HUA BAO-ZHEN
Published: January 2020

The Bittacidae of South China consist of two species of Bicaubittacus and eight species of Bittacus, among which three species are described here as new to science. Bittacus acutus sp. n. from Guangxi is recognized mainly by the hat-shaped epandrial lobe with an acute ventro-distal process in the male genitalia. Bittacus shaoguanensis sp. n. from Guangdong is distinguished by the triangular epandrial lobe in the male genitalia, and a V-shaped streak in the central part of wings. Bittacus longilobus sp. n. from Guangdong is recognizable by the main body of the epandrial lobe trapezoid, with an elongate ventro-distal lobe twice as long. The number of described species of the Chinese Bittacus is now raised to 41. A key to the species of Bittacidae in South China is provided.
Modular Group Algebras with Small Upper Lie Nilpotency Index
Authors: Bhatt Suchi , Chandra Harish
Published: January 2020

Let KG be the modular group algebra of a group G over a field K of characteristic p > 0. The classification of group algebras KG with upper Lie nilpotency index tL(KG) greater than or equal to |G′|
– 13p + 14 have already been done. In this paper, our aim is to classify the group algebras KG for which tL(KG) = |G′| – 14p + 15.
"Double-W-shaped" temperature dependence of emission linewidth in an InGaN/GaN multiple quantum well structure with intense phase separation
Authors: Li Changfu , Xu Mingsheng , Ji Ziwu , Shi Kaiju , Li Hongbin , Wei Yehui , Xu Xiangang
Published: January 2020

The temperature dependence of the spectra of photoluminescence (PL) from a blue InGaN/GaN multiplequantum-well (MQW) structure is investigated at lower excitation power. Two emission peaks, related to InGaN and assigned to In-rich quasi-quantum dots (QDs) and InGaN-matrix in the full
PL spectrum, were observed. Upon increasing the temperature, both PL peak linewidths exhibited "double-W-shaped" (narrowing–broadening–narrowing–broadening–narrowing–broadening) temperature dependence. Combined with the observed features of the temperature dependences
of the PL intensities, the temperature-dependent behaviors in this case can be interpreted as the relaxation and thermalization of carriers inside respective phase structures and the transfer of carriers between two phase structures, because of the strong phase separation and significant component
fluctuation in the InGaN well layers.