bluuebunny/crossref_metadata_2025 huggingface dataset:
Raltegravir pharmacokinetics before and during treatment with ombitasvir, paritaprevir/ritonavir plus dasabuvir in adults with human immunodeficiency virus‐1 and hepatitis C virus coinfection: AIDS Clinical Trials Group sub‐study A5334s
Authors: Venuto Charles S. , Cramer Yoninah S. , Rosenkranz Susan L. , Sulkowski Mark , Wyles David L. , Cohen Daniel E. , Schmidt Jeffrey , Alston‐Smith Beverly L. , Morse Gene D.
Published: October 2019

Aims

AIDS Clinical Trials Group study A5334s evaluated the pharmacokinetics of raltegravir before and during combined administration of ombitasvir, paritaprevir/ritonavir, plus dasabuvir (OBV/PTV/r + DSV) and weight‐based ribavirin in human immunodeficiency virus (HIV) and hepatitis C virus (HCV) coinfected adults. The pharmacokinetics of OBV/PTV/r + DSV during raltegravir coadministration were also characterized.

Methods

Adults living with HIV/HCV coinfection receiving steady‐state raltegravir (400 mg twice daily) with 2 nucleos(t)ide analogues were enrolled. Pharmacokinetics of raltegravir were assessed prior to HCV therapy, and 4 weeks later following initiation of OBV/PTV/r (25/150/100 mg) once daily + DSV (250 mg) twice daily. Geometric mean ratios (GMRs) and 90% confidence intervals (CIs) were used to compare the following: raltegravir pharmacokinetics with HCV therapy (week 4) vs before HCV therapy (week 0); OBV/PTV/r and DSV pharmacokinetics vs historical healthy controls; raltegravir pharmacokinetics at week 0 vs historical control adults living with HIV.

Results

Eight of 11 participants had decreased raltegravir exposures after initiation of HCV therapy. The GMRs (90% CI) for maximum concentration and area under the concentration–time curve of raltegravir with vs without HCV therapy were 0.68 (0.38–1.19) and 0.82 (0.58–1.17), respectively. Comparing OBV/PTV/r pharmacokinetics in healthy controls, A5334s study participants demonstrated generally lower maximum concentration and area under the concentration–time curve values by 41–82% and 4–73%, respectively. Raltegravir exposures tended to be higher in A5334s study participants compared to adults living with HIV.

Conclusions

The majority of participants' plasma raltegravir exposures were lower after initiation of HCV therapy in coinfected adults; however, confidence intervals were wide.
The Opioid Hydra: Understanding Overdose Mortality Epidemics and Syndemics Across the Rural‐Urban Continuum
Authors: Peters David J. , Monnat Shannon M. , Hochstetler Andrew L. , Berg Mark T.
Published: October 2019

The rapid increase of fatal opioid overdoses over the past two decades is a major U.S. public health problem, especially in non‐metropolitan communities. The crisis has transitioned from pharmaceuticals to illicit synthetic opioids and street mixtures, especially in urban areas. Using latent profile analysis, we classify n = 3,079 counties into distinct classes using CDC fatal overdose rates for specific opioids in 2002–2004, 2008–2012, and 2014–2016. We identify three distinct epidemics (prescription opioids, heroin, and prescription‐synthetic opioid mixtures) and one syndemic involving all opioids. We find that prescription‐related epidemic counties, whether rural or urban, have been “left behind” the rest of the nation. These communities are less populated and more remote, older and mostly white, have a history of drug abuse, and are former farm and factory communities that have been in decline since the 1990s. Overdoses in these places exemplify the “deaths of despair” narrative. By contrast, heroin and opioid syndemic counties tend to be more urban, connected to interstates, ethnically diverse, and in general more economically secure. The urban opioid crisis follows the path of previous drug epidemics, affecting a disadvantaged subpopulation that has been left behind rather than the entire community. County data on opioid epidemic class membership are provided.
Mechanical Modeling of Roof Fracture Instability Mechanism and Its Control in Top‐Coal Caving Mining under Thin Topsoil of Shallow Coal Seam
Authors: Gong Peilin , Zhao Tong , Yetilmezsoy Kaan , Yi Kang
Published: October 2019

This study aimed to explore the safe and efficient top‐coal caving mining under thin topsoil of shallow coal seam (SCS) and realize the optimization of hydraulic support. Numerical simulation and theoretical analysis were used to reveal the stress distribution of the topsoil, the structure characteristics of the main roof blocks, and the development of the roof subsidence convergence. Step subsidence of the initial fractured main roof after sliding destabilization frequently existed, which seriously threatened the safety of the hydraulic supports. Hence, a mechanical model of the main roof blocks, where the topsoil thickness was less than the minimum height of the unloading arch, was established, and the mechanical criterion of the stability was achieved. The working resistance of the hydraulic support was calculated, and the reasonable type was optimized so as to avoid crushing accident. Findings of the present analysis indicated that the hydraulic support optimization was mainly affected by fractured main roof blocks during the first weighting. According to the block stability mechanical model based on Mohr–Coulomb criterion, the required working resistance and the supporting intensity were determined as 4899 kN and 0.58 MPa, respectively. The ZZF5200/19/32S low‐position top‐coal caving hydraulic support was selected for the studied mine and support‐surrounding rock stability control of thin‐topsoil SCS could be achieved without crushing accident.
Progressive Multifocal Liquid Lenses Based on Asymmetric Freeform Surface Structure of Nonuniform Thickness Elastic Membranes with Different Constraints
Authors: Jia Weiliang , Zhang Biao , Li Songjing
Published: October 2019

For a progressive multifocal liquid lens with an elastic membrane deformed by liquid pressure, to realize a reasonably power distribution, asymmetric deformation characteristics of the membrane surface are needed. Based on the asymmetric freeform surface structure, this paper proposed progressive multifocal liquid lenses focused by liquid with nonuniform thickness membranes. The structure and mathematical model of power distribution for the lens are introduced. The membrane deformation and the corresponding power distribution of the lenses with asymmetric freeform surface are predicted and compared under uniform pressure load and different boundary conditions using the finite element method. An optical testing system is constructed to analyze the optical characteristics of the fabricated lenses through observing the focusing performance of the F target image at different regions of the lenses. Experimental results show that the liquid lenses can realize as asymmetrical progressive multifocal liquid lenses after liquid accommodation; meanwhile, the trends of power distribution of the lenses generally agree well with simulations.
Descemet Membrane Endothelial Keratoplasty for Corneal Decompensation Secondary to Phakic Intraocular Lenses
Authors: López Ester Fernández , Martínez Cristina Peris
Published: October 2019

Purpose. To describe the surgical technique and clinical outcomes of bilensectomy (pIOL explant and phacoemulsification), followed by DMEK performed for bullous keratopathy secondary to pIOL.Methods. Seven eyes of seven patients, who developed corneal decompensation after pIOL implantation, underwent bilensectomy followed by DMEK in a two-step procedure. Main outcome measures included uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), refraction, endothelial cell density (ECD) at 1, 3, 6, and 12 months, and intraoperative and postoperative complications.Results. DMEK was performed at a mean time of 9.83 ± 8.23 months after bilensectomy. BCVA (log MAR) improved in all eyes, increasing from 1.11 ± 0.78 preoperatively to 0.54 ± 0.21, 0.28 ± 0.23, 0.21 ± 0.21, and 0.17 ± 0.17 at 1, 3, 6, and 12 months after DMEK. One year after surgery, mean spherical equivalent and cylinder were −0.70 ± 0.92 D and −1.50 ± 0.54 D, respectively. ECD decreased by 62 ± 4%, 69 ± 4%, 74 ± 4%, and 77 ± 3% at 1, 3, 6, and 12 months after DMEK. There was one case of primary graft failure and no other postoperative complications.Conclusions. The two-step technique bilensectomy followed by DMEK is a feasible technique for the management of bullous keratopathy secondary to pIOL, providing a fast visual recovery with good visual and refractive results.
A Case of Ileocecal IgG4-Related Sclerosing Mesenteritis Diagnosed by Endoscopic Ultrasound-Guided Fine Needle Aspiration using Forward-Viewing Linear Echoendoscope
Authors: Takano Yuichi , Niiya Fumitaka , Kobayashi Takahiro , Yamamura Eiichi , Maruoka Naotaka , Norose Tomoko , Ohike Nobuyuki , Nagahama Masatsugu
Published: October 2019

A 25-year-old woman had undergone removal of a cryptogenic tumor in the left maxillary sinus 1 year prior to presentation. The patient experienced abdominal pain for 4 days with repeated vomiting episodes; therefore, she was transferred to our hospital by an ambulance. Contrast-enhanced computed tomography revealed a 3-cm tumor in the ileocecal region, which caused small bowel obstruction. Contrast imaging of the ileus tube showed extrinsic compression of the ileocecal region. Forward-viewing linear echoendoscope revealed an irregular hypoechoic tumor measuring 3 cm outside the gastrointestinal tract. Using a 25G needle, endoscopic ultrasound-guided fine needle aspiration (EUS–FNA) was performed. Pathological finding was an inflammatory fibrous tissue with diffuse lymphoplasmacytic infiltration, with more than 10 IgG4-positive cells detected in a high-power field. Re-examination of a pathology specimen of the maxillary sinus tumor provided by the previous attending physician revealed that the inflammatory tissue had diffuse lymphoplasmacytic infiltration, which were accompanied by storiform fibrosis and obliterative phlebitis. Immunostaining revealed more than 50 IgG4-positive cells in a high-power field, a finding suggestive of IgG4-related disease. The serum IgG4 level was 21 mg/dl, which was within the normal range. Treatment was initiated with prednisolone at a dose of 50 mg/day, and the dose was later tapered off. CT and MRI performed 2 months later showed complete disappearance of the ileocecal tumor. The final diagnosis was asynchronously occurring IgG4-related maxillary sinusitis and sclerosing mesenteritis.
Nonlinear Stochastic Analysis of Footbridge Lateral Vibration Based on Probability Density Evolution Method
Authors: Yang Zheng , Jia Buyu , Yan Quansheng , Yu Xiaolin , Zhao Yinghao
Published: October 2019

Footbridge lateral vibration remains an unsolved problem and is characterized by the following: (1) pedestrians are sensitive to bridge vibration, which causes the pedestrian’s excitation being dependent on the bridge vibration; (2) pedestrian lateral excitation is a stochastic process rather than a perfect periodic load. Therefore, footbridge lateral vibration is essentially a complex nonlinear stochastic vibration system. Thus far, an effective method of dealing with such nonlinear stochastic vibration of footbridges remains lacking. A framework based on the probability density evolution (PDE) method is presented. For the mathematical model, the parameter resonance model is used to describe the pedestrian‐bridge interaction while treating the pedestrian lateral excitation as a narrow‐band process. For the analysis method, PDE is used to solve the nonlinear stochastic equations in combination with the number theoretical and finite difference methods. The proposed method establishes a new approach in studying footbridge lateral vibration. First, PDE based on the small sample strategy avoids the large amount of computation. Second, the randomness of both structural parameters and pedestrian lateral excitation could be taken into consideration by the proposed method. Third, based on the probability results with rich information, the serviceability, dynamic reliability, and random stability analyses are realized in a convenient manner.
Flight Safety Assessment Based on a Modified Human Reliability Quantification Method
Authors: Guo Yundong , Sun Youchao , Yang Xiufang , Wang Zongpeng
Published: October 2019

Human error is one of the most important risk factors affecting aviation safety. The original Cognitive Reliability and Error Analysis Method (CREAM) developed for the nuclear industry is reliable for human reliability quantification, but it is not fully applicable to human reliability analysis in aviation because it neglects the characteristics of long-duration flights. Here, we propose a modified CREAM method to predict human error probability in flight and provide some improvement measures for critical operations. A set of performance influencing factors (PIFs), such as flight procedures and ground support, is established to reflect operational scenarios in flight. Then, we develop the expected affect index of PIFs and the Scenario Influence Index to construct a quantitative model of human reliability. The probability of human error for each operation in the approach and landing phases is obtained with the modified CREAM method, and the results indicate that the most important cognitive function that influences human reliability is missed action. The proposed method may be a suitable tool for human reliability quantification in aviation considering long-duration flights. The method also has great practical significance for improving flight safety.
Numerical Study on Zonal Disintegration of Deep Rock Mass Using Three‐Dimensional Bonded Block Model
Authors: Tang Qingteng , Xie Wenbing , Wang Xingkai , Su Zhili , Xu Jinhai
Published: October 2019

Zonal disintegration, a phenomenon of fractured zones and intact zones distributed alternately in deep rock mass, is different from the excavation‐damaged zone of shallow rock mass. In this study, bonded block model of 3DEC was employed to study the fracture mode and origination condition of zonal disintegration. Initiation, propagation, and coalescence progress of fracture around the roadway boundary under different triaxial stress conditions are elaborated. Numerical simulation demonstrated that zonal disintegration may occur when the direction of maximum principal stress is parallel to the roadway axis. It is interesting to find that the fracture around the roadway boundary traced the line of a spiral line, while slip‐line fractures distributed apart from the roadway boundary. The extent of the alternate fracture zone decreased as the confining pressure increased, and alternate fracture zone was no longer in existence when the confining pressure reaches a certain value. Effects of roadway shape on zonal disintegration were also studied, and the results indicated that the curvature of the fracture track line tends to be equal to the roadway boundary in shallow surrounding rock of the roadway, while the fractures in deep surrounding rock seems unaffected by the roadway shape. Those findings are of great significance to support design of deep underground openings.
Experimental Investigation of the Influence of Cellulose Ether on the Floating of Rubber Particles in Mortar
Authors: Liang Jian , Zhang Bin , Liu Changshun , Zhang Chao
Published: October 2019

As a kind of hyperelastic material, rubber can be mixed into mortar (or concrete) to improve the anticracking ability and ductility of concrete. The mixture of rubber can change the internal structure of concrete through physical interaction, without changing the chemical properties of each component in the mortar (or concrete). But since the apparent density of rubber is far less than the density of cement‐based materials, rubber particles are likely to separate from cement‐based materials in the mixture of rubber and mortar, and consequently, rubber particles will float upward. This study proposes a new method to restrain the rubber particles from floating upward: add cellulose ether in the mortar with a water‐cement ratio of 0.45 so as to improve the mobility of mixture. Meanwhile, this study employs the method of quadratic orthogonal rotation combination experiment to carry out research on the influence of the mixing amount of cellulose ether (0∼5.43 kg/m3) and the ratio of rubber substituting for mortar (0∼0.5) on the degree of uniformity, consistency, and 28‐day (28 d) strength of crumb rubber mortar, and it also studies the inhibiting effect of cellulose ether on the floating of rubber. The results show that cellulose ether mixed into the mortar can significantly improve the mobility of the mixture and restrain the floating of rubber. But with the increase of the mixing amount of cellulose ether, the 28 d strength of the mortar shows an obvious decreasing trend. This study has a guiding role in the practical application of crumb rubber mortar, crumb rubber concrete, and other lightweight aggregate concrete.
Boost Converters’ Proximate Constrained Time‐Optimal Sliding Mode Control Based on Hybrid Switching Model
Authors: Taheri Asghar , Ghasemian Amir , Ren Hai-Peng
Published: October 2019

It is well known in the literature studies that the theoretical time‐optimal control of boost converters can be achieved using switching surfaces based on the converter’s natural state trajectories. However, this method has two important drawbacks: First, the transient current peak of the time‐optimal controller is far beyond the current limitations of related circuit elements in many practical cases. Second, switching based on the converter’s natural trajectories has high computational complexity and high dependence on circuit parameters. In this paper, based on the hybrid dynamical model of the converter and geometrical representation of its corresponding vector fields, a proximate constrained time‐optimal sliding mode controller is proposed. The proposed method has a fast response that is near that of a time‐optimal controller, with less computational complexity and sensitivity to parameter changes. The proposed method and its relevant theoretical framework are validated on an experimental setup with a boost converter prototype and an eZdsp TMS320F2812 processor board.
Dynamic Response Analysis of the Coal Gangue‐like Elastic Rock Sphere Impact on the Massless Tail Beam Based on Contact‐Structure Theory and FEM
Authors: Yang Yang , Wan Lirong , Xin Zhengyuan
Published: October 2019

The impact and collision behavior between the coal gangue and the hydraulic support widely exists in the top coal caving. However, due to the complex interactions between the large number of coal gangue particles in the mining surface and the limitations of the coal mining technology and other factors, it becomes a difficult problem to study the collision behavior and the contact response between the coal gangue and the hydraulic support or its main components under the actual caving conditions. In order to accurately grasp the contact response law when the coal gangue impacts the tail beam of the hydraulic support, in combination with the equivalent stiffness of the tail beam jack, the Lankarani–Nikravesh (L‐N) nonlinear spring‐damping contact model, the structural mechanics model of the tail beam, and the energy conservation law, this paper firstly establishes the system contact‐structure dynamic model when the particles impact on the tail beam based on the tail beam equivalent kinematics model. Then, to further study the system contact response, the spring damper module is used in the finite element software for the first time to replace the hydraulic cylinder, and four different types of the rigid‐flexible coupling simulations when the impact heights, the impact positions, the rock radii, and the rock materials change are conducted, respectively. Through the combination of the theory and the simulation, the contact response law when the particles impacting the massless tail beam under different working conditions is obtained, and the system contact response differences as well as the coal gangue identifying feasibility on the basis of the response differences after the coal gangue impact are analyzed. The conclusions will provide theoretical reference and simulation method for the study of the impact‐contact behavior between the coal gangue and the hydraulic support.
LncRNA AW112010 Promotes Mitochondrial Biogenesis and Hair Cell Survival: Implications for Age-Related Hearing Loss
Authors: Su Zhongwu , Xiong Hao , Pang Jiaqi , Lin Hanqing , Lai Lan , Zhang Huasong , Zhang Weijian , Zheng Yiqing
Published: October 2019

Long noncoding RNA (lncRNA) disorder has been found in many kinds of age-associated diseases. However, the role of lncRNA in the development of age-related hearing loss (AHL) is still largely unknown. This study sought to uncover AHL-associated lncRNAs and the function. RNA-sequencing was conducted to profile lncRNA expression in the cochlea of an early-onset AHL mouse model. RT-qPCR assay was used to validate the expression pattern of lncRNAs. ATP assay, JC-1 assay, mitochondrial probe staining, CCK-8 assay, Western blot, and immunocytochemistry were performed to detect the effects of lncRNA AW112010 in HEI-OC1 cells and the mouse cochlea. We identified 88 significantly upregulated lncRNAs and 46 significantly downregulated lncRNAs in the cochlea of aged C57BL/6 mice. We focused on the significantly upregulated AW112010. Silencing of AW112010 decreased the ATP level, mitochondrial membrane potential, and cell viability and increased mitochondrial ROS generation under oxidative stress in HEI-OC1 cells. AW112010 overexpression promoted cell survival in HEI-OC1 cells. AW112010 knockdown reduced mitochondrial mass and impaired mitochondrial biogenesis in HEI-OC1 cells. Activation of mitochondrial biogenesis by resveratrol and STR1720 promoted cell survival. The mitochondrial biogenesis process was activated in the cochlea of aged mice. Moreover, AW112010 regulated AMPK signaling in HEI-OC1 cells. Transcription factor Arid5b elevated in the aged cochlea and induced AW112010 expression and mitochondrial biogenesis in HEI-OC1 cells. Taken together, lncRNAs are dysregulated with aging in the cochlea of C57BL/6 mice. The Arid5b/AW112010 signaling was induced in the aged mouse cochlea and positively modulated the mitochondrial biogenesis to maintain mitochondrial function.
Effect of Particle Breakage and Shape on the Mechanical Behaviors of Granular Materials
Authors: Wang Yongxin , Shao Shengjun , Wang Zhi
Published: October 2019

The particle breakage property under loading is an important factor affecting the nonlinearity of the shear strength and stress‐strain curves of coarse‐grained soils. The macromechanical behaviors of coarse granular materials under consolidation and drainage shearing were tested by using a large true triaxial apparatus. The particle breakage mechanism has been analyzed by the fluctuation change of stress‐strain curve and particle composition change. It was shown that the particle shape is an extremely important microproperty of the influence of granular material breakage. The variation rules of the internal friction angle and interlocking strength with the index of fine‐grained breakage were sorted out, and the critical particle size for measuring the two friction modes under the given gradation was determined to be 1 mm. In addition, the numerical analysis was conducted by simulating the microshape parameters of particles. The conclusion is as follows: (1) The effect of shape parameters on shear strength can be simulated using the smoothness index Fd. (2) Compared with spherical particles, irregular‐shaped particles lead to a decrease in the number of strong force chains. Moreover, more coordination numbers are needed to maintain a stable configuration, and the shear strength is improved.
In Vitro Study of Combined Application of Bevacizumab and 5-Fluorouracil or Bevacizumab and Mitomycin C to Inhibit Scar Formation in Glaucoma Filtration Surgery
Authors: Zhang Yuanyuan , Zhu Shaopin , Xu Xun , Zuo Lei
Published: October 2019

This is an in vitro study conducted to observe the safety and antiscarring effects of combined application of bevacizumab (BVZ) and 5-fluorouracil (5-Fu) or BVZ and mitomycin C (MMC) during glaucoma filtration surgery (GFS). The cytotoxicity of drug combinations in human Tenon’s fibroblasts (HTFs) and human umbilical vein endothelial cells (HUVECs) was evaluated. Their effects on the levels of vascular endothelial growth factor (VEGF) in HUVECs, cell proliferation and migration in HTFs, and the expression of collagen type I alpha 1 (Col1A1) gene in HTFs were evaluated. In addition, the effects of combined drugs on VEGF(R) mRNA in HTFs were detected to explore the possible underlying drug mechanisms. The results showed that BVZ combined with 5-Fu demonstrated more significant antiscarring effects than BVZ or 5-Fu alone. However, the inhibitory effects of BVZ combined with MMC were similar to those of MMC alone. The cytotoxicity of the drug combinations was significantly greater than that of single drug, suggesting that combined application of BVZ and antimetabolites after GFS was safer when applied at different sites (such as subconjunctival injection at bilateral sides of the filtering bleb) or at varied time points.
The Dynamic Interplay between the Gut Microbiota and Autoimmune Diseases
Authors: Xu Huihui , Liu Meijie , Cao Jinfeng , Li Xiaoya , Fan Danping , Xia Ya , Lu Xiangchen , Li Jingtao , Ju Dahong , Zhao Hongyan
Published: October 2019

The human gut-resident commensal microbiota is a unique ecosystem associated with various bodily functions, especially immunity. Gut microbiota dysbiosis plays a crucial role in autoimmune disease pathogenesis as well as in bowel-related diseases. However, the role of the gut microbiota, which causes or influences systemic immunity in autoimmune diseases, remains elusive. Aryl hydrocarbon receptor, a ligand-activated transcription factor, is a master moderator of host-microbiota interactions because it shapes the immune system and impacts host metabolism. In addition, treatment optimization while minimizing potential adverse effects in autoimmune diseases remains essential, and modulation of the gut microbiota constitutes a potential clinical therapy. Here, we present evidence linking gut microbiota dysbiosis with autoimmune mechanisms involved in disease development to identify future effective approaches based on the gut microbiota for preventing autoimmune diseases.
The Role of Quality Improvement Process in Improving the Culture of Information among Health Staff in Ghana
Authors: Okyere Boadu Richard , Adzakpah Godwin , Agyei-Baffour Peter
Published: October 2019

Background. Over the past decades, knowledge and understanding have grown regarding the role that health information systems play in improving global health. Even so, using data to make evidence-informed decisions is still weak in most low- and middle-income countries. People do not always act on what they are told to do but act on sharing what is important and valued in an organization. Shared principles related to information systems are alluded to as a pre-existing culture of data collection or “culture of information” without specifying how these values originate and sustain themselves. They work in an organizational environment, which ultimately impacts them through organizational directives, principles, and practices. The objective of the study was to determines the role of quality improvement process in improving culture of information among health staff in Ghana, particularly in the Ejisu Juaben Health Service over time. Methods. A quasi-non-experimental pre- and post-intervention study was conducted in 26 health facilities in the Ejisu Juaben municipal health service of Ghana. The study involved assessment of perceived culture of information of staff coupled with training of 141 core staff selected from 26 facilities who were involved in data collection and use of information through application of data quality improvement training module over a twelve-month period. Results. Overall perceived promotion of culture of information improved from 71 percent in the baseline to 81 percent in the endline. Test-retest analysis suggested that the mean levels of the indices measuring promotion of a perceived culture of information, was significantly higher in endline compared to the situation in baseline. Conclusions. The study concluded that the improvement in staff perceived culture of information improved significantly overtime and this might have been contributed by the application and adoption of quality improvement training.
Cap-Assisted Endoscopic Mucosal Resection of an Incidental Rectal Traumatic Neuroma
Authors: Estifan Elias , Patel Varun , Grossman Matthew
Published: October 2019

A traumatic neuroma is a well-known complication after acute trauma to a peripheral nerve; the nerve tries to re-establish continuity by an orderly growth of axons from the peripheral to distal stump through the proliferation of Schwann cells. However, this process is not always perfect, and aberrant repair gives rise to a neuroma. We present a 50-year-old female who underwent an initial colonoscopy for change in bowel habits and was found to have a 7 mm submucosal lesion in the proximal rectum. Endoscopic ultrasound was done which showed a hypoechoic lesion in the submucosal plane without muscularis propria invasion. The patient underwent successful cap-assisted endoscopic mucosal resection of the lesion without complication. Pathology of the specimen revealed a traumatic rectal neuroma with immunostaining positive for S100. However, this patient did not have any known risk factors such as previous surgery including polypectomy or hemorrhoidectomy or any previous rectal manipulation. Interestingly, this is the second case of traumatic rectal neuroma reported in the English-language literature.
Experimental Study on Seismic Performance of Prefabricated Utility Tunnel
Authors: Duan Xu , Dong Qi , Ye Wanjun
Published: October 2019

Utility tunnel is a kind of underground tunnel structure that carries more than two types of public utility lines, and the utility tunnels built by the prefabricated method have been adopted in many modern cities due to their easy maintenance and environmental protection capabilities. However, knowledge about the seismic performance of the prefabricated utility tunnel and pipelines inside is quite limited. In this paper, a prefabricated utility tunnel newly built in Xi’an, China, is taken as the prototype; a series of shaking table tests are conducted to investigate the seismic performance of the prefabricated utility tunnel in loess foundation, using El Centro earthquake wave as the input loading. Details of the experimental setup focus on the design of the soil container, scaled model (1 : 10), sensor arrangement, and test cases. Dynamic responses including evaluation of boundary effect, the amplification factor of the ground and structure, distribution of soil pressure, characteristics of predominant frequencies, and the damage phenomena are analyzed. Dynamic strain obtained by Fiber Bragg Grating sensors releases the critical positions of the prefabricated utility tunnel during the earthquake. Moreover, the dynamic responses of the pipelines contained in the utility tunnel are also analyzed. From aforementioned results, the seismic performance of the prefabricated utility tunnel has been revealed. The results will provide a reference for the seismic design of prefabricated utility tunnels.
Adaptive Asymptotic Tracking Control for a Class of Uncertain Switched Systems via Dynamic Surface Technique
Authors: Chen Xuemiao , Zhao Qianjin , Zhang Chunsheng , Wu Jian
Published: October 2019

A novel adaptive tracking control scheme is proposed for a class of uncertain nonlinear switched systems with perturbations in this paper. The common Lyapunov function method is introduced to handle the switched system in the design process of the desired adaptive controller. In addition, a dynamic surface control method is proposed by employing a nonlinear filter such that the “explosion of complexity” problem existing in the conventional backstepping design can be overcome. Under the presented adaptive controller, all the closed‐loop signals are semiglobally bounded, and especially the output signal of the controlled system can follow the given reference signal asymptotically. To show the availability of the presented control scheme, a simulation is given in this paper.
The Rise of the Jöüngars Based on Primary Oyirod Sources
Authors: Taupier Richard
Published: October 2019

This paper draws on primary Oyirod and Mongol sources concerning the rise of the seventeenth-century Jöüngars. It relies on eighteenth- and nineteenth-century Mongolian historical texts to identify the 1638 creation of an Oyirod Jöüngar [Left Wing] and Baroun Gar [Right Wing]. This origin of the Jöüngars differs substantially from historical accounts that project existence of a Jöüngar to an earlier time. From Sarayin Gerel [Moon Light] and other sources we learn that the creation of the Jöüngar Khanate was sudden and even unlikely after the division of Baatar Khong Tayiji’s people among his sons. The Jöüngars were so weakened by this division that the Dalai Lama gave the title of Chechen Khaan to the Khoshoud Ochirtu Tayiji in 1666. The Yeke Caaji [Great Code] describes Oyirod political organisation in 1640. Sarayin Gerel also provides details of the reign of Galdan Boshugtu from 1672 until 1692.
The Ruler, the Wrestler, and the Archer
Authors: Delaplace Grégory
Published: October 2019

This paper is an attempt to understand dwelling in Mongolia as the cultivated balancing of three interconnected virtues, prominently exhibited by some particular characters and exemplary people, yet actually to varying degrees expected from anybody else. These virtues are skilfulness (being mergen), force (hiimor’) and power or diplomacy (erh); they are best embodied by archers, wrestlers and rulers, respectively. Drawing on three ethnographic vignettes featuring a troubled diviner, an unlucky young man and a confused anthropologist, this paper highlights how different kinds of people strive to dwell well in post-socialist Mongolia, associating elements that compose the world they live in and checking the conditions in which they might impose themselves in it.
Dark Tent and Light Tent
Authors: Stépanoff Charles
Published: October 2019

Humans have a unique ability to coordinate their imaginations and together explore virtual spaces. Shamanic traditions have cultivated this ability and developed powerful techniques to share mental travels. This article discusses two basic types of shamanic seance spread among indigenous peoples in North Asia and partly in North America and explores the relational and sensory-cognitive contrasts between these ritual techniques. One is carried out in the dark and the audience is more focused on hearing, while in the other the tent is light and watching the shaman’s act is a central part of the participants’ experience. This article describes the geographical distribution of these rituals and analyses the different ways in which they divide cognitive labour.
Powerful Deity or National Geopark?: the Pilgrimage to A-myes-rma-chen in 2014/2015, Transformations of Modernisation and State Secularism, and Environmental Change
Authors: Sehnalova Anna
Published: October 2019

The paper focuses on one of the most sacred mountains of Tibet, A-myes-rma-chen, located in east Tibet (contemporary mGo-log Prefecture, Qinghai Province, People’s Republic of China). It deals mainly with two topics: the ongoing vivid revitalisation of the cult of the mountain and its deity since the Cultural Revolution, and how this interacts with the current changes at the site due to state-planned modernisation and development within the ‘Great Development of the West’ (Xibu da kaifa) strategy extensively implemented since the beginning of the twenty-first century. Particular attention is paid to the recent great circumambulation pilgrimage to A-myes-rma-chen, performed once every 12 years in a Horse Year, which took place in 2014/15, in the Horse Year 2143 of the Tibetan calendar. The article shows the present form of the pilgrimage, its reflection of and accustomisation to these changes, and the resulting quick transformation of the institution of pilgrimage. Pilgrims’ and local people’s understandings and views, alterations and modifications of their behaviour and pilgrimage practice, as well as actual reactions, are discussed. The article argues that the site of A-myes-rma-chen is currently being reinterpreted by the state in a secularised, commodifying and territorialising discourse in order to incorporate the area more closely, both politically and culturally. A-myes-rma-chen thus represents a space contested by different cultural and interest groups.
Il nucleo di manoscritti arabi provenienti da San Martino delle Scale e conservati presso la Biblioteca Centrale della Regione Siciliana
Authors: Sciortino Maria Grazia
Published: October 2019

Among the manuscripts located into the Central Library of the Sicilian Region “Alberto Bombace” in Palermo there is a corpus of Arabic manuscripts coming from the Benedictine Monastery of San Martino delle Scale, as testified by the shelf-mark S.M., indicating that they used to belong to the Library of San Martino delle Scale’s Monastery. Through an in-depth philological and historical investigation, the author will try to give a general description of the documents providing a reconstruction of their arrival to San Martino delle Scale first and then to the Central Library of the Sicilian Region.
Sufism and the Muslim Brotherhood: Ḥasan al-Bannā’s wird and the Transformation of Sufi Traditions in Modern Islamic Activism
Authors: Elsässer Sebastian
Published: October 2019

Scholarship on the Muslim Brotherhood has often commented on its initial connection with Sufism. However, the question of how and why Sufism matters in the fully established Muslim Brotherhood movement has so far gone unanswered. This article gives a detailed account of the Sufi elements adopted into Muslim Brotherhood activism by its founder, Ḥasan al-Bannā (1906-1949). It analyses their function, especially their important role in the education of recruits as they become members of a hierarchical organisation based on the ‘family system’. Among the Sufi practices and ideas relevant in the Muslim Brotherhood tradition are the heart-bond (rābiṭah) prayer and self-examination, as well as concepts such as the spiritual path and ‘friendship of God’. Their incorporation into an Islamic project focused on activism and politics radically altered the meaning of these Sufi elements. Beyond al-Bannā and Egypt, the article follows this development within the Muslim Brotherhood movement across the Arab world from the 1950s until the present day.
The Kurdish Emirate of Brādōst, 1510-1609
Authors: Dehqan Mustafa , Genç Vural
Published: October 2019

The Brādōst Kurdish emirate, ruling over Rawāndiz and adjoining areas including parts of Urmīya, is one of the numerous Kurdish ruling families of Kurdistan, which succumbed to the conquering Ottoman and Safavid arms in the 16th-century. While Ardalān, Ḥakkārī, Chamīšgazak, and many other Kurdish emirates were yielded to the several recent studies, Brādōst remained a neglected Kurdish emirate. By analyzing written documents produced during the 16th-century — from both Ottoman and Safavid sources — a better understanding can be had of what political interactions were possible at this emirate in Ottoman-Safavid frontier history. This paper critically contributes to scholarly discussions of 16th-century political history of Brādōst and Ottoman-Safavid borderlands.
Quantitative gait assessment in children with 16p11.2 syndrome
Authors: Goldman Sylvie , McCullough Aston K. , Young Sally Dunaway , Mueller Carly , Stahl Adrianna , Zoeller Audrey , Abbruzzese Laurel Daniels , Rao Ashwini K. , Montes Jacqueline
Published: October 2019

Background

Neurodevelopmental disorders such as 16p11.2 syndrome are frequently associated with motor impairments including locomotion. The lack of precise measures of gait, combined with the challenges inherent in studying children with neurodevelopmental disorders, hinders quantitative motor assessments. Gait and balance are quantifiable measures that may help to refine the motor phenotype in 16p11.2. The characterization of motor profile is useful to study the trajectories of locomotion performance of children with genetic variants and may provide insights into neural pathway dysfunction based on genotype/phenotype model.

Methods

Thirty-six children (21 probands with 16p11.2 deletion and duplication mutation and 15 unaffected siblings), with a mean age of 8.5 years (range 3.2–15.4) and 55% male, were enrolled. Of the probands, 23% (n = 6) had a confirmed diagnosis of autism spectrum disorder (ASD) and were all male. Gait assessments included 6-min walk test (6MWT), 10-m walk/run test (10MWR), timed-up-and-go test (TUG), and spatio-temporal measurements of preferred- and fast-paced walking. The Pediatric Evaluation of Disability Inventory-Computer Adaptive Tests (PEDI-CAT), a caregiver-reported functional assessment, was administered. Measures of balance were calculated using percent time in double support and base of support. Analyses of the six children with ASD were described separately.

Results

Thirty-six participants completed the protocol. Compared with sibling controls, probands had significantly lower scores on the 6MWT (p = 0.04), 10MWR (p = 0.01), and TUG (p = 0.005). Group differences were also identified in base of support (p = 0.003). Probands had significantly lower PEDI-CAT scores in all domains including the mobility scale (p < 0.001). Using age-matched subsamples, the ASD and non-ASD genetic variant groups had larger base of support compared to the controls. In the fast-paced condition, all participants increased their velocity, and there was a corresponding decrease in percent time in double support compared to the preferred-pace condition in all participants. Only the ASD group presented with upper limb arm/hand stereotypies.

Conclusions

Children with 16p11.2, with and without ASD, present with balance impairment during locomotion activities. Probands performed worse on functional assessments, and quantitative measures revealed differences in base of support. These results highlight the importance of using precise measures to differentiate motor dysfunction in children with neurodevelopmental disorders.
Lack of impact of nil-per-os (NPO) time on goal-directed fluid delivery in first case versus afternoon case starts: a retrospective cohort study
Authors: Field R. Ryan , Mai Tuan , Hanna Samouel , Harrington Brian , Calderon Michael-David , Rinehart Joseph
Published: October 2019

Background

Goal Directed Fluid Therapy (GDFT) represents an objective fluid replacement algorithm. The effect of provider variability remains a confounder. Overhydration worsens perioperative morbidity and mortality; therefore, the impact of the calculated NPO deficit prior to the operating room may reach harm.

Methods

A retrospective single-institution study analyzed patients at UC Irvine Medical Center main operating rooms from September 1, 2013 through September 1, 2015 receiving GDFT. The primary study question asked if GDFT suggested different fluid delivery after different NPO periods, while reducing inter-provider variability. We created two patient groups distinguished by 0715 surgical start time or start time after 1200. We analyzed fluid administration totals with either a 1:1 crystalloid to colloid ratio or a 3:1 ratio. We performed direct group-wise testing on total administered volume expressed as total ml, total ml/hr., and total ml/kg/hr. between the first case start (AM) and afternoon case (PM) groups. A linear regression model included all baseline covariates that differed between groups as well as plausible confounding factors for differing fluid needs. Finally, we combined all patients from both groups, and created NPO time to total administered fluid scatterplots to assess the effect of patient-reported NPO time on fluid administration.

Results

Whether reported by total administered volume or net fluid volume, and whether we expressed the sum as ml, ml/hr., or ml/kg/hr., the AM group received more fluid on average than the PM group in all cases. In the general linear models, for all significant independent variables evaluated, AM vs PM case start did not reach significance in both cases atp = 0.64 andp = 0.19, respectively. In scatterplots of NPO time to fluid volumes, absolute adjusted and unadjusted R2 values are < 0.01 for each plot, indicating virtually non-existent correlations between uncorrected NPO time and fluid volumes measured.

Conclusions

This study showed NPO periods do not influence a patient’s volume status just prior to presentation to the operating room for surgical intervention. We hope this data will influence the practice of providers routinely replacing calculated NPO period volume deficit; particularly with those presenting with later surgical case start times.
Sexual dysfunction and associated factors among patients with epilepsy at Amanuel Mental Specialty Hospital, Addis Ababa – Ethiopia
Authors: Ejigu Alem K. , Zewlde Kelemwa H. , Muluneh Niguse Y. , Seraj Zehara R. , GebreLibanos Mahlet W. , Bezabih Yodit H.
Published: October 2019

Background

Many patients with chronic illness have sexual dysfunction that may be related to the condition itself, drug side effects, emotional sequel, or a combination of those factors. Patients with epilepsy are no exception. Men and women with epilepsy are frequently complaining sexual dysfunction and they appear to have a higher incidence of sexual dysfunction than peoples with other chronic neurologic illness. These problems can have a substantial impact on their sexuality thus; it needs careful study and evaluation.

Methods

Hospital based cross sectional study was conducted from January to July, 2016 among Patient with Epilepsy at Amanuel Mental Specialty Hospital. Interviewer administered Changes in Sexual Functioning Questionnaire (CSFQ-14) was used in order to assess the sexual problems. Finally, the data was analyzed by using Statistical Package for Social Science (SPSS) V-20. Descriptive statistics and logistic regression were used to describe the variables. Levels of significance of association determined at < 0.05.

Results

A total of 694 respondents participated, with response rate 99.14%. Among them 576 completed all items. The result showed that 363 subjects (63.9, 95%CI = 59.5–67.7) had global sexual dysfunction. Furthermore, the rate of sexual dysfunction was reported as 55.6% (95%CI = 49.1–62.6) and 67.4% (95%CI = 62.8–72.1) in female and male participants, respectively. Among domains of sexual dysfunction; sexual arousal problem (97.8% (95%CI = 95.8–98.3)) and sexual pain problem (11.3% (95%CI = 8.8–13.9)) were the most and the least prevalent sexual dysfunctions respectively. Concerning associated factors; age grouped > 51, depression, being out of relationship or not satisfied with non-sexual aspect of relationship, being jobless and khat use has positive association with sexual dysfunction. By the other side alcohol use, level of education & age groups 18–21 years associated negatively.

Conclusions

The prevalence of sexual dysfunction among patients with epilepsy is very high; its prevalence is more among males than females. Sexual arousal problem and sexual pain problem were the most and the least prevalent sexual dysfunctions respectively.