bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multi-objective robust optimization method for the modified epoxy resin sheet molding compounds of the impeller
Authors: Qu Xiaozhang , Liu Guiping , Duan Shuyong , Yang Jichu 
Published: March 2016

Abstract
A kind of modified epoxy resin sheet molding compounds of the impeller has been designed. Through the test, the non-metal impeller has a better environmental aging performance, but must do the waterproof processing design. In order to improve the stability of the impeller vibration design, the influence of uncertainty factors is considered, and a multi-objective robust optimization method is proposed to reduce the weight of the impeller. Firstly, based on the fluid-structure interaction, the analysis model of the impeller vibration is constructed. Secondly, the optimal approximate model of the impeller is constructed by using the Latin hypercube and radial basis function, and the fitting and optimization accuracy of the approximate model is improved by increasing the sample points. Finally, the micro multi-objective genetic algorithm is applied to the robust optimization of approximate model, and the Monte Carlo simulation and Sobol sampling techniques are used for reliability analysis. By comparing the results of the deterministic, different sigma levels and different materials, the multi-objective optimization of the SMC molding impeller can meet the requirements of engineering stability and lightweight. And the effectiveness of the proposed multi-objective robust optimization method is verified by the error analysis. After the SMC molding and the robust optimization of the impeller, the optimized rate reached 42.5%, which greatly improved the economic benefit, and greatly reduce the vibration of the ventilation system.
IL-17A plays a central role in the expression of psoriasis signature genes through the induction of IκB-ζ in keratinocytes
Authors: Muromoto Ryuta , Hirao Toru , Tawa Keisuke , Hirashima Koki , Kon Shigeyuki , Kitai Yuichi , Matsuda Tadashi 
Published: March 2016

Abstract
In psoriasis lesions, a diverse mixture of cytokines is up-regulated that influence each other generating a complex inflammatory situation. Although this is the case, the inhibition of IL-17A alone showed unprecedented clinical results in patients, indicating that IL-17A is a critical inducer of psoriasis pathogenesis. To elucidate IL-17A-driven keratinocyte-intrinsic signaling pathways, we treated monolayers of normal human epidermal keratinocytes in vitro with a mixture of six cytokines (IL-17A, TNF-α, IL-17C, IL-22, IL-36γ and IFN-γ) involved in psoriasis to mimic the inflammatory milieu in psoriasis lesions. Microarray and gene set enrichment analysis revealed that this cytokine mixture induced similar gene expression changes with the previous transcriptome studies using psoriasis lesions. Importantly, we identified a set of IL-17A-regulated genes in keratinocytes, which recapitulate typical psoriasis genes exemplified by DEFB4A, S100A7, IL19 and CSF3, based on the differences in the expression profiles of cells stimulated with six cytokines versus cells stimulated with only five cytokines lacking IL-17A. Furthermore, a specific IL-17A-induced gene, NFKBIZ, which encodes IκB-ζ, a transcriptional regulator for NF-κB, was demonstrated to have a significant role for IL-17A-induced gene expression. Thus, we present novel in vitro data from normal human keratinocytes that would help elucidating the IL-17A-driven keratinocyte activation in psoriasis.
Auscultation versus Point-of-care Ultrasound to Determine Endotracheal versus Bronchial Intubation
Authors: Ramsingh Davinder , Frank Ethan , Haughton Robert , Schilling John , Gimenez Kimberly M. , Banh Esther , Rinehart Joseph , Cannesson Maxime 
Published: March 2016

AbstractAbstract
This prospective, randomized, double-blinded, crossover trial compared the accuracy of detecting bronchial intubation between point-of-care ultrasound and auscultation in 42 adult subjects. The point-of-care ultrasound was a reliable technique to detect bronchial intubation by demonstrating absent contralateral pleural lung sliding on the unintubated side.
Supplemental Digital Content is available in the text.

Background
Unrecognized malposition of the endotracheal tube (ETT) can lead to severe complications in patients under general anesthesia. The focus of this double-blinded randomized study was to assess the accuracy of point-of-care ultrasound in verifying the correct position of the ETT and to compare it with the accuracy of auscultation.

Methods
Forty-two adult patients requiring general anesthesia with ETT were consented. Patients were randomized to right main bronchus, left main bronchus, or tracheal intubation. After randomization, the ETT was placed via fiber-optic visualization. Next, the location of the ETT was assessed using auscultation by a separate blinded anesthesiologist, followed by an ultrasound performed by a third blinded anesthesiologist. Ultrasound examination included assessment of tracheal dilation via cuff inflation with air and evaluation of pleural lung sliding. Statistical analysis included sensitivity, specificity, positive predictive value, negative predictive value, and interobserver agreement for the ultrasound examination (95% CI).

Results
In differentiating tracheal versus bronchial intubations, auscultation showed a sensitivity of 66% (0.39 to 0.87) and a specificity of 59% (0.39 to 0.77), whereas ultrasound showed a sensitivity of 93% (0.66 to 0.99) and specificity of 96% (0.79 to 1). Identification of tracheal versus bronchial intubation was 62% (26 of 42) in the auscultation group and 95% (40 of 42) in the ultrasound group (P = 0.0005) (CI for difference, 0.15 to 0.52), and the McNemar comparison showed statistically significant improvement with ultrasound (P < 0.0001). Interobserver agreement of ultrasound findings was 100%.

Conclusion
Assessment of trachea and pleura via point-of-care ultrasound is superior to auscultation in determining the location of ETT.
Trabeculectomy Outcomes by Supervised Trainees in a Veterans Affairs Medical Center
Authors: Biggerstaff Kristin S. , Vincent Ryan D. , Lin Albert P. , Orengo-Nania Silvia , Frankfort Benjamin J. 
Published: March 2016

Purpose:
To evaluate the outcomes of trabeculectomy performed in an ophthalmology training program.

Design:
Retrospective study.

Participants:
A total of 160 patients undergoing trabeculectomy performed by a resident or fellow under attending supervision.

Materials and Methods:
Trabeculectomy surgeries performed by a supervised resident or fellow surgeon between October 2000 and April 2010 were reviewed. Success was considered to be complete or partial if intraocular pressure (IOP)-lowering medications were not or were required to achieve IOP≤21 mm Hg, respectively. Failure was defined as IOP>21 mm Hg on 2 consecutive visits, loss of light perception vision, IOP≤5 on 2 consecutive visits with associated visual acuity loss of ≥2 lines, or need for surgical intervention. Trabeculectomy survival was determined using Kaplan-Meier analysis through 60 months of follow-up.

Main Outcome Measures:
Final IOP, success/failure rate.

Results:
Complete success was achieved in 65 patients (41%). The average final IOP of this group was 9.1±3.7 mm Hg. Qualified success was achieved in 56 patients (35%). The average final IOP of this group was 11.5±6.4 mm Hg. At 60 months, the estimated cumulative probability of survival for complete and qualified successes was 28.9% and 63.7%, respectively.

Conclusions:
Among patients undergoing trabeculectomy by supervised residents or glaucoma fellows in a large Veterans Affairs Medical Center, IOP reduction was significant and similar to published studies. Trabeculectomy remains a successful intervention to lower IOP, with satisfactory success rates in the hands of trainee surgeons.
Suture Trabeculotomy Ab Interno for Secondary Glaucoma Combined With Scleromalacia
Authors: Manabe Shin-ichi , Sawaguchi Shoichi , Hayashi Ken 
Published: March 2016

Purpose:
To report 2 cases of secondary glaucoma combined with scleromalacia that were successfully treated with trabeculotomy ab interno.

Design:
Retrospective case report

Methods:
Trabeculotomy ab interno was used to treat secondary glaucoma combined with scleromalacia, which occurred due to refractory scleritis, in 2 cases. In case 2, goniosynechialysis was performed before the trabeculotomy to identify the trabecular meshwork. The sclera and conjunctiva were not incised in either case.

Results:
The patients’ postoperative intraocular pressure (IOP) levels (which were achieved without medication) were lower than their preoperative IOP levels (which were recorded during the administration of the maximum tolerable medication dosage); that is, they had dropped from 24 to 12 mm Hg in case 1 and from 33 to 11 mm Hg in case 2 by 12 postoperative months. No recurrent scleritis or postoperative worsening of the patient’s scleromalacia was seen in either case.

Conclusions:
Trabeculotomy ab interno is a very valuable treatment for secondary glaucoma combined with scleromalacia.
The mitochondrial metabolic checkpoint and aging of hematopoietic stem cells
Authors: Mohrin Mary , Chen Danica 
Published: March 2016

Purpose of review
Cell-cycle checkpoints are surveillance mechanisms in eukaryotic cells that monitor the condition of the cell, repair cellular damages, and allow the cell to progress through the various phases of the cell cycle when conditions become favorable. We review recent advances in hematopoietic stem cell (HSC) biology, highlighting a mitochondrial metabolic checkpoint that is essential for HSCs to return to the quiescent state.

Recent findings
As quiescent HSCs enter the cell cycle, mitochondrial biogenesis is induced, which is associated with increased mitochondrial protein folding stress and mitochondrial oxidative stress. Mitochondrial unfolded protein response and mitochondrial oxidative stress response are activated to alleviate stresses and allow HSCs to exit the cell cycle and return to quiescence. Other mitochondrial maintenance mechanisms include mitophagy and asymmetric segregation of aged mitochondria.

Summary
Because loss of HSC quiescence results in the depletion of the HSC pool and compromised tissue regeneration, deciphering the molecular mechanisms that regulate the mitochondrial metabolic checkpoint in HSCs will increase our understanding of hematopoiesis and how it becomes dysregulated under pathological conditions and during aging. More broadly, this knowledge is instrumental for understanding the maintenance of cells that convert between quiescence and proliferation to support their physiological functions.
Expression of Cancer Stem Cell Markers OCT4 and CD133 in Transitional Cell Carcinomas
Authors: Sedaghat Shirin , Gheytanchi Elmira , Asgari Mojgan , Roudi Raheleh , Keymoosi Hossein , Madjd Zahra 
Published: March 2016

Background:
Treatment failure, recurrence, and metastasis in bladder cancer are attributed to a subset of tumor cells expressing cancer stem cell (CSC) markers. This study aimed to explore the expression levels and the clinical significance of putative CSC markers OCT4 and CD133 in bladder cancer.

Materials and Methods:
Tissue microarray-based immunohistochemical analysis was applied to investigate the expression patterns of potential CSC markers OCT4 and CD133 in bladder cancer samples. The correlation between the expressions of each marker and clinicopathologic parameters was then analyzed.

Results:
There was a significant association between OCT4 expression and the TNM stage of bladder cancer (P<0.001). Our analysis demonstrated a significant association between the intensity of staining and the presence of lamina propria and muscularis propria invasion (P=0.02 and 0.02, respectively), whereas a relative inverse correlation was found between CD133 expression with lamina propria invasion (P=0.051) and muscularis propria invasion (P=0.07).

Conclusions:
The correlation of OCT4, but not CD133, with the invasiveness of bladder cancer revealed that OCT4 can be considered as a key regulator of tumor progression, aggressive behavior, and metastasis; therefore, OCT4 can be a potential marker for targeted therapy of bladder cancer.
Can Telemedicine Improve Adherence to Resuscitation Guidelines for Critically Ill Children at Community Hospitals? A Randomized Controlled Trial Using High-Fidelity Simulation
Authors: Yang Chris P. , Hunt Elizabeth A. , Shilkofski Nicole , Dudas Robert , Egbuta Chinyere , Schwartz Jamie M. 
Published: March 2016

Objectives
Children transferred from community hospitals lacking specialized pediatric care are more seriously ill than those presenting to pediatric centers. Pediatric consultation and adherence to management guidelines improve outcomes. The aims of the study were (1) to assess whether telemedicine consultation in critical situations is feasible and (2) to compare the impact of pediatric critical care medicine (PCCM) consultation via telemedicine versus telephone on community hospital adherence to resuscitation guidelines through a randomized controlled telemedicine trial.

Methods
In situ, high-fidelity simulation scenarios of critically ill children presenting to a community hospital and progressing to cardiopulmonary arrest were performed. Scenarios were randomized to PCCM consultation via telephone (control) or telemedicine (intervention). Primary outcome measure was proportion of teams who successfully defibrillated in 180 seconds or less from presentation of pulseless ventricular tachycardia.

Results
The following 30 scenarios were completed: 15 control and 15 intervention. Only 11 (37%) of 30 teams, defibrillated in 180 seconds or less from presentation of pulseless ventricular tachycardia; control: 6 (40%) of 15 versus intervention: 5 (33%) of 15, P = 0.7. Request for or use of backboard during cardiopulmonary resuscitation occurred in 24 (80%) of 30 scenarios; control: 9 (60%) of 15 versus intervention: 15 (100%) of 15, P = 0.006. Request for or use of stepstool during cardiopulmonary resuscitation occurred in 6 (20%) of 30 scenarios; control: 1 (7%) of 15 versus intervention: 5 (33%) of 15, P = 0.07.

Conclusions
This study demonstrates the feasibility of using telemedicine to support acute management of children who present to community hospitals. Neither study arm adhered to current resuscitation guidelines and telemedicine consultation with PCCM experts was not associated with improvement. However, further research on optimizing telemedicine impact on the quality of pediatric care at community hospitals is warranted.
Membrane association of SadC enhances its diguanylate cyclase activity to control exopolysaccharides synthesis and biofilm formation in Pseudomonas aeruginosa
Authors: Zhu Bin , Liu Cuilan , Liu Shiheng , Cong Hengjiang , Chen Yihuan , Gu Lichuan , Ma Luyan Z. 
Published: March 2016

SummaryCyclic diguanosine monophosphate (c‐di‐GMP) is one of the most important bacterial second messengers that controls many bacterial cellular functions including lifestyle switch between plankton and biofilm. Surface attachment defective (SadC) is a diguanylate cyclase (DGC) involved in the biosynthesis of c‐di‐GMP in Pseudomonas aeruginosa, an opportunistic pathogen that can cause diverse infections. Here we report the crystal structure of GGDEF domain from SadC and the critical role of the trans‐membrane (TM) domain of SadC with regard to biofilm formation, exopolysaccharide production and motility. We showed that over‐expression of SadC in P. aeruginosa PAO1 totally inhibited swimming motility and significantly enhanced the production of exopolysaccharide Psl. SadC lacking TM domains (SadC300–487) could not localize on cytoplasmic membrane and form cluster, lost the ability to inhibit the swimming and twitching motility, and showed the attenuated activity to promote Psl production despite that SadC300–487 was able to catalyze the synthesize of c‐di‐GMP in vitro and in vivo. The GGDEF domain of SadC has a typical GGDEF structure and the α‐helix connected the TM domains with SadC GGDEF domain is essential for SadC to form DGC oligomers. Our data imply that membrane association of SadC promotes its DGC activity by affecting the formation of active DGC oligomers.
Usability of dexmedetomidine for deep sedation in infants and small children with respiratory morbidities
Authors: Najafi N. , Veyckemans F. , Van de Velde A. , Poelaert J. 
Published: March 2016

BackgroundChildren with respiratory morbidities are at increased risk of developing adverse respiratory events while undergoing deep sedation. Dexmedetomidine possesses sedative properties with minimal respiratory depression. This report aimed to determine the usability of dexmedetomidine in children with significant respiratory morbidities who require deep sedation.MethodsMedical records of children with ASA classification III who had at least three characteristics of respiratory morbidities and who received dexmedetomidine sedation for magnetic resonance imaging (MRI) between January 2014 and May 2015 were retrospectively reviewed. Dexmedetomidine was administered as a bolus of 1 μg/kg over 10 min followed by 1 μg/kg/h infusion. If necessary, an additional bolus dose was given and the infusion rate was increased to 2 μg/kg/h. Respiratory morbidities, haemodynamic parameters, total dexmedetomidine dose, adverse cardiorespiratory events and sedation characteristics were analysed.ResultsNineteen out of 642 children who underwent MRI were eligible for evaluation. Seventeen children (89%) had at least four characteristics of respiratory morbidities. The median [IQR] age was 9 months [3.5–14]. All patients completed MRI scans while breathing spontaneously via the native airway. No episodes of adverse respiratory events or haemodynamic instability were observed. Children who were administered a lower dexmedetomidine dose and had a shorter sedation time were more likely to be younger than 1 year of age.ConclusionThese data demonstrate that dexmedetomidine deep sedation was well‐tolerated in children with significant respiratory morbidities. Moreover, children younger than 1 year of age were administered lower dexmedetomidine dose than children older than 1 year of age for the same sedation level.Trial registrationClinicalTrials.gov identifier NCT02555605.
Laparoscopic revision of Roux‐en‐Y gastric bypass to sleeve gastrectomy: A ray of hope for failed Roux‐en‐Y gastric bypass
Authors: Lakdawala Muffazal , Limas Peter , Dhar Shilpa , Remedios Carlyne , Dhulla Neha , Sood Amit , Bhasker Aparna Govil 
Published: March 2016

AbstractIntroductionRoux‐en‐Y gastric bypass (RYGB) is the most commonly performed bariatric operation across the world, but sometimes revision is necessary. Inadequate weight loss, weight regain, and complications such as dumping syndrome are common reasons for revision. We report the 1‐year outcomes of five patients who underwent laparoscopic conversion of RYGB to sleeve gastrectomy during surgical revision.MethodsMean age was 38.8 ± 9.1 years. Mean BMI at primary surgery was 57.9 ± 8.1 kg/m2. Two patients were diabetic and sleep apneic. One was hypertensive. All patients underwent a RYGB as the primary weight loss procedure. Mean weight loss was 36.8 ± 8.6 kg (excess weight loss  = 39.8 ± 14.9%) at 2 years. At the end of 5 years, these patients regained 10.9 ± 4.1 kg (31.5 ± 13.6% of excess weight loss). Primary indications for revision surgery were failure to lose weight, weight regain, and intractable dumping syndrome. Mean duration between primary and revision surgery was 6.2 ± 1.1 years. RYGB was converted to sleeve gastrectomy as a first stage in all cases.ResultsMean duration of revision surgery was 120.0 ± 15.5 min. Mean blood loss was 70 ± 50 mL. One year after revision surgery, a mean weight loss of 21.5 ± 10.5 kg was achieved (mean excess weight loss = 35.8 ± 8.8%). Two patients with type 2 diabetes mellitus and the one with hypertension achieved remission. Dumping was resolved. There were no complications.ConclusionLaparoscopic conversion of RYGB to sleeve gastrectomy as a first stage may be considered as an additional option in the armamentarium of revision procedures after RYGB.
The Role of NGOs in Ameliorating Sweatshop‐like Conditions in the Global Supply Chain: The Case of Fair Labor Association (FLA), and Social Accountability International (SAI)
Authors: Sethi S. Prakash , Rovenpor Janet L. 
Published: March 2016

AbstractOver the last 20+ years, globalization has made international trade and investment more efficient and productive. In the absence of coordinated global regulatory regimes, it has also made multinational corporations (MNCs) impervious to social concerns in the countries where they operate. There is considerable debate in the academic, political, and business arena as to the causes of the apparently inequitable distribution of benefits between labor and capital. Notwithstanding, the relative merits of this debate, and facing tremendous societal pressure, companies have adopted voluntary codes of conduct to ensure that workers making products for them in poor and developing countries are protected from hazardous working conditions and receive wages that meet local laws and market conditions. These codes, however, suffer from a lack of credibility and proof of substantive compliance. A new type of nongovernmental organization (NGO) has emerged that monitors a company's compliance with prespecified standards and provides assurance to the external stakeholders that the company has fulfilled its voluntary obligations. From an historical perspective, this has been an innovative phenomenon where the monitoring organization purports to act as an honest broker to ensure all concerned that the company/industry has fulfilled its obligations. In this article, we undertake a thorough examination of two such organizations, that is, Fair Labor Association, and Social Accountability International, that have played a pioneering role in bridging the gap between societal expectations and corporate performance. We examine their governance structures, operating procedures, monitoring standards, and public disclosure of findings, and above all, their success in improving the level of corporate compliance with their self‐created codes or standards. Unfortunately, our findings and conclusions are disappointing. In our view, the two groups have mostly failed to meet their avowed goals. Rather than using their NGO status to help companies improve their code compliance, they have suffered from managerial capture and have been reduced to corporate apologists.
Alpha‐Synuclein as a Biomarker for Parkinson's Disease
Authors: Atik Anzari , Stewart Tessandra , Zhang Jing 
Published: March 2016

AbstractParkinson's disease (PD) is a common neurodegenerative disorder, characterized pathologically by the presence of α‐synuclein (α‐syn)‐rich Lewy bodies. As clinical diagnosis of PD is challenging, misdiagnosis is common, highlighting the need for disease‐specific and early stage biomarkers. Both early diagnosis of PD and adequate tracking of disease progression could significantly improve outcomes for patients, particularly in regard to existing and future disease modifying treatments. Given its critical roles in PD pathogenesis, α‐syn may be useful as a biomarker of PD. The aim of this review is, therefore, to summarize the efficacy of tissue and body fluid α‐syn measurements in the detection of PD as well as monitoring disease progression. In comparison to solid tissue specimens and biopsies, biofluid α‐syn levels may be the most promising candidates in PD diagnosis and progression based on specificity, sensitivity and availability. Although α‐syn has been tested most extensively in cerebrospinal fluid (CSF), the relatively invasive procedure for collecting CSF is not suitable in most clinical settings, leading to investigation of plasma, blood and saliva as alternatives. The exploration of combined biomarkers, along with α‐syn, to improve diagnostic accuracy is also likely required.