bluuebunny/crossref_metadata_2025 huggingface dataset:
Determinants of timeliness in early childhood vaccination among mothers with vaccination cards in Sindh province, Pakistan: a secondary analysis of cross-sectional survey data
Authors: Noh Jin-Won , Kim Young-mi , Akram Nabeel , Yoo Ki Bong , Cheon Jooyoung , Lee Lena J , Kwon Young Dae , Stekelenburg Jelle
Published: September 2019

Objective

Untimely vaccination refers to receiving the given dose before (early) or after (delayed) the recommended time window. The purpose of this study was to assess the extent of timeliness of childhood vaccinations and examine the determinants of vaccination timeliness in Sindh province, Pakistan.

Design

Cross-sectional analysis of data from the 2013 and 2014 Maternal and Child Health Program Indicator Surveys.

Setting

Community-based maternal and child health surveys.

Participants

Among 10 200 respondents of Maternal and Child Health Program Indicator Surveys, 1143 women who had a live birth in the 2 years preceding the survey were included.

Outcomes

At the participants’ home, an interviewer asked mothers to show their children’s vaccination cards, which contained information regarding vaccinations. Children’s vaccination status was categorised into timely or early/delayed compared with vaccination schedule. A logistic regression analysis using Firth’s penalised likelihood was performed to identify factors associated with timeliness of vaccinations.

Results

238 children (20.8% of children who received a full set of basic vaccinations) received all vaccinations on schedule among children who received a full set of basic vaccinations. The percentages of timely vaccinations ranged from 2.3% for second measles vaccination to 89.3% for bacillus Calmette-Guérin. Child’s age and place of delivery were associated with timely vaccinations. Older child age and institutional delivery were associated with decreased timely vaccination rate.

Conclusions

Home-based vaccination record is a key tool to improve the timeliness of vaccinations. The redesigned vaccination cards, the new electronic registries for vaccination card information and the vaccination tracking system to remind the second/third vaccination visits may be helpful to improve timely vaccinations for children under 2 years old.
The Surveillance After Extremity Tumor Surgery (SAFETY) trial: protocol for a pilot study to determine the feasibility of a multi-centre randomised controlled trial
Authors:   The SAFETY Investigators
Published: September 2019

Introduction

Following the treatment of patients with soft tissue sarcomas (STS) that are not metastatic at presentation, the high risk for local and systemic disease recurrence necessitates post-treatment surveillance. Systemic recurrence is most often detected in the lungs. The most appropriate surveillance frequency and modality remain unknown and, as such, clinical practice is highly varied. We plan to assess the feasibility of conducting a multi-centre randomised controlled trial (RCT) that will evaluate the effect on overall 5-year survival of two different surveillance frequencies and imaging modalities in patients with STS who undergo surgical excision with curative intent.

Methods and analysis

The Surveillance After Extremity Tumor Surgery trial will be a multi-centre 2×2 factorial RCT. Patients with non-metastatic primary Grade II or III STS treated with excision will be allocated to one of four treatment arms1: chest radiograph (CXR) every 3 months for 2 years2; CXR every 6 months for 2 years3; chest CT every 3 months for 2 years or4 chest CT every 6 months for 2 years. The primary outcome of the pilot study is the feasibility of a definitive RCT based on a combination of feasibility endpoints. Secondary outcomes for the pilot study include the primary outcome of the definitive trial (overall survival), patient-reported outcomes on anxiety, satisfaction and quality of life, local recurrence-free survival, metastasis-free survival, treatment-related complications and net healthcare costs related to surveillance.

Ethics and dissemination

This trial received provisional ethics approval from the McMaster/Hamilton Health Sciences Research Ethics Board on 7 August 2019 (Project number 7562). Final ethics approval will be obtained prior to commencing patient recruitment. Once feasibility has been established and the definitive protocol is finalised, the study will transition to the definitive study.

Trial registration

NCT03944798; Pre-results.
LIPid Intensive Drug therapy for Sepsis Pilot (LIPIDS-P): Phase I/II clinical trial protocol of lipid emulsion therapy for stabilising cholesterol levels in sepsis and septic shock
Authors: Guirgis Faheem W , Black Lauren Page , Rosenthal Martin Daniel , Henson Morgan , Ferreira Jason , Leeuwenburgh Christiaan , Kalynych Colleen , Moldawer Lyle L , Miller Taylor , Jones Lisa , Crandall Marie , Reddy Srinivasa T , Wu Samuel S , Moore Frederick A
Published: September 2019

Introduction

Sepsis is a life-threatening, dysregulated response to infection. Both high-density lipoprotein and low-density lipoprotein cholesterol should protect against sepsis by several mechanisms; however, for partially unknown reasons, cholesterol levels become critically low in patients with early sepsis who experience poor outcomes. An anti-inflammatory lipid injectable emulsion containing fish oil is approved by the Food and Drug Administration as parenteral nutrition for critically ill patients and may prevent this decrease in serum cholesterol levels by providing substrate for cholesterol synthesis and may favourably modulate inflammation. This LIPid Intensive Drug therapy for Sepsis Pilot clinical trial is the first study to attempt to stabilise early cholesterol levels using lipid emulsion as a treatment modality for sepsis.

Methods and analysis

This is a two-centre, phase I/II clinical trial. Phase I is a non-randomised dose-escalation study using a Bayesian optimal interval design in which up to 16 patients will be enrolled to evaluate the safest and most efficacious dose for stabilising cholesterol levels. Based on phase I results, the two best doses will be used to randomise 48 patients to either lipid injectable emulsion or active control (no treatment). Twenty-four patients will be randomised to one of two doses of the study drug, while 24 control group patients will receive no drug and will be followed during their hospitalisation. The control group will receive all standard treatments mandated by the institutional sepsis alert protocol. The phase II study will employ a permuted blocked randomisation technique, and the primary endpoint will be change in serum total cholesterol level (48 hours − enrolment). Secondary endpoints include change in cholesterol level from enrolment to 7 days, change in Sequential Organ Failure Assessment score over the first 48 hours and 7 days, in-hospital and 28-day mortality, lipid oxidation status, inflammatory biomarkers, and high-density lipoprotein function.

Ethics and dissemination

Investigators are trained and follow good clinical practices, and each phase of the study was reviewed and approved by the institutional review boards of each institution. Results of each phase will be disseminated through presentations at national meetings and publication in peer-reviewed journals. If promising, data from the pilot study will be used for a larger, multicentre, phase II clinical trial.

Trial registration number

NCT03405870.
Is age more than manual material handling associated with lumbar vertebral body and disc changes? A cross-sectional multicentre MRI study
Authors: Violante Francesco S , Zompatori Maurizio , Lovreglio Piero , Apostoli Pietro , Marinelli Francesco , Bonfiglioli Roberta
Published: September 2019

Objective

Conflicting evidence exists to what extent manual material handling (MMH) causes lumbar disc disease, lack of evidence exist that this effect takes place especially at L5-S1 level, where the greatest moment occurs. The aim was to assess if lumbar vertebral body and disc changes are more common in people whose job involves significant MMH and, if so, to evaluate if lumbar vertebral body and disc changes are more prevalent in the lower part of the lumbar spine (L4-L5 and L5-S1).

Design

Observational, cross-sectional, with quasi-random recruitment.

Setting

Outpatient radiology units of three large hospitals in northern (Bologna and Brescia) and southern (Bari) Italy.

Participants

183 consecutive adult subjects (89 males, 94 females) aged 20–70 years referred by the general practitioner or a specialist for MRI of the lumbar spine.

Primary and secondary outcome measures

Neuroradiologists (blind to clinical assessment) evaluated the prevalence of intervertebral disc and vertebral body changes in standardised MRI examinations. History of personal and family musculoskeletal diseases and injuries, current and previous MMH at work and during leisure time were assessed by interview and self-administered questionnaire.

Results

Participants were classified according their occupational exposure to MMH. No association was found between MMH and vertebral body and intervertebral disc changes, whereas age over 45 years was consistently associated with more disc extension beyond the interspace changes, Pfirrmann changes, osteophytes and Modic changes: the association was statistically significant at the conventional 5% level.

Conclusions

Age, and not MMH, seems to primarily affect the presence of intervertebral disc changes; prospective studies are needed to better explore the relationship between MMH and the possible presence (and level) of lumbar vertebral body and/or disc changes.
Cumulative exposure to ionising radiation from diagnostic imaging tests: a 12-year follow-up population-based analysis in Spain
Authors: Lumbreras Blanca , Salinas Josee María , Gonzalez-Alvarez Isabel
Published: September 2019

Objectives

To calculate each patient’s cumulative radiation exposure and the recurrent tests during a 12-year study period, according to sex and age, in routine practice.

Design

Retrospective cohort study.

Setting

A general hospital with a catchment population of 224 751 people, in the Southeast of Spain.

Participants

Population belonged to the catchment area of that hospital in 2007. We collected all consecutive diagnostic imaging tests undergone by this population until 31 December 2018. We excluded: imaging tests that did not involve radiation exposure.

Main outcome measures

The cumulative effective dose and the recurrent imaging tests by sex and age at entry of study.

Results

Of the 224 751 people, 154 520 (68.8%) underwent an imaging test. The population had 1 335 752 imaging tests during the period of study: 1 110 077 (83.0%) plain radiography; 156 848 (11.8%) CT; 63 157 (4.8%) fluoroscopy and 5670 (0.4%) interventional radiography. 25.4% of the patients who had a CT, underwent five or more CTs (5.4% in the 0–20 years age group). The median total cumulative effective dose was 2.10 mSv (maximum 3980.30) and 16.30 mSv (maximum 1419.30 mSv) if we considered only doses associated with CT. Women received more effective dose than men (median 2.38 vs median 1.90, p<0.001). A total of 7142 (4.6%) patients received more than 50 mSv, with differences in men and women (p<0.001) and 2.5% of the patients in the 0–20 years age group, if we considered only doses associated with CT.

Conclusions

Nearly 5% of patients received doses higher than 50 mSv during the 12-year period of study and 2.5% of the patients in the 0–20 years age group, if we considered only doses associated with CT. The rate of recurrent examinations was high, especially in older patients, but also relevant in the 0–20 years age group.
Male contraception: where are we going and where have we been?
Authors: Reynolds-Wright John Joseph , Anderson Richard A
Published: September 2019

Progress in developing new reversible male contraception has been slow. While the hormonal approach has been clearly shown to be capable of providing effective and reversible contraception, there remains no product available. Currently, trials of a self-administered gel combination of testosterone and the progestogen Nestorone® are under way, complementing the largely injectable methods previously investigated. Novel long-acting steroids with both androgenic and progestogenic activity are also in early clinical trials. The non-hormonal approach offers potential advantages, with potential sites of action on spermatogenesis, and sperm maturation in the epididymis or at the vas, but remains in preclinical testing. Surveys indicate the willingness of men, and their partners, to use a new male method, but they continue to lack that opportunity.
Implantable cardioverter defibrillator deactivation and advance care planning: a focus group study
Authors: Stoevelaar Rik , Brinkman-Stoppelenburg Arianne , van Driel Anne Geert , van Bruchem-Visser Rozemarijn L , Theuns Dominic AMJ , Bhagwandien Rohit E , Van der Heide Agnes , Rietjens Judith AC
Published: September 2019

Objective

Implantable cardioverter defibrillators can treat life-threatening arrhythmias, but may negatively influence the last phase of life if not deactivated. Advance care planning conversations can prepare patients for future decision-making about implantable cardioverter defibrillator deactivation. This study aimed at gaining insight in the experiences of patients with advance care planning conversations about implantable cardioverter defibrillator deactivation.

Methods

In this qualitative study, we held five focus groups with 41 patients in total. Focus groups were audio-recorded and transcribed. Transcripts were analysed thematically, using the constant comparative method, whereby themes emerging from the data are compared with previously emerged themes.

Results

Most patients could imagine deciding to have their implantable cardioverter defibrillator deactivated, for instance because the benefits of an active device no longer outweigh the harm of unwanted shocks, when having another life-limiting illness, or when relatives would think this would be in their best interest. Some patients expressed a need for advance care planning conversations with a healthcare professional about deactivation, but few had had these. Others did not, saying they solely focused on living. Some patients were hesitant to record their preferences about deactivation in advance care directives, because they were unsure whether their current preferences would reflect future preferences.

Conclusions

Although patients expressed a need for more information, advance care planning conversations about implantable cardioverter defibrillator deactivation seemed to be uncommon. Deactivation should be more frequently addressed by healthcare professionals, tailored to the disease stage of the patient and readiness to discuss this topic.
Will you give my kidney back? Organ restitution in living-related kidney transplantation: ethical analyses
Authors: Nakazawa Eisuke , Yamamoto Keiichiro , Akabayashi Aru , Shaw Margie H , Demme Richard A , Akabayashi Akira
Published: September 2019

In this article, we perform a thought experiment about living donor kidney transplantation. If a living kidney donor becomes in need of renal replacement treatment due to dysfunction of the remaining kidney after donation, can the donor ask the recipient to give back the kidney that had been donated? We call this problem organ restitution and discussed it from the ethical viewpoint. Living organ transplantation is a kind of ‘designated donation’ and subsequently has a contract-like character. First, assuming a case in which original donor (A) wishes the return of the organ which had been transplanted into B, and the original recipient (B) agrees, organ restitution will be permissible based on contract-like agreement. However, careful and detailed consideration is necessary to determine whether this leaves no room to question the authenticity of B’s consent. Second, if B offers to give back the organ to A, then B’s act is a supererogatory act, and is praiseworthy and meritorious. Such an offer is a matter of virtue, not obligation. Third, if A wishes B to return the organ, but B does not wish/allow this to happen, it is likely difficult to justify returning the organ to A by violating B’s right to bodily integrity. But B’s refusal to return the donated organ cannot be deemed praiseworthy, because B forgets the great kindness once received from A. Rather than calling this an obligation, we encourage B to consider such virtuous conduct.
Effect of probiotic containing Lactobacillus plantarum on growth performance, nutrient digestibility, and fecal microbiota in weaning pigs
Authors: Yang Y. , Park J.H. , Kim I.H.
Published: September 2019

A total of 150 weaning pigs (7.53 ± 1.23 kg) were randomly assigned to three treatments consisting of basal diet, and the basal diet supplemented with 300 and 600 mg kg−1 of probiotics, respectively, in a 42 d trial. The incremental levels of probiotics linearly increased average daily gain during week 1 and through the overall experimental period (P < 0.05). The average daily feed intake, body weight, and the apparent total tract digestibility of dry matter, nitrogen, and gross energy also increased (P < 0.05) with the increased level of probiotics. A significant reduction in Escherichia coli counts (P = 0.0037) and increase (P = 0.0016) in Lactobacillus counts were observed on day 42.
A service life model of metal ties embedded in the mortar joints of brick veneer walls with applications to reinforced concrete
Authors: Hagel Mark. D. , Sturgeon Gary R. , Cruz-Noguez Carlos
Published: September 2019

The issue regarding the corrosion of steel ties connecting brick veneer to a structural backing is well documented. In this paper, the predicted corrosion rate and resulting service life estimates, produced by a time-stepped service life model developed in Visual Basic for EXCEL, for metal ties embedded in mortar, are compared with the empirically determined corrosion rates and service lives of 16 zinc galvanized tie specimens taken from 13 buildings located in 6 different Canadian cities. This tie service life model, coined the “Tie Service Life Predictor”, correlates the external environment of the building to the tie life. As with most corrosion models for steel embedded in concrete (or mortar), the model is broken into two distinct phases: corrosion initiation using Fick’s law of diffusion and corrosion propagation. By considering the mortar surrounding the tie as the tie’s atmosphere, the Tie Service Life Predictor characterizes the microenvironment (atmospheric conditions) surrounding the tie from the macroenvironment conditions. Once the atmospheric conditions were established, the ISOCORRAG atmospheric corrosion model could be used to predict the corrosion rate of zinc galvanized steel ties embedded in the mortar joints of the exterior wythe of brick veneer wall systems. The methods used to create the Tie Service Life Predictor could also be applied to service life estimation of reinforcing steel in concrete structures such as bridge decks and parking structures.
Kuratowski Algebras Generated by Prefix-, Suffix-, Factor-, and Subword-Free Languages Under Star and Complementation
Authors: Jirásek Jozef , Palmovský Matúš , Šebej Juraj
Published: September 2019

We study Kuratowski algebras generated by prefix-, suffix-, factor-, and subword-free languages under the operations of star and complementation. We examine 12 possible algebras, and for each of them, we decide whether or not it can be generated by a prefix-, suffix-, factor-, or subword-free language. In each case when an algebra can be generated by such a language, we show that this language can be taken to be regular, and we compute upper bounds on the state complexities of all the generated languages. Finally, we find generators that maximize these complexities.
Concise Representations of Reversible Automata
Authors: Lavado Giovanna J. , Prigioniero Luca
Published: September 2019

In this paper, we present two concise representations of reversible automata. Both representations have a size comparable to the size of the minimum equivalent deterministic automaton and can be exponentially smaller than the size of the explicit representations of corresponding reversible automata. Using these representations it is possible to simulate the computations of reversible automata without explicitly writing down their complete descriptions.
Void ratio–permeability relations for clays
Authors: Li Chunguang
Published: September 2019

In spite of the Kozeny–Carman formula having been applied effectively to sands, there is at present no generally accepted explanation for why it is inadequate for clays. The impermeable adsorbed water layer surrounding the soil particles throws further light on the issue. By introducing the pervious void ratio, which accounts for the effective voids that a fluid flows through, a modified Kozeny–Carman formula is presented. The results presented here show that the modified Kozeny–Carman formula predicts fairly well the hydraulic conductivity of clays, especially for fine-grained soils.
Wadi gravel – a new concrete aggregate in Qatar: Part 1 – investigation, processing and trials
Authors: Hassan Khaled , Reid Murray , Sims Ian , Al-Kuwari Mohammed bin Saif , Attia Mohamed , Sediq Ahmed , Al-Naemi Abdulrahman
Published: September 2019

In hot desert regions, attention is turning to local sources of aggregate that were previously regarded as ‘too difficult' to exploit. This paper describes an investigation of such a deposit in Qatar. The material, known as Wadi gravel, is a gravelly sand of Tertiary age cemented by gypsum. A field survey found the gravel content to be in the range of 10 to 20%. As-dug samples had excessively high sulfate content, which could not be removed with conventional aggregate operations. However, intensive treatment in a local sand-processing plant using multi-stage crushing, screening and washing reduced the sulfate to acceptable levels. Petrographic analysis was carried out to identify rock types potentially susceptible to Alkali Silica Reaction (ASR). Trial concrete mixes using the processed Wadi gravel were found to produce satisfactory C40 and C60 concrete. Full-scale building trials were constructed to demonstrate the practicality of using the gravel and assess in-service performance. The smooth surface and rounded particles of Wadi gravel improved the concrete workability and strength, and durability-related properties were similar to concrete made with imported gabbro. Strata similar to Wadi gravel occur widely in hot desert regions and could be useful sources of coarse and fine aggregate for concrete.
An Incentive Mechanism for Crowdsourcing Systems with Network Effects
Authors: Chen Yanjiao , Wang Xu , Li Baochun , Zhang Qian
Published: September 2019

In a crowdsourcing system, it is important for the crowdsourcer to engineer extrinsic rewards to incentivize the participants. With mobile social networking, a user enjoys an intrinsic benefit when she aligns her behavior with the behavior of others. Referred to as
network effects
, such an intrinsic benefit becomes more significant as more users join and contribute to the crowdsourcing system. But should a crowdsourcer design her extrinsic rewards differently when such network effects are taken into consideration? In this article, we incorporate network effects as a contributing factor to intrinsic rewards, and study its influence on the design of extrinsic rewards. We show that the number of participating users and their contributions to the crowdsourcing system evolve to a steady equilibrium, thanks to subtle interactions between intrinsic rewards due to network effects and extrinsic rewards offered by the crowdsourcer. Taken network effects into consideration, we design progressively more sophisticated extrinsic reward mechanisms, and propose new and optimal strategies for a crowdsourcer to obtain a higher utility. Through simulations and examples, we demonstrate that with our new strategies, a crowdsourcer is able to attract more participants with higher contributed efforts; and the participants gain higher utilities from both intrinsic and extrinsic rewards.
An Operational Characterization of Mutual Information in Algorithmic Information Theory
Authors: Romashchenko Andrei , Zimand Marius
Published: September 2019

We show that the mutual information, in the sense of Kolmogorov complexity, of any pair of strings
x
and
y
is equal, up to logarithmic precision, to the length of the longest shared secret key that two parties—one having
x
and the complexity profile of the pair and the other one having
y
and the complexity profile of the pair—can establish via a probabilistic protocol with interaction on a public channel. For ℓ > 2, the longest shared secret that can be established from a tuple of strings (
x
1
, …,
x
ℓ
) by ℓ parties—each one having one component of the tuple and the complexity profile of the tuple—is equal, up to logarithmic precision, to the complexity of the tuple minus the minimum communication necessary for distributing the tuple to all parties. We establish the communication complexity of secret key agreement protocols that produce a secret key of maximal length for protocols with public randomness. We also show that if the communication complexity drops below the established threshold, then only very short secret keys can be obtained.
Accuracy Assessment of Nonlinear Seismic Displacement Demand Predicted by Simplified Methods for the Plateau Range of Design Response Spectra
Authors: Lestuzzi Pierino , Diana Lorenzo
Published: September 2019

The nonlinear seismic displacement demand prediction for low‐period structures, i.e., with an initial fundamental period situated in the plateau of design response spectra, is studied. In Eurocode 8, the computation of seismic displacement demands is essentially based on a simplified method called the N2 method. Alternative approaches using linear computation with increased damping ratio are common in other parts of the world. The accuracy of three methods for seismic displacement demand prediction is carefully examined for the plateau range of Type‐1 soil class response spectra of Eurocode 8. The accuracy is assessed through comparing the displacement demand computed using nonlinear time‐history analysis (NLTHA) with predictions using simplified methods. The N2 method, a recently proposed optimization of the N2 method, and the Lin and Miranda method are compared. Nonlinear single‐degree‐of‐freedom systems are subjected to several sets of recorded earthquakes that are modified to match design response spectra prescribed by Eurocode 8. The shape of Eurocode 8 response spectra after the plateau is defined by a constant pseudovelocity range (1/T). However, the slope of this declining branch may be specified using precise spectral microzonation investigation. However, the N2 method has been found to be particularly inaccurate with certain microzonation response spectra that are characterized by a gently decreasing branch after the plateau. The present study investigates the impact of the slope of the decreasing branch after the plateau of response spectra on the accuracy of displacement demand predictions. The results show that the accuracy domain of the N2 method is restricted to strength reduction factor values around 3.5. Using the N2 method to predict displacement demands leads to significant overestimations for strength reduction factors smaller than 2.5 and to significant underestimations for strength reduction factors larger than 4. Fortunately, the optimized N2 method leads to accurate results for the whole range of strength reduction factors. For small values of strength reduction factors, up to 2.5, the optimized N2 method and the Lin and Miranda method both provide accurate displacement demand predictions. However, the accuracy of displacement demand prediction strongly depends on the shape of the response spectrum after the plateau. A gently decreasing branch after the plateau affects the accuracy of displacement demand predictions. A threshold value of 0.75 for the exponent of the decreasing branch (1/Tα) after the plateau is proposed. This issue should be considered for the ongoing developments of Eurocode 8.
Superficial Morphea: Clinicopathological Characteristics and a Novel Therapeutic Outcome to Excimer Light Therapy
Authors: Mosbeh Al-Sadat , Aboeldahab Soha , El-Khalawany Mohamed
Published: September 2019

Introduction. Superficial morphea (SM) is an uncommon entity that was described in the literature without definitive correlation to localized scleroderma (LS) or other atrophoderma diseases. Aim. To demonstrate the clinicopathological features of SM and evaluate the efficacy of different therapeutic modalities in its management. Patients and methods. A total of 28 patients with SM were studied during the period from 2010 to 2015. Clinicopathological features and therapeutic outcomes were recorded and analyzed. Results. Clinically, SM was predominant in females (71.4%) with an average onset at 33 years of age and an average duration of 15 months. It was commonly presented as asymptomatic, darkly pigmented, and multiple and slightly indurated patches. The lesions were mostly ill-defined, large-sized, and located more on the trunk. Histologically, thickening of collagen fibers was observed either localized to the papillary dermis only (38.9%) or extended into the upper reticular dermis (61.1%). Elastic fibers were generally diminished in the upper reticular dermis while the number of fibroblasts and basal melanin pigmentation were increased in the majority of cases (92.9% and 96.4%, respectively). The most commonly associated diseases were diabetes mellitus (50%) and hepatitis C virus (HCV) infection (42.8%), and their incidence was significantly higher than that in patients with LS. Excimer light showed promising effective results in the treatment of most cases (78.9%) while the response to other modalities such as topical corticosteroid alone or in combination with tacrolimus or treatment with UVA1 alone was less effective (7.1%, 23.1%, and 5%, respectively). Conclusion. Our results proposed that SM is a distinctive clinicopathological variant and not a stage in the spectrum of LS. The novel response of SM to excimer light and not for UVA1 therapy also suggests the different therapeutic outcome of SM from LS. Although SM has a significant association with DM and HCV infection, they seem not to affect the course of the disease.
Analysis of Sluice Foundation Seepage Using Monitoring Data and Numerical Simulation
Authors: Xuefeng Fan , Wu Zhenyu , Lijun Liu , Wen Yanfeng , Yu Shu , Zepeng Zhao , Li Zefa
Published: September 2019

For sluices built on soil foundations, seepage safety of the foundation is one of the most concerns during operation of sluices. Monitoring data could reflect the real seepage behavior in the foundation, but of which the shortcoming is that generally only the local seepage states can be measured. The seepage field in the whole foundation can be analyzed by numerical simulation. The permeability coefficients of the foundation materials significantly affect the numerical simulation results; however, it is difficult to accurately determine the values of permeability coefficients. In this paper, an approach based on response surface method (RSM) for calibration of permeability coefficients was proposed, and the efficiency of parameter calibration is improved by constructing the response surface equation instead of time‐consuming finite element calculation of foundation seepage. The seepage in a sluice foundation was analyzed using monitoring data and numerical simulation. The monitoring data showed that the seepage pressure in the foundation periodically varies with high value in flood season and low value in dry season. After calibration of the permeability coefficients of the foundation materials using the measured seepage pressure, the seepage fields in the foundation for different water levels were numerically simulated to investigate the cause for the periodical variation of the seepage pressure and the seepage safety of the foundation was assessed with the calculated seepage gradients. The methods adopted in this study could be applied to seepage analysis for sluice foundations with similar geologic conditions and antiseepage measures.
Cerebellar Neurocysticercosis as Long-Term Complication of Allogeneic Haematopoietic Stem Cell Transplantation from Haploidentical Donor
Authors: Meconi Federico , Ciangola Giulia , Mariotti Benedetta , Cerretti Raffaella , Cudillo Laura , Arcese William , Picardi Alessandra
Published: September 2019

Neurocysticercosis, an infection of the central nervous system with the larval stage of the cestode Taenia solium, is uncommon in developed countries. We report a case of allogeneic haematopoietic stem cell transplantation from a haploidentical donor complicated, in the long term, by T. solium infection of the central nervous system and successfully treated with empiric antiparasitic therapy with albendazole plus dexamethasone. Revised diagnostic criteria proposed by Del Brutto et al. were used for the definitive diagnosis of cerebellar neurocysticercosis.
Mitochondrial Fusion by M1 Promotes Embryoid Body Cardiac Differentiation of Human Pluripotent Stem Cells
Authors: Lees Jarmon G. , Kong Anne M. , Chen Yi C. , Sivakumaran Priyadharshini , Hernández Damián , Pébay Alice , Harvey Alexandra J. , Gardner David K. , Lim Shiang Y.
Published: September 2019

Human induced pluripotent stem cells (iPSCs) can be differentiated in vitro into bona fide cardiomyocytes for disease modelling and personalized medicine. Mitochondrial morphology and metabolism change dramatically as iPSCs differentiate into mesodermal cardiac lineages. Inhibiting mitochondrial fission has been shown to promote cardiac differentiation of iPSCs. However, the effect of hydrazone M1, a small molecule that promotes mitochondrial fusion, on cardiac mesodermal commitment of human iPSCs is unknown. Here, we demonstrate that treatment with M1 promoted mitochondrial fusion in human iPSCs. Treatment of iPSCs with M1 during embryoid body formation significantly increased the percentage of beating embryoid bodies and expression of cardiac-specific genes. The pro-fusion and pro-cardiogenic effects of M1 were not associated with changes in expression of the α and β subunits of adenosine triphosphate (ATP) synthase. Our findings demonstrate for the first time that hydrazone M1 is capable of promoting cardiac differentiation of human iPSCs, highlighting the important role of mitochondrial dynamics in cardiac mesoderm lineage specification and cardiac development. M1 and other mitochondrial fusion promoters emerge as promising molecular targets to generate lineages of the heart from human iPSCs for patient-specific regenerative medicine.
The Epidemiology of Bloodstream Infections and Antimicrobial Susceptibility Patterns: A Nine-Year Retrospective Study at St. Dominic Hospital, Akwatia, Ghana
Authors: Deku John Gameli , Dakorah Mavis Puopelle , Lokpo Sylvester Yao , Orish Verner N. , Ussher Francis Abeku , Kpene Godsway Edem , Angmorkie Eshun Vida , Agyei Eunice , Attivor Waldermer , Osei-Yeboah James
Published: September 2019

Background. Bloodstream infections are among the top causes of morbidity and mortality in people of all ages, especially in immunocompromised patients in sub-Saharan Africa. This study aimed at describing the epidemiology of bloodstream infections and antimicrobial susceptibility pattern over a nine-year period at St. Dominic Hospital, Akwatia, in the Eastern Region of Ghana. Method. This study retrospectively analysed data from 4,489 patients who were referred to the Laboratory Department for blood culture and sensitivity testing from January 2009 to December 2017. Sociodemographic data included age, gender, and patients’ department. Blood culture results were retrieved from archival records in the laboratory. The authorities of St. Dominic Hospital granted approval for the study. Results. The incidence of bloodstream infection over the 9 years was 51.4 positive cultures per 100,000 hospital attendance. Staphylococcus aureus was the leading causative agent of bacteraemia for the first two scalar years (2009–2011 (38.9%) and 2012–2014 (42.2%)) while coagulase-negative staphylococcus (CoNS) (50.5%) was predominant for the last scalar year (2015–2017), followed by Staphylococcus aureus (169/587 (28.8%)). The highest incidence of bloodstream infections was recorded in the wet seasons (months of May (8.9 per 10,000 persons) and October (10.1 per 10,000 persons)). The bacterial isolates demonstrated high resistance to tetracyclines (390/531 (73.4%)), penicillins (1282/1669 (76.8%)), and sulphonamides (450/499 (90.2%)). Conclusion. Bloodstream infection and antimicrobial resistance are high in patients seeking healthcare in Akwatia. This therefore calls for concerted efforts aimed at reducing the incidence in the study area.
The Prevalence of Celiac Disease-Specific Auto-Antibodies in Type 1 Diabetes in a Moroccan Population
Authors: Oujamaa Ider , Sebbani Majda , Elmoumou Lahcen , Bourrahouate Aïcha , El Qadiry Rabiy , El Moussaoui Soufian , Ait Sab Imane , Sbihi Mohamed , Ennazk Laila , El Mghari-Tabib Ghizlane , El Ansari Nawal , Baizri Hicham , Amine Mohamed , Admou Brahim
Published: September 2019

Objective. We aimed to determine the prevalence of specific auto-antibodies to celiac disease (CD) in Moroccan type 1 diabetic (T1D) patients and compare the clinical and biological characteristics of seropositive and seronegative cases. Patients and Methods. A cross-sectional study was carried out on 276 T1D patients including 109 adults and 167 pediatric cases. The screening for CD was performed by an Elisa IgA anti-tissue transglutaminase antibody (tTGA) testing, combined with IgA quantification by nephelometry. Positive-IgA-tTGA cases were secondly tested for anti-endomysial antibodies (EMA) using an immunofluorescence technique, and the IgA deficiency cases were screened for IgG-tTGA. Patients with low positive tTGA titers underwent HLA-DQ2/DQ8 typing. Sociodemographic and clinical data of the patients were collected using a hetero-administered questionnaire. The comparison of clinical and biological data between seropositive and seronegative diabetics was done using independent T, Mann–Whitney U, chi-squared, and Fisher tests, which were considered significant if p value <0.05. Results. The prevalence of CD-specific auto-antibodies was estimated to be 9.1% (IC = 95%), with 25 positive cases in tTGA and EMA testing. Eight cases displayed low titers of IgA-tTGA, among which 4 were positive for HLA-DQ2, 1 for HLA-DQ8, and 1 for both DQ2 and DQ8. The other 2 cases had a biopsy-proven CD. Compared to seronegative patients, seropositive cases had a higher percentage of associated autoimmune disorders (16% vs. 2.4%, p=0.008), with a significant lower height Z-scores (median: −0.90 (−3.93 to 0.95) vs. −0.51 (−4.54 to 2.18), p=0.029) and a higher HbA1c level (median: 11.30% (7.31 to 16.00) vs. 9.30% (4.40 to17.31), p=0.022). Conclusion. The current study gave evidence of a high prevalence of CD specific auto-antibodies in T1D population. The co-existence of these two conditions was associated with a poor glycemic control, a lower height, and other autoimmune diseases. These findings may suggest the necessity of a systematic screening of CD in T1D patients.
Influence of Hydraulic Domain on Vibration Control and Overload Prediction of High‐Speed Punching Press: Multidomain Modelling and Experiment
Authors: Xu Teng , Xia Qinxiang , Wu Xiaoyu , Ran Jiaqi , Gong Feng , Lee Chunying
Published: September 2019

By the multidomain modelling method, the vibration of a high‐speed punching press was modelled and simulated, and the influence of the hydraulic system on the vibration of the punching press and the protection efficiency of the punching press under the overload condition was discussed. The multidomain simulation results were compared with the experimental results to the validity of the multidomain model on a punching press with a hydraulic system for vibration reduction function.
Multiorgan Drug Action of Levosimendan in Critical Illnesses
Authors: Pan Jian , Yang Yun-Mei , Zhu Jian-Yong , Lu Yuan-Qiang
Published: September 2019

Cardiotonic drugs mainly include digitalis, catecholamines, phosphodiesterase inhibitors, and calcium sensitizers, which have been successively discovered and applied in clinical practice. However, there are only a few new drugs available in this field, and the selection is very limited. Digitalis, catecholamines, and phosphodiesterase inhibitors increase myocardial contractility by increasing intracellular concentrations of cyclic adenosine monophosphate (cAMP) and Ca2+, and this increase in intracellular calcium ion concentration enhances myocardial oxygen consumption and causes arrhythmia. For these reasons, the research focus on positive inotropic agents has shifted from calcium mobilization to calcium sensitization. Intracellular calcium sensitizers are more effective and safer drugs because they do not increase the intracellular concentration of calcium ions. However, only three calcium sensitizers have been fully developed and used in the past three decades. One of these drugs, levosimendan, has multiple molecular targets and exerts its pharmacological effects by not only increasing myocardial contractility, but also enhancing respiratory muscle function and liver and kidney protection, and it is useful for patients with severe sepsis and septic shock. Recently, more than 60 randomized controlled clinical trials of levosimendan have been reported; however, these clinical trials have occasionally shown different findings. This article reviews the research progress of levosimendan in critical illnesses in recent years.
MicroRNAs Affect Complement Regulator Expression and Mitochondrial Activity to Modulate Cell Resistance to Complement-Dependent Cytotoxicity
Authors: Hillman Yaron , Mardamshina Mariya , Pasmanik-Chor Metsada , Ziporen Lea , Geiger Tamar , Shomron Noam , Fishelson Zvi
Published: September 2019

MicroRNAs (miR) are small RNA molecules that shape the cell transcriptome and proteome through regulation of mRNA stability and translation. Here, we examined their function as determinants of cell resistance to complement-dependent cytotoxicity (CDC). To achieve this goal, we compared the expression of microRNAs between complement-resistant and -sensitive K562 leukemia, Raji lymphoma, and HCT-116 colorectal carcinoma cells. Global microRNA array analysis identified miR-150, miR-328, and miR-616 as regulators of CDC resistance. Inhibition of miR-150 reduced resistance, whereas inhibition of miR-328 or miR-616 enhanced cell resistance. Treatment of K562 cells with a sublytic dose of complement was shown to rapidly increase miR-150, miR-328, and miR-616 expression. Protein targets of these microRNAs were analyzed in K562 cells by mass spectrometry–based proteomics. Expression of the complement membrane regulatory proteins CD46 and CD59 was significantly enhanced after inhibition of miR-328 and miR-616. Enrichment of proteins of mitochondria, known target organelles in CDC, was observed after miR-150, miR-328, and miR-616 inhibition. In conclusion, miR-150, miR-328, and miR-616 regulate cell resistance to CDC by modifying the expression of the membrane complement regulators CD46 and CD59 and the response of the mitochondria to complement lytic attack. These microRNAs may be considered targets for intervention in complement-associated diseases and in anticancer, complement-based therapy.
Personal Genetic Information about HIV: Research Participants’ Views of Ethical, Social, and Behavioral Implications
Authors: Boyce Angie , Walker Alexis , Duggal Priya , Thio Chloe L. , Geller Gail
Published: September 2019

Background: Personal genetic information (PGI) about HIV is produced in research and entering the clinic and direct-to-consumer market, but little consideration has been given to ethical and social issues, public perspectives, and potential behavioral implications. Objectives: This research queried the views of research participants at risk for or infected with HIV, exploring their perspectives on HIV-related PGI and its ethical, social, and behavioral implications. Methods: We used focus groups to collect rich information about participants’ perspectives on the ethical, social, and behavioral implications of PGI about HIV and host genetic research. We evaluated their reactions to three different types of genetic variants: those that made them more susceptible to HIV, more protected from or resistant to HIV, or more likely to transmit HIV to others. Results: Overall, participants wanted PGI about HIV. Their reasons included a mix of personal or family health benefit and benefit to others, which varied in emphasis depending on variant type. While susceptibility variant information was seen primarily in terms of personal or family health benefit, for transmissibility and protective variant information, benefit to others emerged as a major reason for wanting PGI about HIV. Participants thought transmissibility variant information would help them prevent others from becoming infected, and protective variant information would allow them to volunteer for targeted research to help treat, cure, or prevent HIV. Possible harms were raised regarding the tendencies among some individuals to increase risky behavior with modulations in perceived risk. Potential behavioral implications were seen as significant, though complex, reflecting multifaceted risk perceptions. Conclusions: Our study adds to the evidence that participants in genetic research, across disease type, have a strong desire for PGI. For participants in research on the genetics of HIV, and potentially other infectious diseases, their desire for PGI is grounded in a perceived duty not to infect others, where they feel a moral responsibility regarding research participation and behavior change. Wider dissemination of HIV-related PGI may well increase research participation, but could have mixed effects on risk behavior. More research is needed on the implications of different variant types of PGI beyond susceptibility factors, especially protective variants or resistance factors.
Atrophic Changes and Diffusion Abnormalities of Affected Trigeminal Nerves in Trigeminal Neuralgia Using 7-T MRI
Authors: Lee Youn Joo , Moon Hyeong Cheol , Tak Sungho , Cheong Chaejoon , Park Young Seok
Published: September 2019

Background: Magnetic resonance imaging (MRI) has been widely used for visualizing trigeminal nerves in trigeminal neuralgia. Objective: To assess atrophy and diffusion abnormalities of affected trigeminal nerves in trigeminal neuralgia with 7-T MRI. Methods: In this prospective study, 14 patients (mean age 49 years; range 31–64 years) with trigeminal neuralgia underwent 7-T MRI. We measured trigeminal nerve volumes along their course through the pontocerebellar cistern. We also evaluated fractional anisotropy (FA) and quantitative anisotropy (QA) values within cisternal segment and pontine nuclei of the affected-side and unaffected-side trigeminal nerves, using diffusion tensor imaging (DTI). Associations between DTI metrics and Barrow Neurological Institute (BNI) pain scores were examined. Results: The volumes were significantly smaller for the affected trigeminal nerves (33.83 ± 23.12 mm3) than for the unaffected ones (47.76 ± 32.48 mm3; p = 0.008). Cisternal segment FA and QA values were significantly lower in affected trigeminal nerves than in unaffected ones. However, DTI measurements in the pontine nuclei revealed no significant differences between affected-side and unaffected-side trigeminal nerves. No DTI metrics significantly correlated with BNI pain scores. Conclusion: Our results suggest that 7-T MRI allows identifications of atrophy and diffusion abnormalities of trigeminal nerves in trigeminal neuralgia.