bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of inhalational versus intravenous anaesthesia on early delirium and long-term survival in elderly patients after cancer surgery: study protocol of a multicentre, open-label, and randomised controlled trial
Authors: Zhang Yue , Li Hui-Juan , Wang Dong-Xin , Jia Hui-Qun , Sun Xu-De , Pan Ling-Hui , Ye Qing-Shan , Ouyang Wen , Jia Zhen , Zhang Fang-Xiang , Guo Yong-Qing , Ai Yan-Qiu , Zhao Bin-Jiang , Yang Xu-Dong , Zhang Qin-Gong , Yin Ning , Tan Hong-Yu , Liu Zhi-Heng , Yu Jian-Bo , Ma Daqing
Published: November 2017

Introduction

Elderly patients who have solid organ cancer often receive surgery. Some of them may develop delirium after surgery and delirium development is associated with worse outcomes. Furthermore, despite all of the advances in medical care, the long-term survival in cancer patients is far from optimal. Evidences suggest that choice of anaesthetics during surgery, that is, either inhalational or intravenous anaesthetics, may influence outcomes. However, the impact of general anaesthesia type on the occurrence of postoperative delirium is inconclusive. Although retrospective studies suggest that propofol-based intravenous anaesthesia was associated with longer survival after cancer surgery when compared with inhalational anaesthesia, prospective studies as such are still lacking. The purposes of this randomised controlled trial are to test the hypotheses that when compared with sevoflurane-based inhalational anaesthesia, propofol-based intravenous anaesthesia may reduce the incidence of early delirium and prolong long-term survival in elderly patients after major cancer surgery.

Methods and analysis

This is a multicentre, open-label, randomised controlled trial with two parallel arms. 1200 elderly patients (≥65 years but <90 years) who are scheduled to undergo major cancer surgery (with predicted duration ≥2 hours) are randomised to receive either sevoflurane-based inhalational anaesthesia or propofol-based intravenous anaesthesia. Other anaesthetics and supplemental drugs including sedatives, opioids and muscle relaxants are administered in both arms according to routine practice. The primary early outcome is the incidence of 7-day delirium after surgery and the primary long-term outcome is the duration of 3-year survival after surgery.

Ethics and dissemination

The study protocol has been approved by the Clinical Research Ethics Committees of Peking University First Hospital (2015[869]) and all participating centres. The results of early and long-term outcomes will be analysed and reported separately.

Trial registration number

ChiCTR-IPR-15006209;NCT02662257;NCT02660411.
Is insomnia a risk factor for new-onset asthma? A population-based study in Taiwan
Authors: Lin Yu-Chieh , Lai Chih-Cheng , Chien Chih-Chiang , Chen Chin-Ming , Chiang Shyh-Ren , Ho Chung-Han , Weng Shih-Feng , Cheng Kuo-Chen
Published: November 2017

Objectives

To determine whether insomnia at baseline is a risk factor for new-onset asthma.

Methods

We recruited 48 871 patients with insomnia (insomnia group) newly diagnosed between 2002 and 2007, and 97 742 matched controls without insomnia (control group) from Taiwan’s Longitudinal Health Insurance Database 2000. All of the patients were followed up for 4 years to see whether new-onset asthma developed. Patients with previous asthma or insomnia were excluded. The Poisson regression was used to estimate the incidence rate ratios (IRRs) and 95% CIs of asthma. Cox proportional hazard regression was used to calculate the risk of asthma between the two groups.

Results

After a 4-year follow-up, 424 patients in the insomnia group and 409 in the control group developed asthma. The incidence rate of asthma was significantly higher in the insomnia group (22.01vs10.57 per 10 000 person-years). Patients with insomnia have a higher risk of developing new-onset asthma during the 4-year follow-up (HR: 2.08, 95% CI 1.82 to 2.39). The difference remained significant after adjustment (adjusted HR: 1.89, 95% CI 1.64 to 2.17).

Conclusions

This large population-based study suggests that insomnia at baseline is a risk factor for developing asthma.
Adding value to daily chest X-rays in the ICU through education, restricted daily orders and indication-based prompting
Authors: Keveson Benjamin , Clouser Ryan D , Hamlin Mark P , Stevens Pamela , Stinnett-Donnelly Justin M , Allen Gilman B
Published: November 2017

Background

Chest X-rays (CXRs) are traditionally obtained daily in all patients on invasive mechanical ventilation (IMV) in the intensive care unit (ICU). We sought to reduce overutilisation of CXRs obtained in the ICU, using a multifaceted intervention to eliminate automated daily studies.

Methods

We first educated ICU staff about the low diagnostic yield of automated daily CXRs, then removed the ‘daily’ option from the electronic health records-based ordering system, and added a query (CXR indicated or not indicated) to the ICU daily rounding checklist to prompt a CXR order when clinically warranted. We built a report from billing codes, focusing on all CXRs obtained on IMV census days in the medical (MICU) and surgical (SICU) ICUs, excluding the day of admission and days that a procedure warranting CXR was performed. This generated the number of CXRs obtained every 1000 ‘included’ ventilator days (IVDs), the latter defined as not having an ‘absolute’ clinical indication for CXR.

Results

The average monthly number of CXRs on an IVD decreased from 919±90 (95% CI 877 to 963) to 330±87 (95% CI 295 to 354) per 1000 IVDs in the MICU, and from 995±69 (95% CI 947 to 1055) to 649±133 (95% CI 593 to 697) in the SICU. This yielded an estimated 1830 to 2066 CXRs avoided over 2 years and an estimated annual savings of $191 600 to $224 200. There was no increase in reported adverse events.

Conclusion

ICUs can safely transition to a higher value strategy of indication-based chest imaging by educating staff, eliminating the ‘daily’ order option and adding a simplified prompt to avoid missing clinically indicated CXRs.
Evaluation of an integrated multisector campaign to increase child helmet use in Vietnam
Authors: Nhan Le Dinh Trong , Parker Lukas , Son Mai Thi Hoai , Parker Erin M , Moore Matthew R , Sidik Mirjam , Draisin Natalie
Published: November 2017

Objective

This study presents child helmet use before, during and after implementing the Vietnamese National Child Helmet Action Plan (NCHAP) and evaluates its effect on child helmet use. The NCHAP, an integrated multisector campaign, incorporated a wide-scale public awareness campaign, school-based interventions, increased police patrolling and enforcement, and capacity building and support to relevant government departments in target provinces.

Methods

In Vietnam’s three largest cities, 100 schools in 20 districts were selected to monitor motorcycle helmet use behaviour. The effectiveness of the NCHAP was measured by unannounced, filmed observations of student motorcycle passengers and their adult drivers as they arrived or left their schools at four points. Baseline observations at each school were conducted in March 2014, with subsequent observations in April 2015, December 2015 and May 2016.

Results

Across the 84 218 observed students, student helmet prevalence increased from 36.1% in March 2014 to 69.3% immediately after the initiation in April 2015. Subsequent observations in December 2015 and May 2016 showed a reduction and stabilisation of helmet use, with 49.8% and 56.9% of students wearing helmets, respectively. Helmet use in students was higher when adult drivers were also wearing helmets.

Conclusions

Integrated multisectoral interventions between governments, civil society and the corporate sector that incorporate communications, school-based education, incentives for change and police enforcement have the potential to increase helmet use among children. Future integrated campaigns may be more effective with an increased focus on parents and other adult drivers given their potential influence on child helmet use.
Early clinical outcomes as a function of use of newer oral P2Y12inhibitors versus clopidogrel in the EUROMAX trial
Authors: Huber Kurt , Ducrocq Gregory , Hamm Christian W , van ’t Hof Arnoud , Lapostolle Frédéric , Coste Pierre , Gordini Giovanni , Steinmetz Jacob , Verheugt Freek W A , Adgey Jennifer , Nibbe Lutz , Kaniĉ Vojko , Clemmensen Peter , Zeymer Uwe , Bernstein Debra , Prats Jayne , Deliargyris Efthymios N , Gabriel Steg Ph
Published: November 2017

Objective

To ascertain whether different oral P2Y12inhibitors might affect rates of acute stent thrombosis and 30-day outcomes after primary percutaneous coronary intervention (pPCI).

Methods

The European Ambulance Acute Coronary Syndrome Angiography (EUROMAX) randomised trial compared prehospital bivalirudin with heparin with optional glycoprotein IIb/IIIa inhibitor treatment in patients with ST-segment elevation myocardial infarction triaged to pPCI. Choice of P2Y12inhibitor was at the investigator’s discretion. In a prespecified analysis, we compared event rates with clopidogrel and newer oral P2Y12inhibitors (prasugrel, ticagrelor). Rates of the primary outcome (acute stent thrombosis) were examined as a function of the P2Y12inhibitor used for loading and 30-day outcomes (including major adverse cardiac events) as a function of the P2Y12inhibitor used for maintenance therapy. Logistic regression was used to adjust for differences in baseline characteristics.

Results

Prasugrel or ticagrelor was given as the loading P2Y12inhibitor in 49% of 2198 patients and as a maintenance therapy in 59%. No differences were observed in rates of acute stent thrombosis for clopidogrel versus newer P2Y12inhibitors (adjusted OR 0.50, 95% CI 0.13 to 1.85). After adjustment, no difference was observed in 30-day outcomes according to maintenance therapy except for protocol major (p=0.029) or minor (p=0.025) bleeding and Thrombolysis In Myocardial Infarction minor bleeding (p=0.002), which were less frequent in patients on clopidogrel. Consistent results were observed in the bivalirudin and heparin arms.

Conclusions

The choice of prasugrel or ticagrelor over clopidogrel was not associated with differences in acute stent thrombosis or 30-day ischaemic outcomes after pPCI.

Trial registration number

NCT01087723.
Increased relative abundance of colonial scaled chrysophytes since pre-industrial times in minimally disturbed lakes from the Experimental Lakes Area, Ontario
Authors: Mushet Graham R. , Flear Karlee , Wiltse Brendan , Paterson Andrew M. , Cumming Brian F.
Published: November 2017

A top–bottom paleolimnological analysis of 30 undisturbed lakes in the Experimental Lakes Area (ELA) in northwest Ontario showed marked increases in the relative abundance of colonial scaled chrysophyte taxa in most lakes since pre-industrial times. The increase in abundance of colonial taxa was primarily driven by Synura sphagnicola in small, high-nutrient, and warm lakes. The colonial taxa Synura petersenii and Synura echinulata also increased in the deeper study lakes. Detailed analysis of sediment cores from six lakes revealed that these changes occurred in the early to mid-1900s. Based on the modern distribution of scaled chrysophytes relative to lake physicochemical data, we propose multiple processes that may be contributing to these changes, such as changes in lake thermal properties and historical changes in the flux of important particles and solutes to lakes. Additional mechanisms that may contribute to the observed changes are discussed, including trophic interactions and changes in limnetic pCO2. Because the ELA is relatively undisturbed, our findings provide important information on the drivers responsible for increases in colonial chrysophyte abundance, which have been documented in studies of lakes in central Ontario and northeast United States.
Optimal Design of Fractional-Order Digital Differentiator Using Flower Pollination Algorithm
Authors: Mahata Shibendu , Saha Suman Kumar , Kar Rajib , Mandal Durbadal
Published: November 2017

This paper presents an efficient approach to design wideband, accurate, stable, and minimum-phase fractional-order digital differentiators (FODDs) in terms of the infinite impulse response (IIR) filters using an evolutionary optimization technique called flower pollination algorithm (FPA). The efficiency comparisons of FPA with real-coded genetic algorithm (RGA), particle swarm optimization (PSO), and differential evolution (DE)-based designs are conducted with respect to different magnitude and phase response error metrics, parametric and nonparametric statistical hypotheses tests, computational time, and fitness convergence. Exhaustive simulation results clearly demonstrate that FPA significantly outperforms RGA, PSO, and DE in attaining the best solution quality consistently. Extensive analysis is also conducted in order to determine the role of control parameters of FPA on the performance of the designed FODDs. The proposed FPA-based FODDs outperform all the designs published in the recent literature with respect to the magnitude responses and also achieve a competitive performance in terms of the phase response.
Partially composed property of generalized lexicographic product graphs
Authors: Pleanmani Nopparat , Gyurov Boyko , Panma Sayan
Published: November 2017

For a vertex property [Formula: see text] and a graph [Formula: see text], a set [Formula: see text] of vertices of [Formula: see text] is a [Formula: see text]-set of [Formula: see text] if [Formula: see text]. The maximum and minimum cardinality of a [Formula: see text]-set of [Formula: see text] are denoted by [Formula: see text] and [Formula: see text], respectively. If [Formula: see text] is a [Formula: see text]-set such that its cardinality equals [Formula: see text] or [Formula: see text], we say that [Formula: see text] is an [Formula: see text]-set or [Formula: see text]-set of [Formula: see text], respectively. In this paper, we obtain such numbers of generalized lexicographic product graphs in some vertex properties.
iBAT sympathetic innervation is not required for body weight loss induced by central leptin delivery
Authors: Côté Isabelle , Sakarya Yasemin , Green Sara M. , Morgan Drake , Carter Christy S. , Tümer Nihal , Scarpace Philip J.
Published: November 2017

We evaluated the contribution of brown adipose tissue (BAT) sympathetic innervation on central leptin-mediated weight loss. In a short- and long-term study, F344BN rats were submitted to either a denervation of interscapular BAT (Denervated) or a sham operation (Sham). Animals from each group received the Ob (Leptin) or green fluorescent protein (GFP; Control) gene through a single injection of recombinant adeno-associated virus delivered centrally. Changes in body weight were recorded for 14 or 35 days, after which adipose tissues and skeletal muscles were weighed. In both studies, hypothalamic phosphorylated STAT3 (P-STAT3) was significantly higher in Sham-Leptin and Denervated-Leptin groups compared with their respective Control groups ( P < 0.01), indicating that leptin signaling was enhanced at the end point. We measured uncoupling protein 1 (UCP1), a marker of BAT thermogenic activity, and found a significant induction in Leptin in Sham animals ( P < 0.001) but not in Denervated animals, demonstrating that BAT UCP1 protein was only induced in Sham rats. Both Sham-Leptin and Denervated-Leptin rats lost ~15% of their initial body weight ( P < 0.001) by day 14 and reached a maximum of 18% body weight loss that stabilized over week 3 of treatment, indicating that sympathetic outflow to BAT is not required for leptin-mediated weight loss. In summary, interscapular BAT (iBAT) denervation did not prevent body weight loss following central leptin gene delivery. The present data show that sympathetic innervation of iBAT is not essential for leptin-induced body weight loss.
Clustering of heading selectivity and perception-related activity in the ventral intraparietal area
Authors: Shao Mengmeng , DeAngelis Gregory C. , Angelaki Dora E. , Chen Aihua
Published: November 2017

The ventral intraparietal area (VIP) of the macaque brain is a multimodal cortical region, with many cells tuned to both optic flow and vestibular stimuli. Responses of many VIP neurons also show robust correlations with perceptual judgments during a fine heading discrimination task. Previous studies have shown that heading tuning based on optic flow is represented in a clustered fashion in VIP. However, it is unknown whether vestibular self-motion selectivity is clustered in VIP. Moreover, it is not known whether stimulus- and choice-related signals in VIP show clustering in the context of a heading discrimination task. To address these issues, we compared the response characteristics of isolated single units (SUs) with those of the undifferentiated multiunit (MU) activity corresponding to several neighboring neurons recorded from the same microelectrode. We find that MU activity typically shows selectivity similar to that of simultaneously recorded SUs, for both the vestibular and visual stimulus conditions. In addition, the choice-related activity of MU signals, as quantified using choice probabilities, is correlated with the choice-related activity of SUs. Overall, these findings suggest that both sensory and choice-related signals regarding self-motion are clustered in VIP.

NEW & NOTEWORTHY We demonstrate, for the first time, that the vestibular tuning of ventral intraparietal area (VIP) neurons in response to both translational and rotational motion is clustered. In addition, heading discriminability and choice-related activity are also weakly clustered in VIP.
Effect of Optimization of Glycaemic Control on Mannan-Binding Lectin in Type 1 Diabetes
Authors: Dørflinger Gry Høst , Holt Charlotte Brink , Thiel Steffen , Østergaard Jakob Appel , Hansen Troels Krarup
Published: November 2017

Objective. Mannan-binding lectin (MBL) concentration in plasma is increased in subjects with type 1 diabetes and associated with increased mortality and risk of diabetic nephropathy. Recent findings show that pancreas transplantation reduces MBL concentration. Whether the increased MBL concentration is reversed by improved glycaemic control remains unknown. We investigated the effects of improved glycaemic control on MBL concentration in patients with type 1 diabetes. Methods. We measured MBL, fructosamine, and HbA1cat baseline and after 6 weeks in 52 type 1 diabetic patients following the change from conventional insulin therapy to insulin pump therapy. Results. After initiation of insulin pump therapy, the total daily insulin dose was significantly reduced (from 51 ± 18 IE/day to 39 ± 13 IE/day, P<0.0001). There was a significant decrease in HbA1c from 8.6% to 7.7% (from 70 mmol/mol to 61 mmol/mol, P<0.0001) and in fructosamine levels (from 356 μmol/L to 311 μmol/L, P<0.0001). MBL levels decreased by 10% from 2165 μg/L (IQR 919–3389 μg/L) at baseline to 1928 μ/L (IQR 811–2758 μg/L) at follow-up (P=0.005), but MBL change was not significantly correlated with changes in insulin dose, HbA1c, or fructosamine. Conclusions. MBL concentration decreased following the initiation of insulin pump therapy in patients with type 1 diabetes and did not correlate with changes in glycaemic control.
Cysticercus fasciolaris in Brown Rats (Rattus norvegicus) in Grenada, West Indies
Authors: Sharma Ravindra , Tiwari Keshaw , Birmingham Kristen , Armstrong Elan , Montanez Andrea , Guy Reneka , Sepulveda Yvette , Mapp-Alexander Veronica , DeAllie Claude
Published: November 2017

Cat is the definitive host of Taenia taeniaeformis (T. taeniaeformis). Cysticercus fasciolaris (C. fasciolaris), the larval stage of T. taeniaeformis, develops in small rodents which act as intermediate host. The aim of this study was to estimate the prevalence of C. fasciolaris in brown rats (Rattus norvegicus) in the densely human populated parishes, St. George’s and St. David’s of Grenada, West Indies. One hundred and seventy rats were trapped near the residential areas from May to July, 2017 and examined for C. fasciolaris in their liver. Of the 170 rats 115 (67.6%, CI 95% from 60.1 to 74.6) were positive for the larval stage of T. taeniaeformis. One to three cysts were observed in each liver, containing a single larva in each cyst. The prevalence was 77.9% in St. George and 59.1% in St. David which is a significant difference (p<0.05) between the two parishes under study. Based on gender, prevalence in males was 60.9% and females 74.7%. Significant difference was observed between young and adult rats (p=0.03). Prevalence in young rats was 45.0% compared to adults (70.7%). Further study of risk assessment in the cat population in areas of the present research is strongly suggested.
Immune-Stimulatory and Therapeutic Activity of Tinospora cordifolia: Double-Edged Sword against Salmonellosis
Authors: Alsuhaibani Sultan , Khan Masood A.
Published: November 2017

The present study was aimed at determining the activity of aqueous and methanolic extracts of Tinospora cordifolia (AETC and METC) against Salmonella typhimurium. In vitro anti-Salmonella activity of T. cordifolia was determined through the broth dilution and agar well diffusion assays. The immune-stimulating potential of AETC or METC was determined by measuring the cytokine levels in the culture supernatants of treated murine J774 macrophages. Antibacterial activity of AETC or METC was determined by treating S. typhimurium-infected macrophages and BALB/C mice. The toxicity of AETC or METC was determined by measuring the levels of liver inflammation markers aspartate transaminase (AST) and alanine transaminase (ALT) and antioxidant enzymes. Macrophages treated with AETC or METC secreted greater levels of IFN-γ, TNF-α, and IL-1β. METC showed greater activity against S. typhimurium infection in macrophages and mice as well. Treatment with METC resulted in increased survival and reduced bacterial load in S. typhimurium-infected mice. Moreover, METC or AETC treatment reduced the liver inflammation and rescued the levels of antioxidant enzymes in S. typhimurium-infected mice. The results of the present study suggest that the use of T. cordifolia may act as a double-edged sword in combating salmonellosis.
Attitude Motion of Cylindrical Space Debris during Its Removal by Ion Beam
Authors: Aslanov Vladimir S. , Ledkov Alexander S.
Published: November 2017

The paper is devoted to the problem of space debris mitigation. Contactless method of the space debris deorbiting is considered. It is assumed that ion thrusters on the active spacecraft create the ion flow, which blows the debris and slows it down. The objectives of this work are the development of mathematical models and the research of space debris motion under the action of the ion flow. It is supposed that the space debris is a rigid body of a cylindrical shape. Calculation of ion beam force and torque was performed for a self‐similar model of plasma plume expansion using the hypothesis of ion fully diffused reflection from a surface. A mathematical model describing plane motions of the cylindrical space debris under the influence of gravity gradient torque and the ion flux was constructed. It was shown that motion of the space debris around its center of mass has a significant effect on its removal time. Phase portraits, describing the motion of the space debris relative to its center of mass, were constructed. Comparison of the descent times in different motion modes was carried out. The results can be used to create new effective systems of large space debris removal.
α-MSH Influences the Excitability of Feeding-Related Neurons in the Hypothalamus and Dorsal Vagal Complex of Rats
Authors: Guan Hong-Zai , Dong Jing , Jiang Zheng-Yao , Chen Xi
Published: November 2017

Alpha-melanocyte-stimulating hormone (α-MSH) is processed from proopiomelanocortin (POMC) and acts on the melanocortin receptors, MC3 and MC4. α-MSH plays a key role in energy homeostasis. In the present study, to shed light on the mechanisms by which α-MSH exerts its anorectic effects, extracellular neuronal activity was recorded in the hypothalamus and the dorsal vagal complex (DVC) of anesthetized rats. We examined the impact of α-MSH on glucose-sensing neurons and gastric distension (GD) sensitive neurons. In the lateral hypothalamus (LHA), α-MSH inhibited 75.0% of the glucose-inhibited (GI) neurons. In the ventromedial nucleus (VMN), most glucose-sensitive neurons were glucose-excited (GE) neurons, which were mainly activated by α-MSH. In the paraventricular nucleus (PVN), α-MSH suppressed the majority of GI neurons and excited most GE neurons. In the DVC, among the 20 GI neurons examined for a response to α-MSH, 1 was activated, 16 were depressed, and 3 failed to respond. Nineteen of 24 GE neurons were activated by α-MSH administration. Additionally, among the 42 DVC neurons examined for responses to GD, 23 were excited (GD-EXC) and 19 were inhibited (GD-INH). Fifteen of 20 GD-EXC neurons were excited, whereas 11 out of 14 GD-INH neurons were suppressed by α-MSH. All these responses were abolished by pretreatment with the MC3/4R antagonist, SHU9119. In conclusion, the activity of glucose-sensitive neurons and GD-sensitive neurons in the hypothalamus and DVC can be modulated by α-MSH.
Saccharomyces cerevisiaeLaryngitis and Oral Lesions in a Patient with Laryngeal Carcinoma
Authors: Algazaq Jumanah N. , Akrami Kevan , Martinez Fernando , McCutchan Allen , Bharti Ajay R.
Published: November 2017

Saccharomyces cerevisiaeis increasingly being promoted as a nutritional supplement by health food enthusiasts and is also recommended as prophylaxis against antibiotic-associated diarrhea. However, severe opportunistic infections due toS. cerevisiaehave been reported in patients with chronic disease, cancer, and immunosuppression. Fungemia, endocarditis, pneumonia, peritonitis, urinary tract infections, skin infections, and esophagitis have been described. It is important to consider infections due toS. cerevisiaein appropriate clinical settings. Here, we describe the first case ofS. cerevisiaelaryngitis in a patient with a history of laryngeal carcinoma who also had oral lesions.
The Role of Serum Adiponectin for Outcome Prediction in Patients with Dilated Cardiomyopathy and Advanced Heart Failure
Authors: Baltrūnienė Vaida , Bironaitė Daiva , Kažukauskienė Ieva , Bogomolovas Julius , Vitkus Dalius , Ručinskas Kęstutis , Žurauskas Edvardas , Augulis Renaldas , Grabauskienė Virginija
Published: November 2017

Clinical interpretation of patients’ plasma adiponectin (APN) remains challenging; its value as biomarker in dilated cardiomyopathy (DCM) is equivocal. We evaluated whether circulating APN level is an independent predictor of composite outcome: death, left ventricle assist device (LVAD) implantation, and heart transplantation (HT) in patients with nonischemic DCM. 57 patients with nonischemic DCM (average LV diastolic diameter 6.85 cm, LV ejection fraction 26.63%, and pulmonary capillary wedge pressure 22.06  mmHg) were enrolled. Patients underwent echocardiography, right heart catheterization, and endomyocardial biopsy. During a mean follow-up of 33.42 months, 15 (26%) patients died, 12 (21%) patients underwent HT, and 8 (14%) patients were implanted with LVAD. APN level was significantly higher in patients who experienced study endpoints (23.4 versus 10.9 ug/ml, p=0.01). APN was associated with worse outcome in univariate Cox proportional hazards model (HR 1.04, CI 1.02–1.07, p=0.001) but lost significance adjusting for other covariates. Average global strain (AGS) is an independent outcome predictor (HR 1.42, CI 1.081–1.866, p=0.012). Increased circulating APN level was associated with higher mortality and may be an additive prognostic marker in DCM with advanced HF. Combination of serum (APN, BNP, TNF-α) and echocardiographic (AGS) markers may increase the HF predicting power for the nonischemic DCM patients.
Gender Differences in Commuting Injuries in Spain and Their Impact on Injury Prevention
Authors: Camino López Miguel A. , González Alcántara Óscar J. , Fontaneda Ignacio
Published: November 2017

A gender analysis of workers injured while commuting in Spain is presented, distinguishing between injury due to traffic-related accidents and injury due to other causes. Method. A total of 266,646 traffic-related injuries and 168,129 nontraffic-related injuries are studied over the period 2006–2010. Results. In Spain, the accident rate recorded in working hours is much higher among men; nevertheless, it is curious that commuting-related accident rates are higher among women than men, in both traffic-related injuries and nontraffic-related injuries. The study of the frequency distribution confirmed that many more injuries occurred in Spain while commuting to work rather than from work and that women suffered twice as many injuries as men at nine in the morning. Musculoskeletal disorders are the only injuries that registered a higher number of cases among women and falls to the same level are the most relevant cause among women. Conclusions. The analysis of these and more findings established that a great effort should go into the promotion of preventive measures in favour of women workers. These results may encourage companies to modify their accident prevention plans, so as to increase their effectiveness in the struggle against occupational accidents following the five points described in this article.
Plexiform Fibromyxoma: A Rare Gastric Tumor
Authors: Wambura Casmir , Surani Salim
Published: November 2017

Plexiform fibromyxoma is a rare and distinctive benign mesenchymal neoplasm that occurs in the gastric antrum. This tumor has a potential for misdiagnosis as gastrointestinal stromal tumor (GIST). It causes mucosa and vascular ulcerations without advancement of the tumor. Cytological bland spindle cells within a variably myxoid stroma characterize the histology of the tumor. We report the case of a 41-year-old African Tanzanian lady who presented with melena and recurrent anemia. Endoscopy and imaging studies revealed antral mass with initial suspicion of a GIST. However, immunohistochemically it turned to be a plexiform fibromyxoma. Follow-up evaluation 12 months after surgery revealed no evidence of recurrence or metastasis. This is a very uncommon tumor, which, to our knowledge, has been reported only once in Africa. The clinicians need to be aware of this rare occurrence to avoid misdiagnosis as GIST tumor.
Coefficient Bounds for Subclasses of Biunivalent Functions Associated with the Chebyshev Polynomials
Authors: Güney Hatun Özlem , Murugusundaramoorthy G. , Vijaya K.
Published: November 2017

We introduce and investigate new subclasses of biunivalent functions defined in the open unit disk, involving Sălăgean operator associated with Chebyshev polynomials. Furthermore, we find estimates of the first two coefficients of functions in these classes, making use of the Chebyshev polynomials. Also, we give Fekete-Szegö inequalities for these function classes. Several consequences of the results are also pointed out.
Orthodontic Replacement of Lost Permanent Molar with Neighbor Molar: A Six-Year Follow-Up
Authors: Raveli Taisa Boamorte , Shintcovsk Ricardo Lima , Knop Luegya Amorim Henriques , Sampaio Luana Paz , Raveli Dirceu Barnabé
Published: November 2017

Extraction is very frequent indication in orthodontic planning, especially when there are crowding, biprotrusion, and aesthetically unpleasant profiles. Next to extraction comes space closure, which represents a challenge for orthodontists because of extended treatment time, discomfort created for the patient, tissue tolerance, and stability concerns. When it comes to what mechanics to choose for space closure, loops present two major advantages in relation to sliding mechanics: absence of abrasion and possibility to reach pure dental translation. A case is presented where an adult female patient with early loss of the first lower permanent molars, minor lower crowding, and tooth biprotrusion was treated with upper first bicuspids extraction along with upper and lower space closure done with T-loops to promote best space closure control in order to correct the malocclusion and enhance facial aesthetics.
Clinical and Radiographic Features of Pycnodysostosis with Emphasis on Dentofacial Problems
Authors: Aghili Hossein , Tabatabaei Seyed Mohammad Ali , Goldani Moghadam Mahdjoube
Published: November 2017

Pycnodysostosis (PDO) is a rare genetic disorder characterized by cathepsin K deficiency which plays an important role in bone metabolism. Among clinical features of this disease which are mainly caused by altered bone remodeling are craniofacial abnormalities such as hypoplastic maxilla and obtuse gonial angle which consequently lead to respiratory insufficiency in forms of pharyngeal narrowing and severe snoring. In this paper, another case of this rare disorder is presented along with a review on etiology and management issues of respiratory insufficiency in these patients.
A Multilevel Finite Element Variational Multiscale Method for Incompressible Navier‐Stokes Equations Based on Two Local Gauss Integrations
Authors: Zhang Yamiao , Huang Biwu , Zhang Jiazhong , Zhang Zexia
Published: November 2017

A multilevel finite element variational multiscale method is proposed and applied to the numerical simulation of incompressible Navier‐Stokes equations. This method combines the finite element variational multiscale method based on two local Gauss integrations with the multilevel discretization using Newton correction on each step. The main idea of the multilevel finite element variational multiscale method is that the equations are first solved on a single coarse grid by finite element variational multiscale method; then finite element variational multiscale approximations are generated on a succession of refined grids by solving a linearized problem. Moreover, the stability analysis and error estimate of the multilevel finite element variational multiscale method are given. Finally, some numerical examples are presented to support the theoretical analysis and to check the efficiency of the proposed method. The results show that the multilevel finite element variational multiscale method is more efficient than the one‐level finite element variational multiscale method, and for an appropriate choice of meshes, the multilevel finite element variational multiscale method is not only time‐saving but also highly accurate.
Image Classification Based on Convolutional Denoising Sparse Autoencoder
Authors: Chen Shuangshuang , Liu Huiyi , Zeng Xiaoqin , Qian Subin , Yu Jianjiang , Guo Wei
Published: November 2017

Image classification aims to group images into corresponding semantic categories. Due to the difficulties of interclass similarity and intraclass variability, it is a challenging issue in computer vision. In this paper, an unsupervised feature learning approach called convolutional denoising sparse autoencoder (CDSAE) is proposed based on the theory of visual attention mechanism and deep learning methods. Firstly, saliency detection method is utilized to get training samples for unsupervised feature learning. Next, these samples are sent to the denoising sparse autoencoder (DSAE), followed by convolutional layer and local contrast normalization layer. Generally, prior in a specific task is helpful for the task solution. Therefore, a new pooling strategy—spatial pyramid pooling (SPP) fused with center‐bias prior—is introduced into our approach. Experimental results on the common two image datasets (STL‐10 and CIFAR‐10) demonstrate that our approach is effective in image classification. They also demonstrate that none of these three components: local contrast normalization, SPP fused with center‐prior, and l2 vector normalization can be excluded from our proposed approach. They jointly improve image representation and classification performance.
Global Sensitivity Analysis to Assess Salt Precipitation for CO2 Geological Storage in Deep Saline Aquifers
Authors: Wang Yuan , Ren Jie , Hu Shaobin , Feng Di
Published: November 2017

Salt precipitation is generated near the injection well when dry supercritical carbon dioxide (scCO2) is injected into saline aquifers, and it can seriously impair the CO2 injectivity of the well. We used solid saturation (Ss) to map CO2 injectivity. Ss was used as the response variable for the sensitivity analysis, and the input variables included the CO2 injection rate (QCO2), salinity of the aquifer (XNaCl), empirical parameter m, air entry pressure (P0), maximum capillary pressure (Pmax), and liquid residual saturation (Splr and Sclr). Global sensitivity analysis methods, namely, the Morris method and Sobol method, were used. A significant increase in Ss was observed near the injection well, and the results of the two methods were similar: XNaCl had the greatest effect on Ss; the effect of P0 and Pmax on Ss was negligible. On the other hand, with these two methods, QCO2 had various effects on Ss: QCO2 had a large effect on Ss in the Morris method, but it had little effect on Ss in the Sobol method. We also found that a low QCO2 had a profound effect on Ss but that a high QCO2 had almost no effect on the Ss value.
Antibacterial, Antioxidant Activity of Ethanolic Plant Extracts of Some Convolvulus Species and Their DART‐ToF‐MS Profiling
Authors: Al-Rifai Asma’a , Aqel Ahmad , Al-Warhi Tarfah , Wabaidur Saikh M. , Al-Othman Zeid A. , Badjah-Hadj-Ahmed A. Yacine
Published: November 2017

Convolvulus austroaegyptiacus Abdallah & Sa’ad (CA) and Convolvulus pilosellifolius Desr. (CP) are commonly used in the Saudi Arabia folk medicine. They are potent in treating the ulcers and skin diseases. The lack of information about their biological activities led us to investigate the possible biological activities by determination of antibacterial and antioxidant activities of total ethanolic extracts and various fractions. Total flavonoid contents of the plants were determined by colorimetric method while total phenols were determined by using Folin‐Ciocalteu method. In vitro antibacterial activity was studied against E. coli, P. aeruginosa, and B. subtilis, and the total antioxidant capacity was evaluated by radical scavenging method. IC50 were found to be 21.81, 17.62, and 3.31 μg/mL for CA, CP, and vitamin C, respectively, while the lowest MIC value of 0.25 mg/mL was recorded with CP extract against B. subtilis. Around 21 compounds are tentatively elucidated from both plants using rapid, simple, and high‐resolution analytical technique for chemical profiling of natural compounds by direct analysis in real‐time of flight‐mass spectrometry, of which 17 were not isolated or reported previously.
Patient–Physician Differences in Desired Characteristics of NSAID Plasters: An Online Survey
Authors: Takeda On , Chiba Daisuke , Ishibashi Yasuyuki , Tsuda Eiichi
Published: November 2017

In Japan, adhesive skin plasters containing nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently used to treat pain of musculoskeletal origin. There are many reports on their efficacy but few on patients’ impressions of usability or levels of satisfaction. Objectives. To elucidate the differences in perception between patients and physicians concerning NSAID plasters. Subjects. We conducted two surveys about NSAID plasters on patients and physicians. 600 patients currently using plasters and 200 physicians currently prescribing NSAID plasters were studied. Methods. Questionnaire included items concerning usage, efficacy and side effects, site and intensity of their pain, pain management strategies, characteristics they desired from NSAID plasters, and their satisfaction with them. Results. The characteristic most frequently reported as desirable by patients was analgesic efficacy, followed by avoiding skin irritation and low medication cost. The characteristics most frequently reported as desirable by physicians were analgesic efficacy, alignment with patient preference, safety to skin, and comfort when applied. Our survey revealed that both patients and physicians prioritized analgesic efficacy of NSAID plasters. However, approximately half of the patients and physicians were unsatisfied with the analgesic efficacy of plasters. Conclusions. Physicians may improve patient satisfaction by discussing analgesic efficacy, skin complications, and price with patients before prescription.
Review of Blast Loading Models, Masonry Response, and Mitigation
Authors: Badshah Eid , Naseer Amjad , Ashraf Muhammad , Shah Feroz , Akhtar Kareem
Published: November 2017

Different models for prediction of blast loading, response of masonry structure against blast load, and various mitigation strategies are discussed. Variation of peak positive incident pressure with scale distance in free field spherical burst and surface burst scenarios, proposed by different researchers, is presented and compared. The variation is found significant in the region of small scaled distances. Blast wave parameters in urban environment have been found different from the free field scenario. Effects of geometry, boundary conditions, and material properties on response of masonry buildings were found significant. Different mitigation strategies such as blast wall, landscaping, architecture, and retrofitting techniques are presented.
Gallbladder Mucus Plug Mimicking Ascaris Worm: An Ambiguous Cause of Biliary Colic
Authors: Termos Salah , Alali Mohammad , Alkabbani Majd , AlDuwaisan Abdullah , Alsaleh Ahmad , Alyatama Khalifa , Hayati Hussein
Published: November 2017

Biliary colic is a visceral pain caused by attempts of the gallbladder or bile duct to overcome the obstruction in the cystic duct or ampulla of Vater. Obstruction can be due to different etiologies such as stone, mass, worm, and rarely by mucus plug. We report the case of a 31-year-old gentleman who presented with recurrent biliary colic and weight loss. Work-up showed linear calcifications in the gallbladder extending to the common bile duct suggesting hepatobiliary ascariasis. Further investigations including stool analysis, upper endoscopy, endoscopic ultrasonography (EUS), and endoscopic retrograde cholangiopancreatography (ERCP) did not support our provisional diagnosis. Laparoscopic cholecystectomy was performed. Histopathological finding was grossly ambiguous; a rope-like mucus plug resembling ascaris worm was noted. The patient’s condition improved instantly after the procedure. To our knowledge, we are reporting the first case in the English literature describing this unique entity of symptomatic gallbladder disease to increase awareness and improve its management.
On Carrier Sensing Accuracy and Range Scaling Laws in Nakagami Fading Channels
Authors: Wang Yue , Chen Liang , Zhang Li , Li Haifeng , Cao Huaihu , Zhu Jianming
Published: November 2017

We make a detailed study on carrier sensing of 802.11 in Nakagami fading channels. We prove that to maximize sensing accuracy, the optimal channel accessing probability is solely determined by the path-loss SIR (Signal to Interference Ratio). We define pfail-interference range and pbusy-carrier sensing range for fading channels and prove that their scaling laws in Nakagami fading channels are similar to those in the static channel. The newly derived theoretical results show a unified property between the static and fading channels. By extensive simulations, we reveal that fading depresses the probability of a dominating transmission state, and therefore it can mitigate severe hidden and exposed terminal problems, but fading harms the average sensing accuracy for an optimally adjusted carrier sensing threshold.
Examining the Relationship between Park Neighborhoods, Features, Cleanliness, and Condition with Observed Weekday Park Usage and Physical Activity: A Case Study
Authors: Hamilton Kerry , Kaczynski Andrew T. , Fair Melissa L. , Lévesque Lucie
Published: November 2017

Background. Little research has comprehensively explored how park features, quality indicators, and neighborhood environments are associated with observed park usage and physical activity (PA). This case study examined whether weekday park usage and PA differ by neighborhood type, across numerous categories of park features, and according to park feature condition and cleanliness.Methods. Direct observation was used to capture the number of users and PA levels within 143 park features in 6 parks (3 urban, 3 suburban) over the course of six weeks. Audits of park environments assessed the type, condition, and cleanliness of all features and amenities.Results. Urban parks experienced greater usage, but a higher proportion of sedentary users than suburban parks. Usage and PA levels differed across types of park features, with splash pads, pools, paths, and play structures having the greatest proportion of active users. Usage did not differ by park feature condition and cleanliness, but greater condition and cleanliness were generally associated with higher PA levels.Conclusions. Factors such as neighborhood context, types of park features, and condition and cleanliness can impact park usage and PA levels and should be targets for researchers and planners aiming to foster more user-friendly and active neighborhood park environments.
A Mysterious DRESS Case: Autoimmune Enteropathy Associated with DRESS Syndrome
Authors: Adike Abimbola , Boppana Vaishnavi , Lam-Himlin Dora , Stanton Melissa , Nelson Steven , Ruff Kevin C.
Published: November 2017

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) is a rare but potentially life-threatening cutaneous hypersensitivity reaction characterized by extensive mucocutaneous eruption, fever, hematologic abnormalities, and extensive organ involvement. Here, we present a case of a young woman with DRESS syndrome following exposure to vancomycin with renal, cutaneous, and gastrointestinal involvement. To the best of our knowledge, this is the first case description in the literature of DRESS of the gastrointestinal tract with autoimmune enteropathy.
Polyphenols and Oxidative Stress in Atherosclerosis‐Related Ischemic Heart Disease and Stroke
Authors: Cheng Yu-Chen , Sheen Jer-Ming , Hu Wen Long , Hung Yu-Chiang
Published: November 2017

Good nutrition could maintain health and life. Polyphenols are common nutrient mainly derived from fruits, vegetables, tea, coffee, cocoa, mushrooms, beverages, and traditional medicinal herbs. They are potential substances against oxidative‐related diseases, for example, cardiovascular disease, specifically, atherosclerosis‐related ischemic heart disease and stroke, which are health and economic problems recognized worldwide. In this study, we reviewed the risk factors for atherosclerosis, including hypertension, diabetes mellitus, hyperlipidemia, obesity, and cigarette smoking as well as the antioxidative activity of polyphenols, which could prevent the pathology of atherosclerosis, including endothelial dysfunction, low‐density lipoprotein oxidation, vascular smooth muscle cell proliferation, inflammatory process by monocytes, macrophages or T lymphocytes, and platelet aggregation. The strong radical‐scavenging properties of polyphenols would exhibit antioxidative and anti‐inflammation effects. Polyphenols reduce ROS production by inhibiting oxidases, reducing the production of superoxide, inhibiting OxLDL formation, suppressing VSMC proliferation and migration, reducing platelet aggregation, and improving mitochondrial oxidative stress. Polyphenol consumption also inhibits the development of hypertension, diabetes mellitus, hyperlipidemia, and obesity. Despite the numerous in vivo and in vitro studies, more advanced clinical trials are necessary to confirm the efficacy of polyphenols in the treatment of atherosclerosis‐related vascular diseases.
Classification of Daily Activities for the Elderly Using Wearable Sensors
Authors: Liu Jian , Sohn Jeehoon , Kim Sukwon
Published: November 2017

Monitoring of activities of daily living (ADL) using wearable sensors can provide an objective indication of the activity levels or restrictions experienced by patients or elderly. The current study presented a two-sensor ADL classification method designed and tested specifically with elderly subjects. Ten healthy elderly were involved in a laboratory testing with 6 types of daily activities. Two inertial measurement units were attached to the thigh and the trunk of each subject. The results indicated an overall rate of misdetection being 2.8%. The findings of the current study can be used as the first step towards a more comprehensive activity monitoring technology specifically designed for the aging population.