bluuebunny/crossref_metadata_2025 huggingface dataset:
Protocol for a systematic review and meta-analysis of fractional dose compared with standard dose inactivated polio vaccination in children
Authors: Mashunye Thandiwe Runyararo , Ndwandwe Duduzile Edith , Dube Kopano Rebaona , Shey Muki , Shelton Mary , Wiysonge Charles Shey
Published: March 2019

Introduction

WHO recommends the introduction of at least one single dose of inactivated polio vaccine (IPV) in routine immunisation schedules. Thus, there has been an increased demand and concurrent supply shortages of IPV worldwide. One of the strategies to improve access is the use of fractional instead of full doses of IPV. We aim to compare the effects of fractional with standard doses of IPV.

Methods and analysis

We will include randomised trials, non-randomised trials, case-control studies and cohort studies that compared fractional with full doses of IPV among children aged 5 years or younger. We will search for eligible studies among published and grey literature. Two authors will independently screen the results of the search, select studies, extract data and assess risk of bias. We will stratify analyses by study design, type of poliovirus, type of outcome measure and number of IPV doses given. For each type of poliovirus, we will pool the outcome data from studies using random-effects meta-analyses. Statistical heterogeneity will be assessed using the χ2test of homogeneity and quantified using the I2statistic. To investigate statistical heterogeneity, subgroup analyses will be performed based on the timing of the first fractional dose, age of administration, immunisation schedules and country income status. Sensitivity analyses will be used to assess if the effect of IPV fractional dosing is affected by study design, risk of bias and methods of meta-analysis.

Ethics and dissemination

We obtained approval from the University of Cape Town Human Research Ethics Committee (HREC REF: 412/2018). The findings of this review will provide evidence for decision-making with regards to IPV dosage, eventually improving access to the vaccine by stretching vaccine supplies. The results will be published in the University of Cape Town online library and in a peer reviewed journal.

PROSPERO registration number

CRD42018092647.
Protocol for a randomised, open-label, parallel group, multicentre controlled study to evaluate the clinical performance and safety of Stay Safe Link compared with Stay Safe in patients with end-stage kidney disease on continuous ambulatory peritoneal dialysis
Authors: Mak Wen Yao , Ong Loke Meng , Goh Bak Leong , Bavanandan Sunita , Mushahar Lily , Leong Chin Tho , Hooi Lai Seong
Published: March 2019

Introduction

Peritonitis is a major complication of continuous ambulatory peritoneal dialysis (CAPD), the risk of which is significantly influenced by the type of PD transfer system. Although the Y-disconnect and double-bag system is more efficient in preventing peritonitis compared with the spike system, little information is available to differentiate risks between different brands of the Y-disconnect double-bag system. A randomised controlled trial to evaluate the safety and efficacy of a newly introduced system is needed to provide the necessary clinical evidence to guide policy decision-making.

Methods and analysis

The study is an open-label randomised controlled trial. A total of 434 patients with end-stage renal disease undergoing CAPD will be enrolled and randomised to either the intervention group, Stay Safe Link, or the control group, Stay Safe. All study subjects will be followed up and monitored for 1 year. The primary safety outcome is the rate of peritonitis while the primary efficacy outcomes are the delivered dialysis dose and ultrafiltration volume.

Ethics and dissemination

The study was approved by the Medical Research Ethics Committee, National Institute of Health Malaysia. A written informed consent will be obtained from all participating subjects prior to any trial-related procedure and the study conduct will adhere strictly to Good Clinical Practice. The findings will be disseminated in a peer-reviewed journal.

Trial registration number

NCT03177031; Pre-results.
Changes to the frequency and appropriateness of vitamin D testing after the introduction of new Medicare criteria for rebates in Australian general practice: evidence from 1.5 million patients in the NPS MedicineInsight database
Authors: Gonzalez-Chica David , Stocks Nigel
Published: March 2019

Objectives

To assess changes in the frequency of vitamin D testing and detection of moderate/severe vitamin D deficiency (<30 nmol/L) among adults after the introduction of new Medicare Benefits Schedule (MBS) rebate criteria (November 2014), and their relationship to sociodemographic and clinical characteristics.

Design

Dynamic (open) cohort study

Setting

Primary care

Participants

About 1.5 million ‘active’ patients aged 18+ years visiting a general practitioner and included in the National Prescribing Service MedicineInsight database.

Outcome measures

The frequency of vitamin D testing (per 1000 consultations) and moderate/severe vitamin D deficiency (%) recorded between October 2013 and March 2016, stratified by the release of the new MBS criteria for rebate.

Results

More patients were female (57.7%) and 30.2% were aged 60+ years. Vitamin D testing decreased 47% (from 40.3 to 21.4 tests per 1000 consultations) after the new MBS criteria, while the proportion of tests with no indication for being performed increased from 71.3% to 76.5%. The proportion of patients identified as moderate/severe vitamin D deficient among those tested increased from 5.4% to 6.5%. Practices located in high socioeconomic areas continued to have the highest rates of testing, but moderate/severe vitamin D deficiency detection remained 90% more frequent in practices from low socioeconomic areas after the rebate change. Furthermore, the frequency of individuals being tested was reduced independent of the patients’ sociodemographic or clinical condition, and the gap in the prevalence of vitamin D deficiency detection between those meeting or not meeting the criteria for being tested remained the same. Moderate/severe vitamin D deficiency detection decreased slightly among patients with hyperparathyroidism or chronic renal failure.

Conclusions

Although the new criteria for rebate almost halved the frequency of vitamin D testing, it also lessened the frequency of testing among those at higher risk of deficiency, with only a small improvement in vitamin D deficiency detection.
Beliefs, practices and knowledge of community pharmacists regarding complementary and alternative medicine: national cross-sectional study in Lebanon
Authors: Hijazi Mohamad Ali , Shatila Hibeh , El-Lakany Abdalla , Aboul Ela Maha , Kharroubi Samer , Alameddine Mohamad , Naja Farah
Published: March 2019

Introduction

Pharmacists are uniquely positioned to provide patients with evidence-based information in order to ensure effective and safe use of Complementary and alternative medicine (CAM) products.

Objective

Assess beliefs, practices and knowledge related to CAM products among community pharmacists in Lebanon.

Design, methods and setting

Using stratified random sampling, a nationally representative survey was conducted among community pharmacists in Lebanon. Through face-to-face interviews, pharmacists completed a multicomponent questionnaire consisting of four sections: (1) sociodemographic characteristics; (2) beliefs related to regulation of CAM products, role of media in promoting their safe use, availability of resources and continuing education; (3) practices including selling CAM products, providing advice for patients and reporting adverse effects and (4) knowledge about specific CAM products, their uses, side effects and interactions.

Results

A total of 341 pharmacists agreed to participate (response rate: 86%). Only pharmacists with complete data were included in this study (n=310). Pharmacists agreed that CAM products are effective (63.8%) and that they should be exclusively sold in pharmacies (80.3%), but disagreed that commercially marketed CAM products are well regulated (63.5%) and that media plays a positive role in educating users about these products (55.8%). As for practices, 64.5% of pharmacists were always or often advising patients on safe use; however, 74.2% of participants rarely or never reported adverse effects. Regarding knowledge, although the majority of pharmacists were aware of the uses of CAM products, fewer knew about their side effects and their interactions with drugs. After adjustment for covariates, receiving education/training on CAM products during university was the sole predictor of higher knowledge score (ß=0.68, 95% CI 0.29 to 1.07).

Conclusions

This study revealed positive beliefs of pharmacists in Lebanon towards CAM products and indicated important gaps in their practice and knowledge. Deliberate efforts to enhance the education of pharmacists are warranted to ensure the safe integration and use of CAM products in Lebanon.
Rationale and design of a prospective substudy of clinical endpoint adjudication processes within an investigator-reported randomised controlled trial in patients with coronary artery disease: the GLOBAL LEADERS Adjudication Sub-StudY (GLASSY)
Authors: Leonardi Sergio , Franzone Anna , Piccolo Raffaele , McFadden Eugene , Vranckx Pascal , Serruys Patrick , Benit Edouard , Liebetrau Christoph , Janssens Luc , Ferrario Maurizio , Zurakowski Aleksander , van Geuns Robert-Jan , Dominici Marcello , Huber Kurt , Slagboom Ton , Buszman Paweł , Bolognese Leonardo , Tumscitz Carlo , Bryniarski Krzysztof , Aminian Adel , Vrolix Mathias , Petrov Ivo , Garg Scot , Naber Christoph , Prokopczuk Janusz , Hamm Christian , Steg Gabriel , Heg Dik , Juni Peter , Windecker Stephan , Valgimigli Marco
Published: March 2019

Introduction

The GLOBAL LEADERS is an open-label, pragmatic and superiority randomised controlled trial designed to challenge the current treatment paradigm of dual antiplatelet therapy (DAPT) for 12 months followed by aspirin monotherapy among patients undergoing percutaneous coronary intervention. By design, all study endpoints are investigator reported (IR) and not subject to formal adjudication by an independent Clinical Event Committee (CEC), which may introduce detection, reporting or ascertainment bias.

Methods and analysis

We designed the GLOBAL LEADERS Adjudication Sub-StudY (GLASSY) to prospectively implement, in a large sample of patients enrolled within the GLOBAL LEADERS trial (7585 of 15 991, 47.5%), an independent adjudication process of reported and unreported potential endpoints, using standardised CEC procedures, in order to assess whether 23-month ticagrelor monotherapy (90 mg twice daily) after 1-month DAPT is non-inferior to a standard regimen of DAPT for 12 months followed by aspirin monotherapy for the primary efficacy endpoint of death, non-fatal myocardial infarction, non-fatal stroke or urgent target vessel revascularisation and superior for the primary safety endpoint of type 3 or 5 bleeding according to the Bleeding Academic Research Consortium criteria.

This study will comprehensively assess the comparative safety and efficacy of the two tested antithrombotic strategies on CEC-adjudicated ischaemic and bleeding endpoints and will provide insights into the role of a standardised CEC adjudication process on the interpretation of study findings by quantifying the level of concordance between IR-reported and CEC-adjudicated events.

Ethics and dissemination

GLASSY has been approved by local ethics committee of all study sites and/or by the central ethics committee for the country depending on country-specific regulations. In all cases, they deemed that it was not necessary to obtain further informed consent from individual subjects.

Trial registration number

NCT01813435.
Faecal calprotectin to detect inflammatory bowel disease: a systematic review and exploratory meta-analysis of test accuracy
Authors: Freeman Karoline , Willis Brian H , Fraser Hannah , Taylor-Phillips Sian , Clarke Aileen
Published: March 2019

Objective

Test accuracy of faecal calprotectin (FC) testing in primary care is inconclusive. We aimed to assess the test accuracy of FC testing in primary care and compare it to secondary care estimates for the detection of inflammatory bowel disease (IBD).

Methods

Systematic review and meta-analysis of test accuracy using a bivariate random effects model. We searched MEDLINE, EMBASE, Cochrane Library and Web of Science until 31 May 2017 and included studies from auto alerts up until 31 January 2018. Eligible studies measured FC levels in stool samples to detect IBD in adult patients with chronic (at least 6–8 weeks) abdominal symptoms in primary or secondary care. Risk of bias and applicability were assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 criteria. We followed the protocol registered as PROSPERO CRD 42012003287.

Results

38 out of 2168 studies were eligible including five from primary care. Comparison of test accuracy by setting was precluded by extensive heterogeneity. Overall, summary estimates of sensitivity and specificity were not recorded. At a threshold of 50 µg/g, sensitivity from separate meta-analysis of four assay types ranged from 0.85 (95% CI 0.75 to 0.92) to 0.94 (95% CI 0.75 to 0.90) and specificity from 0.67 (95% CI 0.56 to 0.76) to 0.88 (95% CI 0.77 to 0.94). Across three different definitions of disease, sensitivity ranged from 0.80 (95% CI 0.76 to 0.84) to 0.97 (95% CI 0.91 to 0.99) and specificity from 0.67 (95% CI 0.58 to 0.75) to 0.76 (95% CI 0.66 to 0.84). Sensitivity appears to be lower in primary care and is further reduced at a revised threshold of 100 µg/g.

Conclusions

Conclusive estimates of sensitivity and specificity of FC testing in primary care for the detection of IBD are still missing. There is insufficient evidence in the published literature to support the decision to introduce FC testing in primary care. Studies evaluating FC testing in an appropriate primary care setting are needed.
Surgical management of intermittent exotropia: do we have an answer for all?
Authors: Chougule Pratik , Kekunnaya Ramesh
Published: March 2019

Intermittent exotropia (X(T)) is one of the most common form of strabismus with surgery being the mainstay of treatment. The main goal of surgery is to preserve binocular vision and stereopsis and to prevent its further loss. The decision to operate is mainly based on four aspects: increasing angle of exodeviation, deteriorating control of X(T), decrease in stereopsis for near or distance and quality of life. Bilateral lateral rectus muscle recession and unilateral lateral rectus recession with medial rectus resection, are the two most common surgical procedures performed and have been studied extensively in basic, divergence excess and convergence insufficiency types of X(T). However, there is no consensus over the relative efficacy of the two procedures in terms of postoperative alignment, residual or recurrent exotropia and consecutive esotropia with widely variable results, which can be attributed to poor understanding of the natural course of the disease. Multiple demographic, clinical and anatomic features that may influence the surgical outcomes have been studied to explain this variability. Moreover, most of the evidence regarding surgical outcomes of X(T) is from retrospective studies and the ongoing randomised prospective trials can shed light on long-term efficacy of these procedures. The goal of this review is to give a comprehensive overview of the outcomes of various surgical techniques in the management of different types of X(T), the preoperative and postoperative factors that may affect the surgical outcomes and to discuss the dilemmas faced by the treating surgeons including the effective management of overcorrection and undercorrection.
Burden of adverse childhood experiences in children attending paediatric clinics in South Western Sydney, Australia: a retrospective audit
Authors: Wickramasinghe Yuanee Mary , Raman Shanti , Garg Pankaj , Hurwitz Romy
Published: March 2019

Objectives

Adverse childhood experiences (ACE) are associated with poor short, medium and long-term health outcomes. South Western Sydney (SWS) has a large culturally diverse population, including many disadvantaged population groups. Our aims were to determine the burden of ACE in children attending community paediatric (CP) clinics using a purposefully developed ACE checklist, and explore any association with developmental health of children.

Methods

We trialled the ACE checklist in all CP clinics including child development (CD) and vulnerable child (VC) clinics between February 2017 and August 2017. Data were collated from completed ACE checklists and relevant clinical information from CP clinics. Statistical analysis was performed using SPSS and MedCalc software.

Results

Of 279 children seen in CP clinics with checklists completed for the period, 167 (60%) attended CD clinics and 112 (40%) attended VC clinics. Seventy-eight (28%) had ACE ≥4 and 178 (64%) had ACE ≥1. Of those attending CD clinics, 8 (5%) had ACE ≥4 compared with 70 (63%) attending VC clinics (p<0.001). Of all age groups, children ≥10 years of age had the highest proportion of children with ACE ≥4 (65%); significant association between age group and ACE ≥4 (p<0.001). There was a significant association between cultural background and ACE ≥4 (p<0.001); indigenous children had the highest proportion of ACE ≥4 (n=21; 64%), followed by Anglo-Australian children (55%). On logistic regression analysis, only attending VC clinics was significantly associated with ACE ≥4. There was no significant association between ACE ≥4 and developmental health.

Conclusion

Among children attending CP clinics in SWS, more than a quarter had a significant burden of ACE; those attending specialised clinics for vulnerable children, those from particular ethnic groups and from older age groups, had the highest burden of ACE. Our findings support the need for specialised pathways for paediatric assessment for vulnerable, at-risk children.
Use of bubble continuous positive airway pressure (bCPAP) in the management of critically ill children in a Malawian paediatric unit: an observational study
Authors: Myers Sarah , Dinga Precious , Anderson Margot , Schubert Charles , Mlotha Rachel , Phiri Ajib , Colbourn Tim , McCollum Eric Douglass , Mwansambo Charles , Kazembe Peter , Lang Hans-Joerg
Published: March 2019

Introduction

In low-resource countries, respiratory failure is associated with a high mortality risk among critically ill children. We evaluated the role of bubble continuous positive airway pressure (bCPAP) in the routine care of critically ill children in Lilongwe, Malawi.

Methods

We conducted an observational study between 26 February and 15 April 2014, in an urban paediatric unit with approximately 20 000 admissions/year (in-hospital mortality <5% approximately during this time period). Modified oxygen concentrators or oxygen cylinders provided humidified bCPAP air/oxygen flow. Children up to the age of 59 months with signs of severe respiratory dysfunction were recruited. Survival was defined as survival during the bCPAP-treatment and during a period of 48 hours following the end of the bCPAP-weaning process.

Results

117 children with signs of respiratory failure were included in this study and treated with bCPAP. Median age: 7 months. Malaria rapid diagnostic tests were positive in 25 (21%) cases, 15 (13%) had severe anaemia (Hb < 7.0 g/dL); 55 (47%) children had multiorgan failure (MOF); 22 (19%) children were HIV-infected/exposed. 28 (24%) were severely malnourished. Overall survival was 79/117 (68%); survival was 54/62 (87%) in children with very severe pneumonia (VSPNA) but without MOF. Among the 19 children with VSPNA (single-organ failure (SOF)) and negative HIV tests, all children survived. Survival rates were lower in children with MOF (including shock) (45%) as well as in children with severe malnutrition (36%) and proven HIV infection or exposure (45%).

Conclusion

Despite the limitations of this study, the good outcome of children with signs of severe respiratory dysfunction (SOF) suggests that it is feasible to use bCPAP in the hospital management of critically ill children in resource-limited settings. The role of bCPAP and other forms of non-invasive ventilatory support as a part of an improved care package for critically ill children with MOF at tertiary and district hospital level in low-resource countries needs further evaluation. Critically ill children with nutritional deficiencies and/or HIV infection/exposure need further study to determine bCPAP efficacy.
Randomised controlled trial of WISENSE, a real-time quality improving system for monitoring blind spots during esophagogastroduodenoscopy
Authors: Wu Lianlian , Zhang Jun , Zhou Wei , An Ping , Shen Lei , Liu Jun , Jiang Xiaoda , Huang Xu , Mu Ganggang , Wan Xinyue , Lv Xiaoguang , Gao Juan , Cui Ning , Hu Shan , Chen Yiyun , Hu Xiao , Li Jiangjie , Chen Di , Gong Dexin , He Xinqi , Ding Qianshan , Zhu Xiaoyun , Li Suqin , Wei Xiao , Li Xia , Wang Xuemei , Zhou Jie , Zhang Mengjiao , Yu Hong Gang
Published: March 2019

Objective

Esophagogastroduodenoscopy (EGD) is the pivotal procedure in the diagnosis of upper gastrointestinal lesions. However, there are significant variations in EGD performance among endoscopists, impairing the discovery rate of gastric cancers and precursor lesions. The aim of this study was to construct a real-time quality improving system, WISENSE, to monitor blind spots, time the procedure and automatically generate photodocumentation during EGD and thus raise the quality of everyday endoscopy.

Design

WISENSE system was developed using the methods of deep convolutional neural networks and deep reinforcement learning. Patients referred because of health examination, symptoms, surveillance were recruited from Renmin hospital of Wuhan University. Enrolled patients were randomly assigned to groups that underwent EGD with or without the assistance of WISENSE. The primary end point was to ascertain if there was a difference in the rate of blind spots between WISENSE-assisted group and the control group.

Results

WISENSE monitored blind spots with an accuracy of 90.40% in real EGD videos. A total of 324 patients were recruited and randomised. 153 and 150 patients were analysed in the WISENSE and control group, respectively. Blind spot rate was lower in WISENSE group compared with the control (5.86% vs 22.46%, p<0.001), and the mean difference was −15.39% (95% CI −19.23 to −11.54). There was no significant adverse event.

Conclusions

WISENSE significantly reduced blind spot rate of EGD procedure and could be used to improve the quality of everyday endoscopy.

Trial registration number

ChiCTR1800014809; Results.
Immune activation by DNA damage predicts response to chemotherapy and survival in oesophageal adenocarcinoma
Authors: Turkington Richard C , Knight Laura A , Blayney Jaine K , Secrier Maria , Douglas Rosalie , Parkes Eileen E , Sutton Eilis K , Stevenson Leanne , McManus Damian , Halliday Sophia , McCavigan Andrena M , Logan Gemma E , Walker Steven M , Steele Christopher J , Perner Juliane , Bornschein Jan , MacRae Shona , Miremadi Ahmad , McCarron Eamon , McQuaid Stephen , Arthur Kenneth , James Jacqueline A , Eatock Martin M , O’Neill Robert , Noble Fergus , Underwood Timothy J , Harkin D Paul , Salto-Tellez Manuel , Fitzgerald Rebecca C , Kennedy Richard D
Published: March 2019

Objective

Current strategies to guide selection of neoadjuvant therapy in oesophageal adenocarcinoma (OAC) are inadequate. We assessed the ability of a DNA damage immune response (DDIR) assay to predict response following neoadjuvant chemotherapy in OAC.

Design

Transcriptional profiling of 273 formalin-fixed paraffin-embedded prechemotherapy endoscopic OAC biopsies was performed. All patients were treated with platinum-based neoadjuvant chemotherapy and resection between 2003 and 2014 at four centres in the Oesophageal Cancer Clinical and Molecular Stratification consortium. CD8 and programmed death ligand 1 (PD-L1) immunohistochemical staining was assessed in matched resection specimens from 126 cases. Kaplan-Meier and Cox proportional hazards regression analysis were applied according to DDIR status for recurrence-free survival (RFS) and overall survival (OS).

Results

A total of 66 OAC samples (24%) were DDIR positive with the remaining 207 samples (76%) being DDIR negative. DDIR assay positivity was associated with improved RFS (HR: 0.61; 95% CI 0.38 to 0.98; p=0.042) and OS (HR: 0.52; 95% CI 0.31 to 0.88; p=0.015) following multivariate analysis. DDIR-positive patients had a higher pathological response rate (p=0.033), lower nodal burden (p=0.026) and reduced circumferential margin involvement (p=0.007). No difference in OS was observed according to DDIR status in an independent surgery-alone dataset.

DDIR-positive OAC tumours were also associated with the presence of CD8+ lymphocytes (intratumoural: p<0.001; stromal: p=0.026) as well as PD-L1 expression (intratumoural: p=0.047; stromal: p=0.025).

Conclusion

The DDIR assay is strongly predictive of benefit from DNA-damaging neoadjuvant chemotherapy followed by surgical resection and is associated with a proinflammatory microenvironment in OAC.
Nine contemporary therapeutic directions in heart failure
Authors: Almarzooq Zaid , Pareek Manan , Sinnenberg Lauren , Vaduganathan Muthiah , Mehra Mandeep R.
Published: March 2019

The global burden of heart failure has continued to increase dramatically with 26 million people affected and an estimated health expenditure of $31 billion worldwide. Several practice-influencing studies were reported recently, bringing advances along many frontiers in heart failure, particularly heart failure with reduced ejection fraction. In this article, we discuss nine distinct therapeutic areas that were significantly influenced by this scientific progress. These distinct areas include the emergence of sodium-glucose cotransporter-2 inhibitors, broadening the application of angiotensin-neprilysin inhibition, clinical considerations in therapy withdrawal in those patients with heart failure that ‘recover’ myocardial function, benefits of low-dose direct oral anticoagulants in sinus rhythm, targeted therapy for treating cardiac amyloidosis, usefulness of mitral valve repair in heart failure, the advent of newer left ventricular assist devices for advanced heart failure, the role of ablation in atrial fibrillation in heart failure, and finally the use of wearable defibrillators to address sudden death.
Promising member of the short interspersed nuclear elements (Alu elements): mechanisms and clinical applications in human cancers
Authors: Jiang Yun , Zong Wei , Ju Shaoqing , Jing Rongrong , Cui Ming
Published: March 2019

Alu elements are one of most ubiquitous repetitive sequences in human genome, which were considered as the junk DNA in the past. Alu elements have been found to be associated with human diseases including cancers via events such as amplification, insertion, recombination or RNA editing, which provide a new perspective of oncogenesis at both DNA and RNA levels. Due to the prevalent distribution, Alu elements are widely used as target molecule of liquid biopsy. Alu-based cell-free DNA shows feasible application value in tumour diagnosis, postoperative monitoring and adjuvant therapy. In this review, the special tumourigenesis mechanism of Alu elements in human cancers is discussed, and the application of Alu elements in various tumour liquid biopsy is summarised.
Periprocedural safety and technical outcomes of the new Silk Vista Baby flow diverter for the treatment of intracranial aneurysms: results from a multicenter experience
Authors: Martínez-Galdámez Mario , Biondi Alessandra , Kalousek Vladimir , Pereira Vitor M , Ianucci Giuseppe , Gentric Jean-Christophe , Mosimann Pascal J , Brisbois Denis , Schob Stefan , Quäschling Ulf , Kaesmacher Johannes , Ognard Julien , Escartín Jorge , Tsang Chun On Anderson , Čulo Branimir , Chabert Emmanuel , Turjman Francis , Barbier Charlotte , Mihalea Cristian , Spelle Laurent , Chapot René
Published: March 2019

Purpose

The aim of our study was to assess the technical success and the safety of this new low-profile flow diverter Silk Vista Baby (SVB) by evaluating the intraprocedural and periprocedural complication rate.

Material/methods

Clinical, procedural, and angiographic data were analyzed.

Results: 41 consecutive patients (28 women; age average 50.5 years) with 43 aneurysms were treated with SVB. Aneurysm sizes were classified by their maximum diameter, with an average size of 9.5 mm (range 2–30 mm). Thirty-four cases were unruptured. five aneurysms previously ruptured, had recurrence after the initial coiling. There were two ruptured cases. Aneurysms' locations were: M1 segment (five cases), M2 segment (three cases), M3 segment (one case), middle cerebral artery (MCA) bifurcation (six cases), carotid-T (two cases), anterior communicating artery/A1/A2 (11 cases), pericallosal artery (four cases), supraclinoid ICA (two cases), PCom (one case), V4 segment (three cases), PCA (three cases), SCA (one case), and PICA (one case). We had five intraprocedural complications which resolved without clinical consequences and three events postprocedural events. Initial occlusion rates were: eight aneurysms (18.6%) were completely occluded, five aneurysms (11.6%) showed near-complete occlusion, four cases (9.3%) showed incomplete filling, and 26 cases (60.4%) showed persisting filling. The mRS score at discharge from the hospital did not change from the admission mRS score.

Conclusion

Our study demonstrated that the use of the new low-profile flow diverter, SVB device, for the treatment of intracranial aneurysms is feasible and technically safe.
OMERACT agreement and reliability study of ultrasonographic elementary lesions in osteoarthritis of the foot
Authors: Zabotti Alen , Filippou Georgios , Canzoni Marco , Adinolfi Antonella , Picerno Valentina , Carrara Greta , Balint Peter , Bruyn George A , D'Agostino Maria Antonietta , Damjanov Nemanja , Delle Sedie Andrea , Filippucci Emilio , Gonzalez Fernandez Maria Luz , Hammer Hilde Berner , Karim Zunaid , Mandl Peter , Moller Ingrid , Morales Lozano Maria Rosario , Naredo Esperanza , Porta Francesco , Sakellariou Garifallia , Terslev Lene , Scirè Carlo Alberto , Iagnocco Annamaria
Published: March 2019

Objective

To evaluate the level of agreement on ultrasonographic (US) lesions among highly experienced sonographers as well as the intraobserver and interobserver reliability of inflammatory and structural US lesions in patients with osteoarthritis (OA) of the foot.

Methods

After a systematic literature review, a Delphi survey was performed to test definitions of US lesions in OA of the foot, including inflammatory lesions (ie, synovial hypertrophy [SH], joint effusion [JE], power Doppler signal [PD]), and structural abnormalities (ie, cartilage damage [CD] and osteophytes). Subsequently, the reliability of US in assessing the aforementioned lesions was tested on static images as well as during a live exercise. Reliability was assessed by kappa analyses and prevalence-adjusted bias-adjusted kappa (PABAK) on a dichotomous and an ordinal scale.

Results

Intraobserver and interobserver reliability for SH and JE evaluated by binary scoring was good for both components, while the intraobserver reliability for semiquantitative scoring of SH ranged from moderate in the web-based exercise (PABAK 0.49) to good (PABAK 0.8) in the live exercise. Reliability for CD and PD assessments were respectively good and excellent in all exercises (ranged from PABAK 0.61 to 0.79 for CD and 0.88 to 0.95 for PD). The interobserver reliability for the semiquantitative scoring of osteophytes was fair in the live exercise (PABAK 0.36) and moderate in the static exercise (PABAK 0.60).

Conclusions

Consensual US definitions were found to be reliable for assessing inflammatory lesions in OA of the foot, while the use of US to assess structural damage requires further studies.
Transbronchial cryobiopsy in fibrosing interstitial lung disease: modifications of the procedure lead to risk reduction
Authors: Hagmeyer Lars , Theegarten Dirk , Wohlschläger Jeremias , Hager Thomas , Treml Marcel , Herkenrath Simon Dominik , Hekmat Khosro , Heldwein Matthias , Randerath Winfried J
Published: March 2019

Sixty-one subjects with fibrosing interstitial lung disease were prospectively analysed to determine the efficacy of transbronchial cryobiopsy (CryoTBB) and the effect of procedural modifications which were introduced after an interim analysis of the first 19 subjects. The modifications significantly reduced complication rates from 84% to 14% (p<0.001). 30-day-mortality was 2%. The algorithm with initial CryoTBB and surgical lung biopsy (SLB) as optional step-up procedure was feasible. CryoTBB led to a confident diagnosis in 46/61 subjects (75%). Only 21% out of all subjects were forwarded for SLB. As the modified CryoTBB reduced but not eliminated the risk of severe complications, tissue sampling should be limited to patients where confident diagnosis enables life prolonging therapy. Trial registration number:NCT01714518.
Cache Valley virus as a cause of fetal abnormalities in a litter of three Boer kids
Authors: Harvey Jessica , Smith Joseph , Jackson Nicole , Kreuder Amanda , Dohlman Tyler , Smith Jodi
Published: March 2019

A 10‐month‐old Boer doe presented for dystocia. On caesarean section, three non‐viable fetuses, with multiple developmental abnormalities, including hydranencephaly were recovered. Subsequent testing demonstrated the presence of Cache Valley virus in the doe, kids and herdmates. Preventive efforts of insect control and delaying the breeding season to correspond to decreased insect activity resulted in no additional abnormalities in the herd over the two years after the presentation of this case.
Leishmaniosis causing chronic diarrhoea in a dog
Authors: Ward Patricia Maeve , McLauchlan Gerard , Millins Caroline , Mullen Dermot , McBrearty Alix Rebecca
Published: March 2019

A 10‐year‐old, male, neutered Podenco Canario was presented for investigation of chronic mixed intestinal diarrhoea and weight loss. The dog was imported from Spain seven years earlier and had not subsequently travelled outside of the UK. Clinical investigations also revealed a lingual mass, right hindlimb lameness, splenomegaly, a non‐regenerative anaemia and hyperglobulinaemia. Histopathology of endoscopic gastrointestinal biopsies revealed neutrophilic and histiocytic enteritis and colitis with high numbers of intracytoplasmic organisms suggestive ofLeishmania. Similar organisms were identified on cytology from the spleen, bone marrow aspirate and lingual mass.LeishmaniaPCR was positive on a bone marrow aspirate. Clinical signs resolved with miltefosine and allopurinol treatment. This case describes an atypical presentation of leishmaniosis with chronic diarrhoea which presented for veterinary investigation and treatment, seven years after moving from aLeishmaniaendemic area to the UK.
Equine airway inflammation in loose‐housing management compared with pasture and conventional stabling
Authors: Hansen Sanni , Klintoe Kasper , Austevoll Martin , Baptiste Keith E , Fjeldborg Julie
Published: March 2019

Icelandic horses are often stabled in loose‐housing systems, and to date this type of stabling has not been evaluated with regard to its potential impact on respiratory health. The objective was to assess if differences in management systems (eg, conventional stable, loose housing and pasture only) affect the degree of airway inflammation, evaluated by cytology of tracheal aspirate (TA) and bronchoalveolar lavage (BAL) fluid. In total, 84 Icelandic horses (aged 8.1±4.6 years) housed under three different management systems (conventional stables [n=29], loose‐house systems [n=29] and pasture [n=26]) were included. Endoscopy including mucus scoring, TA and BAL was performed. TA and BAL cytologies were evaluated by performing both the total cell count (TCC) and the differential cell count (DCC). Significantly higher BAL neutrophil DCC (P=0.032, P=0.040) and TA TCC (P=0.007, P=0.028) were found for each of the two groups of horses with indoor access (conventional stable and loose housing) compared with the pasture group. Regardless of stabling environment, weak positive correlations were found between TA and BAL TCC (r=0.37, P<0.001), between TA TCC and TA neutrophil ratio (r=0.33, P=0.002), as well as between TA and BAL neutrophil ratio (r=0.39, P=<0.001). A larger proportion of horses with indoor access showed evidence of subclinical airway inflammation characterised by an increase in TA and BAL neutrophil ratios.
Tβ4–Ac-SDKP pathway: Any relevance for the cardiovascular system?
Authors: Kassem Kamal M. , Vaid Sonal , Peng Hongmei , Sarkar Sarah , Rhaleb Nour-Eddine
Published: March 2019

The last 20 years witnessed the emergence of the thymosin β4 (Tβ4)–N-acetyl-seryl-aspartyl-lysyl-proline (Ac-SDKP) pathway as a new source of future therapeutic tools to treat cardiovascular and renal diseases. In this review article, we attempted to shed light on the numerous experimental findings pertaining to the many promising cardiovascular therapeutic avenues for Tβ4 and (or) its N-terminal derivative, Ac-SDKP. Specifically, Ac-SDKP is endogenously produced from the 43-amino acid Tβ4 by 2 successive enzymes, meprin α and prolyl oligopeptidase. We also discussed the possible mechanisms involved in the Tβ4–Ac-SDKP-associated cardiovascular biological effects. In infarcted myocardium, Tβ4 and Ac-SDKP facilitate cardiac repair after infarction by promoting endothelial cell migration and myocyte survival. Additionally, Tβ4 and Ac-SDKP have antifibrotic and anti-inflammatory properties in the arteries, heart, lungs, and kidneys, and stimulate both in vitro and in vivo angiogenesis. The effects of Tβ4 can be mediated directly through a putative receptor (Ku80) or via its enzymatically released N-terminal derivative Ac-SDKP. Despite the localization and characterization of Ac-SDKP binding sites in myocardium, more studies are needed to fully identify and clone Ac-SDKP receptors. It remains promising that Ac-SDKP or its degradation-resistant analogs could serve as new therapeutic tools to treat cardiac, vascular, and renal injury and dysfunction to be used alone or in combination with the already established pharmacotherapy for cardiovascular diseases.
Stochastic Navier–Stokes equations perturbed by Lévy noise with hereditary viscosity
Authors: Mohan Manil T. , Sritharan Sivaguru S.
Published: March 2019

In this paper, we study the stochastic Navier–Stokes equations (SNSE) perturbed by Lévy noise in three dimensions with a hereditary viscous term which depends on the past history. We establish the local solvability of the Cauchy problem for such systems. The local monotonicity property of the nonlinear term of the cutoff problem and a stochastic generalization of the Minty–Browder technique are exploited in the proofs. Finally, we show that the global solvability results hold under smallness condition on the initial data and suitable assumptions on the noise coefficients.
Phytosynthesis and Characterization of Reduced Graphene Oxide using Aqueous Extract of Zingiber officinale and Brassica nigra
Authors: Karthik C. , Swathi N. , Venkatasubbu G. Devanand
Published: March 2019

Nowadays, graphene-based materials are receiving a great interest in the scientific community. The present work describes a novel method of synthesis of reduced graphene oxide (rGO). The Graphene oxide (GO) was prepared using a modified Hummers method. The GO was then reduced using the aqueous extract of Zingiber officinale and Brassica nigra by refluxing method. The reduction of GO was observed by changes in color from dark brown to black and then confirmed using UV-Visible spectral analysis. Surface Plasmon resonance for GO, Z-rGO and B-rGO were observed at 224[Formula: see text]nm, 344[Formula: see text]nm and 339[Formula: see text]nm, respectively. The morphology of the synthesized rGO were analyzed by scanning microscope. The stretching and vibrational mode were studied using FTIR analysis. The physical nature of the GO and rGO were examined using XRD. The synthesis of graphene using phytoextract as a reducing agent involves the simplistic and environmentally friendly approach.
Photoluminescence properties of Li2+xNb3xTi1−4xO3:Eu3+
Authors: Guo Chao-Chao , Zeng Qun , Yao Chun-Feng , Feng Yan-Zhao , Chen Xi , Liu Ying-Yi
Published: March 2019

Red phosphors with compositions of Li[Formula: see text]Nb[Formula: see text]Ti[Formula: see text]O3:3[Formula: see text]wt.% Eu[Formula: see text] [Formula: see text] were synthesized by solid-state reaction method. The samples were investigated by using X-ray diffraction (XRD) and photoluminescence spectroscopy, respectively. XRD results showed that all samples were main phase of Li2TiO3. Emission spectra of Li[Formula: see text]Nb[Formula: see text]Ti[Formula: see text]O3:3[Formula: see text]wt.% Eu[Formula: see text] powders showed strong red emission at 612[Formula: see text]nm (5D0–7F[Formula: see text] with 396[Formula: see text]nm excitation. In addition, the excitation and emission intensity increased up to [Formula: see text], and then decreased with further increasing of the x values. And the chromaticity coordinate (CIE) of the component with [Formula: see text] was superior to other components.
Compact splitting symplectic scheme for the fourth-order dispersive Schrödinger equation with Cubic-Quintic nonlinear term
Authors: Huang Lang-Yang , Weng Zhi-Feng , Lin Chao-Ying
Published: March 2019

Combining symplectic algorithm, splitting technique and compact method, a compact splitting symplectic scheme is proposed to solve the fourth-order dispersive Schrödinger equation with cubic-quintic nonlinear term. The scheme has fourth-order accuracy in space and second-order accuracy in time. The discrete charge conservation law and stability of the scheme are analyzed. Numerical examples are given to confirm the theoretical results.
Evaluation of Inverse Fourier Pressure Integrals for Finite Acoustic Sources on Cylindrical Baffles
Authors: Valacas John L.
Published: March 2019

For various types of finite acoustic sources placed on an infinite cylindrical baffle, the pressure solution in cylindrical coordinates can be given by an infinite series of Inverse Fourier Integrals involving a singular quotient of Hankel functions. A hybrid method is introduced addressing these integrals’ singularity analytically and truncating their infinite integration range with predictable error. Maximum number of significant terms to be taken into account is discussed and determined. Results are obtained for a wide range of dimensionless frequency values ([Formula: see text]–100) and observation point distances ranging from 3 to 100 radii of the cylindrical baffle. As an application, the baffle diffraction step of the infinite cylindrical baffle is evaluated for the on-axis pressure of a uniformly-vibrating piston.
Overlapping and distinct contributions of stimulus location and of spatial context to nonspatial visual short-term memory
Authors: Cai Ying , Sheldon Andrew D. , Yu Qing , Postle Bradley R.
Published: March 2019

Stimulus location is not always informative during visual short-term memory (VSTM) for nonspatial features. Nevertheless, there is considerable evidence for the automatic encoding and retention of location information, regardless of its task relevance. To explore the functional and neural bases of the representation of spatial context in VSTM for nonspatial information, functional magnetic resonance imaging was performed while subjects performed delayed recall for the orientation of individual stimuli. Stimulus location varied across trials, and although this information was irrelevant for task performance, multivariate pattern analysis decoding of stimulus location sustained across trials, and also the decoding strength, predicted the precision of the recall of orientation. The influence of spatial context on the representation of orientation was operationalized by comparing the orientation reconstructions with multivariate inverted encoding models (IEM) trained in location context-dependent vs. -independent data. Although orientation reconstructions were robust for both location-dependent and location-independent IEMs, they were markedly stronger for the former. Furthermore, the functional relevance of location context was demonstrated by the fact that only the location-dependent neural representations of stimulus orientation predicted recall precision.

NEW & NOTEWORTHY Neural representation strength of stimulus location predicts the precision of visual short-term memory (VSTM) recall of nonspatial stimulus, even when this information is task irrelevant. Neural representations of nonspatial stimuli that incorporate location context are stronger than those that do not, and only the former representations are strongly linked to behavior. The contributions to nonspatial VSTM performance of the representation of location context are at least partly distinct from those of the representation of stimulus content.
The Impact of Addition of Consolidation Chemotherapy to Standard Cisplatin-Based Chemoradiotherapy in Uterine Cervical Cancer: Matter of Distant Relapse
Authors: Fabri Vanessa A. , Queiroz Ana C. M. , Mantoan Henrique , Sanches Solange M. , Guimarães Andrea P. G. , Ribeiro Adriana R. G. , Souza Ronaldo P. , Maya Joyce M. L. , Santos Elizabeth S. , Castro Fabrício S. , Lima João P. N. S. , Chen Michael J. , Baiocchi Glauco , da Costa Alexandre A. B. A.
Published: March 2019

Background. Treatment of advanced uterine cervical cancer has advanced little in the last 15 years. Although two phase III trials showed survival benefit with the addition of consolidation chemotherapy (CT) after cisplatin-based chemoradiotherapy (RTCT), it is not considered standard of care. We aimed to evaluate the benefit of consolidation CT compared to no additional treatment in patients treated with RTCT. Methods. This is a retrospective study including 186 patients with FIGO stage IB2, IIA2, or IIB to IVB (paraaortic lymph nodes only) uterine cervical cancer who were treated with standard RTCT alone or RTCT followed by consolidation CT. Overall survival (OS), progression free survival (PFS), and the risk of distant and local relapses were compared between the two treatment groups. Results. At 3 years OS was 91% versus 82.3% (p=0.027), PFS 84.3% versus 54.4% (p=0.047), and distant metastasis free survival (DMFS) 80.4% versus 62.5% (p=0.027) in favor of the consolidation CT group. Multivariate analysis confirmed the benefit of consolidation CT. There was no difference in locoregional free survival (LRFS). Positive lymph node was related to a higher risk of distant relapse. In the lymph node positive subgroup consolidation CT resulted in longer OS (p=0.050), PFS (p=0.014), and DMFS (p=0.022); in the lymph node negative subgroup there was no benefit from consolidation CT. Conclusions. Use of consolidation CT resulted in longer OS and PFS, mostly due to control of distant relapses. Patients at higher risk of distant relapse showed the greatest benefit. This data generates a hypothesis that could help to better select patients to consolidation CT.