bluuebunny/crossref_metadata_2025 huggingface dataset:
Is Low-Dose Haloperidol Effective against Postoperative Nausea and Vomiting? A Randomized Controlled Trial
Authors: Dağ Mehmet Tevfik , Tarıkçı Kılıç Ebru , Taşdoğan Ali Muhittin
Published: September 2019

Background: Nausea and vomiting are undesirable outcomes during the postoperative period. Vomiting may cause life-threatening pulmonary aspiration, as the airway reflex may not be fully restored postoperatively due to the residual effects of anesthetic and analgesic medications. Objective: The aim of this study is to determine the effective dosage of haloperidol against nausea and vomiting, as well as its adverse effects. Materials and Methods: A total of 250 female patients between the ages of 19 and 70, who were admitted for laparoscopic abdominal hysterectomy, were included in this study. The patients were randomized into five groups: placebo (n = 50) (Group I), haloperidol 2 mg (n = 50) (Group II), haloperidol 1 mg (n = 50) (Group III), haloperidol 0.5 mg (n = 50) (Group IV), and haloperidol 0.25 mg (n = 50) (Group V). The patients’ duration of anesthesia, duration of surgery, and nausea/vomiting scores were recorded, along with the antiemetic agents used. The Aldrete’s recovery scale was used as the postoperative recovery criteria. Data from the following variables were recorded for all patients at postoperative minute 30 and hours 1, 2, 3, 4, 6, 12, and 24: heart rate, systolic arterial pressure, diastolic arterial pressure, level of sedation, visual analog scale values, antiemetic need, patient satisfaction, side effects. Results: It was determined that 0.5, 1, and 2 mg doses of haloperidol were effective in preventing nausea and vomiting, and there was no difference in effectiveness between the 0.25 mg dose group and placebo. Conclusion: Haloperidol was found to be an effective agent against nausea and vomiting at a dose of 0.5 mg and can be administered at the doses of 0.5 mg to 2 mg.
Coping and Life Satisfaction: Mediating Role of Ego-Resiliency in Patients with Rheumatoid Arthritis
Authors: Ziarko Michał , Mojs Ewa , Sikorska Dorota , Samborski Włodzimierz
Published: September 2019

Objective: Ego-resiliency is attributed the status of a “meta resource” that is responsible for a flexible selection of coping strategies depending on the requirements of a specific difficult situation. A considerably burdensome critical life event is the development of a chronic illness such as rheumatoid arthritis (RA). Apart from coping with the symptoms, a fundamental task confronting patients is maintaining their quality of life. This raises the question of whether ego-resiliency serves as a mediator between coping strategies and quality of life. Materials and Methods: 210 RA patients were invited to participate in this study. They were requested to complete a questionnaire that included the Satisfaction with Life scale, the stress coping inventory Mini-COPE, and the Ego-Resiliency scale. The collected data were analyzed by a simple mediation procedure and estimation of simple correlation coefficients. Results: The analysis demonstrated that ego-resiliency (r = 0.46; p < 0.001) and emotion-focused coping (r = 0.39; p < 0.001) determined life satisfaction. Additionally, ego-resiliency mediated the relation between emotion-oriented coping strategies and life satisfaction. Partial mediation was observed (a = 0.45**; b = 0.36**; c = 0.39**; c’ =0.22**; R2 = 0.24; F = 35.65; p < 0.001). Conclusion: Our observations partly support the assumption about a controlling role of ego-resiliency in the process of selecting coping strategies according to demands of situations.
Winteraceae R.Br. ex Lindl na Serra da Mantiqueira, Brasil
Authors: Santos-Silva Fernanda , Cardoso Pedro Henrique , Tavares-Silva Pâmela , Cabral Andressa
Published: September 2019

Winteraceae é um elemento característico das floras montanas da América Central e do Sul. No Brasil, a família está representada apenas pelo gênero Drimys, com três espécies aceitas. Considerando a importância dos estudos taxonômicos para a conservação dos remanescentes montanos da Floresta Atlântica e a necessidade de ampliar os estudos da família no Brasil, este trabalho apresenta o tratamento florístico de Winteraceae para a Serra da Mantiqueira, região Sudeste do Brasil. Na região, é registrada Drimys brasiliensis, que possui a maioria dos registros de coleta (86,7%) dentro de Unidades de Conservação (estaduais e nacionais) e maior esforço amostral na porção meridional da Serra. São fornecidas descrições, ilustrações, notas taxonômicas (incluindo comparações entre as espécies ocorrentes no Brasil) e considerações biogeográficas.
Apolipoprotein AI) Promotes Atherosclerosis Regression in Diabetic Mice by Suppressing Myelopoiesis and Plaque Inflammation
Authors: Barrett Tessa J. , Distel Emilie , Murphy Andrew J. , Hu Jiyuan , Garshick Michael S. , Ogando Yoscar , Liu Jianhua , Vaisar Tomas , Heinecke Jay W. , Berger Jeffrey S. , Goldberg Ira J. , Fisher Edward A.
Published: September 2019

Background:

Despite robust cholesterol lowering, cardiovascular disease risk remains increased in patients with diabetes mellitus. Consistent with this, diabetes mellitus impairs atherosclerosis regression after cholesterol lowering in humans and mice. In mice, this is attributed in part to hyperglycemia-induced monocytosis, which increases monocyte entry into plaques despite cholesterol lowering. In addition, diabetes mellitus skews plaque macrophages toward an atherogenic inflammatory M1 phenotype instead of toward the atherosclerosis-resolving M2 state typical with cholesterol lowering. Functional high-density lipoprotein (HDL), typically low in patients with diabetes mellitus, reduces monocyte precursor proliferation in murine bone marrow and has anti-inflammatory effects on human and murine macrophages. Our study aimed to test whether raising functional HDL levels in diabetic mice prevents monocytosis, reduces the quantity and inflammation of plaque macrophages, and enhances atherosclerosis regression after cholesterol lowering.

Methods:

Aortic arches containing plaques developed in
Ldlr
−/−
mice were transplanted into either wild-type, diabetic wild-type, or diabetic mice transgenic for human apolipoprotein AI, which have elevated functional HDL. Recipient mice all had low levels of low-density lipoprotein cholesterol to promote plaque regression. After 2 weeks, plaques in recipient mouse aortic grafts were examined.

Results:

Diabetic wild-type mice had impaired atherosclerosis regression, which was normalized by raising HDL levels. This benefit was linked to suppressed hyperglycemia-driven myelopoiesis, monocytosis, and neutrophilia. Increased HDL improved cholesterol efflux from bone marrow progenitors, suppressing their proliferation and monocyte and neutrophil production capacity. In addition to reducing circulating monocytes available for recruitment into plaques, in the diabetic milieu, HDL suppressed the general recruitability of monocytes to inflammatory sites and promoted plaque macrophage polarization to the M2, atherosclerosis-resolving state. There was also a decrease in plaque neutrophil extracellular traps, which are atherogenic and increased by diabetes mellitus.

Conclusions:

Raising apolipoprotein AI and functional levels of HDL promotes multiple favorable changes in the production of monocytes and neutrophils and in the inflammatory environment of atherosclerotic plaques of diabetic mice after cholesterol lowering and may represent a novel approach to reduce cardiovascular disease risk in people with diabetes mellitus.
Pregnancy-Related Acute Kidney Injury in Preeclampsia
Authors: Conti-Ramsden Frances I. , Nathan Hannah L. , De greeff Annemarie , Hall David R. , Seed Paul T. , Chappell Lucy C. , Shennan Andrew H. , Bramham K.
Published: September 2019

Preeclampsia is a common cause of acute kidney injury (AKI) in low- and middle-income countries, but AKI incidence in preeclampsia, its risk factors, and renal outcomes are unknown. A prospective observational multicenter study of women admitted with preeclampsia in South Africa was conducted. Creatinine concentrations were extracted from national laboratory databases for women with maximum creatinine of ≥90 μmol/L (≥1.02 mg/dL). Renal injury and recovery were defined by Kidney Disease Improving Global Outcomes creatinine criteria. Predefined risk factors, maternal outcomes, and neonatal outcomes were compared between AKI stages. Of 1547 women admitted with preeclampsia 237 (15.3%) met AKI criteria: 6.9% (n=107) stage 1, 4.3% (n=67) stage 2, and 4.1% (n=63) stage 3. There was a higher risk of maternal death (n=7; relative risk, 4.3; 95% CI, 1.6–11.4) and stillbirth (n=80; relative risk, 2.2; 95% CI, 1.8–2.8) in women with AKI compared with those without. Perinatal mortality was also increased (89 of 240; 37.1%). Hypertension in a previous pregnancy was the strongest predictor of AKI stage 2 or 3 (odds ratio, 2.24; 95% CI, 1.21–4.17). Renal recovery rate reduced with increasing AKI stage. A third of surviving women (76 of 230 [33.0%]) had not recovered baseline renal function by discharge. Approximately half (39 of 76; 51.3%) of these women had no further creatinine testing post-discharge. In summary, AKI was common in women with preeclampsia and had high rates of associated maternal and perinatal mortality. Only two-thirds of women had confirmed renal recovery. History of a previous hypertensive pregnancy was an important risk factor.
ANO4 (Anoctamin 4) Is a Novel Marker of Zona Glomerulosa That Regulates Stimulated Aldosterone Secretion
Authors: Maniero Carmela , Scudieri Paolo , Haris Shaikh Lalarukh , Zhao Wanfeng , Gurnell Mark , Galietta Luis J.V. , Brown Morris J.
Published: September 2019

Microarray comparison of the transcriptomes of human adrenal zona glomerulosa (ZG) and zona fasciculata found several ZG-specific genes that negatively regulate aldosterone secretion. The third and most significantly upregulated ZG-gene (19.9-fold compared with zona fasciculata,
P
=6.58×10
−24
) was
ANO4
, a putative Ca
2+
-activated chloride channel. We have investigated the role of
ANO4
in human adrenal, and whether it functions like the prototype anoctamin,
ANO1
. We evaluated
ANO4
mRNA and protein expression in human adrenal by qPCR and immunohistochemistry, compared the effects of
ANO4
and
ANO1
overexpression on baseline and stimulated aldosterone secretion and cell proliferation in H295R cells, and analyzed ANO4 activity as a Ca
2+
-activated chloride channel in comparison with other anoctamins by a fluorescence-based functional assay. The expression of
ANO4
in ZG was confirmed by qPCR as 23.21-fold upregulated compared with zona fasciculata (n=18;
P
=4.93×10
−7
). Immunohistochemistry found cytoplasmic, ZG-selective expression of ANO4 (anoctamin 4) protein.
ANO4
overexpression in H295R cells attenuated calcium-mediated aldosterone secretion and cell proliferation in comparison to controls. The latter effects were in a different direction to those of ANO1. The functional assay showed that, in contrast to ANO1, ANO4 expression results in low levels of calcium-dependent anion transport. In conclusion, ANO4 is one of the most highly expressed genes in ZG. It attenuates stimulated aldosterone secretion and cell proliferation. Although belonging to a family of Ca
2+
-activated chloride channels, it does not generate significant plasma membrane chloride channel activity.
Neural Network Acceptability Judgments
Authors: Warstadt Alex , Singh Amanpreet , Bowman Samuel R.
Published: September 2019

This paper investigates the ability of artificial neural networks to judge the grammatical acceptability of a sentence, with the goal of testing their linguistic competence. We introduce the Corpus of Linguistic Acceptability (CoLA), a set of 10,657 English sentences labeled as grammatical or ungrammatical from published linguistics literature. As baselines, we train several recurrent neural network models on acceptability classification, and find that our models outperform unsupervised models by Lau et al. (2016) on CoLA. Error-analysis on specific grammatical phenomena reveals that both Lau et al.’s models and ours learn systematic generalizations like subject-verb-object order. However, all models we test perform far below human level on a wide range of grammatical constructions.
Typification of the name Stachys recta subsp. tenoreana (Lamiaceae)

Authors: STINCA ADRIANO , ESPOSITO ASSUNTA
Published: September 2019

Stachys Linnaeus (1753: 580) (Lamiaceae) is a genus composed by annual/perennial herbs and small shrubs, with sessile or short-stalked flowers arranged in axillary clusters on the upper part of the stem forming raceme or spike inflorescences, and very variable calyx that represents an important trait for systematics. It is a subcosmopolitan genus, which includes approximately 370 species (Harley et al. 2004), mainly distributed in the Mediterranean and South-West Asia warm temperate regions.
Stratospheric Influences on the MJO-Induced Rossby Wave Train: Effects on Intraseasonal Climate
Authors: Hood Lon L. , Redman Malori A. , Johnson Wes L. , Galarneau Thomas J.
Published: September 2019

The tropical Madden–Julian oscillation (MJO) excites a northward propagating Rossby wave train that largely determines the extratropical surface weather consequences of the MJO. Previous work has demonstrated a significant influence of the tropospheric El Niño–Southern Oscillation (ENSO) on the characteristics of this wave train. Here, composite analyses of ERA-Interim sea level pressure (SLP) and surface air temperature (SAT) data during the extended northern winter season are performed to investigate the additional role of stratospheric forcings [the quasi-biennial oscillation (QBO) and the 11-yr solar cycle] in modifying the wave train and its consequences. MJO phase composites of 20–100-day filtered data for the two QBO phases show that, similar to the cool phase of ENSO, the easterly phase of the QBO (QBOE) produces a stronger wave train and associated modulation of SLP and SAT anomalies. In particular, during MJO phases 5–7, positive SLP and negative SAT anomalies in the North Atlantic/Eurasian sector are enhanced during QBOE relative to the westerly phase of the QBO (QBOW). The opposite occurs during the earliest MJO phases. SAT anomalies over eastern North America are also more strongly modulated during QBOE. Although less certain because of the short data record, there is some evidence that the minimum phase of the solar cycle (SMIN) produces a similar increased modulation of SLP and SAT anomalies. The strongest modulations of SLP and SAT anomalies are produced when two or more of the forcings are superposed (e.g., QBOE/cool ENSO, SMIN/QBOE, etc.).
On the Structure of the Regional-Scale Circulation over Central Africa: Seasonal Evolution, Variability, and Mechanisms
Authors: Longandjo Georges-Noel T. , Rouault Mathieu
Published: September 2019

Atmospheric circulation over central Africa is dominated by the tropical easterly jet, the African easterly jet, and the low-level westerly jet. In the lower troposphere, a zonal overturning cell occurs over central Africa, but the mechanisms driving its formation, seasonal evolution, and variability are still unclear. Here, using reanalyses (ERA-Interim, NCEP-2, and JRA-55) and the ECHAM5.3 atmospheric model forced by observed sea surface temperature, we highlight the existence, in the lower troposphere, of a separated single, closed, counterclockwise, and shallow zonal overturning cell, namely, the Congo basin cell. This Congo basin cell persists year round, with maximum intensity and width in August/September and minimum intensity and width in May. This shallow cell extracts heat from the warm central Africa landmass through latent and internal energies and transports it to the cold eastern equatorial Atlantic Ocean, reminiscent of the mixed Carnot–steam cycle. Indeed, the monsoon-like circulation triggered by the zonal surface pressure gradient between the warm central Africa landmass and surrounding cold oceans produces mass convergence at the Congo Air Boundary, providing necessary upward motion to air parcels to destabilize the atmosphere over central Africa. As result, convective updrafts depend on underlying moist static energy and the induced low-level westerly jet, controlled by the near-surface land–ocean thermal contrast through the zonal surface pressure gradient between the warm central African landmass and cold eastern equatorial Atlantic Ocean, rather than the midlevel easterly jet. This midlevel easterly jet is formed by the mechanical work that balances the convection associated with the saturation and rainfall. Furthermore, the efficiency of the Congo basin cell determines seasonality over central Africa.
Recognising the Role of the Emotion of Fear in Offences and Defences
Authors: Edwards Susan SM
Published: September 2019

Anger, its part in human conduct and in crime commission has been much discussed and accorded a privileged status within the law, while the role of fear has been less considered. Notwithstanding, fear and related emotional states have received some recognition as intrinsic elements of the perpetrator’s object integral to the actus reus of certain offences and relevant to the defendant’s mens rea of some defences. The harm caused by deliberately or negligently instilling fear in another is inconsistently considered in law as is its impact on criminal responsibility and mens rea. Fear has been recently acknowledged as a permissible cause of loss of self-control in a partial defence to murder (Coroners and Justice Act 2009 s 55(3)). It remains a contested emotion and as with anger the male experience of what circumstances trigger fear predominates.
Effects of a Self-Compassion Break Induction on Self-Reported Stress, Self-Compassion, and Depressed Mood
Authors: Williamson Jessica
Published: September 2019

Introduction

The objective of the study was to determine whether practicing a self-compassion induction would reduce self-reported stress, depressed mood, and increase self-compassion in a randomized controlled study measuring variables of interest at two time points spanning three weeks.

Method

Participants were 129 students (91 females and 38 males, Mage = 19.47, SD = 3.20) divided into three groups: Self-compassion Break, Time Management Control Group, and a No-Induction Control Group. Participants were part of the general student body and were not diagnosed or screened for clinical depression. Self-compassion, stress, and depressed mood were assessed at baseline and follow-up. Participants practiced their respective inductions over three weeks after being guided through their respective inductions at Time 1.

Results

There were no significant differences between groups in outcome variables. Results of this study may indicate the importance of weekly group check-in meetings to facilitate positive change as findings in this study did not mirror those of similar studies using frequent meetings.
Enhancement of flow measurement for graft verification
Authors: Vechersky Yury Y , Zatolokin Vasily V , Kozlov Boris N , Nenakhova Aleksandra A , Shipulin Vladimir M
Published: September 2019

Background

We aimed to evaluate multiple transit-time flow measurements during coronary artery bypass grafting.

Methods

Transit-time flow measurements were performed first on the arrested heart both with and without a proximal snare on the target coronary artery, second, after weaning from cardiopulmonary bypass, and third, before chest closure.

Results

Among the 214 grafts considered, 9 (4.2%) were patent and 6 (2.8%) were failing. In the failed grafts, an abnormal transit-time flow was found during the first measurement, in 5 (2.3%) cases with a proximal snare and in one (0.47%) without a snare. In these cases, technical errors with the distal anastomoses were found and immediately corrected. A problem with the proximal anastomosis was found in one graft during the second measurement and corrected right away. Bending due to excessive length was found in 2 (0.93%) grafts during the third measurement, and graft repositioning was performed. The first transit-time flow measurement showed that mean graft flow was significantly decreased with a proximal snare compared to without a proximal snare, throughout the entire coronary territory. Pulsatility index during the first transit-time flow measurement was higher with a proximal snare than without one.

Conclusions

The 3-time transit-time flow measurement strategy makes it possible to verify and immediately correct technical problems with coronary bypass grafts.
Sir Matthew Tierney and the foundation of the 1804 Sussex Vaccine Institution
Authors: Cooper Maxwell J , Morris Hilary , Whiston Benjamin
Published: September 2019

Irish physician Sir Matthew John Tierney (1776–1845) was a vaccine pioneer who learnt the procedure directly from Edward Jenner in Gloucestershire. In 1802 Tierney completed an MD at Glasgow on vaccination and moved to Brighton, where he was appointed physician to the Prince of Wales (the future King George IV). This paper considers Tierney’s role in the foundation of the 1804 Sussex Vaccine Institution. Tierney was the first president of the Institution’s Medical Council. His leadership lay in his knowledge of vaccination (including transporting cowpox material) and his close relationship with the Prince of Wales. The Institution’s official name was the Royal Sussex Jennerian Society for the Extermination of the Small-pox and offered vaccination at 16 stations across the county and one in Kent. Vaccination was undertaken by local surgeons at their houses at set hours. In its first year, the Institution vaccinated 946 individuals, of whom 509 for free. Despite this, concerns were raised over uptake by poorer members of society. The Institution’s Brighton station was probably absorbed into the new 1809 dispensary. Tierney’s promotion of vaccination and instructions for new practitioners represent the embryonic beginnings of evidence-based medicine and modern medical education in Brighton.
Voriconazole prophylaxis in leukemic patients: A retrospective single-center study
Authors: Bui Vivian , Walker Sandra AN , Elligsen Marion , Vyas Anju , Kiss Alex , Palmay Lesley
Published: September 2019

Background

Invasive fungal infections commonly occur in acute myeloid and lymphoblastic leukemia patients receiving chemotherapy. In these patients with acute leukemia, posaconazole prophylaxis is recommended; however, voriconazole may be a less costly alternative.

Objectives

The objective of this study was to evaluate the efficacy and safety of voriconazole prophylaxis in acute leukemia patients.

Methods

A retrospective chart review of inpatients at Sunnybrook Health Sciences Centre between 2005 and 2017 was completed. Hospitalized adult acute leukemia patients who received voriconazole prophylaxis (cases) were compared to patients who received fluconazole or no prophylaxis during chemotherapy (controls). Statistical analyses comparing baseline characteristics, safety, and efficacy outcomes between the study cohorts were completed. A posaconazole literature-based weighted mean risk was compared to the voriconazole risk of invasive fungal infection identified in this study.

Results

Of 490 acute myeloid leukemia or acute lymphoblastic leukemia patients, 83 controls and 92 cases were eligible. Case patients received an average of 24.4 ± 10.8 days of voriconazole prophylaxis. The incidence of proven or probable invasive fungal infections with voriconazole was 3.3% (3/92) versus 7.2% (6/83) in the control cohort (p > 0.05) and was comparable to the literature reported weighted incidence of invasive fungal infection with posaconazole (2.4 ± 2.1%; 95% CI 1.3%–3.4%; p > 0.05). Voriconazole was well tolerated by patients (91%; 84/91; seven discontinued due to asymptomatic elevated liver function tests).

Conclusions

Voriconazole prophylaxis was found to be safe, effective, and comparable to literature-based efficacy data for risk of invasive fungal infection with posaconazole antifungal prophylaxis in patients with acute leukemia undergoing chemotherapy and could represent a significant cost advantage.
Right Atrium Blood Cyst and Calcified Kernel in an Adult
Authors: Shakerian Behnam , Jebelli Mohammad
Published: September 2019

Among benign cardiac tumors, cardiac blood cysts are rare. These congenital lesions may develop in any heart’s cavities and they are not often seen in adults. The present article is a report of a right atrium blood cyst and calcified kernel in an adult case.
Tuned mass damper and high static low dynamic stiffness isolator for vibration reduction of beam structure
Authors: Raei Meysam , Dardel Morteza
Published: September 2019

In this work, the combination effect of tuned mass damper and high static low dynamic stiffness (HSLDS) isolator is investigated in reducing the vibration amplitude of Euler–Bernoulli beam with a nonlinear attachment. The performance of the absorber is studied in two cases; the first case, HSLDS isolator is one degree of freedom and the second case, two degree of freedom isolator is combined of HSLDS isolator and tuned mass damper absorber. By comparing the performance of these two isolators, it is revealed the two degree of freedom isolator has much better performance in direct force excitation and also improves the system performance in the base excitation. This isolator reduces the system amplitude at all frequencies, especially ultra-low frequencies, which is the main advantage to this isolator with respect to other isolators and reduces the natural frequency until the phenomenon of resonance occurs at a lower frequency. Moreover, decreasing the natural frequency increases the damping and in quasi zero stiffness and negative stiffness structure, the system has supercritical damping. This isolator is studied for positive, quasi zero and negative stiffness. The results show that the system with quasi zero stiffness has the best performances. Also, by increasing the excitation amplitude, the isolator loses its effectiveness.
Operational Sex Ratio Predicts Binge Drinking Across U.S. Counties
Authors: Aung Toe , Hughes Susan M. , Hone Liana S. E. , Puts David A.
Published: September 2019

Previous research suggests that binge drinking among young men serves as a “costly signal” to potential mates, such that the binge drinker is capable of bearing the harmful consequences of alcohol consumption. Here, we propose that binge drinking among young adults is conditionally dependent upon the signaler’s willingness to take risks, which is influenced by the local operational sex ratio (OSR). Using archived binge drinking estimates from 2009 to 2012 and Census Bureau records of OSRs, we tested the relationship between OSR and binge drinking rates at the county level across 3,143 U.S. counties against hypotheses drawn from evolutionary theory. Results from our mixed-effects models revealed that a higher overall OSR (i.e., more eligible men compared to women) was associated with higher male binge drinking rates but lower female binge drinking rates. A higher OSR particularly in the 20–29 and 50+ age groups predicted higher male binge drinking rates but lower female binge drinking rates. Our findings generally support predictions derived from evolutionary theory and suggest that binge drinking may function as a costly sexual signal, conditionally regulated by age and the local sex ratio.
A Study on Nonthermal Irreversible Electroporation of the Thyroid
Authors: Lv Yanpeng , Zhang Yanfang , Huang Jianwei , Wang Yunlong , Rubinsky Boris
Published: September 2019

Background:

Nonthermal irreversible electroporation is a minimally invasive surgery technology that employs high and brief electric fields to ablate undesirable tissues. Nonthermal irreversible electroporation can ablate only cells while preserving intact functional properties of the extracellular structures. Therefore, nonthermal irreversible electroporation can be used to ablate tissues safely near large blood vessels, the esophagus, or nerves. This suggests that it could be used for thyroid ablation abutting the esophagus. This study examines the feasibility of using nonthermal irreversible electroporation for thyroid ablation.

Methods:

Rats were used to evaluate the effects of nonthermal irreversible electroporation on the thyroid. The procedure entails the delivery of high electric field pulses (1-3 kV/cm, 100 microseconds) between 2 surface electrodes bracing the thyroid. The right lobe was treated with various nonthermal irreversible electroporation pulse sequences, and the left was the control. After 24 hours of the nonthermal irreversible electroporation treatment, the thyroid was examined with hemotoxylin and eosin histological analysis. Mathematical models of electric fields and the Joule heating-induced temperature raise in the thyroid were developed to examine the experimental results.

Results:

Treatment with nonthermal irreversible electroporation leads to follicular cells damage, associated with cell swelling, inflammatory cell infiltration, and cell ablation. Nonthermal irreversible electroporation spares the trachea structure. Unusually high electric fields, for these types of tissue, 3000 V/cm, are needed for thyroid ablation. The mathematical model suggests that this may be related to the heterogeneous structure of the thyroid-induced distortion of local electric fields. Moreover, most of the tissue does not experience thermal damage inducing temperature elevation. However, the heterogeneous structure of the thyroid may cause local hot spots with the potential for local thermal damage.

Conclusion:

Nonthermal irreversible electroporation with 3000 V/cm can be used for thyroid ablation. Possible applications are treatment of hyperthyroidism and thyroid cancer. The highly heterogeneous structure of the thyroid distorts the electric fields and temperature distribution in the thyroid must be considered when designing treatment protocols for this tissue type.
On the kinematic design of anthropomorphic lower limb exoskeletons and their matching movement
Authors: Ren Bin , Liu Jianwei , Luo Xurong , Chen Jiayu
Published: September 2019

The lower limb exoskeleton is a wearable device for assisting medical rehabilitation. A classical lower limb exoskeleton structures cannot precisely match the kinematics of the wearer’s limbs and joints in movement, so a novel anthropomorphic lower limb exoskeleton based on series–parallel mechanism is proposed in this article. Then, the human lower limb movements are measured by an optical gait capture system. Comparing the simulation results of the series–parallel mechanism with the measured human data, the kinematics matching model at the hip joint is established. The results show that the kinematic matching errors in the X, Y, and Z directions are less than 2 mm. So, the proposed kinematics matching model is effective and the anthropomorphic series–parallel mechanism has a significant improvement in tracing the human positions at the hip joint.
Women’s sexual health in later life: Gaps and opportunities in research and practice
Authors: Nowakowski Alexandra CH , Sumerau JE
Published: September 2019

This article complements emerging reviews and summaries of the recent expansion of sexuality studies within and beyond geriatrics and associated fields. To this end, we synthesize important insights and discussions taking place throughout geriatrics and other fields at present, and situate these conversations in broader discussions concerning sexualities, health, and aging. In so doing, we outline some gaps in existing work as well as opportunities for not only filling these gaps in our understandings of women’s sexual health in later life but also in order to demonstrate the usefulness of expanding prior approaches to analyses concerning womanhood, aging, sexualities, and health over the life course. In conclusion, we outline some specific pathways for future research concerning women’s sexual health in later life.
Aerodynamics of MAV rotors in ground and corner effect
Authors: Prothin S , Fernandez Escudero C , Doué N , Jardin T
Published: September 2019

The work presented in this paper is part of a project called ARChEaN (Aerodynamic of Rotors in Confined ENvironment) whose objective is to study the interactions of a micro drone rotor with its surroundings in the case of flight in enclosed environments such as those encountered, for example, in archeological exploration of caves. To do so the influence of the environment (walls, ground, ceiling, etc) on the rotor’s aerodynamic performance as well as on the flow field between the rotor and the surroundings is studied. This paper focuses on two different configurations, flight near the ground and flight near a corner (wall and ground), and the results are analyzed and compared to a general free flight case (i.e. far away from any obstacle). In order to carry out this analysis both numerical and experimental approaches are conducted. The objective is to validate the numerical model with the results obtained experimentally and to benefit from the advantages of both approaches in terms of flow analysis. This research work will provide knowledge on how to operate these systems as to minimize the possible negative environment disturbances, reduce power consumption and predict the micro drone’s behaviour during enclosed flights.
Sequentially Determined Measures of Interobserver Agreement (Kappa) in Clinical Trials May Vary Independent of Changes in Observer Performance
Authors: Reeve Russell , Gottlieb Klaus
Published: September 2019

Background:

Cohen's kappa is a statistic that estimates interobserver agreement. It was originally introduced to help develop diagnostic tests. Interpretative readings of 2 observers, for example, of a mammogram or other imaging, were compared at a single point in time. It is known that kappa depends on the prevalence of disease and that, therefore, kappas across different settings are hard to compare.

Methods:

Using simulation, we examine an analogous situation, not previously described, that occurs in clinical trials where sequential measurements are obtained to evaluate disease progression or clinical improvement over time.

Results:

We show that weighted kappa, used for multilevel outcomes, changes during the trial even if we keep the performance of the observer constant.

Conclusions:

Kappa and closely related measures can therefore only be used with great difficulty, if at all, in quality assurance in clinical trials.
Donor cell engineering with GSK3 inhibitor–loaded nanoparticles enhances engraftment after in utero transplantation
Authors: Loukogeorgakis Stavros P. , Fachin Camila G. , Dias Andre I. B. S. , Li Haiying , Tang Li , Kim Aimee G. , Vrecenak Jesse D. , Stratigis John D. , Ahn Nicholas J. , Nissim Ilana , Nissim Izhtak , Moron Antonio F. , Martins Jose L. , Peranteau William H. , De Coppi Paolo , Irvine Darrell J. , Flake Alan W.
Published: September 2019

Intrauterine transplantation induces tolerance in the setting of the immature immue system but is hampered by low levels of engraftment. Glycogen synthase kinase 3 (GSK3) inhibition enhances stem cell proliferation, and Loukogeorgakis and colleagues report excellent engraftment in utero in mice following surface attachment of nanoparticles loaded with GSK3 inhibitor to donor stem cells.
Existence and iteration of positive solution for fractional integral boundary value problems with p-Laplacian operator
Authors: He Ying , Bi Bo
Published: September 2019

This paper is concerned with an integral boundary value problem of fractional differential equations with p-Laplacian operator. Sufficient conditions ensuring the existence of extremal solutions for the given problem are obtained. Our results are based on the method of upper and lower solutions and monotone iterative technique.
Home management of lower limb lymphoedema with an intermittent pneumatic compression device: a feasibility study
Authors: Dunn Nyree , Williams E. Mark , Fishbourne Michelle , Dolan Gina , Davies Jane H.
Published: September 2019

Background

Lymphoedema is a chronic condition that causes swelling in the body tissues. Presently, there is no cure for lymphoedema; instead, current treatment is aimed at lifelong management to help control symptoms. Intermittent pneumatic compression (IPC) therapy can be considered as an adjunct to standard lymphoedema care; however, research regarding the efficacy of this treatment modality is limited.

Methods

Twenty participants were recruited from an outpatient lymphoedema clinic (South Wales, UK) to a feasibility randomised control trial designed to evaluate the efficacy of an IPC device (LymphAssist, Huntleigh Healthcare) in reducing lower limb volume. The primary objective was to assess feasibility in terms of (1) study feasibility, including recruitment, retention and assessment of outcome measures, and (2) intervention feasibility, including intervention fidelity and acceptability to participants. Participants were randomly assigned to a control group (n = 10) or intervention group (n = 10). The control group received their standard lymphoedema care only for a 6-month period, whereas the intervention group received their standard lymphoedema care plus an IPC device to use for 6 months. A bilateral lower limb assessment and quality of life survey were undertaken at baseline and 3- and 6-month time points.

Results

The study recruited to target within the planned time frame with a retention rate of 80%. Issues relating to potential recruitment bias and study attrition were identified and possible solutions explored. In addition, supplementary primary outcome measures that are important to the study population were identified and will be incorporated into the design of future studies.

Conclusion

This feasibility study identified that a larger randomised controlled trial investigating the efficacy of home use IPC devices is feasible with modifications to the study protocol.

Trial registration

This trial is registered with clinicaltrials.gov (NCT03825263).
Complications Associated With the Anesthesia Transport of Pediatric Patients: An Analysis of the Wake Up Safe Database
Authors: Haydar Bishr , Baetzel Anne , Stewart Margaret , Voepel-Lewis Terri , Malviya Shobha , Christensen Robert
Published: September 2019

BACKGROUND:

Transporting patients under anesthesia care incurs numerous potential risks, especially for those with critical illness. The purpose of this study is to identify and report all pediatric anesthesia transport-associated adverse events from a preexisting database of perioperative adverse events.

METHODS:

An extract of the Wake Up Safe database was obtained on December 14, 2017, and screened for anesthesia transport-associated complications. This was defined as events occurring during or immediately after transport or movement of a pediatric patient during or in proximity to their care by anesthesiologists, including repositioning and transfer to recovery or an inpatient unit, if the cause was noted to be associated with anesthesia or handover. Events were excluded if the narrative clearly states that an event was ongoing and not impacted by anesthesia transport, such as a patient who develops cardiac arrest that then requires emergent transfer to the operating room. The search methodology included specific existing data elements that indicate transport of the patient, handover or intensive care status preoperatively as well as a free-text search of the narrative for fragments of words indicating movement. Screened events were reviewed by 3 anesthesiologists for inclusion, and all data elements were extracted for analysis.

RESULTS:

Of 2971 events in the database extract, 63.8% met screening criteria and 5.0% (148 events) were related to transport. Events were primarily respiratory in nature. Nearly 40% of all reported events occurred in infants age ≤6 months. A total of 59.7% of events were at least somewhat preventable and 36.4% were associated with patient harm, usually temporary. Of the 86 reported cardiac arrests, 50 (58.1%) had respiratory causes, of which 74% related to anesthesia or perioperative team factors. Respiratory events occurred at all stages of care, with 21.4% during preoperative transport and 75.5% postoperatively. Ninety-three percent of unplanned extubations occurred in patients 6 months and younger. Ten medication events were noted, 2 of which resulted in cardiac arrest. Root causes in all events related primarily to provider and patient factors, with occasional references to verbal miscommunication.

CONCLUSIONS:

Five percent of reported pediatric anesthesia adverse events are associated with transport. Learning points highlight the risk of emergence from anesthesia during transport to recovery or intensive care unit (ICU). ICU patients undergoing anesthesia transport face risks relating to transitions in providers, equipment, sedation, and physical positioning. Sedation and neuromuscular blockade may be necessary for transport in some patients but has been associated with adverse events in others.
Association Between Race and Ethnicity in the Delivery of Regional Anesthesia for Pediatric Patients: A Single-Center Study of 3189 Regional Anesthetics in 25,664 Surgeries
Authors: King Michael R. , De Souza Elizabeth , Rosenbloom Julia M. , Wang Ellen , Anderson T. Anthony
Published: September 2019

BACKGROUND:

Racial and ethnic disparities in health care are well documented in the United States, although evidence of disparities in pediatric anesthesia is limited. We sought to determine whether there is an association between race and ethnicity and the use of intraoperative regional anesthesia at a single academic children’s hospital.

METHODS:

We performed a retrospective review of all anesthetics at an academic tertiary children’s hospital between May 4, 2014, and May 31, 2018. The primary outcome was delivery of regional anesthesia, defined as a neuraxial or peripheral nerve block. The association between patient race and ethnicity (white non-Hispanic or minority) and receipt of regional anesthesia was assessed using multivariable logistic regression. Sensitivity analyses were performed comparing white non-Hispanic to an expansion of the single minority group to individual racial and ethnic groups and on patients undergoing surgeries most likely to receive regional anesthesia (orthopedic and urology patients).

RESULTS:

Of 33,713 patient cases eligible for inclusion, 25,664 met criteria for analysis. Three-thousand one-hundred eighty-nine patients (12.4%) received regional anesthesia. One thousand eighty-six of 8884 (13.3%) white non-Hispanic patients and 2003 of 16,780 (11.9%) minority patients received regional anesthesia. After multivariable adjustment for confounding, race and ethnicity were not found to be significantly associated with receiving intraoperative regional anesthesia (adjusted odds ratios [ORs] = 0.95; 95% confidence interval [CI], 0.86–1.06; P = .36). Sensitivity analyses did not find significant differences between the white non-Hispanic group and individual races and ethnicities, nor did they find significant differences when analyzing only orthopedic and urology patients, despite observing some meaningful clinical differences.

CONCLUSIONS:

In an analysis of patients undergoing surgical anesthesia at a single academic children’s hospital, race and ethnicity were not significantly associated with the adjusted ORs of receiving intraoperative regional anesthesia. This finding contrasts with much of the existing health care disparities literature and warrants further study with additional datasets to understand the mechanisms involved.
Unwinding chromatin at the right places: how BAF is targeted to specific genomic locations during development
Authors: Ho Patric J. , Lloyd Sarah M. , Bao Xiaomin
Published: September 2019

The BAF (SWI/SNF) chromatin remodeling complex plays a crucial role in modulating spatiotemporal gene expression during mammalian development. Although its remodeling activity was characterized in vitro decades ago, the complex actions of BAF in vivo have only recently begun to be unraveled. In living cells, BAF only binds to and remodels a subset of genomic locations. This selectivity of BAF genomic targeting is crucial for cell-type specification and for mediating precise responses to environmental signals. Here, we provide an overview of the distinct molecular mechanisms modulating BAF chromatin binding, including its combinatory assemblies, DNA/histone modification-binding modules and post-translational modifications, as well as its interactions with proteins, RNA and lipids. This Review aims to serve as a primer for future studies to decode the actions of BAF in developmental processes.
Histone H3K27 acetylation precedes active transcription during zebrafish zygotic genome activation as revealed by live-cell analysis
Authors: Sato Yuko , Hilbert Lennart , Oda Haruka , Wan Yinan , Heddleston John M. , Chew Teng-Leong , Zaburdaev Vasily , Keller Philipp , Lionnet Timothee , Vastenhouw Nadine , Kimura Hiroshi
Published: September 2019

Histone post-translational modifications are key gene expression regulators, but their rapid dynamics during development remain difficult to capture. We applied a Fab-based live endogenous modification labeling technique to monitor the changes in histone modification levels during zygotic genome activation (ZGA) in living zebrafish embryos. Among various histone modifications, H3 Lys27 acetylation (H3K27ac) exhibited most drastic changes, accumulating in two nuclear foci in the 64- to 1k-cell-stage embryos. The elongating form of RNA polymerase II, which is phosphorylated at Ser2 in heptad repeats within the C-terminal domain (RNAP2 Ser2ph), and miR-430 transcripts were also concentrated in foci closely associated with H3K27ac. When treated with α-amanitin to inhibit transcription or JQ-1 to inhibit binding of acetyl-reader proteins, H3K27ac foci still appeared but RNAP2 Ser2ph and miR-430 morpholino were not concentrated in foci, suggesting that H3K27ac precedes active transcription during ZGA. We anticipate that the method presented here could be applied to a variety of developmental processes in any model and non-model organisms.
Amphibious fish ‘get a jump’ on terrestrial locomotor performance after exercise training on land
Authors: McFarlane William , Rossi Giulia S. , Wright Patricia A.
Published: September 2019

Many amphibious fishes rely on terrestrial locomotion to accomplish essential daily tasks, but it is unknown if terrestrial exercise improves the locomotor performance of fishes on land. Thus, we tested the hypothesis that terrestrial exercise improves locomotion in amphibious fishes out of water due to skeletal muscle remodeling. We compared the jumping performance of Kryptolebias marmoratus before and after an exercise training regimen, and assessed the muscle phenotype of control and exercise-trained fish. We found that exercise-trained fish jumped 41% farther, and 48% more times before reaching exhaustion. Furthermore, exercise training resulted in the hypertrophy of red muscle fibers, and an increase in red muscle capillarity and aerobic capacity. Lactate accumulation after jumping indicates that white muscle is also important in powering terrestrial jumps. Overall, skeletal muscle in K. marmoratus is highly responsive to terrestrial exercise, and muscle plasticity may assist in the effective exploitation of terrestrial habitats by amphibious fishes.
Competition and Strategic Incentives in the Market for Credit Ratings: Empirics of the Financial Crisis of 2007
Authors: Chu Chenghuan Sean , Rysman Marc
Published: September 2019

We study the market for ratings agencies in the commercial mortgage backed securities sector leading up to and including the financial crisis of 2007–2008. Using a structural model adapted from the auctions literature, we characterize the incentives of ratings agencies to distort ratings in favor of issuers. We find an important equilibrium distortion, which decreased after the crisis. We study several counterfactual experiments motivated by recent policymaking in this industry. (JEL D44, G01, G24)