bluuebunny/crossref_metadata_2025_split huggingface dataset:
New image analysis tool for facial pore characterization and assessment
Authors: Dissanayake Bandara , Miyamoto Kukizo , Purwar Ankur , Chye Rose , Matsubara Akira 
Published: March 2019

AbstractBackgroundVisible facial pores are an important cosmetic concern especially among young females. Number of different methodologies is used today to assess facial pores and efficacy of technologies. Main limitations of these methods are, however, (a) moderate correlation with visual perception, (b) characterization is mostly limited to size or number of pores, (c) measurement is limited to a smaller area of face, and (d) operational difficulties. In order to address these limitations, we developed a 2D image analysis tool to assess and characterize visible facial pores.Materials and MethodsTwo clinical studies were conducted with northeast Asian skin type females. In the first study, 40 subjects age between 20 and 40 with different degree of pore severity were recruited. In the second study, 15 subjects age between 20 and 40 with enlarged pores were recruited to evaluate pore product efficacy. In both studies, full face images were taken using Visia‐CR and assessed by means of the newly developed tool and visual grading.ResultsA high correlation between visual grading and pore size was obtained (r = 0.86). New methodology was able to differentiate products similar to visual grading.ConclusionNovel pore image analysis method using 2D skin surface imaging with standard photography has been developed and validated. In addition to pore size measurements, we propose this method to be used to measure pore shape, color, and orientation for a comprehensive characterization of facial pores.
Epstein‐Barr virus‐associated smooth muscle tumors after lung transplantation
Authors: Hirama Takashi , Tikkanen Jussi , Pal Prodipto , Cleary Sean , Binnie Matthew 
Published: March 2019

AbstractBackgroundRecipients of solid organ transplants are prone to various complications that are seldom encountered in immunocompetent individuals. Post‐transplant lymphoproliferative disorder (PTLD) is the best known and commonest Epstein‐Barr Virus (EBV)‐associated malignancy post solid organ transplant. EBV‐associated smooth muscle tumors (EBV‐SMT) including leiomyomas and leiomyosarcomas are rare and much less studied than PTLD. We recently encountered two cases of EBV‐SMT post lung transplantation and here we summarize their clinical features and course together with a literature review.MethodClinical data and treatment details of two patients who developed EBV‐SMT were reviewed and retrieved up to December 31, 2017. English literature was searched through the PubMed database from 1965 to 2017 for studies of the association between lung transplant and EBV‐SMT.ResultsThe incidence of PTLD is higher among lung transplant recipients compared to kidney transplant recipients, an observation that has been attributed to stronger immune suppression in the lung patients. EBV‐SMT showed a higher incidence among kidney recipients than among lung recipients, suggesting that the degree of immunosuppression may be a less important factor in the development of EBV‐SMT. EBV‐SMT has most often been seen among lung transplant recipients with EBV mismatch.ConclusionsBecause EBV‐SMT is a rare tumor, its incidence, risk factors, and optimal management have not been well‐defined and further study is needed.
Phaeohyphomycosis caused by Medicopsis romeroi in solid organ transplant recipients: Report of two cases and comprehensive review of the literature
Authors: Los‐Arcos Ibai , Royuela Meritxell , Martín‐Gómez M. Teresa , Alastruey‐Izquierdo Ana , Sellarès Joana , Perelló Manel , Castells Lluís , Dopazo Cristina , Gavaldà Joan , Len Oscar 
Published: March 2019

AbstractMedicopsis romeroi is a melanized coelomycetous fungus, mainly found in tropical and subtropical regions and an uncommon cause of infection in solid organ transplant (SOT) recipients. We describe two cases of SOT recipients diagnosed with phaeohyphomycosis due to M romeroi and provide a comprehensive literature review. These infections should be considered in patients native to tropical countries with a localized skin and soft tissue infection. Sequencing is needed for accurate identification of uncommon melanized fungi. Surgical treatment is recommended to cure the infection and co‐adjunctive oral antifungals should be considered.
A Conforming Augmented Finite Element Method for Modeling Arbitrary Cracking in Solids
Authors: Ma Zhaoyang , Yang Qingda , Su Xianyue 
Published: March 2019

Abstract
This paper presents a conforming augmented finite element method (C-AFEM) that can account for arbitrary cracking in solids with similar accuracy of other conforming methods, but with a significantly improved numerical efficiency of about ten times. We show that the numerical gains are mainly due to our proposed new solving procedure, which involves solving a local problem for crack propagation and a global problem for structural equilibrium, through a tightly coupled two-step process. Through several numerical benchmarking examples, we further demonstrate that the C-AFEM is more accurate and mesh insensitive when compared with the original A-FEM, and both C-AFEM and A-FEM are much more robust and efficient than other parallel methods including the extended finite element method (XFEM)/generalized finite element (GFEM) and the conforming embedded discontinuity method.
PEBBLES study protocol: a randomised controlled trial to prevent atopic dermatitis, food allergy and sensitisation in infants with a family history of allergic disease using a skin barrier improvement strategy
Authors: Lowe Adrian , Su John , Tang Mimi , Lodge Caroline J , Matheson Melanie , Allen Katrina J , Varigos George , Sasi Arun , Cranswick Noel , Hamilton Simone , Robertson Colin F , Hui Jennie , Abramson Michael , O’Brien Shaie , Dharmage Shyamali 
Published: March 2019

IntroductionThe skin is an important barrier against environmental allergens, but infants have relatively impaired skin barrier function. There is evidence that impaired skin barrier function increases the risk of allergic sensitisation, atopic dermatitis (AD) and food allergy. We hypothesise that regular prophylactic use of emollients, particularly those that are designed to improve skin barrier structure and function, will help prevent these conditions. With the aim of determining if application of a ceramide-dominant emollient two times per day reduces the risk of AD and food allergy, we have commenced a multicentre phase III, outcome assessor blinded, randomised controlled trial of this emollient applied from birth to 6 months.Methods and analysisInfants (n=760) with a family history of allergic disease will be recruited from maternity hospitals in Melbourne. The primary outcomes are as follows: the presence of AD, assessed using the UK Working Party criteria, and food allergy using food challenge, in the first 12 months of life as assessed by a blinded study outcome assessor. Secondary outcomes are as follows: food sensitisation (skin prick test), skin barrier function, AD severity, the presence of new onset AD after treatment cessation (between 6 and 12 months) and the presence of parent reported AD/eczema. Recruitment commenced in March 2018.Ethics and disseminationThe PEBBLES Study is approved by the Human Research Ethics Committees of the Royal Children’s Hospital (RCH) (#37090A) and the Mercy Hospital for Women (2018–008). Parents or guardians will provide written informed consent. Outcomes will be disseminated through peer-reviewed publications and presented at scientific conferences.Trial registration numbersACTRN12617001380381 andNCT03667651.
Association between socioeconomic status and prevalence of non-communicable diseases risk factors and comorbidities in Bangladesh: findings from a nationwide cross-sectional survey
Authors: Biswas Tuhin , Townsend Nick , Islam Md Saimul , Islam Md Rajibul , Das Gupta Rajat , Das Sumon Kumar , Mamun Abdullah Al 
Published: March 2019

ObjectivesThis study aimed to examine the prevalence and distribution in the comorbidity of non-communicable diseases (NCDs) among the adult population in Bangladesh by measures of socioeconomic status (SES).DesignThis was a cross-sectional study.SettingThis study used Bangladesh Demographic and Health Survey 2011 data.ParticipantsTotal 8763 individuals aged ≥35 years were included.Primary and secondary outcome measuresThe primary outcome measures were diabetes mellitus (DM), hypertension (HTN) and overweight/obesity. The study further assesses factors (in particular SES) associated with these comorbidities (DM, HTN and overweight/obesity).ResultsOf 8763 adults,12% had DM, 27% HTN and 22% were overweight/obese (body mass index ≥23 kg/m2). Just over 1% of the sample had all three conditions, 3% had both DM and HTN, 3% DM and overweight/obesity and 7% HTN and overweight/obesity. DM, HTN and overweight/obesity were more prevalent those who had higher education, were non-manual workers, were in the richer to richest SES and lived in urban settings. Individuals in higher SES groups were also more likely to suffer from comorbidities. In the multivariable analysis, it was found that individual belonging to the richest wealth quintile had the highest odds of having HTN (adjusted OR (AOR) 1.49, 95% CI 1.29 to 1.72), DM (AOR 1.63, 95% CI 1.25 to 2.14) and overweight/obesity (AOR 4.3, 95% CI 3.32 to 5.57).ConclusionsIn contrast to more affluent countries, individuals with NCDs risk factors and comorbidities are more common in higher SES individuals. Public health approaches must consider this social patterning in tackling NCDs in the country.
Proximity extension assay testing reveals novel diagnostic biomarkers of atypical parkinsonian syndromes
Authors: Jabbari Edwin , Woodside John , Guo Tong , Magdalinou Nadia K , Chelban Viorica , Athauda Dilan , Lees Andrew J , Foltynie Thomas , Houlden Henry , Church Alistair , Hu Michele TM , Rowe James B , Zetterberg Henrik , Morris Huw R 
Published: March 2019

ObjectiveThe high degree of clinical overlap between atypical parkinsonian syndromes (APS) and Parkinson’s disease (PD) makes diagnosis challenging. We aimed to identify novel diagnostic protein biomarkers of APS using multiplex proximity extension assay (PEA) testing.MethodsCerebrospinal fluid (CSF) samples from two independent cohorts, each consisting of APS and PD cases, and controls, were analysed for neurofilament light chain (NF-L) and Olink Neurology and Inflammation PEA biomarker panels. Whole-cohort comparisons of biomarker concentrations were made between APS (n=114), PD (n=37) and control (n=34) groups using logistic regression analyses that included gender, age and disease duration as covariates.ResultsAPS versus controls analyses revealed 11 CSF markers with significantly different levels in cases and controls (p<0.002). Four of these markers also reached significance (p<0.05) in APS versus PD analyses. Disease-specific analyses revealed lower group levels of FGF-5, FGF-19 and SPOCK1 in multiple system atrophy compared with progressive supranuclear palsy and corticobasal syndrome. Receiver operating characteristic curve analyses suggested that the diagnostic accuracy of NF-L was superior to the significant PEA biomarkers in distinguishing APS, PD and controls. The biological processes regulated by the significant proteins include cell differentiation and immune cell migration. Delta and notch-like epidermal growth factor-related receptor (DNER) had the strongest effect size in APS versus controls and APS versus PD analyses. DNER is highly expressed in substantia nigra and is an activator of the NOTCH1 pathway which has been implicated in the aetiology of other neurodegenerative disorders including Alzheimer’s disease.ConclusionsPEA testing has identified potential novel diagnostic biomarkers of APS.
Morphine, Morphine-6-Glucuronide, and Morphine-3-Glucuronide in Cerebrospinal Fluid and Plasma After Epidural Administration of Morphine
Authors: Kalman Sigga , Metcalf Kerstin , Eintrei Christina 
Published: March 2019

Background and ObjectivesIt has been suggested that the potency of epidural morphine might be explained by spinal metabolism to the active and potent metabolite morphine-6-glucuronide (M6G). The main objective of this study was to describe the early pharmacokinetics of epidurally administered, morphine with special attention to the appearance of the glucuronated metabolites in cerebrospinal fluid (CSF).MethodsMorphine was administered epidurally to eight patients scheduled for major abdominal surgery. The concentrations of morphine and its 6-glucuronide and 3-glucuronide metabolites were monitored in blood and CSF at 10, 30, 60, and 120 minutes and 10 and 24 hours. Postoperative pain was estimated on a visual analog scale, and analgesia requirements (administered by a patient-controlled techique) were recorded.ResultsOnly traces of the metabolites were found in CSF and in only two patients throughout the 24 hours. Both metabolites appeared rapidly (within 30 minutes) in plasma in all patients and were found in plasma throughout the study period. Morphine concentration peaked in CSF within 30 minutes at a very high level; in plasma, it peaked at 10 minutes. No correlation was seen between initial or later concentrations of morphine in CSF and postoperative pain or morphine requirements.ConclusionsNo evidence of spinal metabolism of morphine could be found. Rapid distribution of morphine to CSF and plasma occurred after epidural administration. No value of initial CSF morphine concentrations for prediction of analgesic requirements could be demonstrated.
Postoperative Analgesia Following Total Knee Arthroplasty
Authors: Allen J. G. , Denny N. M. , Oakman N. 
Published: March 2019

Background and ObjectivesThe quality of analgesia and subsequent morphine requirements following spinal anesthetic block (SAB) or combined sciatic and femoral (3-in-1) block (SFB) for total knee arthroplasty were compared.MethodsThe 39 patients studied were randomly assigned to receive either SAB (n = 19) or SFB (n = 20). All patients received a standardized general anesthetic, patient-controlled analgesia, and regular diclofenac. Visual analog pain scores and morphine requirements were recorded for 48 hours following surgery. Observations were grouped into four 12-hour periods. Pain scores (0-10 cm) were expressed as 95% confidence intervals; the criterion for analgesic success was a confidence interval in the range 0-3 cm.ResultsAlthough pain-free on awakening, the SAB patients failed to achieve analgesic success in any of the four periods, while the SFB patients did so in three of the four periods. Morphine consumption was significantly higher in the SAB group during the first two periods but similar to the SFB group thereafter.ConclusionIn comparison with SAB, SFB resulted in superior analgesia and reduced morphine consumption for the first 24 hours following total knee arthroplasty.
Pain Evaluation in the Intensive Care Unit
Authors: Terai Takekazu , Yukioka Hidekazu , Asada Akira 
Published: March 2019

Background and ObjectivesThe visual analog scale (VAS) is a simple and sensitive mean of pain assessment. The faces scale is also a simple, self-reporting method for children. Facial signs of pain have not been used to assess pain in postoperative adult patients in the intensive care unit (ICU).MethodsFifty patients undergoing esophageal cancer surgery by a thoracoabdominal procedure were studied. Epidural opioids, such as morphine or buprenorphine, combined with bupivacaine were administered during and after surgery. Pain measurement was performed by a physician in the ICU using the self-reported VAS 0.5, 1, 2, 4, and 6 hours after tracheal extubation and thereafter every 4 hours during the stay in the ICU. A nurse who was unaware of the patients' VAS scores assessed facial expression as a measure of pain intensity using a five-grade faces scale immediately before pain evaluation by VAS. The VAS was rescaled into five discrete units that would match the five faces scale scores. Weighted kappa statistics were used to establish a relative level of agreement between the five-grade VAS and faces scale.ResultsGood agreement was found between the five-grade VAS and the faces scale 30 minutes and 1 hour after tracheal extubation (weighted kappa values .67 and .62, respectively). The VAS and faces scales were measured 7-13 times per patient during the stay in the ICU, and 518 observations were collected. Although moderate agreement was found between the five-graded VAS and faces scale for all pairs of observation (weighted kappa values .54), less agreement was found between them in patients with moderate pain. In addition, the calculated mean differences between the five-graded VAS and faces scale differed significantly between patients.ConclusionThe faces scale may be useful for pain evaluation in the ICU.
Intrafascicular Injection of Ammonium Sulfate and Bupivacaine in Peripheral Nerves of Neonatal and Juvenile Rats
Authors: Hertl M. Catherine , Hagberg Patricia K. , Hunter Daniel A. , Mackinnon Susan E. , Langer Jacob C. 
Published: March 2019

Background and ObjectivesRegional nerve blocks are often used for the treatment of postoperative pain in children. Ammonium sulfate is a non-narcotic anesthetic agent, which has been reported to provide pain relief lasting days to weeks, with few reported side effects in adult studies. Prior to considering clinical use in children, the neurotoxicity of ammonium sulfate in 4-day and 3-week old rats was assessed and compared with that of bupivacaine.MethodsEach rat received a posterior tibial nerve intrafascicular injection (0.01 mL in 4-day-old and 0.02 mL in 3-week-old rats) using either 10% ammonium sulfate (n = 24 per age group), 0.5% bupivacaine (n = 18 per age group), 0.9% saline (n = 18 per age group), or 5% phenol (n = 18 per age group). A functional assessment by serial walking track analysis and a morphologic assessment by neurohistology were made.ResultsNo abnormalities in serial walking track analysis and no structural nerve damage were detected after ammonium sulfate, bupivacaine, or saline injection. Bupivacaine caused mild focal changes in both age groups, which recovered by 8 weeks.ConclusionsIntrafascicular injection of ammonium sulfate was as safe as bupivacaine in this animal model. Further animal studies must be made before human trials are initiated.
The Recovery Profile of Hyperbaric Spinal Anesthesia With Lidocaine, Tetracaine, and Bupivacaine
Authors: Frey Kere , Holman Stephen , Mikat-Stevens Marianne , Vazquez John , White Lee , Pedicini Eric , Sheikh Taqdees , Kao T. C. , Kleinman Bruce , Stevens Rom A. 
Published: March 2019

Background and ObjectivesSurgical procedures previously considered too lengthy for the ambulatory surgery setting are now being performed during spinal anesthesia. The complete recovery profile of tetracaine and bupivacaine are now of interest but are not available in the literature. This study was conducted to compare times to ambulation, voiding, and complete block resolution, as well as the incidence of back and radicular pain, after spinal anesthesia with lidocaine, bupivacaine, and tetracaine.MethodsTwelve adult volunteers underwent spinal anesthesia on three separate occasions with three local anesthetics (lidocaine 100 mg, bupivacaine 15 mg, and tetracaine 15 mg in hyperbaric solutions) in random order and in a double-blind fashion. A 24-gauge Sprotte spinal needle was placed at the L2-3 interspace. The level of analgesia to pinprick was determined moving cephalad in the midclavicular line until a dermatome was reached at which the prick felt as sharp as over an unblocked dermatome. One dermatome caudad to this point was recorded every 5 minutes as the level of analgesia. We also recorded the times to voiding, unassisted ambulation, and complete resolution of sacral anesthesia.ResultsThere was no difference between tetracaine and bupivacaine in time taken for two- and four-segment regression of the analgesia level. However, times to ambulation and complete resolution of the block were significantly shorter with bupivacaine then with tetracaine. With lidocaine, times to four-segment regression, ambulation, voiding, and complete regression of the block were significantly shorter than with bupivacaine and tetracaine. Time to two-segment regression did not differ among local anesthetics. Back and radicular pain symptoms were reported by three subjects after lidocaine subarachnoid block but not after tetracaine or bupivacaine.ConclusionAmong individual subjects, lidocaine exhibited the shortest recovery profile. However, the recovery profiles of the three anesthetics were very variable between subjects. Time to meeting discharge criteria after bupivacaine or tetracaine was faster in a few subjects than that after lidocaine in other subjects. For ambulatory anesthesia, times to two- and four-segment regression do not accurately predict time to readiness for discharge after spinal anesthesia.
Central command increases muscle sympathetic nerve activity more to contracting than noncontracting muscle during rhythmic isotonic leg exercise
Authors: Taylor Chloe E. , Boulton Daniel , Howden Erin J. , Siebenmann Christoph , Macefield Vaughan G. 
Published: March 2019

We have previously shown that the increase in muscle sympathetic nerve activity (MSNA) to contracting muscle during sustained isometric exercise is due primarily to central command and that contracting muscle does not express a metaboreceptor-driven increase in MSNA. Here we tested the hypothesis that MSNA increases to the contracting muscle also during rhythmic isotonic exercise, in which muscle metabolites will not accumulate because the contraction is performed without external load. MSNA was recorded from the common peroneal nerve in 10 participants, and negative-going sympathetic spikes were extracted during 50 cycles of sinusoidal (0.15 Hz) isotonic dorsiflexions of the ipsilateral or contralateral ankle. Electromyographic activity (EMG) was recorded from the tibialis anterior muscle on both sides. Cross-correlation analysis between MSNA and EMG revealed a marked cyclic modulation of MSNA to the contracting (ipsilateral) muscle. This modulation, in which MSNA increased during the contraction phase, was three times greater than that to the noncontracting muscle (modulation index = 27.4 ± 3.2% vs. 9.2 ± 1.5%; P < 0.002). There were no differences in either the intensity or the magnitude of modulation of EMG during ipsilateral and contralateral contractions. We conclude that central command increases MSNA to the contracting muscle during rhythmic isotonic exercise. NEW & NOTEWORTHY Muscle sympathetic nerve activity (MSNA) increases to contracting muscle during isometric exercise, but whether this occurs during rhythmic isotonic exercise is unknown. We recorded MSNA to the pretibial flexors during cyclic dorsiflexion of the ipsilateral or contralateral ankle. MSNA showed a cyclic increase during the contraction phase that was significantly higher to the contracting than the noncontracting muscle, supporting central command as the primary mechanism responsible for increasing MSNA.