bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Endoscopic Mucosal Resection With Circumferential Incision and Endoscopic Submucosal Dissection for Rectal Carcinoid Tumor
Authors: Chen Ru , Liu Xiang , Sun Siyu , Wang Sheng , Ge Nan , Wang Guoxin , Guo Jintao
Published: May 2016

Background and Aims:

Endoscopic submucosal dissection (ESD) has been a valuable treatment of choice for rectal carcinoid tumors that are endoscopically treatable because of its satisfactory resection rate and low recurrence rate. For treatment of small rectal carcinoids, endoscopic mucosal resection (EMR) is more often chosen by endoscopists because of its safety and time efficiency. We applied circumferential incision and endoscopic mucosal resection (CI-EMR), which is a modification of EMR, to treat rectal carcinoid tumors and compared their efficacy and safety.

Methods:

Between January 2008 and December 2013, we enrolled 66 patients (30 in the ESD group and 36 in the CI-EMR group) at Shengjing Hospital who were pathologically diagnosed with rectal carcinoid tumors <15 mm in diameter. We retrospectively analyzed en bloc resection rates, pathologic complete resection rates, incidences of complications, follow-up outcomes, and procedure times.

Results:

The en bloc resection rate and the histologic complete resection rate were similar, but the procedure time was longer in the ESD group than in the CI-EMR group. In cases that were incompletely resected, neither local recurrence nor distant metastasis was detected during follow-up. Similarly minor bleeding occurred in both groups, and no perforation occurred after either procedure.

Conclusions:

CI-EMR showed comparable en bloc resection and histologically complete resection rates and is technically simpler and minimally invasive compared with ESD. Because of its easier performance and shorter procedure time, CI-EMR may be preferable to ESD for resection of rectal carcinoid tumors <15 mm in diameter without invasion or distant metastases.
The Effect of Mycophenolate Mofetil on Early Wound Healing in a Rodent Model
Authors: Willems Martine CM , Hendriks Thijs , Lomme Roger MLM , de Man Ben M , van der Vliet J Adam
Published: May 2016

Background

Immunosuppressant agents are inevitable for solid organ recipients, but may have a negative effect on wound healing that is difficult to measure because of clinical use of a polydrug regime. The evidence on mycophenolate mofetil (MMF) is scarce and contradictory. This study aims to investigate the effect of MMF administration on wound healing.

Methods

Ninety-six male Wistar rats divided into 4 groups underwent anastomotic construction in ileum and colon at day 0. Three groups received daily oral doses of 20 or 40 mg/kg MMF or saline (control group) from day 0 until the end of the experiment. Half of each group was analyzed after 3 days and half after 7 days. Another group started the medication 3 days after the laparotomy and was analyzed after 7 days, half of this group received 20 mg/kg and half 40 mg/kg MMF. Wound strength in anastomoses and in the abdominal wall was measured using bursting pressure, breaking strength, and histology. Trough levels were measured.

Results

Significant differences in wound strength were seen in ileum tissue after 3 days, which surprisingly showed a stronger anastomosis in the experimental groups. Bursting pressure as well as breaking strength was higher in the low-dose and high-dose MMF group compared with the control group. A negative effect was measured in abdominal wall tissue for the highest-dose group, which disappeared when the medication was delayed for 3 days. Histology showed poorer bridging of the submucosal layer and more polymorphonuclear cell infiltration in the ileum specimens of the control group compared with the treatment groups.

Conclusions

As a single agent in a preclinical wound healing model in the rat, MMF has no negative effect on healing of bowel anastomoses but might have a negative effect on the healing of abdominal wall.
Diagnostic assessments of student thinking about stochastic processes
Authors: Klymkowsky Michael W. , Koehler Katja , Cooper Melanie M.
Published: May 2016

A number of research studies indicate that students often have difficulties in understanding the presence and/or the implications of stochastic processes within biological systems. While critical to a wide range of phenomena, the presence and implications of stochastic processes are rarely explicitly considered in the course of formal instruction. To help instructors identify gaps in student understanding, we have designed and tested six open source activities covering a range of scenarios, from death rates to noise in gene expression, that can be employed, alone or in combination, as diagnostics to reveal student thinking as a prelude to the presentation of stochastic processes within a course or a curriculum.
Combining complex networks and data mining: why and how
Authors: Zanin M. , Papo D. , Sousa P. A. , Menasalvas E. , Nicchi A. , Kubik E. , Boccaletti S.
Published: May 2016

The increasing power of computer technology does not dispense with the need to extract meaningful in-formation out of data sets of ever growing size, and indeed typically exacerbates the complexity of this task. To tackle this general problem, two methods have emerged, at chronologically different times, that are now commonly used in the scientific community: data mining and complex network theory. Not only do complex network analysis and data mining share the same general goal, that of extracting information from complex systems to ultimately create a new compact quantifiable representation, but they also often address similar problems too. In the face of that, a surprisingly low number of researchers turn out to resort to both methodologies. One may then be tempted to conclude that these two fields are either largely redundant or totally antithetic. The starting point of this review is that this state of affairs should be put down to contingent rather than conceptual differences, and that these two fields can in fact advantageously be used in a synergistic manner. An overview of both fields is first provided, some fundamental concepts of which are illustrated. A variety of contexts in which complex network theory and data mining have been used in a synergistic manner are then presented. Contexts in which the appropriate integration of complex network metrics can lead to improved classification rates with respect to classical data mining algorithms and, conversely, contexts in which data mining can be used to tackle important issues in complex network theory applications are illustrated. Finally, ways to achieve a tighter integration between complex networks and data mining, and open lines of research are discussed.
Millions of Boreal Shield Lakes can be used to Probe Archaean Ocean Biogeochemistry
Authors: Schiff S. L. , Tsuji J. M. , Wu L. , Venkiteswaran J. J. , Molot L. A. , Elgood R. J. , Paterson M. J. , Neufeld J. D.
Published: May 2016

Life originated in Archaean oceans, almost 4 billion years ago, in the absence of oxygen and the presence of high dissolved iron concentrations. Early Earth oxidation is marked globally by extensive banded iron formations but the contributing processes and timing remain controversial. Very few aquatic habitats have been discovered that match key physico-chemical parameters of the early Archaean Ocean. All previous whole ecosystem Archaean analogue studies have been confined to rare, low sulfur, and permanently stratified lakes. Here we provide first evidence that millions of Boreal Shield lakes with natural anoxia offer the opportunity to constrain biogeochemical and microbiological aspects of early Archaean life. Specifically, we combined novel isotopic signatures and nucleic acid sequence data to examine processes in the anoxic zone of stratified boreal lakes that are naturally low in sulfur and rich in ferrous iron, hallmark characteristics predicted for the Archaean Ocean. Anoxygenic photosynthesis was prominent in total water column biogeochemistry, marked by distinctive patterns in natural abundance isotopes of carbon, nitrogen, and iron. These processes are robust, returning reproducibly after water column re-oxygenation following lake turnover. Evidence of coupled iron oxidation, iron reduction, and methane oxidation affect current paradigms of both early Earth and modern aquatic ecosystems.
Disruption of Humanastn2Function by ZIKVns4bGene as a Molecular Basis for Zika Viral Microcephaly
Authors: Ganguly Bhaskar , Ganguly Enakshi
Published: May 2016

The present Zika virus (ZIKV) pandemic is being associated with increased incidence of microcephaly in newborns. However, a molecular basis for such pathogenesis is distinctly lacking. Comparative nucleic acid sequence analysis showed similarity between regions of non-structural protein 4B (ns4b) gene of ZIKV and human astrotactin2 (astn2) gene. Based on these findings, a molecular target of Zika viral microcephaly is being proposed.
Coalescent inferences in conservation genetics: should the exception become the rule?
Authors: Montano Valeria
Published: May 2016

Genetic estimates of effective population size (Ne) are an established means to develop informed conservation policies. Another key goal to pursue the conservation of endangered species is keeping the connectivity across fragmented environments, to which genetic inferences of gene flow and dispersal greatly contribute. Most current statistical tools for estimating such population demographic parameters are based on Kingman's coalescent (KC). However, KC is inappropriate for taxa displaying skewed reproductive variance, a property widely observed in natural species. Coalescent models that consider skewed reproductive success-called multiple merger coalescent (MMCs)-have been shown to substantially improve estimates of Ne when the distribution of offspring per capita is highly skewed. MMCs predictions of standard population genetic parameters, including the rate of loss of genetic variation and the fixation probability of strongly selected alleles, substantially depart from KC predictions. These extended models also allow studying gene genealogies in a spatial continuum, providing a novel theoretical framework to investigate spatial connectivity. Therefore, development of statistical tools based on MMC's should substantially improve estimates of population demographic parameters with major conservation implications.
Cryptic diversity and population structure at small scales: The freshwater snailAncylus(Planorbidae, Pulmonata) in the Montseny mountain range
Authors: Macher Jan N. , Weiss Martina , Beermann Arne J. , Leese Florian
Published: May 2016

Anthropogenic impacts like intensified land use and climate change are severe threats to freshwater biodiversity and effective biodiversity monitoring is therefore one of the most urgent tasks. This is however often hampered by the lack of knowledge regarding the number and ecology of species. Molecular tools have shown many freshwater taxa to comprise morphologically cryptic species, which often occur in sympatry on a small geographic scale. Here, we studied the freshwater snailAncylus fluviatilis(MUELLER, 1774) species complex in the Iberian Montseny Mountains. We hypothesised 1) that several species ofA. fluviatilissensu lato occur in the Montseny, 2) that differentAncylusspecies seldom co-occur in syntopy due to different ecological demands or interspecific competition, and 3) that species show a pattern of strong population structure within streams or catchments due to ecological preferences or local adaptation. We barcoded 180 specimens from 36 sites in the Montseny for the cytochrome c oxidase subunit I (COI) barcoding gene and molecularly identified twoAncylusspecies. These species seldom occurred in syntopy and a species distribution modelling approach showed differing bioclimatic preferences of the species. One species mainly occurs in cooler, higher altitude streams while the second species occurs in lower-altitude areas with higher temperatures. Tests of population structure showed that both species possibly do not disperse well in the study area and that populations within species are likely adapted to certain bioclimatic conditions in different regions of the Montseny. Our results highlight the need to incorporate molecular techniques into routine monitoring programmes.
Circadian rhythms have significant effects on leaf-to-canopy gas exchange under field conditions
Authors: Resco de Dios Víctor , Gessler Arthur , Ferrio Juan Pedro , Alday Josu G , Bahn Michael , del Castillo Jorge , Devidal Sébastien , García-Muñoz Sonia , Kayler Zachary , Landais Damien , Martín Paula , Milcu Alexandru , Piel Clément , Pirhofer-Walzl Karin , Ravel Olivier , Salekin Serajis , Tissue David T , Tjoelker Mark G , Voltas Jordi , Roy Jacques
Published: May 2016

Molecular clocks drive oscillations in leaf photosynthesis, stomatal conductance and other cell and leaf level processes over ~24 h under controlled laboratory conditions. The influence of such circadian regulation over whole canopy fluxes remains uncertain and diurnal CO2and H2O vapor flux dynamics in the field are currently interpreted as resulting almost exclusively from direct physiological responses to variations in light, temperature and other environmental factors. We tested whether circadian regulation would affect plant and canopy gas exchange at the CNRS Ecotron. Canopy and leaf level fluxes were constantly monitored under field-like environmental conditions, and also under constant environmental conditions (no variation in temperature, radiation or other environmental cues). Here we show first direct experimental evidence at canopy scales of circadian gas exchange regulation: 20-79% of the daily variation range in CO2and H2O fluxes occurred under circadian entrainment in canopies of an annual herb (bean) and of a perennial shrub (cotton). We also observed that considering circadian regulation improved performance in commonly used stomatal conductance models. Overall, our results show that overlooked circadian controls affect diurnal patterns of CO2and H2O fluxes in entire canopies and in field-like conditions, although this process is currently unaccounted for in models.
C2c2 is a single-component programmable RNA-guided RNA-targeting CRISPR effector
Authors: Abudayyeh Omar O. , Gootenberg Jonathan S. , Konermann Silvana , Joung Julia , Slaymaker Ian M. , Cox David B.T. , Shmakov Sergey , Makarova Kira S. , Semenova Ekaterina , Minakhin Leonid , Severinov Konstantin , Regev Aviv , Lander Eric S. , Koonin Eugene V. , Zhang Feng
Published: May 2016

The CRISPR-Cas adaptive immune system defends microbes against foreign genetic elements via DNA or RNA-DNA interference. We characterize the Class 2 type VI-A CRISPR-Caseffector C2c2 and demonstrate its RNA-guided RNase function. C2c2 from the bacteriumLeptotrichia shahiiprovides interference against RNA phage.In vitrobiochemical analysis show that C2c2 is guided by a single crRNA and can be programmed to cleave ssRNA targets carrying complementary protospacers. In bacteria, C2c2 can be programmed to knock down specific mRNAs. Cleavage is mediated by catalytic residues in the two conserved HEPN domains, mutations in which generate catalytically inactive RNA-binding proteins. These results broaden our understanding of CRISPR-Cas systems and suggest that C2c2 can be used to develop new RNA-targeting tools.
Predicting Peptide-MHC Binding Affinities with Imputed Training Data
Authors: Rubinsteyn Alex , O'Donnell Timothy , Damaraju Nandita , Hammerbacher Jeff
Published: May 2016

Predicting the binding affinity between MHC proteins and their peptide ligands is a key problem in computational immunology. State of the art performance is currently achieved by the allele-specific predictor NetMHC and the pan-allele predictor NetMHCpan, both of which are ensembles of shallow neural networks. We explore an intermediate between allele-specific and pan-allele prediction: training allele-specific predictors with synthetic samples generated by imputation of the peptide-MHC affinity matrix. We find that the imputation strategy is useful on alleles with very little training data. We have implemented our predictor as an open-source software package called MHCflurry and show that MHCflurry achieves competitive performance to NetMHC and NetMHCpan.
Evolution of local mutation rate and its determinants
Authors: Terekhanova Nadezhda V. , Seplyarskiy Vladimir B. , Soldatov Ruslan A. , Bazykin Georgii A.
Published: May 2016

Mutation rate varies along the human genome, and part of this variation is explainable by measurable local properties of the DNA molecule. Moreover, mutation rates differ between orthologous genomic regions of different species, but the drivers of this change are unclear. Here, we compare the local mutation rates of several species. We show that these rates are very similar between human and apes, implying that their variation has a strong underlying cryptic component not explainable by the known genomic features. Mutation rates become progressively less similar in more distant species, and these changes are partially explainable by changes in the local genomic features of orthologous regions, most importantly, in the recombination rate. However, they are much more rapid, implying that the cryptic component underlying the mutation rate is more ephemeral than the known genomic features. These findings shed light on the determinants of mutation rate evolution.
The effects of network neutrality on the incentive to discriminate, invest, and innovate: a literature review
Authors: Lee Daeho , Shin Dong-Hee
Published: May 2016

Purpose

The purpose of this study is to categorize network neutrality according to its issues under debate and assess the state of the debate based on such organization. In addition, the study discusses the reasons that network neutrality is so difficult to solve and the future research directions that would do so.

Design/methodology/approach

This study presents a critical review of the current network neutrality issues and summarizes the economic background of each position in the debate. The relevant literature is organized by issue to examine the reasons that the network neutrality debate is so difficult to solve and determine the further study required to solve it.

Findings

An analysis of the relevant literature suggests that the proponents and opponents of network neutrality disagree on the best methods of developing the Internet. Therefore, future research and regulatory and practitioners’ applications would greatly benefit from a comprehensive review of that literature.

Originality/value

Network neutrality regulation is receiving increased attention because the development and significant influences of the Internet are becoming more apparent.
Young professionals’ conspicuous consumption of clothing
Authors: Lewis Abbie , Moital Miguel
Published: May 2016

Purpose

– The purpose of this paper is to examine the relationship between conspicuous consumption and public self-consciousness, materialism and domain-specific self-esteem, demographics and shopping behaviour.

Design/methodology/approach

– Focusing on clothing, public self-consciousness, materialism and domain-specific self-esteem are examined in relation to two characteristics of clothing: expensive and fashionable. Using a sample of 261 UK young professionals, the paper compares the five factors across three levels of clothing conspicuous consumption (low, medium and high).

Findings

– Findings indicate that while the five factors were associated to different levels of conspicuous consumption, the relationship was not always evident. Expensive clothing was more related to conspicuousness than fashionable clothing and differences between low- and medium/high-conspicuousness individuals appear to be larger than the difference between medium and high-conspicuousness groups.

Practical implications

– Price appears to be a more powerful influence on conspicuous consumption than the fashionable element and therefore a strategy focused on expensive prices is essential in attracting conspicuous consumers.

Originality/value

– The study provides an insight into conspicuous consumption in the context of clothing and its relationship with public self-consciousness, materialism and self-esteem as they relate to the expensive and fashionable dimensions.
Field‐based evidence for copper contamination induced changes of antibiotic resistance in agricultural soils
Authors: Hu Hang‐Wei , Wang Jun‐Tao , Li Jing , Li Jun‐Jian , Ma Yi‐Bing , Chen Deli , He Ji‐Zheng
Published: May 2016

Bacterial resistance to antibiotics and heavy metals are frequently linked, suggesting that exposure to heavy metals might select for bacterial assemblages conferring resistance to antibiotics. However, there is a lack of clear evidence for the heavy metal‐induced changes of antibiotic resistance in a long‐term basis. Here, we used high‐capacity quantitative PCR array to investigate the responses of a broad spectrum of antibiotic resistance genes (ARGs) to 4–5 year copper contamination (0–800 mg kg−1) in two contrasting agricultural soils. In total, 157 and 149 unique ARGs were detected in the red and fluvo‐aquic soil, respectively, with multidrug and β‐lactam as the most dominant ARG types. The highest diversity and abundance of ARGs were observed in medium copper concentrations (100–200 mg kg−1) of the red soil and in high copper concentrations (400–800 mg kg−1) of the fluvo‐aquic soil. The abundances of total ARGs and several ARG types had significantly positive correlations with mobile genetic elements (MGEs), suggesting mobility potential of ARGs in copper‐contaminated soils. Network analysis revealed significant co‐occurrence patterns between ARGs and microbial taxa, indicating strong associations between ARGs and bacterial communities. Structural equation models showed that the significant impacts of copper contamination on ARG patterns were mainly driven by changes in bacterial community compositions and MGEs. Our results provide field‐based evidence that long‐term Cu contamination significantly changed the diversity, abundance and mobility potential of environmental antibiotic resistance, and caution the un‐perceived risk of the ARG dissemination in heavy metal polluted environments.
The persistence of cliques in the post‐communist state. The case of deniability in drug reimbursement policy in Poland
Authors: Ozierański Piotr , King Lawrence
Published: May 2016

This article explores a key question in political sociology: Can post‐communist policy‐making be described with classical theories of the Western state or do we need a theory of the specificity of the post‐communist state? In so doing, we consider Janine Wedel's clique theory, concerned with informal social actors and processes in post‐communist transition. We conducted a case study of drug reimbursement policy in Poland, using 109 stakeholder interviews, official documents and media coverage. Drawing on ‘sensitizing concepts’ from Wedel's theory, especially the notion of ‘deniability’, we developed an explanation of why Poland's reimbursement policy combined suboptimal outcomes, procedural irregularities with limited accountability of key stakeholders. We argue that deniability was created through four main mechanisms: (1) blurred boundaries between different types of state authority allowing for the dispersion of blame for controversial policy decisions; (2) bridging different sectors by ‘institutional nomads’, who often escaped existing conflicts of interest regulations; (3) institutional nomads’ ‘flexible’ methods of influence premised on managing roles and representations; and (4) coordination of resources and influence by elite cliques monopolizing exclusive policy expertise. Overall, the greatest power over drug reimbursement was often associated with lowest accountability. We suggest, therefore, that the clique theory can be generalized from its home domain of explanation in foreign aid and privatizations to more technologically advanced policies in Poland and other post‐communist countries. This conclusion is not identical, however, with arguing the uniqueness of the post‐communist state. Rather, we show potential for using Wedel's account to analyse policy‐making in Western democracies and indicate scope for its possible integration with the classical theories of the state.
Alternative hypotheses for mammalian herbivore preference of burned areas in a savannah ecosystem
Authors: Eby Stephanie , Ritchie Mark E.
Published: May 2016

Mammalian herbivores prefer burned areas and this attraction has largely been attributed to the increased nutrient content of the postfire green flush and more recently to the avoidance of predators. However, alternative reasons for this attraction could be: (i) to avoid disease carrying and behaviour changing invertebrates; (ii) because burned areas are warmer microclimates; or (iii) to obtain minerals from the ash. This study tests for differences in tick and fly (Diptera) numbers between burned and unburned areas in Serengeti National Park, Tanzania. It also tests for differences in ground and air column temperatures between burned and unburned areas and for differences in the mineral content of ash in burned areas compared to the mineral content of green leaves in unburned areas. We found no difference in the abundance of either type of invertebrate between burned and unburned areas. Only ground temperature was higher in burned areas and this was only during the middle of the day, when increases in temperature would be less important than at night. Ash was higher in Al, Ca, Cu, Mg, Mn and P than nearby green leaves from unburned vegetation. Thus, obtaining minerals from ash is the only alternative reason for attraction to burned areas that maybe supported by this study.
Robot‐assisted partial cystectomy: perioperative outcomes and early oncological efficacy
Authors: Golombos David M. , O'Malley Padraic , Lewicki Patrick , Stone Benjamin V. , Scherr Douglas S.
Published: May 2016

Objective

To report on patients undergoing robot‐assisted partial cystectomy (RAPC), focusing on perioperative outcomes over a range of clinical, anatomical and pathological variables, as well as the overall oncological efficacy of this approach.

Patients and Methods

We retrospectively reviewed all patients who underwent RAPC by a single surgeon between 2005 and 2015. We identified 29 patients who underwent surgery for definitive management of a primary bladder tumour. Clinicopathological data and perioperative variables were recorded. Continuous variables were compared using the Student's t‐test. Prediction of perioperative outcomes for those undergoing RAPC for intra‐diverticular neoplasms was done using univariate logistic regression. Survival was estimated using the Kaplan–Meier method.

Results

The median (interquartile range) patient age was 75 (65–81) years, 18 patients (62.1%) had an American Society of Anesthesiologists classification of ≥3, and 10 patients (34.5%) had a history of prior abdominal surgery. The median estimated blood loss (EBL) was 50 mL and the median length of stay (LOS) was 1 day. Two patients (6.9%) had a perioperative complication and five (17.9%) a post‐discharge complication at ≤90 days, all of which were minor. The positive surgical margin rate was 3.6% and in those with muscle‐invasive disease a median of 12 lymph nodes were removed. Neither the size of diverticulum nor the need for ureteric re‐implantation was predictive of LOS, EBL, or complication (P > 0.05). We did not encounter any wound, port site, or unusual recurrence patterns to suggest the technical factors of a robotic approach influenced oncological outcomes. The 5‐year overall and recurrence‐free survival rates were 79% and 68%, respectively.

Conclusion

RAPC confers the ability to achieve favourable outcomes with low morbidity and reduced hospital stays. Oncological efficacy compares favourably with the published literature. For experienced surgeons, this may represent the optimal surgical approach for organ‐preserving bladder surgery.
Active surveillance for low‐risk non‐muscle‐invasive bladder cancer: mid‐term results from the Bladder cancer Italian Active Surveillance (BIAS) project
Authors: Hurle Rodolfo , Pasini Luisa , Lazzeri Massimo , Colombo Piergiuseppe , Buffi NicolòMaria , Lughezzani Giovanni , Casale Paolo , Morenghi Emanuela , Peschechera Roberto , Zandegiacomo Silvia , Benetti Alessio , Saita Alberto , Cardone Pasquale , Guazzoni Giorgio
Published: May 2016

Objective

To report the oncological safety and the risk of progression for patients with non‐muscle‐invasive bladder cancer (NMIBC) included in an active surveillance (AS) programme after the diagnosis of recurrence.

Patients and methods

This is a prospective study enrolling patients with history of pathologically confirmed low grade pTa–pT1a NMIBC and diagnosed with a tumour recurrence. Inclusion criteria consisted of negative urine cytology, presence of ≤5 lesions with a diameter of ≤10 mm, absence of carcinoma in situ (CIS) or persistent gross haematuria. The primary outcome of interest was adherence to AS. Need to proceed with treatment was defined as progression in number/dimension/positive cytology/symptoms (gross haematuria persistent) or any further intervention (resection or electro‐fulguration). Finally, we assessed the up‐grading and up‐staging when transurethral resection of bladder tumour was performed.

Results

The study population consisted of 55 patients with a previous diagnosis of NMIBC (70 AS events) prospectively recruited since 2008. The mean patient age was 69.8 years. The median follow‐up was 53 months. The median time patients remained under AS was 12.5 months. There was disease progression in 28 patients (51%). No patient progressed to muscle‐invasive disease. In all, 15 patients (27.3%) had an increase in the number and/or size of the tumour, nine (16.4%) had haematuria, and four (7.3%) had a positive cytology. Only five (9%) patients in the whole series progressed to a high‐grade tumour (Grade 3) or presented with associated CIS. The overall adherence to the follow‐up schedule was 95%.

Conclusion

Our data show that an AS protocol for NMIBC could be a reasonable option in a select group of patients with small, recurrent cancers.
Effect of mouthguards on impact to the craniomandibular complex
Authors: Tanaka Yuto , Tsugawa Tsuyoshi , Maeda Yoshinobu
Published: May 2016

Background

The aim of this study was to investigate the effect of wearing a mouthguard and teeth‐clenching on impact to the head and temporomandibular joint (TMJ) during a blow to the jaw.

Material and Methods

A custom‐made mouthguard was fabricated for five participants. A 4.1‐N impact load was applied to the chin with a pendulum. Two acceleration sensors were attached to the forehead and left TMJ. The amplitudes and durations of the accelerations were obtained under five conditions: mouth‐open without mouthguard; light teeth‐clenching without mouthguard; maximum voluntary clenching (MVC) without mouthguard; mouth‐open with mouthguard and MVC with mouthguard.

Results

Wearing a mouthguard led to significant decreases in the amplitude (mouth‐open with mouthguard vs mouth‐open without mouthguard, P = 0.035 at forehead, P = 0.022 at TMJ) and duration (mouth‐open with mouthguard vs mouth‐open without mouthguard, P = 0.043 at forehead, not significant at TMJ). Similarly, teeth‐clenching caused significant decreases in the amplitude (mouth‐open without mouthguard vs MVC without mouthguard, P = 0.024 at forehead, P = 0.025 at TMJ) and duration (mouth‐open without mouthguard vs MVC without mouthguard, P = 0.033 at forehead, not significant at TMJ). Furthermore, wearing a mouthguard in itself provided an impact reduction effect similar to the combination of teeth‐clenching and wearing a mouthguard.

Conclusions

Wearing a mouthguard and/or teeth‐clenching reduced the impact to the head and TMJ during a blow to the jaw. However, it should be noted that the findings are the results from a small impact load to the jaw.
Defining functional biomes and monitoring their change globally
Authors: Higgins Steven I. , Buitenwerf Robert , Moncrieff Glenn R.
Published: May 2016

Biomes are important constructs for organizing understanding of how the worlds’ major terrestrial ecosystems differ from one another and for monitoring change in these ecosystems. Yet existing biome classification schemes have been criticized for being overly subjective and for explicitly or implicitly invoking climate. We propose a new biome map and classification scheme that uses information on (i) an index of vegetation productivity, (ii) whether the minimum of vegetation activity is in the driest or coldest part of the year, and (iii) vegetation height. Although biomes produced on the basis of this classification show a strong spatial coherence, they show little congruence with existing biome classification schemes. Our biome map provides an alternative classification scheme for comparing the biogeochemical rates of terrestrial ecosystems. We use this new biome classification scheme to analyse the patterns of biome change observed over recent decades. Overall, 13% to 14% of analysed pixels shifted in biome state over the 30‐year study period. A wide range of biome transitions were observed. For example, biomes with tall vegetation and minimum vegetation activity in the cold season shifted to higher productivity biome states. Biomes with short vegetation and low seasonality shifted to seasonally moisture‐limited biome states. Our findings and method provide a new source of data for rigorously monitoring global vegetation change, analysing drivers of vegetation change and for benchmarking models of terrestrial ecosystem function.
Striving for God's Attention: Gendered Spaces and Piety
Authors: Fatima Saba
Published: May 2016

This article looks at the inadequacy of space available to women in the two most holy sites for all Muslims: Masjid al‐Haram in Makkah and Masjid an‐Nabawi in Madinah, Saudi Arabia. I argue that religious discourse, shaped by geopolitical factors, has framed piety for women primarily in terms of modesty, such that a woman is often considered a good Muslim if she is visible only within her female community but invisible to the larger society. Furthermore, I argue that the allocation of meager space affects not only the perception of women's religious standing in society, but also women's own perception about their moral selves. The article claims that by being relegated to small sections within religious spaces, women's collective worship is evident neither to the community at large nor can it be fully experienced by individual women, thus placing obstacles in women's path to seek to closeness to God.
Treatment of axillary bromhidrosis through a mini‐incision with subdermal vascular preservation: a retrospective study in 396 patients
Authors: Zhao Hengguang , Li Shuang , Nabi Owais , Hu Li , Gao Xi , Luo Fuling
Published: May 2016

Background

Axillary bromhidrosis is a condition presenting as malodor caused by an interaction between the discharge of apocrine glands and bacteria. Topical agents, liposuction, and elective surgery are currently the main therapeutic modalities. However, the efficiency of these treatments and incidences of side effects are various and frequent, and depend on patient characteristics, surgical technique, and other unknown factors.

Methods

We report a retrospective study of outcomes in 396 patients treated by mini‐incision with subdermal vascular preservation.

Results

At 2 years postoperatively, 87.1% of patients had achieved very satisfactory results. Short‐term side effects included hematomas, epidermal erosions, infections, necrosis, incision dehiscence, and skin ripples. Long‐term side effects comprised comedones, epidermoid cysts, relapsing cyst infections, skin gauffers, scars, keloids, and persistent malodor. Some patients reported unsatisfactory cosmetic results, including skin gauffers, scars, or epidermoid cyst formations.

Conclusions

Two discrete aspects of the procedure that must be considered are the extent of apocrine gland clearance, which must be thorough in order to achieve the resolution of malodor, and the maintenance of an intact subdermal vascular plexus to support the regrowth of skin flaps after surgery and to avoid the occurrence of severe side effects.
Quality assessment of refined oil blends during repeated deep frying monitored by SPME–GC–EIMS, GC and chemometrics
Authors: Zribi Akram , Jabeur Hazem , Flamini Guido , Bouaziz Mohamed
Published: May 2016

The aim of this study was to investigate the effect of the refined palm oil addition (20%) on the fatty acid and sterol compositions of refined olive oil or refined soya bean oil and also to investigate the formation of total polar compounds and volatile compounds in these oil blends during fifty successive deep‐frying sessions of potato fries at 180 °C. The blend of refined olive oil and refined palm oil exhibited a higher chemical stability during the frying process than that of refined soya bean oil and refined palm oil. Indeed, the total polar compounds and volatile compounds formed, especially 2,4‐decadienal, were found to be relatively increased in the refined soya bean oil/refined palm oil blend reaching 36.50% and 46.70%, respectively, after fifty deep‐frying sessions. Moreover, the degradation of linoleic acid and β‐sitosterol was significantly (P < 0.05) observed for the refined soya bean oil/refined palm oil blend. The results have proven that the proper blending of monounsaturated refined olive oil with refined palm oil increases its stability and hence improves the quality of such olive oil during frying process.
Application of sepiolite in clarification of pomegranate juice: changes on quality characteristics during process
Authors: Mirzaaghaei Marzieh , Goli Sayed Amir Hossein , Fathi Milad
Published: May 2016

In this study, for the first time, the function of acid‐activated sepiolite clay was evaluated for clarification of pomegranate juice. The optimum conditions of clarification process were achieved using response surface methodology based on juice turbidity as a response. After that, under optimal condition, efficiency of sepiolite, bentonite and combination of these fining agents with gelatin and kieselgel was compared for clarifying pomegranate juice. The results showed that the best conditions for juice clarification were 0.05% (w/v) clay concentration, temperature of 50 °C and time of 2 h. The results revealed that treatments of bentonite–gelatin–kieselgel and sepiolite–gelatin–kieselgel were the most active fining agents that their use led to a reduction of 99.7% in turbidity of pomegranate juice. Kinetic study for different features was performed, and the results indicated that rate of changes in turbidity, viscosity, total phenolic contents and colour with time followed first‐, first‐, zero‐ and zero‐order kinetic models, respectively.
Patient‐Controlled Fentanyl Iontophoretic Transdermal System Improved Postoperative Mobility Compared to Intravenous Patient‐Controlled Analgesia Morphine: A Pooled Analysis of Randomized, Controlled Trials
Authors: Oliashirazi Ali , Wilson‐Byrne Timothy , Shuler Franklin D. , Parvizi Javad
Published: May 2016

Background

Postoperative pain management protocols that use patient‐controlled analgesia (PCA) can hinder mobility due to attached machinery and tubing. Immobility in the postoperative setting can increase complications, length of stay (LOS), and costs. Early and enhanced mobilization can reduce the cost of care while improving patient outcomes. A needle‐free, compact, patient‐activated, and portable fentanyl iontophoretic transdermal system (fentanyl ITS, IONSYS; The Medicines Company, Parsippany NJ) has been shown to provide comparable efficacy and tolerability to intravenous (IV) PCA morphine that promotes improved mobility.

Methods

This pooled analysis of 1,882 patients across three randomized, controlled trials compared fentanyl ITS to IV PCA morphine for postoperative pain management. Outcomes of patient mobility were assessed by a validated Patient Ease of Care Questionnaire that was given to patients, patients' nurses, and physical therapists involved in patient care. Safety was assessed via spontaneously reported treatment‐emergent adverse events (TEAE).

Results

Fentanyl ITS significantly improved overall patient mobility, each mobility subscore (P < 0.0001) across all demographics (male/female; elderly/non‐elderly; normal BMI/overweight/obese/morbidly obese) and surgery types, and was consistent across nurses and physical therapists mobility assessments. TEAEs were generally similar between the two groups. However, more patients reported an opioid‐related TEAE with morphine IV PCA than with fentanyl IV PCA (P = 0.003).

Conclusion

Due to improved mobility with fentanyl ITS, complications are expected to be less frequent than with IV PCA and epidural PCA. Incorporation of this strategy into postoperative pain management protocols may reduce LOS and total hospital costs.
The Use of Analgesic and Other Pain‐Relief Drugs to Manage Chronic Low Back Pain: Results from a National Survey
Authors: Gouveia Nélia , Rodrigues Ana , Ramiro Sofia , Eusébio Mónica , Machado Pedro M. , Canhão Helena , Branco Jaime C.
Published: May 2016

Objectives

To analyze and characterize the intake profile of pain‐relief drugs in a population‐based study of adults with chronic low back pain (CLBP).

Methods

EpiReumaPt was a cross‐sectional Portuguese population‐based study (10,661 subjects). Self‐reported active CLBP was considered to be low back pain on the day of enrollment and for ≥ 90 days. Prevalence and profile of analgesic intake was characterized among those self‐reporting active CLBP, taking into account the intensity of pain and the World Health Organization (WHO) analgesic ladder. We further investigated whether the presence of active CLBP was a factor independently associated with the intake of analgesics (adjusted for potential confounders).

Results

Among 1,487 subjects with active CLBP, only 18.7% were using analgesic/pain‐relief drugs. Estimated prevalence was anxiolytics, 14.1%; nonsteroidal anti‐inflammatory drugs (NSAIDs), 12.3%; antidepressants, 10.1%; analgesic, antipyretics, 6.6%; anticonvulsants, 3.4%; central muscle relaxants, 2.6%; and analgesic opioids, 1.6%. Most subjects with severe pain were in the first step of the WHO analgesic ladder: NSAIDs plus anxiolytics (4.6%), NSAIDs plus antidepressants (3.2%), or NSAIDs plus muscle relaxants (2.5%). The presence of active CLBP was significantly associated with the intake of all therapeutic groups: antidepressants (odds ratio [OR] = 12.56; P < 0.001); centrally acting muscle relaxants (OR = 12.01; P < 0.001); anticonvulsants (OR = 9.27; P < 0.001); anxiolytics, sedatives, and hypnotics (OR = 8.86; P < 0.001); NSAIDs (OR = 8.56; P < 0.001); and analgesic opioids (OR = 8.13; P < 0.001).

Conclusion

Analgesic/pain‐relief drug intake in patients with active CLBP was very low, even for those with severe pain. The WHO analgesic ladder was carefully followed, with an extremely conservative use of analgesic opioids even for those with severe pain.
Problem-Based Learning in Biomechanics: Advantages, Challenges, and Implementation Strategies
Authors: Clyne Alisa Morss , Billiar Kristen L.
Published: May 2016

Problem-based learning (PBL) has been shown to be effective in biomedical engineering education, particularly in motivating student learning, increasing knowledge retention, and developing problem solving, communication, and teamwork skills. However, PBL adoption remains limited by real challenges in effective implementation. In this paper, we review the literature on advantages and challenges of PBL and present our own experiences. We also provide practical guidelines for implementing PBL, including two examples of PBL modules from biomechanics courses at two different institutions. Overall, we conclude that the benefits for both professors and students support the use of PBL in biomedical engineering education.
Novel Methodology for Characterizing Regional Variations in the Material Properties of Murine Aortas
Authors: Bersi Matthew R. , Bellini Chiara , Di Achille Paolo , Humphrey Jay D. , Genovese Katia , Avril Stéphane
Published: May 2016

Many vascular disorders, including aortic aneurysms and dissections, are characterized by localized changes in wall composition and structure. Notwithstanding the importance of histopathologic changes that occur at the microstructural level, macroscopic manifestations ultimately dictate the mechanical functionality and structural integrity of the aortic wall. Understanding structure–function relationships locally is thus critical for gaining increased insight into conditions that render a vessel susceptible to disease or failure. Given the scarcity of human data, mouse models are increasingly useful in this regard. In this paper, we present a novel inverse characterization of regional, nonlinear, anisotropic properties of the murine aorta. Full-field biaxial data are collected using a panoramic-digital image correlation (p-DIC) system. An inverse method, based on the principle of virtual power (PVP), is used to estimate values of material parameters regionally for a microstructurally motivated constitutive relation. We validate our experimental–computational approach by comparing results to those from standard biaxial testing. The results for the nondiseased suprarenal abdominal aorta from apolipoprotein-E null mice reveal material heterogeneities, with significant differences between dorsal and ventral as well as between proximal and distal locations, which may arise in part due to differential perivascular support and localized branches. Overall results were validated for both a membrane and a thick-wall model that delineated medial and adventitial properties. Whereas full-field characterization can be useful in the study of normal arteries, we submit that it will be particularly useful for studying complex lesions such as aneurysms, which can now be pursued with confidence given the present validation.
Computational Fluid Dynamics Analysis of Gerotor Lubricating Pumps at High-Speed: Geometric Features Influencing the Filling Capability
Authors: Altare Giorgio , Rundo Massimo
Published: May 2016

The paper presents an extensive analysis of the influence on the suction capacity of the main geometric parameters of gerotor lubricating pumps. The study was carried out using a computational fluid dynamics (CFD) model developed with the commercial software PumpLinx®. The model of a reference gerotor unit was validated experimentally in terms of delivered flow rate in different operating conditions, in open and closed circuit configuration. In the former case, different geometries of the inlet pipe were tested. In the latter, the influence of the suction pressure at constant speed was analyzed. After the model validation, several geometric features were changed to assess their influence on the volumetric efficiency in conditions of incomplete filling, such as the thickness and the diameter of the gears, the position of the inlet pipe with respect to the rotors (radial, axial, and tangential), and the shape of the port plate.