bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing Pain Intensity Using Photoplethysmography Signals in Chronic Myofascial Pain Syndrome
Authors: Ye Jing‐Jhao , Lee Kuan‐Ting , Chou Ying‐Yu , Sie Hong‐Hai , Huang Ru‐Nan , Chuang Chiung‐Cheng
Published: May 2017

Background

Efficacy of pain assessment is the basis for effective therapy. Clinically, assessing pain is by subjective scale, but these methods have some shortcomings. Therefore, studies have been conducted on assessment of pain using physiological signals. Photoplethysmography (PPG) signals provide much information about the cardiovascular system. PPG‐derived parameters (PPG parameters) reflect nociceptive stimulation, and obtain an approximation of the R–R interval from the PPG period. The aim of this study was to evaluate PPG signals for assessment of pain intensity in chronic myofascial pain syndrome (MPS) patients.

Methods

This study recruited 37 patients with chronic MPS; all of them were treated with electrotherapy and thermotherapy. The difference between pre‐ and post‐therapy PPG parameters, and the correlation between pulse rate variability (PRV) and heart rate variability (HRV) were determined. We also obtained patients' pain intensity scores by visual analog scale, visual rating scale, and Wong‐Banker face pain rating scale.

Results

Photoplethysmography and PRV/HRV parameters showed significant differences between pre‐ and post‐treatment. The variation trend of PRV was similar with HRV in heart rate, R–R interval, low frequency, high frequency, and LF/HF; in addition, a high correlation between the parameters was observed either in pre‐ or post‐therapy. PPG parameters indicated increased sympathetic tone.

Conclusion

The results of the study indicated that PRV substituted for HRV in assessment of pain intensity in chronic MPS reflected parasympathetic nervous tone increase, and PPG parameters might reflect stress stimulation on skin.
Comorbidity and quality of life in childhood cancer survivors treated with proton beam therapy
Authors: Fukushima Hiroko , Fukushima Takashi , Suzuki Ryoko , Iwabuchi Atsushi , Hidaka Kyoko , Shinkai Toko , Masumoto Kouji , Muroi Ai , Yamamoto Tetsuya , Nakao Tomohei , Oshiro Yoshiko , Mizumoto Masashi , Sakurai Hideyuki , Sumazaki Ryo
Published: May 2017

Background

The rate of childhood cancer survival has recently reached >80%. Various adverse events among childhood cancer survivors (CCS) have been reported. Proton beams are able to avoid unnecessary irradiation to normal/vital organs. We conducted a quality of life (QOL) study for CCS who were treated with proton beam therapy (PBT).

Methods

We included those patients treated with PBT to the brain, head, or neck and who were ≤15 years old at the University of Tsukuba Hospital between 1983 and 2011. Clinical information was collected from medical records. Questionnaires including the Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales (which assess health‐related quality of life) were sent to the families/patients.

Results

Sixty patients were included. Median age at treatment was 6.2 years. The number of patients with status alive/dead/unknown was 32/24/4. Median follow‐up period was 63.0 months (range, 48–340 months) for survivors. Questionnaires were sent to 25 families/patients and 19 were returned. PedsQL was assessed for 17 patients. Eleven of 32 living patients had at least one comorbidity grade 3/4. Average QOL score was above that for Japanese schoolchildren and adolescents. There was no correlation with comorbidity, and only longer time from treatment was correlated with a higher PedsQL score (P = 0.006).

Conclusion

CCS who were treated with multimodal treatment using PBT had a higher QOL score. Higher score was related to longer time since treatment, regardless of comorbidity.
Simultaneous modification of three homoeologs of TaEDR1 by genome editing enhances powdery mildew resistance in wheat
Authors: Zhang Yunwei , Bai Yang , Wu Guangheng , Zou Shenghao , Chen Yongfang , Gao Caixia , Tang Dingzhong
Published: May 2017

Wheat (Triticum aestivum L.) incurs significant yield losses from powdery mildew, a major fungal disease caused by Blumeria graminis f. sp. tritici (Bgt). enhanced disease resistance1 (EDR1) plays a negative role in the defense response against powdery mildew in Arabidopsis thaliana; however, the edr1 mutant does not show constitutively activated defense responses. This makes EDR1 an ideal target for approaches using new genome‐editing tools to improve resistance to powdery mildew. We cloned TaEDR1 from hexaploid wheat and found high similarity among the three homoeologs of EDR1. Knock‐down of TaEDR1 by virus‐induced gene silencing or RNA interference enhanced resistance to powdery mildew, indicating that TaEDR1 negatively regulates powdery mildew resistance in wheat. We used CRISPR/Cas9 technology to generate Taedr1 wheat plants by simultaneous modification of the three homoeologs of wheat EDR1. No off‐target mutations were detected in the Taedr1 mutant plants. The Taedr1 plants were resistant to powdery mildew and did not show mildew‐induced cell death. Our study represents the successful generation of a potentially valuable trait using genome‐editing technology in wheat and provides germplasm for disease resistance breeding.
The impact of age and frailty on ventricular structure and function in C57BL/6J mice
Authors: Feridooni H. A. , Kane A. E. , Ayaz O. , Boroumandi A. , Polidovitch N. , Tsushima R. G. , Rose R. A. , Howlett S. E.
Published: May 2017

Key points

Heart size increases with age (called hypertrophy), and its ability to contract declines. However, these reflect average changes that may not be present, or present to the same extent, in all older individuals.

That aging happens at different rates is well accepted clinically. People who are aging rapidly are frail and frailty is measured with a ‘frailty index’.

We quantified frailty with a validated mouse frailty index tool and evaluated the impacts of age and frailty on cardiac hypertrophy and contractile dysfunction.

Hypertrophy increased with age, while contractions, calcium currents and calcium transients declined; these changes were graded by frailty scores.

Overall health status, quantified as frailty, may promote maladaptive changes associated with cardiac aging and facilitate the development of diseases such as heart failure.

To understand age‐related changes in heart structure and function, it is essential to know both chronological age and the health status of the animal.

On average, cardiac hypertrophy and contractile dysfunction increase with age. Still, individuals age at different rates and their health status varies from fit to frail. We investigated the influence of frailty on age‐dependent ventricular remodelling. Frailty was quantified as deficit accumulation in adult (≈7 months) and aged (≈27 months) C57BL/6J mice by adapting a validated frailty index (FI) tool. Hypertrophy and contractile function were evaluated in Langendorff‐perfused hearts; cellular correlates/mechanisms were investigated in ventricular myocytes. FI scores increased with age. Mean cardiac hypertrophy increased with age, but values in the adult and aged groups overlapped. When plotted as a function of frailty, hypertrophy was graded by FI score (r = 0.67–0.55, P < 0.0003). Myocyte area also correlated positively with FI (r = 0.34, P = 0.03). Left ventricular developed pressure (LVDP) plus rates of pressure development (+dP/dt) and decay (−dP/dt) declined with age and this was graded by frailty (r = −0.51, P = 0.0007; r = −0.48, P = 0.002; r = −0.56, P = 0.0002 for LVDP, +dP/dt and −dP/dt). Smaller, slower contractions graded by FI score were also seen in ventricular myocytes. Contractile dysfunction in cardiomyocytes isolated from frail mice was attributable to parallel changes in underlying Ca2+ transients. These changes were not due to reduced sarcoplasmic reticulum stores, but were graded by smaller Ca2+ currents (r = −0.40, P = 0.008), lower gain (r = −0.37, P = 0.02) and reduced expression of Cav1.2 protein (r = −0.68, P = 0.003). These results show that cardiac hypertrophy and contractile dysfunction in naturally aging mice are graded by overall health and suggest that frailty, in addition to chronological age, can help explain heterogeneity in cardiac aging.
Exercise in type 2 diabetes: genetic, metabolic and neuromuscular adaptations. A review of the evidence
Authors: Zanuso Silvano , Sacchetti Massimo , Sundberg Carl Johan , Orlando Giorgio , Benvenuti Paolo , Balducci Stefano
Published: May 2017

The biological responses to exercise training are complex, as almost all organs and systems are involved in interactions that result in a plethora of adaptations at the genetic, metabolic and neuromuscular levels.

To provide the general practitioner and the sports medicine professionals with a basic understanding of the genetic, metabolic and neuromuscular adaptations at a cellular level that occur with aerobic and resistance exercise in subjects with type 2 diabetes.

For each of the three domains (genetic, metabolic and neuromuscular), the results of the major systematic reviews and original research published in relevant journals, indexed in PubMed, were selected. Owing to limitations of space, we focused primarily on the role of skeletal muscle, given its pivotal role in mediating adaptations at all levels.

Generally, training-induced adaptations in skeletal muscle are seen as changes in contractile proteins, mitochondrial function, metabolic regulation, intracellular signalling, transcriptional responses and neuromuscular modifications. The main adaptation with clinical relevance would include an improved oxidative capacity derived from aerobic training, in addition to neuromuscular remodelling derived from resistance training. Both training modalities improve insulin sensitivity and reduce cardiovascular risk.

Taken together, the modifications that occur at the genetic, metabolic and neuromuscular levels, work correlatively to optimise substrate delivery, mitochondrial respiratory capacity and contractile function during exercise.
Neurological tests improve after Olympic-style boxing bouts: a pretournament and post-tournament study in the 2016 Women’s World Boxing Championships
Authors: Howell David R , Meehan William P , Loosemore Michael P , Cummiskey Joseph , Grabner von Rosenberg Jean-Paul , McDonagh David
Published: May 2017

Aim

To prospectively examine the neurocognitive, postural, dual-task and visual abilities of female Olympic-style boxers before and after participation in a tournament.

Methods

Sixty-one females completed the modified Balance Error Scoring System (mBESS), King-Devick test and 3 m timed-up-and-go test in single-task and dual-task conditions. A subset (n=31) completed the CogState computerised neurocognitive test. Initial testing was completed prior to the 2016 Women’s World Boxing Championships; each participant repeated the testing protocol within a day of elimination. No participant sustained a concussion. Pretournament and post-tournament performance variables were compared using paired t-tests or Wilcoxon signed-rank tests.

Results

Participants completed a mean of 7.5±4.5 rounds of Olympic-style boxing over 2–8 days. Post-tournament scores were significantly lower than pretournament scores for total mBESS (2.2±1.9 errors vs 5.5±2.9 errors, p<0.001,d=1.23) and King-Devick time (14.2±3.9 s vs 18.0±8.3 s, p=0.002,d=0.53). Processing speed was significantly faster after the boxing tournament (maze chase task: 1.39±0.34 correct moves/second vs 1.17±0.44 correct moves/second, p=0.001,d=0.58). No significant changes across time were detected for the other obtained outcome variables.

Conclusions

Female boxers demonstrated either improvement or no significant changes in test performance after competing in an Olympic-style boxing tournament, relative to pretournament performance. As many of the test tasks were novel for the boxers, practice effects may have contributed to improved performance. When there is a short time frame between assessments, clinicians should be aware of potential practice effects when using ringside neurological tests.
Haemodynamic analysis for recanalisation of intracranial aneurysms after endovascular treatment: an observational registry study in China
Authors: Liu Jian , Zhang Yisen , Wang Anxin , Zhang Ying , Li Yiying , Yang Xinjian
Published: May 2017

Introduction

Recanalisation of intracranial aneurysms following endovascular treatment is a major issue. Many factors, including aneurysm morphology, the method of treatment, and haemodynamics, are considered to be associated with recanalisation. However, the underlying haemodynamic mechanisms are not completely understood.

Methods and analysis

This is a prospective, observational, registry study for patients with intracranial aneurysms who are treated endovascularly. It will enrol 200 eligible patients. Data on morphological, haemodynamic, and treatment factors will be collected prospectively. The advanced virtual stenting technique and porous media method will be used in haemodynamic simulations. The clinical and angiographic outcomes at 6 months will be measured and analysed. This observational study will determine the haemodynamic factors that affect the recanalisation of aneurysms.

Ethics and dissemination

Both the study protocol and written informed consent were reviewed and approved by the Institutional Review Board of Beijing Tiantan Hospital (KY2016-023-01). The results of study will be disseminated in professional printed media.

Trial registration number

NCT02812108; Pre-results.
Integrating culturally informed approaches into the physiotherapy assessment and treatment of chronic pain: protocol for a pilot randomised controlled trial
Authors: Brady Bernadette , Veljanova Irena , Schabrun Siobhan , Chipchase Lucinda
Published: May 2017

Introduction

There is strong evidence that biopsychosocial approaches are efficacious in the management of chronic pain. However, implementation of these approaches in clinical practice is known not to account for the beliefs and values of culturally and linguistically diverse (CALD) patients. This limitation in translation of research contributes to the disparities in outcomes for CALD patients with chronic pain adding to the socioeconomic burden of this prevalent condition. Cultural adaptation of chronic pain assessment and management is urgently required. Thus, the aim of this pilot randomised controlled trial (RCT) is to determine the feasibility, participant acceptance with and clinical effectiveness of a culturally adapted physiotherapy assessment and treatment approach when contrasted with ‘usual evidence based physiotherapy care’ for three CALD communities.

Methods and analysis

Using a participant-blinded and assessor-blinded randomised controlled pilot design, patients with chronic pain who self-identify as Assyrian, Mandaean or Vietnamese will be randomised to either 'culturally adapted physiotherapy assessment and treatment' or ‘evidence informed usual physiotherapy care'. We will recruit 16 participants from each ethnocultural community that will give a total of 24 participants in each treatment arm. Both groups will receive physiotherapy treatment for up to 10 sessions over 3 months. Outcomes including feasibility data, acceptance with the culturally adapted intervention, functional and pain-related measures will be collected at baseline and 3 months by a blinded assessor. Analysis will be descriptive for feasibility outcomes, while measures for clinical effectiveness will be explored using independent samples t-tests and repeated measures analysis of variance. This analysis will inform sample size estimates while also allowing for identification of revisions in the protocol or intervention prior to a larger scale RCT.

Ethics and dissemination

This trial has full ethical approval (HREC/16/LPOOL/194). The results from this pilot RCT will be presented at scientific meetings and published in peer-reviewed journals.

Trial registration number

ACTRN12616000857404
The relationship between job satisfaction, work stress, work–family conflict, and turnover intention among physicians in Guangdong, China: a cross-sectional study
Authors: Lu Yong , Hu Xiao-Min , Huang Xiao-Liang , Zhuang Xiao-Dong , Guo Pi , Feng Li-Fen , Hu Wei , Chen Long , Zou Huachun , Hao Yuan-Tao
Published: May 2017

Objective

To investigate the relationship between job satisfaction, work stress, work–family conflict and turnover intention, and explore factors associated with turnover intention, among physicians in Guangdong Province, China.

Methods

From August to October 2013, physicians completed questionnaires and scales with regard to their job satisfaction, work stress, work–family conflict, and turnover intention. Binary logistic regression and structural equation modelling (SEM) were used in data analysis.

Results

A total of 3963 physicians were approached, with 3563 completing the questionnaire. The mean score of the overall perception of turnover intention of physicians who worked in Guangdong was 2.71 on a scale ranging from 1 to 6. Hours worked per week, working in an urban/rural area, type of institution, and age significantly impacted on turnover intention. Turnover intention was directly and negatively related to job satisfaction, and it was directly, indirectly and positively related to work stress and work–family conflict.

Conclusion

Job satisfaction, work stress, work–family conflict, hours worked per week, working in an urban/rural area, types of institution and age are influencing factors of turnover intention. Reducing working hours, raising salary, providing more opportunities for career development and training, supporting and encouraging physicians by senior managers could potentially contribute to the reduction in turnover intention.
A scoping review protocol on social participation of indigenous elders, intergenerational solidarity and their influence on individual and community wellness
Authors: Viscogliosi Chantal , Asselin Hugo , Basile Suzy , Couturier Yves , Drolet Marie-Josée , Gagnon Dominique , Torrie Jill , Levasseur Mélanie
Published: May 2017

Introduction

Indigenous elders have traditionally played an important role in maintaining social cohesion within their communities. Today, part of this role has been taken over by government social and healthcare services, but they are having limited success in addressing social challenges. Increasing elders’ social participation and intergenerational solidarity might foster community development and benefit young people, families, communities and the elders themselves. However, knowledge of the contribution of elders’ social participation and intergenerational solidarity to wellness is scattered and needs to be synthesised. This protocol presents a scoping review on the social participation of indigenous elders, intergenerational solidarity and their influence on individual and community wellness.

Methods and analysis

This scoping review protocol is based on an innovative methodological framework designed to gather information from the scientific and grey literature and from indigenous sources. It was developed by an interdisciplinary team including indigenous scholars/researchers, knowledge users and key informants. In addition to searching information databases in fields such as public health and indigenous studies, an advisory committee will ensure that information is gathered from grey literature and indigenous sources.

Ethics

The protocol was approved by the Ethics Review Board of the Université du Québec en Abitibi-Témiscamingue and the First Nations of Quebec and Labrador Health and Social Services Commission.

Discussion

The comprehensive synthesis of the scientific and grey literature and indigenous sources proposed in this protocol will not only raise awareness within indigenous communities and among healthcare professionals and community organisations, but will also enable decision-makers to better meet the needs of indigenous people.

Conclusion

The innovative methodological framework proposed in this scoping review protocol will yield richer information on the contribution of elders to community wellness. This work is an essential preliminary step towards developing research involving indigenous communities, drawing on the social participation of elders and intergenerational solidarity.
Inclusion of emergency department patients in early stages of sepsis in a quality improvement programme has the potential to improve survival: a prospective dual-centre study
Authors: De Groot Bas , Struyk Bastiaan , Najafi Rashed , Halma Nieke , Pelser Loekie , Vorst Denise , Mertens Bart , Ansems Annemieke , Rijpsma Douwe
Published: May 2017

Study objective

Sepsis quality improvement programmes typically focus on severe sepsis (ie, with acute organ failure). However, quality of ED care might be improved if these programmes included patients whose progression to severe sepsis could still be prevented (ie, infectionwithoutacute organ failure). We compared the impact on mortality of implementing a quality improvement programme among ED patients with a suspected infection with or without acute organ failure.

Methods

This prospective observational study among ED patients hospitalised with suspected infection was conducted in two hospitals in the Netherlands. After stratification by sepsis category (with or without organ failure), in-hospital mortality was compared between a full compliance (allquality performance measures achieved) and an incomplete compliance group. Multivariable logistic regression analysis was used to quantify the impact of full compliance on in-hospital mortality, adjusting for disease severity, disposition and hospital.

Results

There were 1732 ED patients and 130 deaths. Full compliance was independently associated with approximately two-thirds reduction in the odds of hospital mortality (adjustedOR of 0.30 (95% CI 0.19 to 0.47), which was similar in patients with and without organ failure. Among the 1379 patients with suspected infection without acute organ failure, there were 64 deaths, 15 (1.1%) in the full compliance group and 49 (3.6%) in the incomplete compliance group (mortality difference 2.5% (95% CI 1.6% to 3.3%)). Among 353 patients with organ failure, there were 66 deaths, 12 (3.4%) in the full compliance compared with 54 (15.3%) in the incomplete compliance group (mortality difference 11.9% (95% CI 8.5% to 15.3%)). Thus, there was a difference of 76 deaths between full and incomplete compliance groups, and 34 (45%) who benefited were thosewithoutacute organ failure.

Conclusions

Sepsis quality improvement programmes should incorporate ED patients in earlier stages of sepsis given the potential to reduce in-hospital mortality among this population.
Can the prehospital National Early Warning Score identify patients most at risk from subsequent deterioration?
Authors: Shaw Joanna , Fothergill Rachael T , Clark Sophie , Moore Fionna
Published: May 2017

Introduction

The National Early Warning Score (NEWS) aids the early recognition of those at risk of becoming critically ill. NEWS has been recommended for use by ambulance services, but very little work has been undertaken to date to determine its suitability. This paper examines whether a prehospital NEWS derived from ambulance service clinical observations is associated with the hospital ED disposition.

Methods

Prehospital NEWS was retrospectively calculated from the ambulance service clinical records of 287 patients who were treated by the ambulance service and transported to hospital. In this cohort study, derived NEWS scores were compared with ED disposition data and patients were categorised into the following groups depending on their outcome: discharged from ED, admitted to a ward, admitted to intensive therapy unit (ITU) or died.

Results

Prehospital NEWS-based ambulance service clinical observations were significantly associated with discharge disposition groups (p<0.001), with scores escalating in line with increasing severity of outcome. Patients who died or were admitted to ITU had higher scores than those admitted to a ward or discharged from ED (mean NEWS 7.2 and 7.5 vs 2.6 and 1.7, respectively), and in turn those who were admitted to a ward had higher pre-hospital NEWS than those who were discharged (2.6 vs 1.7).

Conclusion

Our findings suggest that the NEWS could successfully be used by ambulance services to identify patients most at risk from subsequent deterioration. The implementation of this early warning system has the potential to support ambulance clinician decision making, providing an additional tool to identify and appropriately escalate care for acutely unwell patients.
Transmission improvement options via local energy degradation at a cyclotron driven ocular tumor treatment facility
Authors: Gerbershagen Alexander , Hrbacek Jan , Ijpes Dennis , Schippers Jacobus Maarten
Published: May 2017

The goal of this work is to increase the beam transmission from the cyclotron to the patient location of ocular tumor treatment facility Optis 2 at the Paul Scherrer Institute and thus to reduce the patient treatment times. The examined options for such transmission increase were the installation of local degraders in the patient treatment room and modification of the energy selection collimator settings. The experiments have shown that an improvement of the beam transmission is possible to achieve, however on a cost of an increase in lateral or distal penumbra of the beam. The benefits and drawbacks of the examined options are discussed.
Relationship between Central Arterial Stiffness and Insulin Resistance in Chinese Community-Dwelling Population without Diabetes Mellitus
Authors: Fu Shihui , Lin Ying , Luo Leiming , Ye Ping
Published: May 2017

Objective. Insulin resistance (IR) is a pathological condition present not only in patients with type 2 diabetes mellitus (DM), but also in community-dwelling population without DM. Both central arterial stiffness and IR are closely correlated with cardiovascular morbidity and mortality. The relationship between central arterial stiffness and IR has not been described in Chinese community-dwelling population without DM. The current analysis was designed to investigate the relationship between central arterial stiffness and IR in Chinese community-dwelling population without DM. Methods. There were 1150 participants fully assessed for not only homeostasis model assessment of insulin resistance (HOMA-IR) but also carotid-femoral pulse wave velocity (cfPWV). Results. Median age was 39 (18–80) years, and 69.7% were men. Bivariate correlation analysis showed that cfPWV was significantly related to HOMA-IR (P<0.05). Logistic regression analysis indicated that cfPWV was independently associated with HOMA-IR (P<0.05). Conclusions. This community-based analysis testified that the relationship between central arterial stiffness and IR was evident as early as during nondiabetic stage. Early interventions in Chinese community-dwelling population without DM to improve the IR are also important in the prevention of cardiovascular diseases.
The Association of Chemokine Gene Polymorphisms with VKH and Behcet’s Disease in a Chinese Han Population
Authors: Huang Yang , Yu Hongsong , Cao Qingfeng , Deng Jing , Huang Xinyue , Kijlstra Aize , Yang Peizeng
Published: May 2017

To investigate the association of chemokine gene polymorphisms and Behcet’s disease (BD) and Vogt Koyanagi Harada (VKH) disease in a Chinese Han population. A case-control study was performed. Three hundred and seventy-one BD patients, 371 VKH disease patients, and 605 healthy controls were recruited to determine genetic variants of 26 SNPs in 12 chemokine genes with iPLEX Gold genotyping assay and Sequenom MassARRAY or TaqMan SNP assays. In this study, Puncorr values showed a weak association of five SNPs of five genes in BD and three SNPs of three genes in VKH disease. However, after Bonferroni correction, the 26 investigated SNPs showed no significant differences in genetic variants, including genotype and allele frequencies, between BD or VKH disease patients and healthy individuals. Haplotype analysis for the chemokine genes showed a significant association with the TC haplotype of CXCL12 in VKH. Stratified gender analysis and genotype-phenotype analysis were conducted to analyze the association of the 26 SNPs of 12 chemokine genes with BD and VKH disease. However, no significant association was observed after Bonferroni correction. This study showed no association of 26 SNPs in 12 chemokine genes with both BD and VKH disease in a Chinese Han population.
An Application-Driven Modular IoT Architecture
Authors: Yelamarthi Kumar , Aman Md Sayedul , Abdelgawad Ahmed
Published: May 2017

Building upon the advancements in the recent years, a new paradigm in technology has emerged in Internet of Things (IoT). IoT has allowed for communication with the surrounding environment through a multitude of sensors and actuators, yet operating on limited energy. Several researchers have presented IoT architectures for respective applications, often challenged by requiring major updates for adoption to a different application. Further, this comes with several uncertainties such as type of computational device required at the edge, mode of wireless connectivity required, methods to obtain power efficiency, and not ensuring rapid deployment. This paper starts with providing a horizontal overview of each layer in IoT architecture and options for different applications. Then it presents a broad application-driven modular architecture, which can be easily customized for rapid deployment. This paper presents the diverse hardware used in several IoT layers such as sensors, embedded processors, wireless transceivers, internet gateway, and application management cloud server. Later, this paper presents implementation results for diverse applications including healthcare, structural health monitoring, agriculture, and indoor tour guide systems. It is hoped that this research will assist the potential user to easily choose IoT hardware and software as it pertains to their respective needs.
Ventilator Management of Bronchopleural Fistula Secondary to Methicillin-Resistant Staphylococcus aureus Necrotizing Pneumonia in a Pregnant Patient with Systemic Lupus Erythematosus
Authors: Alohali Ahmed F. , Abu-Daff Saleh , Alao Kamardeen , Almaani Mohammed
Published: May 2017

Managing mechanical ventilation in patient with bronchopleural fistula with coexisting acute respiratory distress syndrome is a challenging situation for the intensivist. We are reporting a case of a pregnant patient with systemic lupus erythematosus on immunosuppressive medications who developed methicillin-resistant Staphylococcus aureus necrotizing pneumonia complicated by bronchopleural fistula and acute respiratory distress syndrome.
Review and Long-Term Outcomes of Cruciate Ligament Reconstruction versus Conservative Treatment in Siblings with Congenital Anterior Cruciate Ligament Aplasia
Authors: Davanzo Diego , Fornaciari Paolo , Barbier Geoffroy , Maniglio Mauro , Petek Daniel
Published: May 2017

There is no consensus on the best treatment for anterior cruciate ligament hypoplasia or aplasia. To our knowledge, no comparative study between operative and conservative treatment of this condition has ever been performed. Conservative treatment is a viable alternative to surgery for ACL aplasia. Two siblings were examined at our outpatient clinic. The male patient underwent bilateral ACL reconstruction, while his sister was treated conservatively. Our results show a worse long-term outcome for the operative patient. At her last follow-up, the female patient treated conservatively showed subjective improvement in stability and gait. A review of the literature shows inconsistent outcomes after reconstruction in contrast to reports with cruciate ligament agenesis that did not undergo reconstruction with acceptable to good outcomes. Cruciate reconstruction should be reserved for cases of impaired articular instability, objectively manifest in the frequency of giving-way episodes. Treatment depends on the patient’s condition and expectations. Surgery should therefore only be suggested after proper patient counseling.
MicroPET/CT Imaging of AXL Downregulation by HSP90 Inhibition in Triple-Negative Breast Cancer
Authors: Wang Wanqin , Zhao Jun , Wen Xiaoxia , Lin Curtis Chun-Jen , Li Junjie , Huang Qian , Yu Yongqiang , Lin Shiaw-Yih , Li Chun
Published: May 2017

AXL receptor tyrosine kinase is overexpressed in a number of solid tumor types including triple-negative breast cancer (TNBC). AXL is considered an important regulator of epithelial-to-mesenchymal transition (EMT) and a potential therapeutic target for TNBC. In this work, we used microPET/CT with 64Cu-labeled anti-human AXL antibody (64Cu-anti-hAXL) to noninvasively interrogate the degradation of AXL in vivo in response to 17-allylamino-17-demethoxygeldanamycin (17-AAG), a potent inhibitor of HSP90. 17-AAG treatment caused significant decline in AXL expression in orthotopic TNBC MDA-MB-231 tumors, inhibited EMT, and delayed tumor growth in vivo, resulting in significant reduction in tumor uptake of 64Cu-anti-hAXL as clearly visualized by microPET/CT. Our data indicate that 64Cu-anti-hAXL can be useful for monitoring anti-AXL therapies and for assessing inhibition of HSP90 molecular chaperone using AXL as a molecular surrogate.
Speaker Recognition Using Wavelet Packet Entropy, I-Vector, and Cosine Distance Scoring
Authors: Lei Lei , Kun She
Published: May 2017

Today, more and more people have benefited from the speaker recognition. However, the accuracy of speaker recognition often drops off rapidly because of the low-quality speech and noise. This paper proposed a new speaker recognition model based on wavelet packet entropy (WPE), i-vector, and cosine distance scoring (CDS). In the proposed model, WPE transforms the speeches into short-term spectrum feature vectors (short vectors) and resists the noise. I-vector is generated from those short vectors and characterizes speech to improve the recognition accuracy. CDS fast compares with the difference between two i-vectors to give out the recognition result. The proposed model is evaluated by TIMIT speech database. The results of the experiments show that the proposed model can obtain good performance in clear and noisy environment and be insensitive to the low-quality speech, but the time cost of the model is high. To reduce the time cost, the parallel computation is used.
Analysis of Microarray-Identified Genes and MicroRNAs Associated with Idiopathic Pulmonary Fibrosis
Authors: Fan Lichao , Yu Xiaoting , Huang Ziling , Zheng Shaoqiang , Zhou Yongxin , Lv Hanjing , Zeng Yu , Xu Jin-Fu , Zhu Xuyou , Yi Xianghua
Published: May 2017

The aim of this study was to identify potential microRNAs and genes associated with idiopathic pulmonary fibrosis (IPF) through web-available microarrays. The microRNA microarray dataset GSE32538 and the mRNA datasets GSE32537, GSE53845, and GSE10667 were downloaded from the Gene Expression Omnibus (GEO) database. Differentially expressed miRNAs (DE-miRNAs)/genes (DEGs) were screened with GEO2R, and their associations with IPF were analyzed by comprehensive bioinformatic analyses. A total of 45 DE-microRNAs were identified between IPF and control tissues, whereas 67 common DEGs were determined to exhibit the same expression trends in all three microarrays. Furthermore, functional analysis indicated that microRNAs in cancer and ECM-receptor interaction were the most significant pathways and were enriched by the 45 DE-miRNAs and 67 common DEGs. Finally, we predicted potential microRNA-target interactions between 17 DE-miRNAs and 17 DEGs by using at least three online programs. A microRNA-mediated regulatory network among the DE-miRNAs and DEGs was constructed that might shed new light on potential biomarkers for the prediction of IPF progression.
Human Bone Marrow Mesenchymal Stem/Stromal Cells Preserve Their Immunomodulatory and Chemotactic Properties When Expanded in a Human Plasma Derived Xeno-Free Medium
Authors: Blázquez-Prunera A. , Almeida C. R. , Barbosa M. A.
Published: May 2017

Due to their immunomodulatory and chemotactic properties, hMSC are being explored to treat immune-related diseases. For their use in human therapies, it is necessary to culture hMSC in xeno-free conditions. In this study, the impact that a xeno-free medium based on a human plasma derivate has on these properties was analysed. Bone marrow-derived hMSC preserved their immunosuppressive and immunostimulatory properties, as observed with in vitro assays with hMSC cocultured with mixed leukocyte reactions or with mitogen-stimulated leukocytes. Moreover, hMSC expanded in xeno-free medium were recruited by macrophages in both migration and invasion assays, which indicates that the cells maintained their chemotactic properties. These data suggest that xeno-free expanded hMSC preserved their immunomodulatory and chemotactic properties, indicating that the described xeno-free medium composition is a potential candidate to culture and expand hMSC for human cell therapies.
Robust Kernel Clustering Algorithm for Nonlinear System Identification
Authors: Bouzbida Mohamed , Hassine Lassad , Chaari Abdelkader
Published: May 2017

In engineering field, it is necessary to know the model of the real nonlinear systems to ensure its control and supervision; in this context, fuzzy modeling and especially the Takagi‐Sugeno fuzzy model has drawn the attention of several researchers in recent decades owing to their potential to approximate nonlinear behavior. To identify the parameters of Takagi‐Sugeno fuzzy model several clustering algorithms are developed such as the Fuzzy C‐Means (FCM) algorithm, Possibilistic C‐Means (PCM) algorithm, and Possibilistic Fuzzy C‐Means (PFCM) algorithm. This paper presents a new clustering algorithm for Takagi‐Sugeno fuzzy model identification. Our proposed algorithm called Robust Kernel Possibilistic Fuzzy C‐Means (RKPFCM) algorithm is an extension of the PFCM algorithm based on kernel method, where the Euclidean distance used the robust hyper tangent kernel function. The proposed algorithm can solve the nonlinear separable problems found by FCM, PCM, and PFCM algorithms. Then an optimization method using the Particle Swarm Optimization (PSO) method combined with the RKPFCM algorithm is presented to overcome the convergence to a local minimum of the objective function. Finally, validation results of examples are given to demonstrate the effectiveness, practicality, and robustness of our proposed algorithm in stochastic environment.
Effect of Hydraulic Retention Time on Anaerobic Digestion of Wheat Straw in the Semicontinuous Continuous Stirred-Tank Reactors
Authors: Shi Xiao-Shuang , Dong Jian-Jun , Yu Jun-Hong , Yin Hua , Hu Shu-Min , Huang Shu-Xia , Yuan Xian-Zheng
Published: May 2017

Three semicontinuous continuous stirred-tank reactors (CSTR) operating at mesophilic conditions (35°C) were used to investigate the effect of hydraulic retention time (HRT) on anaerobic digestion of wheat straw. The results showed that the average biogas production with HRT of 20, 40, and 60 days was 46.8, 79.9, and 89.1 mL/g total solid as well as 55.2, 94.3, and 105.2 mL/g volatile solids, respectively. The methane content with HRT of 20 days, from 14.2% to 28.5%, was the lowest among the three reactors. The pH values with HRT of 40 and 60 days were in the acceptable range compared to that with HRT of 20 days. The propionate was dominant in the reactor with HRT of 20 days, inhibiting the activities of methanogens and causing the lower methane content in biogas. The degradation of cellulose, hemicellulose, and crystalline cellulose based on XRD was also strongly influenced by HRTs.
Optimization of Aflatoxin B1 Aptasensing
Authors: Jafari Marzieh , Rezaei Mohsen , Kalantari Heibatullah , Tabarzad Maryam , Daraei Bahram
Published: May 2017

Combination of aptamers with DNAzymes attracted intense attention for development of DNA-based biosensors for detection of mycotoxins. In the present study a combination of aflatoxin B1 specific aptamer and HRP- (horseradish peroxidase-) mimicking DNAzyme was optimized for detecting aflatoxin B1. Detecting approach is based on the binding affinity of aflatoxin B1 to its specific aptamer and conversion of substrate to a detectable colorimetric signal by a linked DNAzyme. Compared to conventional methods for aflatoxin B1 detection, DNA-based assay has the advantages of low cost, long-term stability, and rapid, simple, and user-friendly steps.
Chronic Lymphocytic Inflammation with Pontine Perivascular Enhancement Responsive to Steroids, with Cranial and Caudal Extension
Authors: Mubasher Mahmood , Sukik Aseel , El Beltagi Ahmed Hassan , Rahil Ali
Published: May 2017

A 23-year-old lady presented with vertigo and imbalance in walking, blurring of vision, diplopia, and headache, in addition to numbness in the lower limbs over a period of six days. On examination patient had nystagmus, ataxia, positive Romberg test, and hyperreflexia. MRI examination of the brain and spinal cord showed evidence of faint bright signal intensity foci in T2/FLAIR involving bilateral cerebral hemispheres, subcortical deep white matter, bilateral thalami, posterior pons and left brachium pontis, and basal ganglia, with small nodular enhancement that aligned along curvilinear structures; those lesions also were apparent along the spinal cord at multiple levels. The clinical and radiological features suggested CLIPPERS (chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids) syndrome. Symptoms improved dramatically with high dose oral corticosteroids. Our report addresses the radiological and clinical pattern of a case of CLIPPERS rhombencephalitis, with added superior and inferior extension to involve the brain and spinal cord, which is to emphasize the importance of raising the awareness of this disease and the combined role of radiologist and physicians for the diagnosis of this potentially treatable entity, responsive to glucocorticosteroid immunosuppression.
Safe and Effective Reduction Technique for Intertrochanteric Fracture with Ipsilateral Below-Knee Amputated Limb
Authors: Ochi Hironori , Baba Tomonori , Hamanaka Takahiro , Ozaki Yu , Watari Taiji , Homma Yasuhiro , Matsumoto Mikio , Kaneko Kazuo
Published: May 2017

The positioning of the patient on the fracture table is critical for the successful reduction and operative fixation of intertrochanteric hip fractures. However, this manipulation is challenging with patients who have undergone amputations of their legs. A 97-year-old man presented to the emergency department with symptom of right hip pain following a mechanical fall. He had a below-knee amputation on his right leg following a traffic accident as a 19-year-old and had a below-knee patellar tendon bearing prosthesis fitted to his lower limb for mobility. Radiographs of his pelvis revealed a displaced intertrochanteric fracture of the right side femur. The patient was positioned on a fracture table, as in the standard procedure. The method of inverting the traction boot to accommodate the flexed knee and stump described by Al-Harthy could be used to provide traction and rotational control. Internal fixation was performed using a short femoral nail. Postoperatively, the patient could walk with full weight bearing using a prosthesis on his affected limb. The method of inverting the traction boot to accommodate the flexed knee and stump can be used safely and effectively to achieve and maintain fracture reduction during fixation of intertrochanteric fractures for patients with a below-knee amputated limb.
Long-Term Impairment of Sound Processing in the Auditory Midbrain by Daily Short-Term Exposure to Moderate Noise
Authors: Cheng Liang , Wang Shao-Hui , Peng Kang , Liao Xiao-Mei
Published: May 2017

Most citizen people are exposed daily to environmental noise at moderate levels with a short duration. The aim of the present study was to determine the effects of daily short-term exposure to moderate noise on sound level processing in the auditory midbrain. Sound processing properties of auditory midbrain neurons were recorded in anesthetized mice exposed to moderate noise (80 dB SPL, 2 h/d for 6 weeks) and were compared with those from age-matched controls. Neurons in exposed mice had a higher minimum threshold and maximum response intensity, a longer first spike latency, and a higher slope and narrower dynamic range for rate level function. However, these observed changes were greater in neurons with the best frequency within the noise exposure frequency range compared with those outside the frequency range. These sound processing properties also remained abnormal after a 12-week period of recovery in a quiet laboratory environment after completion of noise exposure. In conclusion, even daily short-term exposure to moderate noise can cause long-term impairment of sound level processing in a frequency-specific manner in auditory midbrain neurons.
Prevalence, Impact, and Management Practice of Dysmenorrhea among University of Gondar Students, Northwestern Ethiopia: A Cross-Sectional Study
Authors: Gebeyehu Minaleshewa Biruk , Mekuria Abebe Basazn , Tefera Yonas Getaye , Andarge Dagmawi Abate , Debay Yabsira Belayneh , Bejiga Geremew Sokile , Gebresillassie Begashaw Melaku
Published: May 2017

Background. Dysmenorrhea is an important health problem of adolescents in school, as well as health practitioners, that badly affects the daily activities and quality of life. The aim of this study was to measure the prevalence of dysmenorrhea and assess its management practice among University of Gondar students. Methods. A cross-sectional study was done from April 06 to May 08, 2016, on female students of University of Gondar. Descriptive and binary logistic regression analyses were used to describe and assess the association between different variables. Results. More than two-thirds (75.3%) of the respondents were nonmedical students and the prevalence of dysmenorrhea was 77.6%. About half (50.6%) of the participants reported that they have a family history of dysmenorrhea and experienced continuous type of pain (53%) which lasts 1-2 days (47.8%). Abdominal spasm (70.4%), back pain (69.7%) fatigue, and weakness (63.5%) were the most commonly experienced dysmenorrhea symptoms. More than half (63%) of the respondents had encountered social withdrawal and decrease in academic performance (51.4%). More than two-thirds (63.8%) of the respondents use home remedies as a primary management option. Ibuprofen and diclofenac were the most commonly used medications to manage dysmenorrhea. Conclusions. The present study revealed that high proportion of University of Gondar female students had dysmenorrhea. Findings suggest the need for educating adolescent girls on appropriate and effective management of dysmenorrhea.
Effect of Acupuncture on Endometrial Angiogenesis and Uterus Dendritic Cells in COH Rats during Peri‐Implantation Period
Authors: Dong Haoxu , Zhong Zhiyan , Chen Wei , Wu Xiao , Zhang Qing , Huang Guangying , Yang Wei
Published: May 2017

This study was to explore the mechanism of acupuncture on regulating the endometrial angiogenesis and uterus dendritic cells (uDCs) during the peri‐implantation period. Rats, in early pregnancy, were randomized into five groups: normal (N), model (M), acupuncture (A), progesterone (P), and A + P groups. The COH model was established using pregnant mare serum, combined with human chorionic gonadotrophin. Endometrium was collected on days 4, 6, and 8 (D4, D6, and D8) of gestation. Compared with group M, both VEGF and FGF‐2 protein and mRNA levels were significantly lower on D4 and higher on D6 and D8 (P < 0.05), except for VEGF of group P on D8; the proportion of uterus dendritic cells (uDCs) in the endometrium was significantly lower on D4 and D6 and higher on D8 (P < 0.05). In vitro, except for the proliferation of group P on D8, proliferation, tube formation, and migration of uDCs were significantly decreased on D4 and increased on D8 (P < 0.05). In addition, acupuncture or progesterone regulated the secretion levels of VEGF, IL‐15, and IL‐18 secreted by uDCs instead of soluble sFLT‐1. In conclusion, acupuncture may regulate angiogenesis of the endometrium and the number and roles of uDCs after COH, and the specific mechanism may be different with progesterone.