bluuebunny/crossref_metadata_2025 huggingface dataset:
Hypomethylation‐mediated H19 overexpression increases the risk of disease evolution through the association with BCR‐ABL transcript in chronic myeloid leukemia
Authors: Zhou Jing‐dong , Lin Jiang , Zhang Ting‐juan , Ma Ji‐chun , Li Xi‐xi , Wen Xiang‐mei , Guo Hong , Xu Zi‐jun , Deng Zhao‐qun , Zhang Wei , Qian Jun
Published: August 2017

Previous study has revealed that H19 expression is required for efficient tumor growth induced by BCR‐ABL in chronic myeloid leukemia (CML). Herein, we further determined H19 expression and its clinical implication in patients with CML. H19 expression and methylation were detected by real‐time quantitative PCR and real‐time quantitative methylation‐specific PCR, and then clinical implication of H19 expression was further analyzed. H19 expression was significantly up‐regulated in CML patients (p < 0.001). H19 expression with an area under receiver operating characteristic curve value of 0.824 might serve as a promising biomarker in distinguishing CML patients from controls. The patients with high H19 expression had a tendency of higher white blood cells and BCR‐ABL transcript than those with low H19 expression. H19 overexpression occurred with the higher frequency in blast crisis stage (11/11, 100%), lower in accelerated phase (3/5, 60%), and chronic phase (42/62, 66%) stages. Moreover, paired patients during disease progression with increased BCR‐ABL transcript also showed a significant upregulation of H19 expression. Meanwhile, H19 expression was decreased in follow‐up patients who achieved complete molecular remission after tyrosine kinase inhibitors‐based therapy. Epigenetic studies showed that H19 differentially methylated region/imprinting control region (DMR/ICR) was hypomethylated and associated with H19 expression in CML patients. Moreover, demethylation of H19 DMR/ICR reactivated H19 expression in K562 cells. Collectively, H19 overexpression, a frequent event in CML, was associated with higher BCR‐ABL transcript involving in disease progression. Moreover, H19 DMR/ICR hypomethylation in CML may be one of the mechanisms mediating H19 overexpression.
Basal progenitor cells bridge the development, malignant cancers, and multiple diseases of esophagus
Authors: Lin Baoshun , Xie Fuan , Xiao Zhangwu , Hong Xiaoqian , Tian Liming , Liu Kuancan
Published: August 2017

The esophagus is a pivotal organ originating from anterior foregut that links the mouth and stomach. Moreover, its development involves precise regulation of multiple signal molecules and signal transduction pathways. After abnormal regulation of these molecules in the basal cells of the esophagus occurs, multiple diseases, including esophageal atresia with or without tracheoesophageal fistula, Barrett esophagus, gastroesophageal reflux, and eosinophilic esophagitis, will take place as a result. Furthermore, expression changes of signal molecules or signal pathways in basal cells and the microenvironment around basal cells both can initiate the switch of malignant transformation. In this review, we highlight the molecular events underlying the transition of normal development to multiple esophageal diseases. Additionally, the animal models of esophageal development and related diseases, challenges, and strategies are extensively discussed.
Non‐stationary bias correction of monthly CMIP5 temperature projections over China using a residual‐based bagging tree model
Authors: Tao Yumeng , Yang Tiantian , Faridzad Mohammad , Jiang Lin , He Xiaojia , Zhang Xiaoming
Published: August 2017

The biases in the Global Circulation Models (GCMs) are crucial for understanding future climate changes. Currently, most bias correction methodologies suffer from the assumption that model bias is stationary. This paper provides a non‐stationary bias correction model, termed residual‐based bagging tree (RBT) model, to reduce simulation biases and to quantify the contributions of single models. Specifically, the proposed model estimates the residuals between individual models and observations, and takes the differences between observations and the ensemble mean into consideration during the model training process. A case study is conducted for 10 major river basins in Mainland China during different seasons. Results show that the proposed model is capable of providing accurate and stable predictions while including the non‐stationarities into the modelling framework. Significant reductions in both bias and root mean squared error are achieved with the proposed RBT model, especially for the central and western parts of China. The proposed RBT model has consistently better performance in reducing biases when compared with the raw ensemble mean, the ensemble mean with simple additive bias correction, and the single best model for different seasons. Furthermore, the contribution of each single GCM in reducing the overall bias is quantified. The single model importance varies between 3.1% and 7.2%. For different future scenarios (RCP 2.6, RCP 4.5, and RCP 8.5), the results from RBT model suggest temperature increases of 1.44, 2.59, and 4.71 °C by the end of the century, respectively, when compared with the average temperature during 1970–1999.
An Interposed Pad in Open‐Chest Echocardiographic Porcine Scans for Mimicking Ultrasound Signal Attenuation in a Human Chest
Authors: Kinnick Randall R. , Katayama Minako , Belohlavek Marek
Published: August 2017

Opening a chest in an experimental echocardiographic animal study eliminates ultrasound signal attenuation by the chest wall. We developed a scanning technique that involves the use of an attenuative pad created from a mixture of urethane and titanium dioxide. The pad was interposed within transmission gel between the transducer face and cardiac surface in open‐chest scans in a porcine model. Comparative measurements of left ventricular echogenicity without and with the pad demonstrate that the pad reproducibly causes ultrasound signal attenuation that closely mimics chest attenuation in clinical transthoracic echocardiographic studies.
Three‐dimensionally printed polyetherketoneketone scaffolds with mesenchymal stem cells for the reconstruction of critical‐sized mandibular defects
Authors: Roskies Michael G. , Fang Dongdong , Abdallah Mohamed‐Nur , Charbonneau Andre M. , Cohen Navi , Jordan Jack O. , Hier Michael P. , Mlynarek Alex , Tamimi Faleh , Tran Simon D.
Published: August 2017

Objective

Additive manufacturing offers a tailored approach to tissue engineering by providing anatomically precise scaffolds onto which stem cells and growth factors can be supplied. Polyetherketoneketone (PEKK), an ideal candidate biomaterial, is limited by a poor implant–bone interface but can be functionalized with adipose‐derived stem cells (ADSC) to promote integration. This in vivo study examined the interaction of a three‐dimensional printed PEKK/ADSC implant within the critical‐sized mandibular defect in a rabbit model.

Study Design/Methods

Trapezoidal porous scaffolds with dimensions of 1.5 × 1.0 × 0.5 cm were printed using selective laser sintering. ADSCs were seeded on the scaffolds that were then implanted in marginal defects created in New Zealand rabbits. Rabbits were euthanized at 10‐ and 20‐week intervals. Microcomputed tomography was used to characterize bone ingrowth and was correlated with histological analysis. Stress testing was performed on the scaffolds before and after implantation.

Results

All scaffolds were well integrated into adjacent bone. Bone‐to‐tissue volume increased from 30.34% ( ± 12.46) to 61.27% ( ± 8.24), and trabecular thickness increased from 0.178 mm ( ± 0.069) to 0.331 mm ( ± 0.0306) in the 10‐ and 20‐week groups, respectively, compared to no bone regrowth on the control side (P < 0.05). Histology confirmed integration at the bone–implant interface. Biomechanical testing revealed a compressive resistance 15 times that of bone alone (P < 0.05)

Conclusion

3D‐printed PEKK scaffolds combined with ADSCs present a promising solution to improve the bone–implant interface and increase the resistance to forces of mastication after mandibular reconstruction.

Level of Evidence

NA. Laryngoscope, 127:E392–E398, 2017
Analysis of factors associated with electing endoscopic sinus surgery
Authors: DeConde Adam S. , Mace Jess C. , Ramakrishnan Vijay R. , Alt Jeremiah A. , Smith Timothy L.
Published: August 2017

Objective

Medically refractory chronic rhinosinusitis (CRS) can be managed with appropriate continued medical therapy (CMT) or surgery followed by CMT. Patients who initially elect CMT and do not experience adequate symptom resolution may “cross over” to endoscopic sinus surgery (ESS). Our objective was to identify patient covariates associated with this subset of patients who elect this change in treatment modality.

Study Design

Retrospective analysis of a prospective, multi‐center cohort of adult patients with CRS enrolled between March 2011 and June 2015 in academic, tertiary referral clinics.

Methods

Subjects who initially elected CMT were followed up to 18 months, provided a comprehensive medical history, and completed the 22‐item SinoNasal Outcome Test (SNOT‐22) at baseline and during 6‐month follow‐up intervals. Hazard regression modeling was used to identify covariates associated with elective change in treatment modality.

Results

One hundred seventy‐nine subjects were followed for an average 15.1 (standard deviation ± 4.6) months. Subjects who elected ESS (55 of 179) had significantly worse average endoscopy scores and reported worse SNOT‐22 sleep dysfunction scores at baseline (P ≤ 0.026). For each single increasing (worsening) point of Lund‐Kennedy endoscopy score, the hazard ratio (HR) of crossover increased by ∼6%. Similarly, for every point of worsening in baseline SNOT‐22 total score, the hazard of treatment crossover increased by ∼2%. After covariate adjustment, only baseline SNOT‐22 sleep dysfunction scores were associated with an increased risk of treatment crossover (HR = 1.07; 95% confidence interval: 1.02–1.11; P = 0.003).

Conclusion

Baseline total SNOT‐22 and endoscopy scores are associated with treatment crossover, but reported sleep dysfunction is the only significant independent predictor of treatment crossover.

Level of Evidence

2c. Laryngoscope, 128:304–310, 2018
Carbon Nanotubes‐Polyurethane Vitrimer Nanocomposites with the Ability of Surface Welding Controlled by Heat and Near‐Infrared Light
Authors: Yan Peiyao , Zhao Wei , Wang Yanjun , Jiang Yuanyuan , Zhou Changlin , Lei Jingxin
Published: August 2017

Welding technology of polymer materials, serving as an exceedingly good tactics to save materials, reduce cost, and reduce material loss, is only extensively applied in thermoplastic materials for the moment. Recently, a new class of polymer, known as vitrimer, has attracted the eye of researchers because it realizes the reprocessing and reshape of thermosets and possesses many excellent functions, such as multishape memory, healing, and surface welding. Among these, the vitrimer makes the surface welding of thermosetting material possible. In this paper, carbon nanotubes‐polyurethane vitrimer nanocomposites with the capability of surface welding controlled by heat and near‐infrared (NIR) light are successfully prepared. Here, the effects of surface welding are characterized by lap shear tests and optical microscope. In addition, from the control experiments, it is found that the shear strength of the light‐welding sample under NIR illumination for 1 min is greater than that of the heat‐welding sample at 110 °C for 10 min. Furthermore, thermosetting polyurethane has been applied in many fields, and it is hoped that the findings, especially near‐infrared welding technology, will make some contributions for welding technology of polymer.
Preparation of semi‐alternating conjugated polymers using direct arylation polymerization (DArP) and improvement of photovoltaic device performance through structural variation
Authors: Pankow Robert M. , Gobalasingham Nemal S. , Munteanu John D. , Thompson Barry C.
Published: August 2017

The results herein expand on optimized direct arylation polymerization (DArP) conditions for defect‐free poly[(2,5‐bis (2‐hexyldecyloxy)phenylene)‐alt‐(4,7‐di(thiophen‐2‐yl)benzo[c][1,2,5] thiadiazole)] (PPDTBT). Semi‐alternating and alternating donor–acceptor polymers containing alkoxy phenylene, dithienyl‐substituted thieno[3,4‐c]pyrrole‐4,6‐dione (DTTPD), and dithienyl‐substituted diketopyrrolopyrrole (DTDPP) were prepared via DArP, including a four‐component semi‐alternating copolymer PPDTDPPTPD. Variation of the alkoxy substituents on the phenylene donor including n‐hexyl, 2‐ethylhexyl, or 2‐hexyldecyl allowed for the tuning of thephysical and electronic properties. Molecular weights (Mn) ranged from 3.07 to 28.3 kDa for the PPDTTPD polymers and 2.63‐44.0 kDa for the PPDTDPP polymers, depending on the alkoxy substituents. Absorbance maxima and HOMO energies were varied from 550 to 602 nm and −5.31 to −5.69 eV for the PPDTTPD polymers and from 671 to 794 nm and −5.41 to −5.55 eV for the PPDTDPP polymers, respectively. Additive‐free, bulk heterojunction (BHJ) solar cells were fabricated, and the fill‐factors obtained (0.57–0.63) are some of the highest reported for polymers prepared using DArP. Higher molecular weight polymers for both PPDTTPD (28 kDa) and PPDTDPP (44 kDa) series performed poorly in solar cells. In contrast, the semi‐alternating polymers of lower Mn for the PPDTTPD (12.4 kDa) and PPDTDPP (9.05 kDa) series, incorporating both n‐hexyl and 2‐hexyldecyl alkoxy phenylene donors, provided power conversion efficiencies (PCE) of 3.26% and 3.49%, respectively. © 2017 Wiley Periodicals, Inc. J. Polym. Sci., Part A: Polym. Chem. 2017, 55, 3370–3380
Novel approaches for the preparation of magnetic nanogels via covalent bonding
Authors: Pikabea Aintzane , Forcada Jacqueline
Published: August 2017

Here, novel methods to encapsulate magnetic nanoparticles (MNPs) into dual‐stimuli‐responsive nanogels via covalent bonding are reported. With the aim of strengthening the attachment of MNPs with the nanogels, primary amine‐ and epoxide‐functionalized stimuli‐sensitive poly(2‐(diethylamino)ethyl methacrylate) (PDEAEMA)‐based nanogels were firstly synthesized. Then, MNPs were incorporated into the nanogels by using different methods, obtaining different families of magnetic nanogels (MNGs). Those MNGs, showing pH‐sensitivity and high superparamagnetic response, could be considered to be widely useful as theranostic agents in biomedical applications. © 2017 Wiley Periodicals, Inc. J. Polym. Sci., Part A: Polym. Chem. 2017, 55, 3573–3586
Self‐assembly and lower critical solution temperature properties of supramolecular block copolymer/ionic liquid complexes depending on the alkyl chain length of imidazolium rings
Authors: Noh Minjoo , Cho Byoung‐Ki
Published: August 2017

We report the liquid crystalline (LC) assembly and lower critical solution temperature (LCST) properties of wedge‐shaped block copolymer (BCP)/1‐alkyl‐3‐methylimidazolium tetrafluoroborate ([CnMIM][BF4], n = 2, 4, 6) complexes (1–3) depending on the alkyl chain length of the ionic liquids (ILs). In contrast to the crystalline BCP, all of the ionic samples showed LC phases. 1 with [C2MIM][BF4] exhibited a hexagonal columnar phase, and 3 with [C6MIM][BF4] exhibited a gyroid phase. Interestingly, a temperature‐dependent transformation from columnar phase to gyroid phase was revealed for 2 with [C4MIM][BF4]. The phase difference may be explained by the supramolecular shape change that was dependent on the alkyl chain length of the ILs. The LCST behavior was characterized using the differential scanning calorimetry, turbidity observations, and the X‐ray diffraction techniques. Notably, the primary d‐spacing began to decrease at the clouding temperature (Tc). 3 showed the highest Tc at 130 °C, which is greater than the temperature of the order‐to‐disorder transition. The results demonstrate that the subtle variation in the IL structure affects the morphological and LCST properties. © 2017 Wiley Periodicals, Inc. J. Polym. Sci., Part A: Polym. Chem. 2017, 55, 3587–3596
Educational and vocational goal disruption in adolescent and young adult cancer survivors
Authors: Vetsch Janine , Wakefield Claire E. , McGill Brittany C. , Cohn Richard J. , Ellis Sarah J. , Stefanic Natalie , Sawyer Susan M. , Zebrack Brad , Sansom‐Daly Ursula M.
Published: August 2017

Objective

Cancer in adolescents and young adults (AYAs) can interrupt important developmental milestones. Absence from school and time lost from work, together with the physical impacts of treatment on energy and cognition, can disrupt educational and vocational goals. The purpose of this paper is to report on AYA cancer survivors' experiences of reintegration into school and/or work and to describe perceived changes in their educational and vocational goals.

Methods

Adolescents and young adults recruited from 7 hospitals in Australia, aged 15 to 26 years and ≤24 months posttreatment, were interviewed using the psychosocial adjustment to illness scale. Responses were analysed to determine the extent of, and explanations for, cancer's effect on school/work.

Results

Forty‐two AYA cancer survivors (50% female) participated. Compared with their previous vocational functioning, 12 (28.6%) were scored as experiencing mild impairment, 14 (33.3%) moderate impairment, and 3 (7.1%) marked impairment. Adolescents and young adults described difficulties reintegrating to school/work as a result of cognitive impacts such as concentration problems and physical impacts of their treatment, including fatigue. Despite these reported difficulties, the majority indicated that their vocation goals were of equal or greater importance than before diagnosis (26/42; 62%), and most AYAs did not see their performance as compromised (23/42; 55%). Many survivors described a positive shift in life goals and priorities. The theme of goal conflict emerged where AYAs reported compromised abilities to achieve their goals.

Conclusions

The physical and cognitive impacts of treatment can make returning to school/work challenging for AYA cancer survivors. Adolescents and young adults experiencing difficulties may benefit from additional supports to facilitate meaningful engagement with their chosen educational/vocational goals.
Tensile and Deformation Behavior of Auxetic Plied Yarns
Authors: Ng Wing Sum , Hu Hong
Published: August 2017

This paper presents an experimental study of tensile and deformation behavior of an auxetic plied yarn structure. The basic configuration of the plied structure formed with two soft yarns and two stiff yarns was firstly introduced. Based on this 4‐ply helix structure, six kinds of yarn samples were made by different combinations of soft yarns, stiff yarns and twist levels. These yarn samples were first tested and the effects of different design parameters were analyzed. Apart from the tensile test, changes in the internal structure of two samples upon stretching were also studied through microscopic examination. Finally, double helix yarn and 6‐ply auxetic yarn were made for a comparative purpose to investigate the effect of helical structure. The study shows that all of the 4‐ply auxetic yarn samples exhibit negative Poisson's ratio (NPR) throughout the entire tensile process, and the magnitude of NPR gets larger with a smaller soft yarn diameter, a higher tensile modulus of stiff yarn and a lower twist level. The study also shows that auxetic behavior inside the 4‐ply structure is generated by the interplay between the soft yarns and stiff yarns and 4‐ply auxetic yarns have the advantages to produce immediate auxetic effect upon stretching.
Wafer yield prediction using derived spatial variables
Authors: Dong Hang , Chen Nan , Wang Kaibo
Published: August 2017

Unreliable chips tend to form spatial clusters on semiconductor wafers. The spatial patterns of these defects are largely reflected in functional testing results. However, the spatial cluster information of unreliable chips has not been fully used to predict the performance in field use in the literature. This paper proposes a novel wafer yield prediction model that incorporates the spatial clustering information in functional testing. Fused LASSO is first adopted to derive variables based on the spatial distribution of defect clusters. Then, a logistic regression model is used to predict the final yield (ratio of chips that remain functional until expected lifetime) with derived spatial covariates and functional testing values. The proposed model is evaluated both on real production wafers and in an extensive simulation study. The results show that by explicitly considering the characteristics of defect clusters, our proposed model provides improved performance compared to existing methods. Moreover, the cross‐validation experiments prove that our approach is capable of using historical data to predict yield on newly produced wafers.
Uncertainty analysis of trade‐offs between multiple responses using hypervolume
Authors: Cao Yongtao , Lu Lu , Anderson‐Cook Christine M.
Published: August 2017

When multiple responses are considered in process optimization, the degree to which they can be simultaneously optimized depends on the optimization objectives and the amount of trade‐offs between the responses. The normalized hypervolume of the Pareto front is a useful summary to quantify the amount of trade‐offs required to balance performance across the multiple responses. To quantify the impact of uncertainty of the estimated response surfaces and add realism to what future data to expect, 2 versions of the scaled normalized hypervolume of the Pareto front are presented. To demonstrate the variation of the hypervolume distributions, we explore a case study for a chemical process involving 3 responses, each with a different type of optimization goal. Results show that the global normalized hypervolume characterizes the proximity to the ideal results possible, while the instance‐specific summary considers the richness of the front and the severity of trade‐offs between alternatives. The 2 scaling schemes complement each other and highlight different features of the Pareto front and hence are useful to quantify what solutions are possible for simultaneous optimization of multiple responses.
Facile Hydrothermal Synthesis of Sn‐Mn Mixed Oxide Nano‐rods with Exposed (110) Facets and Remarkable Catalytic Performance
Authors: Peng Honggen , Zhang Li , Sun Qi , Shen Jiating , Xu Xianglan , Fang Xiuzhong , Liu Wenming , Wang Zheng , Zhang Ning , Wang Xiang
Published: August 2017

Metal oxides with special exposed facets have very important effect on their catalytic performances. Though mono‐metal oxides exposed special facets can be easily prepared via various approaches, the synthesis of mixed metal oxides exposed special facets are still a challenge to date. Herein, Sn−Mn mixed oxide nano‐rods exposed (110) facet have been successfully synthesized by a facile one step hydrothermal method firstly. The structure of Sn−Mn mixed metal oxide nano‐rods was confirmed by transmission electron microscopy (TEM), energy dispersive X‐Ray spectroscopy (EDX)‐mapping and the powder X‐ray diffraction (XRD) techniques. With the Sn−Mn molar ratios changed from 10–0 to 7–3, the morphology of the samples also changed simultaneously. Interestingly, with increasing the amount of Mn, the diameter of the nano‐rods was decreased evidently. On the other hand, when the Sn−Mn molar ratio was below 8–2 (assigned as SnMn8‐2 NR), the nano‐particles with irregular morphology were beginning occurred. All of the SnMn mixed oxides nano‐rods were shown improved catalytic performance for CO oxidation compared with pure SnO2 nano‐rods and MnOx nano‐particles. The superior catalytic performance of SnMn nano‐rods should be attributed to their special exposed (110) facet and more amount of surface active O species. It is noted that SnMn8‐2 NR is the most active catalyst among all these samples and have a good stability in the presence or absence of water vapor. This work can help people to design new kinds of mixed metal oxide catalysts with exposed facets.
The atmosphere under the waves: forgotten meteorology from Nazi Germany
Authors: Worthington R. M.
Published: August 2017

Mountain waves are oscillations of stable airflow over mountains which remain roughly fixed relative to the ground as the airflows through them. They are significant to numerical weather models, ozone depletion, and aviation safety. Textbook descriptions of mountain waves assume laminar flow down to the mountain surface, following the classic theory of Scorer. However, there can be a region of non‐wavelike atmosphere under the mountain waves, such as convection, turbulent eddies and rotors in the boundary layer, implying a different paradigm to explain wave launching. This paper reviews how the existence of the atmosphere under the mountain waves was realised in Nazi Germany, where mountain waves were discovered using gliders in 1933 and studied in the run‐up to World War 2.1
Macrometastasis in Papillary Thyroid Cancer Patients is Associated with Higher Recurrence in Lateral Neck Nodes
Authors: Kim Soo Young , Kim Bup‐Woo , Pyo Ju Yeon , Hong Soon Won , Chang Hang‐Seok , Park Cheong Soo
Published: August 2017

Background

The use of routine central compartment neck dissection surgery for papillary thyroid carcinoma (PTC) is controversial. Although macroscopic central neck lymph node metastasis (CNLN) in PTC is a poor prognostic factor correlated with increased loco‐regional recurrence, the significance of microscopic metastasis to the central lymph nodes is not established. Herein, we aimed to assess the influence of the size of CNLN on disease recurrence among PTC patients.

Methods

Data from 233 patients who underwent less than total thyroidectomy with CNLN dissection in 1989–1999 were retrospectively reviewed. The patients were assigned to three groups according to the central node metastasis: no metastasis (Group I), micrometastasis (<2 mm, Group II), and macrometastasis (≥2 mm, Group III). Clinicopathological features, recurrence rate, site of recurrence, and disease‐free survival (DFS) were assessed.

Results

Of the 233 patients enrolled (mean follow‐up period, 16.1 years), 134 (57.5%) had no central neck metastasis, 37 (15.9%) had micrometastasis, and 62 (26.6%) had macrometastasis. Demographics and tumour variables were similar among the three groups. Recurrence rates were 12.7, 16.2, and 43.5% in Groups I, II, and III, respectively (p < 0.001). Group III had a 3.2‐fold increased relative risk of recurrence and a significantly decreased DFS compared to Group I. Group III showed significantly higher rates of lateral neck nodes metastasis than Groups I and II.

Conclusions

In conclusion, macrometastasis significantly affects disease recurrence in PTC patients, whereas microscopic metastasis has only marginal effects. Macroscopic CNLN metastasis showed a significantly higher recurrence in the lateral neck node compared to micrometastasis.
Derivation, Validation and Application of a Pragmatic Risk Prediction Index for Benchmarking of Surgical Outcomes
Authors: Spence Richard T. , Chang David C. , Kaafarani Haytham M. A. , Panieri Eugenio , Anderson Geoffrey A. , Hutter Matthew M.
Published: August 2017

Background

Despite the existence of multiple validated risk assessment and quality benchmarking tools in surgery, their utility outside of high‐income countries is limited. We sought to derive, validate and apply a scoring system that is both (1) feasible, and (2) reliably predicts mortality in a middle‐income country (MIC) context.

Methods

A 5‐step methodology was used: (1) development of a de novo surgical outcomes database modeled around the American College of Surgeons’ National Surgical Quality Improvement Program (ACS‐NSQIP) in South Africa (SA dataset), (2) use of the resultant data to identify all predictors of in‐hospital death with more than 90% capture indicating feasibility of collection, (3) use these predictors to derive and validate an integer‐based score that reliably predicts in‐hospital death in the 2012 ACS‐NSQIP, (4) apply the score in the original SA dataset and demonstrate its performance, (5) identify threshold cutoffs of the score to prompt action and drive quality improvement.

Results

Following step one‐three above, the 13 point Codman’s score was derived and validated on 211,737 and 109,079 patients, respectively, and includes: age 65 (1), partially or completely dependent functional status (1), preoperative transfusions ≥4 units (1), emergency operation (2), sepsis or septic shock (2) American Society of Anesthesia score ≥3 (3) and operative procedure (1–3). Application of the score to 373 patients in the SA dataset showed good discrimination and calibration to predict an in‐hospital death. A Codman Score of 8 is an optimal cutoff point for defining expected and unexpected deaths.

Conclusion

We have designed a novel risk prediction score specific for a MIC context. The Codman Score can prove useful for both (1) preoperative decision‐making and (2) benchmarking the quality of surgical care in MIC’s.
Identifying priority habitats and monitoring species for conservation and restoration of lentic Odonata habitats: assemblage nestedness on Amami‐Oshima Island, Japan
Authors: Sakai Masaru , Suda Shin‐ichi , Okeda Taichi , Washitani Izumi
Published: August 2017

We investigated Odonata faunal and habitat characteristics (forest cover, emergent, submerged, floating‐leaved and floating plant covers, pond area, NO3−, chemical oxygen demand, and presence/absence of a nonnative fish) in 10 ponds on Amami‐Oshima Island. In total, 26 species of six odonate families were found, and we detected significant nestedness of species composition among the ponds (22 species in the most species‐rich pond, and 8 species in the most species‐poor pond). Species found only in the most species‐rich ponds were: Anax nigrofasciatus nigrofasciatus, Acisoma panorpoides panorpoides, Agriocnemis famina oryzae, Rhyothemis severini, Anasiaeschna martini, Hemicordulia okinawaensis, Lyriothemis elegantissima, and Hydrobasileus croceus (hereafter referred to as the rare species). These rare species are generally known to preferentially inhabit ponds with lush emergent plants and/or to prefer cooler habitats shaded by forest cover, such as Anax nigrofasciatus nigrofasciatus, Anac. martini, He. okinawaensis, and L. elegantissima. In contrast, the common species also found in species‐poor ponds were: Ischnura senegalensis, Pantala flavescens, Anax parthenope julis, Ictinogomphus pertinax, and Tramea verginia, which are known to prefer an open water surface as spawning habitat. These differences in habitat preference between the rare and common species may be among the major reasons for the significant positive effects of percent forest cover and emergent plants on Odonata species richness. These results suggest that nestedness helped identify precise habitat characteristics and rare species that should be considered for conservation and restoration of lentic habitats on Amami‐Oshima Island.
Dairy Productivity and Technical Change: An Analysis of Confinement and Management Intensive Grazing Dairies in Maryland for 1995–2009
Authors: Minegishi Kota , Johnson Dale M.
Published: August 2017

U.S. dairy production has been consolidating into large-scale confinement operations. Large numbers of small- to medium-scale dairies have disappeared in the last two decades, and many more are disappearing. This article analyzes small- to medium-scale dairy operations in Maryland during 1995–2009 for changes in technology and efficiency through a novel two-stage DEA approach to examine productivity changes. Conventional confinement dairy operations and management-intensive grazing dairies are analyzed separately. The results show that both dairy systems have become more productive on the technological frontiers, yet the rate of technical change for graziers was less than half the rate for confinement.
Correlation of age and rurality with low-urgency use of emergency medical services (LUEMS): A geographic analysis
Authors: Terashima Mikiko , Carter Alix J.E.
Published: August 2017

Objectives

Studies suggest that addressing the needs of the older population in rural areas may substantially reduce their low-urgency use of emergency medical services (LUEMS). It may ultimately also help improve the efficiency in our health system. There is, however, a dearth of evidence substantiating geographic patterns in LUEMS by different age cohorts. This exploratory study was aimed to clarify the understanding of emergency medical services (EMS) use in Nova Scotia through a geographic analysis.

Methods

Records with Canadian Triage and Acuity Scale of 4 and 5 were considered as LUEMS. We assessed the distribution of LUEMS incidence rates (proportion of LUEMS out of all EMS uses) by age and rurality, using descriptive statistics and Geographic Information Systems mapping.

Results

Nearly half of all EMS transports were individuals of 65+ years of age; 35% of those were LUEMS. The rates increased along with the level of rurality, and the older cohort had the highest incidence rates in non-metro communities. High rates were seen primarily in some rural communities farthest away from the capital/tertiary care centre.

Conclusion

High LUEMS incidence rates are rural phenomena but not specific to the older population. However, the absolute number of LUEMS by the older cohort is significant, and elder-specific interventions in rural regions could still lead to effective cost savings. Further investigation of other factors, such as distance to the emergency department, availability of public transportation, and socioeconomic conditions of EMS users, is needed.
Linear stability of two-layer Couette flows
Authors: Mohammadi Alireza , Smits Alexander J.
Published: August 2017

The stability of two-layer Couette flow is investigated under variations in viscosity ratio, thickness ratio, interfacial tension and density ratio. The effects of the base flow on eigenvalue spectra are explained. A new type of interfacial mode is discovered at low viscosity ratio with properties that are different from Yih’s original interfacial mode (Yih, J. Fluid Mech., vol. 27, 1967, pp. 337–352). No unstable Tollmien–Schlichting waves were found over the range of parameters considered in this work. The results for thin films with different thicknesses can be collapsed onto a single curve if the Reynolds number and wavenumber are suitably defined based on the parameters of the thin layer. Interfacial tension always has a stabilizing effect, but the effects of density ratio cannot be so easily generalized. Neutral stability curves for water–alkane and water–air systems are presented as an initial step towards better understanding the effects of flow stability on the longevity and performance of liquid-infused surfaces and superhydrophobic surfaces.
Hepatitis C – Diagnostik und Therapie
Authors: Semela David
Published: August 2017

Zusammenfassung. Die Hepatitis C Virus Infektion ist die häufigste durch Blut übertragene Infektion und ist global wie auch in der Schweiz eine der führenden Ursachen von Leberzirrhose, hepatozellulären Karzinomen und chronischer Hepatitis. Seit der Entdeckung im Jahr 1989 wurde die Diagnostik und Therapie der Hepatitis C Virus Infektion enorm vorangebracht. In der Schweiz wird ein risikobasiertes Screening auf Hepatitis C empfohlen. Neben zuverlässigen diagnostischen Testen ist 2014 der therapeutische Durchbruch gelungen. Heute können 90 bis 100 % der Betroffenen mit einer gut verträglichen Therapie über zwei bis drei Monate geheilt werden. In dieser Übersichtsarbeit wird schwerpunktmässig auf die Diagnostik, Epidemiologie, Prävention und aktuelle Therapien der Hepatitis C Virus Infektion eingegangen.
The growing tree of Archaea: new perspectives on their diversity, evolution and ecology
Authors: Adam Panagiotis S , Borrel Guillaume , Brochier-Armanet Céline , Gribaldo Simonetta
Published: August 2017

The Archaea occupy a key position in the Tree of Life, and are a major fraction of microbial diversity. Abundant in soils, ocean sediments and the water column, they have crucial roles in processes mediating global carbon and nutrient fluxes. Moreover, they represent an important component of the human microbiome, where their role in health and disease is still unclear. The development of culture-independent sequencing techniques has provided unprecedented access to genomic data from a large number of so far inaccessible archaeal lineages. This is revolutionizing our view of the diversity and metabolic potential of the Archaea in a wide variety of environments, an important step toward understanding their ecological role. The archaeal tree is being rapidly filled up with new branches constituting phyla, classes and orders, generating novel challenges for high-rank systematics, and providing key information for dissecting the origin of this domain, the evolutionary trajectories that have shaped its current diversity, and its relationships with Bacteria and Eukarya. The present picture is that of a huge diversity of the Archaea, which we are only starting to explore.
The sex ratio of singleton and twin delivery offspring in assisted reproductive technology in China
Authors: Chen Mengxi , Du Jiangbo , Zhao Jing , Lv Hong , Wang Yifeng , Chen XiaoJiao , Zhang Junqiang , Hu Lingmin , Jin Guangfu , Shen Hongbing , Hu Zhibin , Xiong Fang , Chen Li , Ling Xiufeng
Published: August 2017

In order to evaluate the impact of assisted reproductive technology (ART) procedure and individual factors on the sex ratio of singletons and twins at birth after in vitro fertilization (IVF) and intra-cytoplasmic sperm injection (ICSI) treatment in China. We conducted a retrospective cohort study including patients undergoing their first cycle of IVF or ICSI with autologous oocytes from 2001 to 2015. A total of 7410 babies were born from 5832 women with 7410 live birth. The secondary sex ratio (SSR) in singletons was significantly higher than twins (53.97% vs. 50.89%, P = 0.009). The largest disparity was observed in ‘thawed blastocyst embryos ICSI’ subgroup that SSR was 59.84% in singletons and 42.45% in twins (P = 0.013). Blastocyst transfer was positively associated with elevated SSR when compared to cleavage stage embryos in singletons (Odds Ratio [OR] = 1.17, P < 0.001). In addition, paternal age was significantly associated with SSR (OR = 0.75, P = 0.014). While the decrease of SSR was significantly associated with ICSI when compared to IVF (OR = 0.61, P = 0.046) in twins. Blastocyst transfer increases SSR in comparing with cleavage stage embryos in singletons, while the use of ICSI reduces SSR in twins. Our findings offered important complement for better understanding the underlying determinant of SSR in ART offspring.
Modeling the transmission and control of Zika in Brazil
Authors: Wang Liping , Zhao Hongyong , Oliva Sergio Muniz , Zhu Huaiping
Published: August 2017

Zika virus, a reemerging mosquito-borne flavivirus, started spread across Central and Southern America and more recently to North America. The most serious impacted country is Brazil. Based on the transmission mechanism of the virus and assessment of the limited data on the reported suspected cases, we establish a dynamical model which allows us to estimate the basic reproduction number R0 = 2.5020. The wild spreading of the virus make it a great challenge to public health to control and prevention of the virus. We formulate two control models to study the impact of releasing transgenosis mosquitoes (introducing bacterium Wolbachia into Aedes aegypti) on the transmission of Zika virus in Brazil. Our models and analysis suggest that simultaneously releasing Wolbachia-harboring female and male mosquitoes will achieve the target of population replacement, while releasing only Wolbachia-harboring male mosquitoes will suppress or even eradicate wild mosquitoes eventually. We conclude that only releasing male Wolbachia mosquitoes is a better strategy for control the spreading of Zika virus in Brazil.
Comparative Study of Recessive Spherical Headed Silicone Intubation and Endonasal Dacryocystorhinostomy under Nasal Endoscopy for Nasolacrimal Duct Obstruction
Authors: Deng Hui-yi , Wang Tao , Huang Xue-kun , Yang Qin-tai , Ling Shi-qi , Wang Wei-hao , Li Mei-jiao , Ning Fang-qin , Zhang Ge-hua
Published: August 2017

Between July 2014 and November 2015, we compared the curative effects and cost-effectiveness of two kinds of nasal endoscopic surgery for nasolacrimal duct obstruction (NLDO) in a single-centre, two-armed clinical trial with a 1-year follow-up. We included two groups: a recessive spherical headed silicone intubation (RSHSI) group and an endonasal dacryocystorhinostomy (En-DCR) group; both received nasal endoscopy. Patients were recruited from the Otorhinolaryngology and Ophthalmology departments. The main outcome measures were epiphora improvement (classified as cure, effective, or invalid), cost-effectiveness, visual analogue scale (VAS) intraoperative pain score, bleeding volume, operating time, hospitalisation time, total cost, and VAS postoperative epiphora score. No significant group difference was identified in postoperative epiphora VAS scores (P > 0.050) or success rate (P = 0.406). However, average VAS intraoperative pain score, operating time, bleeding volume, hospitalisation time and total cost in the RSHSI group were clearly lower to those in the En-DCR group (P = 0.000). In conclusion, RSHSI under nasal endoscopy can provide similar treatment outcomes to En-DCR. RSHSI has advantages including minimal invasiveness, reduced risk, shorter duration of surgery and hospitalisation, reduced intraoperative discomfort, and lower financial burden, which is more acceptable to patients. Thus, RSHSI may be the preferred option for NLDO.
Virtual touch tissue imaging and quantification: value in malignancy prediction for complex cystic and solid breast lesions
Authors: Zhang Ying , Zhao Chong-Ke , Li Xiao-Long , He Ya-Ping , Ren Wei-Wei , Zou Cai-Ping , Du Yue-Wu , Xu Hui-Xiong
Published: August 2017

This study was aimed to evaluatethe usefulness of conventional ultrasound (US) and US elastography, including the latest virtual touch tissue imaging and quantification (VTIQ), in malignancy prediction for complex cystic and solid breast lesions. Eighty-nine complex cystic and solid breast lesions were subject to conventional US and US elastography, including strain elastography (SE), virtual touch tissue imaging (VTI) and VTIQ. Among the 89 lesions, thirty-four (38.2%) lesions were malignant and 55 (61.8%) lesions were benign. Sixteen variables were subject to multivariate logistic regression analysis. Pattern 4b in VTI (odds ratio, OR:15.278), not circumscribed margin of lesion (OR:12.346), SWS mean >4.6 m/s in VTIQ (OR:11.896), and age elder than 50 years (OR:6.303) were identified to be independent predictors for malignancy. In receiver operating characteristic (ROC) curve analyses, associated areas under the ROC curve (Az) for conventional US could be significantly elevated, from 0.649 to 0.918, by combining with US elastography (p < 0.0001). The combined diagnostic method was able to improve the specificity (32.7% vs. 87.3%, p < 0.0001) without sacrificing the sensitivity (97.1% vs. 85.3%, p = 0.075). Both conventional US and US elastography contribute substantially to malignancy prediction in complex cystic and solid lesions. The diagnostic efficacy of conventional US in terms of Az and specificity could be significantly improved by combining with US elastography.
Orthosteric- versus allosteric-dependent activation of the GABAA receptor requires numerically distinct subunit level rearrangements
Authors: Amin Jahanshah , Subbarayan Meena S.
Published: August 2017

Anaesthetic molecules act on synaptic transmission via the allosteric modulation of ligand-gated chloride channels, such as hetero-oligomeric α1β2γ2 GABAA receptors. To elucidate the overall activation paradigm via allosteric versus orthosteric sites, we used highly homologous, but homo-oligomeric, ρ1 receptors that are contrastingly insensitive to anaesthetics and respond partially to several full GABA α1β2γ2 receptor agonists. Here, we coexpressed varying ratios of RNAs encoding the wild-type and the mutated ρ1 subunits, which are anaesthetic-sensitive and respond with full efficacy to partial GABA agonists, to generate distinct ensembles of receptors containing five, four, three, two, one, or zero mutated subunits. Using these experiments, we then demonstrate that, in the pentamer, three anaesthetic-sensitive ρ1 subunits are needed to impart full efficacy to the partial GABA agonists. By contrast, five anaesthetic-sensitive subunits are required for direct activation by anaesthetics alone, and only one anaesthetic-sensitive subunit is sufficient to confer the anaesthetic-dependent potentiation to the GABA current. In conclusion, our data indicate that GABA and anaesthetics holistically activate the GABAA ρ1 receptor through distinct subunit level rearrangements and suggest that in contrast to the global impact of GABA via orthosteric sites, the force of anaesthetics through allosteric sites may not propagate to the neighbouring subunits and, thus, may have only a local and limited effect on the ρ1 GABAA receptor model system.
Global temporal dynamic landscape of pathogen-mediated subversion of Arabidopsis innate immunity
Authors: Mishra Bharat , Sun Yali , Ahmed Hadia , Liu Xiaoyu , Mukhtar M. Shahid
Published: August 2017

The universal nature of networks’ structural and physical properties across diverse systems offers a better prospect to elucidate the interplay between a system and its environment. In the last decade, several large-scale transcriptome and interactome studies were conducted to understand the complex and dynamic nature of interactions between Arabidopsis and its bacterial pathogen, Pseudomonas syringae pv. tomato DC3000. We took advantage of these publicly available datasets and performed “-omics”-based integrative, and network topology analyses to decipher the transcriptional and protein-protein interaction activities of effector targets. We demonstrated that effector targets exhibit shorter distance to differentially expressed genes (DEGs) and possess increased information centrality. Intriguingly, effector targets are differentially expressed in a sequential manner and make for 1% of the total DEGs at any time point of infection with virulent or defense-inducing DC3000 strains. We revealed that DC3000 significantly alters the expression levels of 71% effector targets and their downstream physical interacting proteins in Arabidopsis interactome. Our integrative “-omics”-–based analyses identified dynamic complexes associated with MTI and disease susceptibility. Finally, we discovered five novel plant defense players using a systems biology-fueled top-to-bottom approach and demonstrated immune-related functions for them, further validating the power and resolution of our network analyses.
Morphology, membrane nanostructure and stiffness for quality assessment of packed red blood cells
Authors: Kozlova E. , Chernysh A. , Moroz V. , Sergunova V. , Gudkova O. , Manchenko E.
Published: August 2017

Transfusion of packed red blood cells (PRBC) to patients in critical states is often accompanied by post-transfusion complications. This may be related with disturbance of properties of PRBC and their membranes during long-term storage in the hemopreservative solution. The purpose of our work is the study of transformation of morphology, membranes stiffness and nanostructure for assessment of PRBC quality, in vitro. By atomic force microscopy we studied the transformation of cell morphology, the appearance of topological nanodefects of membranes and by atomic force spectroscopy studied the change of membrane stiffness during 40 days of storage of PRBC. It was shown that there is a transition period (20–26 days), in which we observed an increase in the Young’s modulus of the membranes 1.6–2 times and transition of cells into irreversible forms. This process was preceded by the appearance of topological nanodefects of membranes. These parameters can be used for quality assessment of PRBC and for improvement of transfusion rules.