bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality of Life in Painful Peripheral Neuropathies: A Systematic Review
Authors: Girach Ayesha , Julian Thomas Henry , Varrassi Giustino , Paladini Antonella , Vadalouka Athina , Zis Panagiotis
Published: May 2019

Objective. Neuropathic pain is a common presenting complaint of patients with peripheral neuropathy (PN) and is considered one of the most disabling neuropathic symptoms, with detrimental effects on patients’ quality of life (QoL). The aim of this review was to overview the current literature that focuses on QoL in painful PN of various aetiologies. We sought to clarify the direct effect of pain and its treatment on patients’ QoL.Methodology. A systematic computer-based literature search was conducted using the PubMed database to search for papers on QoL in painful PN. Information was extracted regarding prevalence, demographics, and response to treatment where relevant.Results. We identified 66 articles eligible for inclusion. The vast majority of studies (n=47) focused on patients with diabetic PN. Other aetiologies of painful PN where QoL has been studied to date include gluten, immune-mediated, HIV, chemotherapy-induced, and chronic idiopathic axonal polyneuropathy. Pharmacological treatment is the mainstay in managing pain and has a direct positive and independent effect on the overall QoL. Other nonpharmacological approaches can also be of benefit, either alone or as adjuvant treatments, and are discussed.Conclusion. The findings demonstrate that QoL is impaired in painful PN and should not be neglected in clinical practice. Patients’ pain management and subsequent impact on QoL should routinely be assessed and monitored.
Pseudohypoadrenocorticism in a Siberian Husky with Trichuris vulpis Infection
Authors: Car Stephanie , Croton Catriona , Haworth Mark
Published: May 2019

An entire male Siberian Husky presented for diarrhoea, weakness, inappetence, and collapse following a six-day period of illness. On clinical examination the dog displayed vasoconstrictive circulatory shock, dehydration, and melena. Laboratory tests revealed a marked hyponatraemia, hyperkalaemia, and a decreased sodium/potassium ratio of ≤ 12.4. The baseline and poststimulation serum cortisol concentrations were markedly elevated following adrenocorticotropin hormone (ACTH) stimulation test, yielding 712 nmol/L and 706 nmol/L, respectively. The elevated cortisol concentration excluded hypoadrenocorticism. A concurrent Trichuris vulpis (whipworm) infection was also identified. The dog was treated with supportive care including fenbendazole and recovered uneventfully. The final diagnosis was Trichuris vulpis infection with secondary pseudohypoadrenocorticism. This case report further supports a previous observation that the Siberian Husky breed may have an increased sensitivity to infection with Trichuris vulpis and development of pseudohypoadrenocorticism.
Destructive Upper Airway Disease from Eosinophilic Granulomatosis with Polyangiitis (EGPA): The Very First Case
Authors: Saha Biplab , Saha Aditi , Cordeiro-Rudnisky Fernanda , Shkolnik Boris , Beegle Scott
Published: May 2019

Eosinophilic granulomatosis with polyangiitis (EGPA) is a multisystem vasculitic disorder that predominantly affects medium- and small-sized blood vessels. EGPA belongs to a group of vasculitides known as anti-neutrophil cytoplasmic antibody- (ANCA-) associated vasculitis (AAV). Upper airway involvement is seen in all ANCA-associated vasculitides, but destructive upper airway disease has never been reported in patients with EGPA. We report the first case of erosive chondritis and saddle nose deformity in a 50-year-old patient suffering from EGPA.
Umbilical Cord Mesenchymal Stem Cell Transplantation Prevents Chemotherapy-Induced Ovarian Failure via the NGF/TrkA Pathway in Rats
Authors: Zheng Qun , Fu Xiaoyan , Jiang Jinzhan , Zhang Ning , Zou Libo , Wang Wenqian , Ding Mingxing , Chen Haohao
Published: May 2019

Chemotherapy leads to a loss of fertility and reproductive endocrine function, thereby increasing the risk of premature ovarian failure (POF). Studies have suggested that the transplantation of mesenchymal stem cells could inhibit apoptosis in ovarian granulosa cells and improve follicular development. In the present study, the effects of human umbilical cord mesenchymal stem cell (UCMSC) transplantation on ovarian function after ovarian damage caused by chemotherapy and the mechanism underlying these effects were investigated. POF model rats were obtained by the intraperitoneal injection of cyclophosphamide, and cultured UCMSCs were transplanted by tail vein injection. Serum estrogen, follicle-stimulating hormone, gonadotropin releasing hormone, and anti-Mullerian hormone levels were detected by ELISA. Folliculogenesis was evaluated by histopathological examination. The expression levels of nerve growth factor (NGF), high affinity nerve growth factor receptor (TrkA), follicle-stimulating hormone receptor (FSHR), and caspase-3 were evaluated by western blotting and RT-qPCR. The natural reproductive capacity was assessed by pregnant rate and numbers of embryos. The results indicated that UCMSC transplantation recovered disturbed hormone secretion and folliculogenesis in POF rats. NGF and TrkA levels increased, while FSHR and caspase-3 decreased. The pregnancy rate of POF rats was improved. Therefore, UCMSCs could reduce ovarian failure due to premature senescence caused by chemotherapy, and the NGF/TrkA signaling pathway was involved in the amelioration of POF.
An Improved Electromagnetic Field Optimization for the Global Optimization Problems
Authors: Yurtkuran Alkin
Published: May 2019

Electromagnetic field optimization (EFO) is a relatively new physics-inspired population-based metaheuristic algorithm, which simulates the behavior of electromagnets with different polarities and takes advantage of a nature-inspired ratio, known as the golden ratio. In EFO, the population consists of electromagnetic particles made of electromagnets corresponding to variables of an optimization problem and is divided into three fields: positive, negative, and neutral. In each iteration, a new electromagnetic particle is generated based on the attraction-repulsion forces among these electromagnetic fields, where the repulsion force helps particle to avoid the local optimal point, and the attraction force leads to find global optimal. This paper introduces an improved version of the EFO called improved electromagnetic field optimization (iEFO). Distinct from the EFO, the iEFO has two novel modifications: new solution generation function for the electromagnets and adaptive control of algorithmic parameters. In addition to these major improvements, the boundary control and randomization procedures for the newly generated electromagnets are modified. In the computational studies, the performance of the proposed iEFO is tested against original EFO, existing physics-inspired algorithms, and state-of-the-art meta-heuristic algorithms as artificial bee colony algorithm, particle swarm optimization, and differential evolution. Obtained results are verified with statistical testing, and results reveal that proposed iEFO outperforms the EFO and other considered competitor algorithms by providing better results.
An Enhanced and Resource-Aware RFID Multitag Grouping Protocol
Authors: Abu Dhailah Hala , Taqieddin Eyad , Alma'aitah Abdallah
Published: May 2019

Several grouping proof protocols were presented to meet the security requirements of Radio Frequency Identification Systems. Nevertheless, these protocols were shown to be vulnerable to various attacks. In this work, we cryptanalyze one of the newest grouping proof protocols. Through this analysis, we show the weaknesses of the protocol and launch a full-disclosure attack to disclose all secrets in the protocol. We show that the probability of success of the protocol is one and that increasing the length of the strings adds little complexity to the attack. We follow this by proposing an enhanced version of the protocol with better overall security. We show its efficiency by providing a security and performance analysis and comparing it with some of the existing protocols in the literature.
The Pull-Back Technique for the 532 Slim Modiolar Electrode
Authors: Riemann C. , Sudhoff H. , Todt I.
Published: May 2019

Introduction. The distance between the modiolus and the electrode array is one factor that has become the focus of many discussions and studies. Positioning the electrode array closer to the spiral ganglion with the goal of reducing the current spread has been shown to improve hearing outcomes. The perimodiolar electrode arrays can be complemented with a surgical manoeuvre called the pull-back technique. This study focuses its attention on the recently developed 532 slim modiolar electrode. Objective. To investigate the intracochlear movements and pull-back technique for the 532 slim modiolar electrode. Material and Methods. A decapping procedure of the cochlea was performed on 5 temporal bones. The electrode array was inserted, and the intracochlear movements were microscopically examined and digitally captured. Three situations were analysed: the initial insertion, the overinsertion, and the pull-back position. The position of the three white markers of the electrode array in relation to the round window (RW) was evaluated while performing these three actions. Results. The initial insertion achieved an acceptable perimodiolar position of the electrode array, but a gap was still observed between the mid-portion of the array and the modiolus (the first white marker was seen in the RW). When we inserted the electrode more deeply, the mid-portion of the array was pushed away from the modiolus (the second and third white markers were seen in the RW). After applying the pull-back technique, the gap observed during the initial insertion disappeared, resulting in an optimal perimodiolar position (the first white marker was once again visible in the RW). Conclusion. This temporal bone study demonstrated that when applying the pull-back technique for the 532 slim modiolar electrode, a closer proximity to the modiolus was achieved when the first white marker of the electrode array was visible in the round window.
High Bone Mineral Density of the Lumbar Spine Is Positively Associated with Breast Cancer
Authors: Gonçalves Larissa Vaz , Martins Karine Anusca , Godinho-Mota Jordana Carolina Marques , Schincaglia Raquel Machado , Sousa Ana Luisa Lima , Freitas-Junior Ruffo
Published: May 2019

Objective. The objective of this study was to verify possible associations between bone mineral density (BMD) and breast cancer in recently diagnosed women in the Brazilian Mid-west region, considering the menopausal status of patients. Methods. A case-control study was conducted with 142 cases of breast cancer and 234 controls matched by for age, body mass index (BMI), and menopausal status (pre- and postmenopause), performed in a university hospital in the Brazilian Mid-west. Lumbar spine (L1–L4), femoral neck, and total femur BMD were measured by the dual-energy X-ray absorptiometry (DXA) method. For association, a logistic regression analysis was used. Results. Women in the highest lumbar spine BMD quartile presented had a higher chance of developing breast cancer (OR = 2.31; 1.02–5.25; p = 0.045), after adjusting for the confounding variables. Nonetheless, there were no statistically significant differences in the association between pre- and postmenopause in that quartile and breast cancer. Conclusions. High lumbar spine BMD was positively associated with breast cancer in the total sample. In evaluating the BMD of the femoral neck and total femur, such an association was not observed.
Multiobjective Simulated Annealing: Principles and Algorithm Variants
Authors: Amine Khalil
Published: May 2019

Simulated annealing is a stochastic local search method, initially introduced for global combinatorial mono-objective optimisation problems, allowing gradual convergence to a near-optimal solution. An extended version for multiobjective optimisation has been introduced to allow a construction of near-Pareto optimal solutions by means of an archive that catches nondominated solutions while exploring the feasible domain. Although simulated annealing provides a balance between the exploration and the exploitation, multiobjective optimisation problems require a special design to achieve this balance due to many factors including the number of objective functions. Accordingly, many variants of multiobjective simulated annealing have been introduced in the literature. This paper reviews the state of the art of simulated annealing algorithm with a focus upon multiobjective optimisation field.
Treatment Outcomes in Anaplastic Thyroid Cancer
Authors: Corrigan Kelsey L. , Williamson Hannah , Elliott Range Danielle , Niedzwiecki Donna , Brizel David M. , Mowery Yvonne M.
Published: May 2019

Background. Anaplastic thyroid cancer (ATC) is rare, accounting for 1-2% of thyroid malignancies. Median survival is only 3-10 months, and the optimal therapeutic approach has not been established. This study aimed to evaluate outcomes in ATC based on treatment modality. Methods. Retrospective review was performed for patients treated at a single institution between 1990 and 2015. Demographic and clinical covariates were extracted from the medical record. Overall survival (OS) was modeled using Kaplan Meier curves for different treatment modalities. Univariate and multivariate analyses were conducted to assess the relationships between treatment and disease characteristics and OS. Results. 28 patients with ATC were identified (n = 16 female, n = 12 male; n = 22 Caucasian, n = 6 African-American; median age 70.9). Majority presented as Stage IVB (71.4%). Most patients received multimodality therapy. 19 patients underwent local surgical resection. 21 patients received locoregional external beam radiotherapy (EBRT) with a median cumulative dose of 3,000 cGy and median number of fractions of 16. 14 patients received systemic therapy (n = 11 concurrent with EBRT), most commonly doxorubicin (n = 9). 16 patients were never disease free, 11 patients had disease recurrence, and 1 patient had no evidence of disease progression. Median OS was 4 months with 1-year survival of 17.9%. Regression analysis showed that EBRT (HR: 0.174; 95% CI: 0.050–0.613; p=0.007) and surgical resection (HR: 0.198; 95% CI: 0.065–0.598; p=0.004) were associated with improved OS. Administration of chemotherapy was not associated with OS. Conclusions. Anaplastic thyroid cancer patients receiving EBRT to the thyroid area/neck and/or surgical resection had better OS than patients without these therapies, though selection bias likely contributed to improved outcomes since patients who can undergo these therapies tend to have better performance status. Prognosis remains poor overall, and new therapeutic approaches are needed to improve outcomes.
Nonclosure of the Peritoneum during Appendectomy May Cause Less Postoperative Pain: A Randomized, Double-Blind Study
Authors: Bektasoglu Huseyin Kazim , Hasbahceci Mustafa , Yigman Samet , Yardimci Erkan , Kunduz Enver , Malya Fatma Umit
Published: May 2019

Objective. We aim to evaluate the effect of peritoneal closure on postoperative pain and life quality associated with open appendectomy operations. Methods. This is a single-center, prospective, randomized, and double-blinded study. Here, 18–65-year-old patients who underwent open appendectomy for acute appendicitis were included. Demographic data of the patients, operation time, length of hospital stay, pain scores using a 10 cm visual analogue scale (VAS) on the first postoperative day, quality of life assessment using the EuroQol-5D-5L questionnaire on postoperative 10th day, deep wound dehiscence, bowel obstruction, and mortality data were recorded. Results. In total, 112 patients were included in the study. The demographic data showed no significant difference between the groups. The median VAS score was lower in the group with open peritoneum, but this difference was not statistically significant (3 vs. 4, p=0.134). The duration of surgery was significantly shorter in the peritoneal nonclosure group (31.0 ± 15.1 vs. 38.5 ± 17.5 minutes, p=0.016). Overall complication rates and life quality test (EuroQol-5D-5L) results were similar between groups. Conclusion. Nonclosure of the peritoneum seems to shorten the duration of surgery without increasing complications during open appendectomy. Postoperative pain and life quality measures were not affected by nonclosure of the peritoneum. This trial is registered with NCT02803463.
Cynomorium songaricum Extract Alleviates Memory Impairment through Increasing CREB/BDNF via Suppression of p38MAPK/ERK Pathway in Ovariectomized Rats
Authors: Tian Fang-ze , Chang Hong-sheng , Liu Jian-xun , Zheng Junchao , Cheng Dan , Lu Yi
Published: May 2019

Cynomorium songaricum Rupr is a very important traditional Chinese medicine for tonifying the kidney, which has a significant effect on improving estrogen level on the long term. In many studies, it can improve the learning and memory function of ovariectomized (OVX) model animals. 10 of the 50 rats received only bilateral back surgery and were harvested with the same amount of fat as the ovaries without removing the ovaries as sham group; remains underwent bilateral ovariectomy and equally randomized into five groups: sham group, with OVX as model group, estradiol valerate (EV, 0.2 mg/kg) as positive control, with 3.3 and 33 mg/kg body weight/day of ethyl acetate extract of Cynomorium songaricum extract (CSE) as low and high dosage groups, respectively. The orally administered CSE to ovariectomized rats exerted an ameliorative effect on learning and memory in the Morris water maze tests. All rats were sacrificed after 8 weeks of treatment, and tissue was analyzed using histopathology and electron microscopy. To comprehensively examine the mechanism, brain derived neurotrophic factor (BDNF), p-p38 mitogen-activated protein kinase (p-p38MAPK), extracellular regulated protein kinases (ERK), p-extracellular regulated protein kinases (p-ERK), and p-cAMP-response element binding protein (p-CREB) were detected by Western blotting. Using histopathology and electron microscopy, it was clearly observed that the pyramidal neurons of the hippocampal CA1 area were reduced in the OVX groups, indicating that CSE could attenuate the loss of pyramidal neurons in hippocampal CA1 and revert the synaptic morphological variations produced by ovariectomy. Mechanistically, the expressions of p-p38MAPK and p-ERK levels were significantly downregulated by CSE intervention, whereas the BDNF and p-CREB were significantly upregulated by CSE as compared to the control. Concisely, Cynomorium songaricum Rupr exhibited potential therapeutic effect on Neuroprotection of ovariectomized rats, and its effect was possibly exerted by p-CREB/BDNF mediated down regulation of ERK/p38MAPK.
MicroRNA-147b Promotes Proliferation and Invasion of Human Colorectal Cancer by Targeting RAS Oncogene Family (RAP2B)
Authors: Yi Lizhi , Zhong Xianfei , Chen Zhengyu , Wang Qin , Yan Yongrong , Wang Jianmei , Deng Xuejie
Published: May 2019

Background: MicroRNAs (miRNAs), a class of small-regulatory RNA molecules, were closely involved in the pathogenesis of a broad-spectrum of colorectal cancer (CRC). But role of miR-147b in CRC still remains unclear. Methods: Real-time RT-PCR or Western blotting was utilized to detect the expressions of miR-147b and RAP2B in CRC cell lines and tissues. Luciferase reporter assays were conducted to detect the associations between miR-147b and 3′UTRs of RAP2B. A series of assays were performed to evaluate the effect of miR-147b on proliferation, migration, and invasion of CRC in vitro and in vivo. Results: We found that the level of miR-147b was significantly lower in CRC tissues than in normal tissues (p = 0.0006). Enforced expression of miR-147b led to suppression of CRC cell proliferation in vitro and tumor growth in vivo. Specifically, miR-147b promoted proliferation by arresting CRC cells in the G1/G0 phase. Mechanically, RAP2B was identified as a direct target gene of miR-147b and RAP2B rescued the suppression of proliferation and invasion reduced by miR-147b in CRC cells. Conclusions: miR-147b not only plays important roles in the regulation of cell proliferation and tumor growth in CRC, which might be a potential prognostic marker or therapeutic target for CRC.
C-X-C Chemokine Receptor 4 in Diffuse Large B Cell Lymphoma: Achievements and Challenges
Authors: Du Hui , Gao Lei , Luan Jing , Zhang Hangfan , Xiao Taiwu
Published: May 2019

Diffuse large B cell lymphoma (DLBCL), an aggressive cancer of the B cells, is the most common subtype of non-Hodgkin lymphoma (NHL) worldwide. In China, the cases of DLBCL increase yearly. C-X-C chemokine receptor 4 (CXCR4) has been implicated in the migration and trafficking of malignant B cells in several hematological malignancies, and only a few reports have been published on the role of CXCR4 in the metastasis of DLBCL. This review summarizes the relevant perspectives on the functional mechanism, prognostic significance, and therapeutic applications of the CXCL12/CXCR4 axis in DLBCL, in particular DLBCL with bone marrow involvement.
Fundus Autofluorescence Change as an Early Indicator of Treatment Effect of Brachytherapy for Choroidal Melanomas
Authors: Navaratnam Jesintha , Bærland Thomas P. , Eide Nils A. , Faber Rowan T. , Rekstad Bernt L. , Vavvas Demetrios G. , Bragadóttir Ragnheiður
Published: May 2019

Background: Early confirmation of the effect of brachytherapy for choroidal melanoma showing that tumour coverage is valuable. The irradiated retinal pigment epithelium (RPE) commonly develops atrophy. This study compares the fundus autofluorescence (AF) changes to the development of RPE atrophy following brachytherapy. Methods: Retrospective study of 19 patients treated with 106Ru and 2 with 125I plaques with either a 3- or 6-month follow-up period. Ultra-widefield (UW) composite colour and AF images were obtained with Optomap 200Tx and interpreted as complete, partial, or no RPE changes and complete or partial hyperautofluorescence, hypoautofluorescence, or isoautofluorescence. Results: At the 3-month follow-up, 9 of 13 patients (69%) (95% confidence interval [CI], 0.389–0.896) treated with 106Ru plaques developed complete homogenous hyperautofluorescence surrounding the tumour, but only 1 of 13 (8%) (95% CI, 0.004–0.379) developed complete RPE atrophy at the same time point. Six patients in the 106Ru plaque group had their first follow-up with UW imaging at 6 months. Four of them developed homogenous hyperautofluorescence and none developed complete RPE atrophy around the tumour. The 2 patients treated with 125I did not demonstrate any clear RPE or AF changes. Conclusion: The effect of 106Ru plaque treatment on fundus UW imaging is detected as homogenous and well-demarcated hyperautofluorescence before visible RPE atrophy.
Clinically Relevant Anti-Neuronal Cell Surface Antibodies in Schizophrenia Spectrum Disorders
Authors: Colijn Mark Ainsley , Ismail Zahinoor
Published: May 2019

Schizophrenia is a phenotypically heterogeneous and poorly understood disorder. While its etiology is likely multifactorial, immune system dysfunction has increasingly been implicated in its development. As hallucinations and delusions occur frequently and prominently in autoimmune encephalitis (AE), numerous studies have sought to determine whether a small subset of individuals diagnosed with schizophrenia possess anti-neuronal antibodies implicated in AE. Exploring this possibility is of clinical relevance, as identifying individuals with AE who have been misdiagnosed as having a primary psychotic disorder may allow for the implementation of appropriate immune-related therapies as early as possible in the course of the illness, in order to optimize outcomes, reduce illness chronicity, and minimize adverse events. This qualitative review serves to provide an overview of the existing literature on this topic, as well as to update previously published reviews. Although there is some evidence to suggest that in rare cases AE may be misdiagnosed as a primary psychotic disorder, particularly early in the course of the illness, numerous methodological differences between studies likely account for the highly variable findings, and interpretation of the results is particularly limited by a paucity of cerebrospinal fluid data. Moreover, the prevalence of misdiagnosis in chronic and treatment-resistant populations remains understudied. This is particularly problematic, as treatment resistance may represent an enriched population with respect to the presence of anti-neuronal antibodies, and given that such patients have few evidence-based treatment options available to them beyond clozapine.
Touch Imprint Cytology: A Rapid and Accurate Method for Diagnosis of Oral Cancer
Authors: Adhya Amit Kumar , Kar Madhabananda , Mohanty Ranjan
Published: May 2019

Objectives: Touch imprint cytology (TIC) is a rapid and cheap method and can be used as an adjunct to biopsy for the evaluation of suspected malignancy. We evaluated the advantages and limitations of TIC for the preoperative diagnosis of oral squamous cell carcinoma. Study Design: We used 280 incisional biopsies of clinically suspected oral squamous cell carcinoma and compared TIC diagnosis to histopathological sections. The sensitivity, specificity, and diagnostic accuracy of TIC were evaluated. Results: A total of 201 (82.5%) cases were diagnosed as malignant, 22 (7.9%) cases were diagnosed as suspicious of malignancy, and 54 (19.3%) cases as benign/negative on TIC. The overall sensitivity of TIC was 98.2%, specificity was 89.3%, the positive-predictive value 97.3%, and the negative-predictive value was 92.6%. The accuracy of the test was 96.4%. Conclusions: TIC is an accurate, simple, rapid, and cost-effective method that aids the diagnosis of oral squamous cell carcinoma but does not replace incisional biopsy. The cytologic examination of imprints of biopsies also helps determine the adequacy of the specimen for histologic examination.
Incidence and Risk Factors of the Watershed Shift Phenomenon after Superficial Temporal Artery-Middle Cerebral Artery Anastomosis for Adult Moyamoya Disease
Authors: Tashiro Ryosuke , Fujimura Miki , Kameyama Masayuki , Mugikura Shunji , Endo Hidenori , Takeuchi Yohei , Tomata Yasutake , Niizuma Kuniyasu , Tominaga Teiji
Published: May 2019

Objective: Superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis is the standard surgical management for adult moyamoya disease (MMD) patients, but local cerebral hyperperfusion (CHP) and cerebral ischemia are potential complications of this procedure. Recent hemodynamic analysis of the acute stage after revascularization surgery for MMD revealed a more complex and unique pathophysiological condition, the so-called “watershed shift (WS) phenomenon,” which is defined as a paradoxical decrease in the cerebral blood flow (CBF) at the adjacent cortex near the site of local CHP. The objective of this study was to clarify the exact incidence, clinical presentation, and risk factors of the WS phenomenon after direct revascularization surgery for adult MMD. Patients and Methods: Among 74 patients with MMD undergoing STA-MCA anastomosis for 78 affected hemispheres, 60 adult patients comprising 64 hemispheres underwent serial quantitative CBF analysis by N-isopropyl-p-[123I] iodoamphetamine single-photon emission computed tomography after revascularization surgery. The local CBF was quantitatively measured at the site of anastomosis and the adjacent cortex before surgery, as well as on 1 and 7 days after surgery. Then, we investigated the incidence, clinical presentation, and risk factors of the WS phenomenon. Results: The WS phenomenon was evident in 7 patients (7/64 hemispheres; 10.9%) after STA-MCA anastomosis for adult MMD. None of the patients developed neurological deterioration due to the WS phenomenon, but 1 patient developed reversible ischemic change on diffusion-weighted imaging at the site of the WS phenomenon. Multivariate analysis revealed that a lower preoperative CBF value was significantly associated with the occurrence of the WS phenomenon (20.3 ± 7.70 mL/100 g/min in WS-positive group vs. 31.7 ± 8.81 mL/100 g/min in WS-negative group, p= 1.1 × 10–2). Conclusions: The incidence of the WS phenomenon was as high as 10.9% after STA-MCA anastomosis for adult MMD. The clinical outcome of the WS phenomenon is generally favorable, but there is a potential risk for perioperative cerebral infarction. Thus, we recommend routine CBF measurement in the acute stage after revascularization surgery for adult MMD to avoid surgical complications, such as local CHP and cerebral ischemia, caused by the WS phenomenon. Concomitant detection of the WS phenomenon with local CHP is clinically important because blood pressure reduction to counteract local CHP may have to be avoided in the presence of the WS phenomenon.
Sex-Related Differences in Management and Outcome of Acute Ischemic Stroke in Eligible Patients to Thrombolysis
Authors: Fraticelli Laurie , Freyssenge Julie , Claustre Clément , Buisson Marielle , Bischoff Magali , Nighoghossian Norbert , Derex Laurent , El Khoury Carlos ,   on behalf of the RESUVal Group
Published: May 2019

Background: Literature has highlighted sex-based differences in the natural course of stroke and in response to treatment with intravenous tissue plasminogen activator (tPA). Objectives: We aimed to compare the management and outcome of acute ischemic stroke (AIS) among women and men on a French registry based on a federated network of emergency physicians and neurologists. Method: We included 2,790 patients received tPA between 2010 and 2016 from the stroke centers in the RESUVal area. We provided age-adjusted analysis and multivariate models for determining the role of sex in the outcome measures. Results: After age-adjustment, women presented more moderate to severe stroke at admission with more proximal occlusions. Among tPA eligible patients, the therapeutic strategy and in-hospital hemorrhagic complications were proportionally identical whatever the sex. The total ischemic time from onset symptom to thrombolysis did not differ from women to men. Age-adjusted 3-month mortality did not differ between women and men, and the determinants of mortality were age (relative risk [RR] 1.56 [1.37–1.78], p < 0.0001), proximal occlusion (RR 2.5 [1.88–3.33], p < 0.0001), and at least one complication (RR 2.43 [1.89–3.13], p < 0.0001). The determinants of poor functional outcome at 3 months were the sex (RR 1.22 [1.01–1.48] for women, p = 0.0385) and the occurrence of onset symptom in rural landscape (RR 1.26 [1.03–1.55], p = 0.0219) compared to urban landscape. Conclusions: We provided an exhaustive overview and real-life professional practices conditions in thrombolyzed AIS. Despite a later prehospital management in neurovascular units and more severe strokes at admission, women and men had both similar outcomes at hospital discharge and in 3-month survival, but women were associated to worst functional outcome at 3 months.
Medical Therapy for Heart Failure Associated With Pulmonary Hypertension
Authors: Zelt Jason G.E. , Chaudhary Ketul R. , Cadete Virgilio J. , Mielniczuk Lisa M. , Stewart Duncan J.
Published: May 2019

The past 2 decades have witnessed a >40% improvement in mortality for patients with heart failure and left ventricular systolic dysfunction.

1

This success has coincided with the stepwise availability of drugs that target neurohormonal activation: β-adrenergic receptor blockers (β-blockers), ACE (angiotensin-converting enzyme) inhibitors and ANG (angiotensin) II blockers, neprilysin inhibitors, and aldosterone antagonists. Our understanding of right heart failure (RHF) has lagged behind and many proven targeted therapies for left heart failure do not appear to provide similar benefits for RHF. Until recently, the right ventricle (RV) has often been viewed as less important than the left ventricle and in contemporary literature received the moniker “The Forgotten Ventricle”. Recent advances in echocardiography and magnetic resonance imaging have enabled detailed assessments of RV anatomy and physiology in both health and disease allowing us to more accurately describe the clinical sequelae and end-organ manifestations of RHF. RV function is now recognized as one of the most important predictors of prognosis in many cardiovascular disease states.

2

Despite the significance of RV function to survival, there are no clinically approved therapies that directly nor selectively improve RV function. As well, relative to our understanding of left heart failure, the basis for RHF remains poorly understood. This article aims to condense the current knowledge on RV adaptation and failure, review current management strategies for RHF, and explore evolving therapeutic approaches.
Simple Hyper-Heuristics Control the Neighbourhood Size of Randomised Local Search Optimally for LeadingOnes
Authors: Lissovoi Andrei , Oliveto Pietro S. , Warwicker John Alasdair
Published: May 2019

Selection hyper-heuristics (HHs) are randomised search methodologies which choose and execute heuristics during the optimisation process from a set of low-level heuristics. A machine learning mechanism is generally used to decide which low-level heuristic should be applied in each decision step. In this article, we analyse whether sophisticated learning mechanisms are always necessary for HHs to perform well. To this end we consider the most simple HHs from the literature and rigorously analyse their performance for the LeadingOnes benchmark function. Our analysis shows that the standard Simple Random, Permutation, Greedy, and Random Gradient HHs show no signs of learning. While the former HHs do not attempt to learn from the past performance of low-level heuristics, the idea behind the Random Gradient HH is to continue to exploit the currently selected heuristic as long as it is successful. Hence, it is embedded with a reinforcement learning mechanism with the shortest possible memory. However, the probability that a promising heuristic is successful in the next step is relatively low when perturbing a reasonable solution to a combinatorial optimisation problem. We generalise the “simple” Random Gradient HH so success can be measured over a fixed period of time [Formula: see text], instead of a single iteration. For LeadingOnes we prove that the Generalised Random Gradient (GRG) HH can learn to adapt the neighbourhood size of Randomised Local Search to optimality during the run. As a result, we prove it has the best possible performance achievable with the low-level heuristics (Randomised Local Search with different neighbourhood sizes), up to lower-order terms. We also prove that the performance of the HH improves as the number of low-level local search heuristics to choose from increases. In particular, with access to [Formula: see text] low-level local search heuristics, it outperforms the best-possible algorithm using any subset of the [Formula: see text] heuristics. Finally, we show that the advantages of GRG over Randomised Local Search and Evolutionary Algorithms using standard bit mutation increase if the anytime performance is considered (i.e., the performance gap is larger if approximate solutions are sought rather than exact ones). Experimental analyses confirm these results for different problem sizes (up to [Formula: see text]) and shed some light on the best choices for the parameter [Formula: see text] in various situations.
Difficulty Adjustable and Scalable Constrained Multiobjective Test Problem Toolkit
Authors: Fan Zhun , Li Wenji , Cai Xinye , Li Hui , Wei Caimin , Zhang Qingfu , Deb Kalyanmoy , Goodman Erik
Published: May 2019

Multiobjective evolutionary algorithms (MOEAs) have progressed significantly in recent decades, but most of them are designed to solve unconstrained multiobjective optimization problems. In fact, many real-world multiobjective problems contain a number of constraints. To promote research on constrained multiobjective optimization, we first propose a problem classification scheme with three primary types of difficulty, which reflect various types of challenges presented by real-world optimization problems, in order to characterize the constraint functions in constrained multiobjective optimization problems (CMOPs). These are feasibility-hardness, convergence-hardness, and diversity-hardness. We then develop a general toolkit to construct difficulty adjustable and scalable CMOPs (DAS-CMOPs, or DAS-CMaOPs when the number of objectives is greater than three) with three types of parameterized constraint functions developed to capture the three proposed types of difficulty. In fact, the combination of the three primary constraint functions with different parameters allows the construction of a large variety of CMOPs, with difficulty that can be defined by a triplet, with each of its parameters specifying the level of one of the types of primary difficulty. Furthermore, the number of objectives in this toolkit can be scaled beyond three. Based on this toolkit, we suggest nine difficulty adjustable and scalable CMOPs and nine CMaOPs, to be called DAS-CMOP1-9 and DAS-CMaOP1-9, respectively. To evaluate the proposed test problems, two popular CMOEAs—MOEA/D-CDP (MOEA/D with constraint dominance principle) and NSGA-II-CDP (NSGA-II with constraint dominance principle) and two popular constrained many-objective evolutionary algorithms (CMaOEAs)—C-MOEA/DD and C-NSGA-III—are used to compare performance on DAS-CMOP1-9 and DAS-CMaOP1-9 with a variety of difficulty triplets, respectively. The experimental results reveal that mechanisms in MOEA/D-CDP may be more effective in solving convergence-hard DAS-CMOPs, while mechanisms of NSGA-II-CDP may be more effective in solving DAS-CMOPs with simultaneous diversity-, feasibility-, and convergence-hardness. Mechanisms in C-NSGA-III may be more effective in solving feasibility-hard CMaOPs, while mechanisms of C-MOEA/DD may be more effective in solving CMaOPs with convergence-hardness. In addition, none of them can solve these problems efficiently, which stimulates us to continue to develop new CMOEAs and CMaOEAs to solve the suggested DAS-CMOPs and DAS-CMaOPs.
New species of Bulbophyllum (Orchidaceae) in the flora of Vietnam Ⅱ
Authors: AVERYANOV LEONID V. , NGUYEN KHANG SINH , TRUONG BA VUONG , NGUYEN VAN CANH , MAISAK TATIANA V. , THAI TRAN HUY , DAT PHAM THI THANH , TU BAO NGAN
Published: May 2019

Three species, Bulbophyllum layae, B. metallica and B. papilligerum (all from sect. Cirrhopetalum) are described as new for science. All of these novelties are local endemics of limestone areas of northern Vietnam. Additionally, three species, B. alcicorne (sect. Brachystachya), B. psittacoglossum and B. yunnanense (both from sect. Sestochilus) are recorded for the flora of Vietnam for the first time. These species have wide distribution in mainland Asia. Data on ecology, phenology, distribution, brief relevant taxonomic notes, as well as color photographs, analytical plates of the type and voucher specimens are provided for all reported taxa. Lectotypification is provided for B. yunnanense.
A new skink of the genus Subdoluseps (Hardwicke & Gray, 1828) from Peninsular Malaysia
Authors: GRISMER L. LEE , DZUKAFLY ZAHARIL , MUIN MOHD ABDUL , QUAH EVAN S. H. , KARIN BENJAMIN R. , ANUAR SHAHRUL , FREITAS ELYSE S.
Published: May 2019

An integrative taxonomic analysis of Subdoluseps herberti from southern Thailand and Peninsular Malaysia and S. samajaya from Sarawak, East Malaysia (Borneo) recovers the former as paraphyletic with respect to the latter. The analyses recover the three southernmost populations of S. herberti in Peninsular Malaysia as conspecific and the sister lineage of S. samajaya, whereas S. herberti from Thailand and northern Peninsular Malaysia constitute the sister species to S. samajaya plus the southern three Peninsular Malaysian populations. As such, the southern populations are described herein as S. malayana sp. nov. and all three species are referred to as the S. herberti group. Clade boundaries and breaks within this group on the Thai-Malay Peninsula occurring at the Isthmus of Kra, across the Kangar-Pattani line, and between the Thai-Malay Peninsula and Borneo are consistent with phylogeographic patterns of other Sundaic taxa. The discovery of S. malayana sp. nov. continues to underscore the fact that, despite the well-studied nature of the lizard fauna of Peninsular Malaysia, much of it still remains unrealized and for conservation efforts to move forward, field research followed by expeditiously revised taxonomies must continue.
Loop Current Variability as Trigger of Coherent Gulf Stream Transport Anomalies
Authors: Hirschi Joël J.-M. , Frajka-Williams Eleanor , Blaker Adam T. , Sinha Bablu , Coward Andrew , Hyder Pat , Biastoch Arne , Böning Claus , Barnier Bernard , Penduff Thierry , Garcia Ixetl , Fransner Filippa , Madec Gurvan
Published: May 2019

Satellite observations and output from a high-resolution ocean model are used to investigate how the Loop Current in the Gulf of Mexico affects the Gulf Stream transport through the Florida Straits. We find that the expansion (contraction) of the Loop Current leads to lower (higher) transports through the Straits of Florida. The associated surface velocity anomalies are coherent from the southwestern tip of Florida to Cape Hatteras. A simple continuity-based argument can be used to explain the link between the Loop Current and the downstream Gulf Stream transport: as the Loop Current lengthens (shortens) its path in the Gulf of Mexico, the flow out of the Gulf decreases (increases). Anomalies in the surface velocity field are first seen to the southwest of Florida and within 4 weeks propagate through the Florida Straits up to Cape Hatteras and into the Gulf Stream Extension. In both the observations and the model this propagation can be seen as pulses in the surface velocities. We estimate that the Loop Current variability can be linked to a variability of several Sverdrups (1Sv = 106 m3 s−1) through the Florida Straits. The exact timing of the Loop Current variability is largely unpredictable beyond a few weeks and its variability is therefore likely a major contributor to the chaotic/intrinsic variability of the Gulf Stream. However, the time lag between the Loop Current and the flow downstream of the Gulf of Mexico means that if a lengthening/shortening of the Loop Current is observed this introduces some predictability in the downstream flow for a few weeks.
Book review: Ramnarayan S. Rawat and K. Satyanarayana, eds, Dalit Studies
Authors: Kumar Aishwary
Published: May 2019

Ramnarayan S. Rawat and K. Satyanarayana, eds, Dalit Studies, Durham, NC: Duke University Press, 2016, 304 pp.
Training a model-free reinforcement learning controller for a 3-degree-of-freedom helicopter under multiple constraints
Authors: Xue Shengri , Li Zhan , Yang Liu
Published: May 2019

The purpose of the article is to design data-driven attitude controllers for a 3-degree-of-freedom experimental helicopter under multiple constraints. Controllers were updated by utilizing the reinforcement learning technique. The 3-degree-of-freedom helicopter platform is an approximation to a practical helicopter attitude control system, which includes realistic features such as complicated dynamics, coupling and uncertainties. The method in this paper first describes the training environment, which consists of user-defined constraints and performance expectations by using a reward function module. Then, actor–critic-based controllers were designed for helicopter elevation and pitch axis. Next, the policy gradient method, which is an important branch of the reinforcement learning algorithms, is utilized to train the networks and optimize controllers. Finally, from experimental results acquired by the 3-degree-of-freedom helicopter platform, the advantages of the proposed method are illustrated by satisfying multiple control constraints.
Engendering liminality: The experience of re-enchantment in wild woman workshops
Authors: Plancke Carine
Published: May 2019

According to Paul Heelas, new spiritualities radicalize the expressivist strand in modernity and, hence, not only affirm modern values but also react against them. In particular, they challenge the ‘bounded self’ as foundational for the modern being and progress. Charles Taylor, in discussing the emergence in modern times of ‘the buffered self’, points to three important changes: disenchantment, the loss of the complementary play between structure and anti-structure, and the replacement of the idea of cosmos with that of a neutral, mechanical universe. This article, through a detailed ethnographic study, explores how these changes are temporally counteracted in spiritual women workshops in North-West Europe focused on the trope of the ‘wild woman’. Moreover, it shows that these retreats bring into being ritual spaces of liminality, which have the potential to engender experiences of re-enchantment and/or give a new sense of interpersonal and cosmic connection.
Catheter-directed foam sclerotherapy with tumescence of the great saphenous vein versus ultrasound-guided foam sclerotherapy: A randomized controlled trial
Authors: dos Santos Jorgete B , Júnior Walter Campos , Porta Rina MP , Puggina Juliana , da Silva Daniela FT , Puech-Leão Pedro , de Luccia Nelson , da Silva Erasmo S
Published: May 2019

Objectives

To compare the effectiveness of two foam sclerotherapy techniques of the great saphenous vein.

Methods

Fifty subjects with varicose veins, edema, and great saphenous vein incompetence (diameter 6–10 mm) were randomly categorized into two equal groups and were treated with different foam sclerotherapy techniques: A (usual ultrasound-guided) and B (catheter-directed with tumescence). Concomitant phlebectomy was performed in all patients. Patients were seen on days 7 and 28, and at six and 12 months. The primary outcomes were the full success rate of the treated great saphenous vein and the number of patients who required retreatment sessions performed at 28-day follow-up. The secondary-assisted outcomes were the full success rates of the treated great saphenous vein after the retreatment sessions at six- and 12-month follow-up. Secondary outcomes were changes in quality of life and side effects and complications of the intervention. In case of reflux, retreatment sessions were performed at 28 days and six months in both groups.

Results

Full success rate of the treated great saphenous vein was 36% in group A vs. 80% in group B ( p = 0.012) and the number of patients who required retreatment sessions were n = 14 in group A vs. n = 3 in group B at 28-day follow-up ( p = 0.002). Both were statistically significant. At six and 12 months, the success rates were not statistically significant between the groups. Complication rates were similar between the groups. Quality of life improved in both groups with statistical difference ( p < 0.001).

Conclusions

Catheter-directed foam sclerotherapy with tumescence was better than usual ultrasound-guided foam sclerotherapy as it reached higher full success rate of the treated great saphenous vein and as a lower number of patients required retreatment sessions in the short-term. Both methods proved to be safe and improved the quality of life.