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Abstract Background Chloride intracellular channel 1 (CLIC1) is expressed ubiquitously in human tissues and is involved in the regulation of cell cycle, cell proliferation and differentiation. Recent studies have shown that CLIC1 is highly expressed in several human malignant tumors. However, its roles in human gliomas are still unclear. The aim of this study was to investigate the clinicopathological significance and prognostic value of CLIC1 expression in human gliomas. Methods CLIC1 expression in human gliomas and nonneoplastic brain tissues was measured by real-time quantitative RT-PCR assay and immunohistochemistry. Its association with clinicopathological factors or prognosis in patients with gliomas was statistically analyzed. Results The expression of CLIC1 at both mRNA and protein levels was significantly increased in high-grade (Grade III~IV) glioma tissues compared with that in low-grade (Grade I~II) and nonneoplastic brain tissues, and was up-regulated with ascending tumor World Health Organization (WHO) grades. The elevated expression of CLIC1 protein was also significantly correlated with low Karnofsky performance score (KPS) (P=0.008). Moreover, both univariate and multivariate analysis shown that high CLIC1 expression was significantly associated with poor prognosis in patients with gliomas (P Conclusions Our data provide the first evidence that CLIC1 expression might play an important role in the regulation of aggressiveness in human gliomas. The elevated expression of CLIC1 might represent a valuable prognostic marker for this disease.

Background: Infratentorial craniotomy patients have a high incidence of postoperative nausea and vomiting (PONV). Enhanced Recovery After Surgery (ERAS) protocols have been shown in multiple surgical disciplines to improve outcomes, including reduced PONV. However, very few studies have described the application of ERAS to infratentorial craniotomy. The aim of this study was to examine whether our ERAS protocol for infratentorial craniotomy could improve PONV.Methods: We implemented an evidence-based, multimodal ERAS protocol for patients undergoing infratentorial craniotomy. A total of 105 patients who underwent infratentorial craniotomy were randomized into either the ERAS group (n = 50) or the control group (n = 55). Primary outcomes were the incidence of vomiting, nausea score, and use of rescue antiemetic during the first 72 h after surgery. Secondary outcomes included postoperative anxiety level, sleep quality, and complications.Results: Over the entire 72 h post-craniotomy observation period, the cumulative incidence of vomiting was significantly lower in the ERAS group than in the control group. Meanwhile, the incidence of vomiting was significantly lower in the ERAS group on postoperative days (PODs) 2 and 3. Notably, the proportion of patients with mild nausea (VAS 0-4) was higher in the ERAS group as compared to the control group on PODs 2 or 3. Additionally, the postoperative anxiety level and quality of sleep were significantly better in the ERAS group.Conclusion: Successful implementation of our ERAS protocol in infratentorial craniotomy patients could attenuate postoperative anxiety, improve sleep quality, and reduce the incidence of PONV, without increasing the rate of postoperative complications.Trial Registration: ChiCTR-INR-16009662, 27 Oct 2016, Clinical study on the development and efficacy evaluation of Enhanced Recovery After Surgery (ERAS) in Neurosurgery. [ABSTRACT FROM AUTHOR]

Operating on the basic principle of "telling people about what lots of other people do," social norms interventions have demonstrated efficacy in inducing behavior change in diverse settings. However, very few studies examine how the effect of social norms is differentially manifest across individuals, especially in the contemporary socially connected digital world. We provide new empirical evidence from a randomized field experiment that included more than 7,000 individuals on an online physical activity community observed for a two-month period. We find that connectivity plays an important role in moderating the effectiveness of social norms: individuals with higher levels of social connectivity are more susceptible to a social norms message. Additional analysis reveals that individuals who engage in information sharing (high followers and low followees) are the most susceptible to the social norms message. This study has important implications for the effective and safe use of social norms in nudging people's behavior. Our finding that social norms do not affect all users equally should help optimize interventions by focusing on users with high susceptibility based on easily observable measures. Abundant empirical evidence supports the overall efficacy of social norms as a strategy to induce behavior change. However, very few studies examine how the effect of social norms is differentially manifest across individuals, especially in the contemporary socially connected digital world. We conjecture that the effects of social norms are conditional on an individual's digital social ties and provide new empirical evidence from a randomized field experiment that included more than 7,000 individuals on an online physical activity community observed for a two-month period. In our investigation of the effect of social norms on users' goal-setting and goal attainment behaviors, we find a significant moderating role for social connectivity: individuals with higher levels of social connectivity are more susceptible to a social norms message containing information indicating the number of users in this community who set a goal in the pretreatment month. Additional analysis reveals that individuals who have many followers (i.e., high in-degree) but do not follow many others (low out-degree) are the most susceptible to the social norms treatment. Strikingly, we find that social norms also lead to a substantially lower rate of goal attainment compared with the control message that simply highlights the benefits of setting a goal. This adverse effect is also heterogeneously experienced, conditional on the number of social ties. Our findings have important implications for the design of interventions based on social norms. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the effect of preoperative oral carbohydrate loading versus fasting on the outcomes of patients undergoing elective craniotomy. In a single-center randomized controlled study, 120 neurosurgical patients who were admitted for elective craniotomy were included and randomized into 2 groups: 58 patients received 400 mL of oral carbohydrate loading 2 h before surgery (intervention group), and 62 patients were fasting for 8 h prior to surgery as routine management (control group). The primary end point was glucose homeostasis. Secondary outcomes included handgrip strength, pulmonary function and postoperative complications. Better glucose homeostasis (5.6 ± 1.0 mmol/L vs. 6.3 ± 1.2 mmol/L, P = 0.001) was achieved in patients who received preoperative oral carbohydrate loading compared to fasting. Furthermore, patients in the intervention group had better handgrip strength (25.3 ± 7.1 kg vs. 19.9 ± 7.5 kg, P < 0.0001) and pulmonary function (in terms of peak expiratory flow rate) (315.8 ± 91.5 L/min vs. 270.0 ± 102.7 L/min, P = 0.036) compared to the controls postoperatively. The rates of postoperative surgical and non-surgical complications did not differ between the groups. Both postoperative and total hospital length of stay (LOS) reduced significantly in the intervention group (-3d, P < 0.0001 and P = 0.004). Oral carbohydrate loading given 2 h before surgery in patients undergoing elective craniotomy seems to improve glucose homeostasis, handgrip strength and pulmonary function as well as decrease LOS without increasing the risk of postoperative complications. Routine use of preoperative oral carbohydrate loading could be suggested in clinical settings, though further evaluation of its safety and efficacy is warranted. [ABSTRACT FROM AUTHOR]

In this paper, we use mobile messaging to leverage recipients' social ties and encourage offline prosocial activities in groups. In particular, we conduct a randomized field experiment with 80,000 blood donors and study how behavioral interventions and economic rewards motivate offline group formation. We find that two commonly used interventions—reminder messages and individual reward—are ineffective in motivating group formation because they do not compensate donors for the cost of bringing friends. In contrast, we find that group reward—a new reward that is contingent on a donor bringing a friend—is effective in motivating group formation. Furthermore, group reward tends to attract different types of donors, especially those who are traditionally less active in online social settings but have more local social ties. Structural estimation further reveals the underlying mechanisms, suggesting that group reward is four times more cost-effective than individual reward in driving total donation. Our study suggests that motivating offline group formation is a promising approach to boost prosocial activities. The online appendix is available at https://doi.org/10.1287/mnsc.2018.3069. This paper was accepted by Chris Forman, information systems. [ABSTRACT FROM AUTHOR]

Statistics from past strong earthquakes revealed that electricity transmission towers were vulnerable to earthquake excitations. It is necessary to mitigate the seismic responses of power transmission towers to ensure the safety of such structures. In this research, a novel shape memory alloy-tuned mass damper is proposed, and seismic vibration control of power transmission tower using shape memory alloy-tuned mass damper based on three types of shape memory alloy materials (i.e. NiTi, M-CuAlBe, P-CuAlBe) is analyzed. The detailed three-dimensional finite element model of a power transmission tower incorporated with shape memory alloy-tuned mass damper is developed using numerical simulation software ANSYS. The control effects of shape memory alloy-tuned mass damper on the seismic vibration of power transmission tower are assessed using nonlinear time history analysis method. The interested seismic performance indices include displacement, acceleration, and base shear force. In addition to the shape memory alloy materials, the influence of seismic intensity and frequency ratio are conducted for the optimal design. It is shown that installing shape memory alloy-tuned mass damper well reduced the seismic responses of power transmission tower. The comparison between different shape memory alloys indicated that the damping of the shape memory alloy-tuned mass damper is beneficial to mitigate the vibrations. [ABSTRACT FROM AUTHOR]

Objective: China has limited data on stress-related gastrointestinal ulcers in patients admitted for neurosurgical care. This study evaluated the incidence of upper gastrointestinal bleeding (UGIB) and use of stress ulcer prophylaxis (SUP) in Chinese neurocritical care patients (Glasgow Coma Scale [GCS] score ≤10).Methods: This multicenter, retrospective study was performed from January 2015 to July 2015. Medical records of 1468 patients hospitalized during 2014 were reviewed. An estimated UGIB incidence rate of 4.4% was considered for precision of 1.3% for estimation of UGIB. The primary endpoint was evaluation of overall incidence of any overt UGIB in ≤14 days after cerebral lesion. Secondary endpoints included incidence of UGIB with or and without clinically significant complications, time to UGIB, associated risk factors and SUP used.Results: We analyzed 1416 patients (mean age: 53.7 ± 14.00 years; males: 62.4%) with cerebral lesions. Overall incidence rate of UGIB ≤14 days was 12.9% (95% CI: 11.2%-14.7%), 0.76% with and 12.1% without significant clinical complications. Average time and duration of bleeding were 2.9 ± 3.37 days and 4.2 ± 8.4 days, respectively. The most significant risk factors for UGIB were mechanical ventilation for >48 hours (p < .0001), UGIB history (p = .0026) and use of anticoagulants (p < .0001). Acid-suppression drugs were administered for SUP in 79.0% of the patients, whereas 40.5% received hemostatic drugs.Conclusions: The rate of UGIB incidence was higher than the estimated rate in neurocritical care patients in China, suggesting the need for better management and treatment for stress-related mucosal disease in China. History of UGIB, mechanical ventilation and/or anticoagulants significantly affected UGIB. ClinicalTrials registry number: NCT02316990. [ABSTRACT FROM AUTHOR]

Abstract Background Deep brain stimulation (DBS) is currently used to treat addiction, with the nucleus accumbens (NAc) as one promising target. The anterior limb of the internal capsule (ALIC) is also a potential target, as it carries fiber tracts connecting the mesocorticolimbic circuits that are crucially involved in several psychiatric disorders, including addiction. Stimulating the NAc and ALIC simultaneously may have a synergistic effect against addiction. Methods Eight patients with a long history of heroin use and multiple relapses, despite optimal conventional treatments, were enrolled. Customized electrodes were implanted through the ALIC into the NAc, and deep brain stimulation (DBS) treatment began two weeks after surgery. The patients were followed for at least 24 months. The duration of drug-free time, severity of drug cravings, psychometric evaluations, and PET studies of glucose metabolism before and after DBS were conducted. All adverse events were recorded. Results With DBS, five patients were abstinent for more than three years, two relapsed after abstaining for six months, and one was lost of follow-up at three months. The degree of cravings for drug use after DBS was reduced if the patients remained abstinent (p < 0.001). Simultaneous DBS of the NAc and ALIC also improved the quality of life, alleviated psychiatric symptoms, and increased glucose metabolism in addiction-related brain regions. Moreover, stimulation-related adverse events were few and reversible. Conclusions Simultaneous DBS of the NAc and ALIC appears to be safe, with few side effects, and may prevent long-term heroin relapse after detoxification in certain patients. (This trial was registered at ClinicalTrials.gov , NCT01274988). Highlights • Bilateral NAc and ALIC were simultaneously stimulated in heroin addicts for preventing relapse after detoxification. • Five of eight patients have kept abstinent for more than 3 years, with few side effects. • Decreased cravings for drug use, improved quality of life and alleviated mental disorders were observed. • Simultaneous DBS of NAc and ALIC appears to be safe, and produces long-term effects for preventing heroin relapse. [ABSTRACT FROM AUTHOR]