bluuebunny/crossref_metadata_2025 huggingface dataset:
Oscillation of Half-Linear Differential Equations with Delay
Authors: Fišnarová Simona , Mařík Robert
Published: November 2013

We study the half-linear delay differential equation , , We establish a new a priori bound for the nonoscillatory solution of this equation and utilize this bound to derive new oscillation criteria for this equation in terms of oscillation criteria for an ordinary half-linear differential equation. The presented results extend and improve previous results of other authors. An extension to neutral equations is also provided.
Correlation Measures of Dual Hesitant Fuzzy Sets
Authors: Wang Lei , Ni Mingfang , Zhu Lei
Published: November 2013

The dual hesitant fuzzy sets (DHFSs) were proposed by Zhu et al. (2012), which encompass fuzzy sets, intuitionistic fuzzy sets, hesitant fuzzy sets, and fuzzy multisets as special cases. Correlation measures analysis is an important research topic. In this paper, we define the correlation measures for dual hesitant fuzzy information and then discuss their properties in detail. One numerical example is provided to illustrate these correlation measures. Then we present a direct transfer algorithm with respect to the problem of complex operation of matrix synthesis when reconstructing an equivalent correlation matrix for clustering DHFSs. Furthermore, we prove that the direct transfer algorithm is equivalent to transfer closure algorithm, but its asymptotic time complexity and space complexity are superior to the latter. Another real world example, that is, diamond evaluation and classification, is employed to show the effectiveness of the association coefficient and the algorithm for clustering DHFSs.
Differences of Composition Operators Followed by Differentiation between Weighted Banach Spaces of Holomorphic Functions
Authors: Chen Cui , Chen Ren-Yu , Zhou Ze-Hua
Published: November 2013

We characterize the boundedness and compactness of differences of the composition operators followed by differentiation between weighted Banach spaces of holomorphic functions in the unit disk. As their corollaries, some related results on the differences of composition operators acting from weighted Banach spaces to weighted Bloch type spaces are also obtained.
Parameter Matching Analysis of Hydraulic Hybrid Excavators Based on Dynamic Programming Algorithm
Authors: Shen Wei , Jiang Jihai , Su Xiaoyu , Karimi Hamid Reza
Published: November 2013

In order to meet the energy saving requirement of the excavator, hybrid excavators are becoming the hot spot for researchers. The initial problem is to match the parameter of each component, because the system is tending to be more complicated due to the introduction of the accumulator. In this paper, firstly, a new architecture is presented which is hydraulic hybrid excavator based on common pressure rail combined switched function (HHES). Secondly, the general principle of dynamic programming algorithm (DPA) is explained. Then, the method by using DPA for parameter matching of HHES is described in detail. Furthermore, the DPA is translated into the M language for simulation. Finally, the calculation results are analyzed, and the optimal matching group is obtained.
Fast Facial Detection by Depth Map Analysis
Authors: Shieh Ming-Yuan , Hsieh Tsung-Min
Published: November 2013

In order to obtain correct facial recognition results, one needs to adopt appropriate facial detection techniques. Moreover, the effects of facial detection are usually affected by the environmental conditions such as background, illumination, and complexity of objectives. In this paper, the proposed facial detection scheme, which is based on depth map analysis, aims to improve the effectiveness of facial detection and recognition under different environmental illumination conditions. The proposed procedures consist of scene depth determination, outline analysis, Haar-like classification, and related image processing operations. Since infrared light sources can be used to increase dark visibility, the active infrared visual images captured by a structured light sensory device such as Kinect will be less influenced by environmental lights. It benefits the accuracy of the facial detection. Therefore, the proposed system will detect the objective human and face firstly and obtain the relative position by structured light analysis. Next, the face can be determined by image processing operations. From the experimental results, it demonstrates that the proposed scheme not only improves facial detection under varying light conditions but also benefits facial recognition.
Modeling Gender-Based Differences in Mode Choice considering Time-Use Pattern: Analysis of Bicycle, Public Transit, and Car Use in Suzhou, China
Authors: Yang Min , Li Dan , Wang Wei , Zhao Jingyao , Chen Xuewu
Published: November 2013

Activity-travel behavior differs between women and men. Previous researches dealing with gender differences mainly focus on travel in itself rather than the interaction between time-use pattern and travel mode choice. Based on the activity-travel survey data of Suzhou, China, multigroup structural equation modeling is adopted to explore the reason for gender-based differences in mode choice through comparing the interactions among sociodemographics, time-use pattern, and mode choice. The results indicate that gender-based differences do exist in mode choice. Women prefer traveling by bicycle while men prefer traveling by car in Suzhou. And compared to women, men's mode choice is not so easy to be affected by other travel modes. Besides, gender-based differences exist in the magnitude or the sign of the interrelations among socio-demographics, time-use pattern, and mode choice. It is better to explain gender-based differences in mode choice by including time-use pattern endogenously than through socio-demographics alone. Furthermore, the study shows that by examining the direct, indirect, and total effects in the model system simultaneously, we are able to better capture the differences in mode choice across genders and further able to understand the reason for those differences. Finally, some dedicated suggestions are presented for planners and government to ensure a healthy transportation system.
Congestion Service Facilities Location Problem with Promise of Response Time
Authors: Hu Dandan , Liu Zhi-Wei , Hu Wenshan
Published: November 2013

In many services, promise of specific response time is advertised as a commitment by the service providers for the customer satisfaction. Congestion on service facilities could delay the delivery of the services and hurts the overall satisfaction. In this paper, congestion service facilities location problem with promise of response time is studied, and a mixed integer nonlinear programming model is presented with budget constrained. The facilities are modeled as M/M/c queues. The decision variables of the model are the locations of the service facilities and the number of servers at each facility. The objective function is to maximize the demands served within specific response time promised by the service provider. To solve this problem, we propose an algorithm that combines greedy and genetic algorithms. In order to verify the proposed algorithm, a lot of computational experiments are tested. And the results demonstrate that response time has a significant impact on location decision.
Delay Pressure Detection Method to Eliminate Pump Pressure Interference on the Downhole Mud Pressure Signals
Authors: Shen Yue , Zhang Ling-Tan , Cui Shi-Li , Sheng Li-Min , Li Lin , Su Yi-Nao
Published: November 2013

The feasibility of applying delay pressure detection method to eliminate mud pump pressure interference on the downhole mud pressure signals is studied. Two pressure sensors mounted on the mud pipe in some distance apart are provided to detect the downhole mud continuous pressure wave signals on the surface according to the delayed time produced by mud pressure wave transmitting between the two sensors. A mathematical model of delay pressure detection is built by analysis of transmission path between mud pump pressure interference and downhole mud pressure signals. Considering pressure signal transmission characteristics of the mud pipe, a mathematical model of ideal low-pass filter for limited frequency band signal is introduced to study the pole frequency impact on the signal reconstruction and the constraints of pressure sensor distance are obtained by pole frequencies analysis. Theoretical calculation and numerical simulation show that the method can effectively eliminate mud pump pressure interference and the downhole mud continuous pressure wave signals can be reconstructed successfully with a significant improvement in signal-to-noise ratio (SNR) in the condition of satisfying the constraints of pressure sensor distance.
Sliding Mode Control for Multiagent System with Time-Delay and Uncertainties: An LMI Approach
Authors: Guo Pengfei , Zhang Jie , Lyu Ming , Bo Yuming
Published: November 2013

This paper considers the sliding mode control of multiagent systems (MAS) with time-delay and uncertainties in terms of linear matrix inequality (LMI). By constructing virtual feedback control method, the design of control system is simplified for time-delay independent system without uncertainties. For a class of uncertain systems with single time-delay, the essence of SMC design is analyzed in order to acquire a simple method for designing sliding surface. In terms of multiple timedelay system with uncertainties, a sufficient condition for sliding surface with independent time-delay is acquired, while control law is also designed to ensure the robust stability of closed-loop system. Finally, the effectiveness of conclusion is demonstrated by simulation results.
Stationary Patterns of a Cross-Diffusion Epidemic Model
Authors: Cai Yongli , Chi Dongxuan , Liu Wenbin , Wang Weiming
Published: November 2013

We investigate the complex dynamics of cross-diffusionSIepidemic model. We first give the conditions of the local and global stability of the nonnegative constant steady states, which indicates that the basic reproduction number determines whether there is an endemic outbreak or not. Furthermore, we prove the existence and nonexistence of the positive nonconstant steady states, which guarantees the existence of the stationary patterns.
Fractal Behavior in the Clarification Process of Cane Sugar Production
Authors: Yu Xiaomo , Ye Junke , Hu Jing , Liao Xiaoping , Gao Jianbo
Published: November 2013

Cane sugar production is an important industrial process. One of the most important steps in cane sugar production is the clarification process, which provides high-quality, concentrated sugar syrup crystal for further processing. To gain fundamental understanding of the physical and chemical processes associated with the clarification process and help design better approaches to improve the clarification of the mixed juice, we explore the fractal behavior of the variables pertinent to the clarification process. We show that the major variables in this key process all show persistent long-range correlations, for time scales up to at least a few days. Persistent long-range correlations amount to unilateral deviations from a preset target. This means that when the process is in a desired mode such that the target variables, color of the produced sugar and its clarity degree, both satisfy preset conditions, they will remain so for a long period of time. However, adversity could happen, in the sense that when they do not satisfy the requirements, the adverse situation may last quite long. These findings have to be explicitly accounted for when designing active controlling strategies to improve the quality of the produced sugar.
0-1 Test for Chaos in a Fractional Order Financial System with Investment Incentive
Authors: Xin Baogui , Li Yuting
Published: November 2013

A new integer-order chaotic financial system is extended by introducing a simple investment incentive into a three-dimensional chaotic financial system. A four-dimensional fractional-order chaotic financial system is presented by bringing fractional calculus into the new integer-order financial system. By using weighted integral thought, the fractional order derivative's economics meaning is given. The 0-1 test algorithm and the improved Adams-Bashforth-Moulton predictor-corrector scheme are employed to detect numerically the chaos in the proposed fractional order financial system.
Building a Smart E-Portfolio Platform for Optimal E-Learning Objects Acquisition
Authors: Ke Chih-Kun , Liu Kai-Ping , Chen Wen-Chin
Published: November 2013

In modern education, an e-portfolio platform helps students in acquiring e-learning objects in a learning activity. Quality is an important consideration in evaluating the desirable e-learning object. Finding a means of determining a high quality e-learning object from a large number of candidate e-learning objects is an important requirement. To assist student learning in a modern e-portfolio platform, this work proposed an optimal selection approach determining a reasonable e-learning object from various candidate e-learning objects. An optimal selection approach which uses advanced information techniques is proposed. Each e-learning object undergoes a formalization process. An Information Retrieval (IR) technique extracts and analyses key concepts from the student’s previous learning contexts. A context-based utility model computes the expected utility values of various e-learning objects based on the extracted key concepts. The expected utility values of e-learning objects are used in a multicriteria decision analysis to determine the optimal selection order of the candidate e-learning objects. The main contribution of this work is the demonstration of an effective e-learning object selection method which is easy to implement within an e-portfolio platform and which makes it smarter.
New Algorithms for Bidirectional Singleton Arc Consistency
Authors: Zhang Yonggang , Yin Qian , Zhu Xingjun , Li Zhanshan , Zhang Sibo , Liu Quan
Published: November 2013

Bidirectional singleton arc consistency (BiSAC) which is an extended singleton arc consistency (SAC) has been proposed recently. The first contribution of this paper is to propose and prove two theorems of BiSAC theoretically (one is a property of BiSAC and the other is the property of allowing the deletion of some BiSAC-inconsistent values). Secondly, based on these properties we present two algorithms, denoted by BiSAC-DF and BiSAC-DP, to enforce BiSAC. Also, we prove their correctness and analyze the space and time complexity of them in detail. Besides, for special circumstances, we show that BiSAC-DF admits a worst-case time complexity inO(en2d4)and a best one inO(en2d3)when the problem is an already BiSAC, while BiSAC-DP also has the same best one when the tightness is small. Finally, experiments on a wide range of CSP instances show BiSAC-DF and BiSAC-DP are usually around one order of magnitude faster than the existing BiSAC-1. For some special instances, BiSAC-DP is about two orders of magnitude efficient.
Positive Solutions of Nonlocal Boundary Value Problem for High-Order Nonlinear Fractional -Difference Equations
Authors: Yu Changlong , Wang Jufang
Published: November 2013

We study the nonlinear -difference equations of fractional order , , , , , where is the fractional -derivative of the Riemann-Liouville type of order , , , , and . We obtain the existence and multiplicity results of positive solutions by using some fixed point theorems. Finally, we give examples to illustrate the results.
Order Allocation Research of Logistics Service Supply Chain with Mass Customization Logistics Service
Authors: Liu Weihua , Xu Haitao , Sun Xinyu , Yang Yi , Mo Yuming
Published: November 2013

This paper studies the order allocation between a logistics service integrator (LSI) and multiple functional logistics service providers (FLSPs) with MCLS. To maximize the satisfaction of FLSPs, minimize the total cost of LSI, and maximize the customized degree, this paper establishes a multiobjective order allocation model of LSSC that is constrained by meeting customer demand, customer order decoupling point, and order difference tolerance coefficient. Numerical analysis is performed with Lingo 12 software. This paper also discusses the influences of scale effect coefficient, order difference tolerance coefficient, and relationship cost coefficient on the comprehensive order allocation performance of the LSSC. Results show that LSI prefers FLSPs with better scale effect coefficients and does not need to set an extremely high order difference tolerance coefficient. Similarly, setting a high relationship cost coefficient does not necessarily correspond to better results. For FLSPs, the continuous improvement of large-scale operational capacity is required. When the comprehensive order allocation performance of the LSSC is high, the LSI should offer cost compensation to improve the satisfaction of the LSSC.
Effects of Alpine Wetland Landscapes on Regional Climate on the Zoige Plateau of China
Authors: Bai Junhong , Lu Qiongqiong , Zhao Qingqing , Wang Junjing , Ouyang Hua
Published: November 2013

The differences in the air temperature, precipitation, evaporation, and relative humidity between wetlands and nonwetlands were analyzed to investigate the effects of alpine wetlands on regional climate. Meanwhile, the changes in precipitation and surface runoff fluxes before and after the typical wetland degradation were discussed, and the effects of wetland degradation on soil organic carbon were assessed. Correlation and regression analyses were applied to exhibit the relationships between wetland landscape areas and meteorological factors. Our results showed that the cooling effects of wetlands on ambient environment were very obvious, and soil temperature could be higher in the area with less surrounding wetland area. The evaporation capacity and relative humidity in wetlands were higher compared to the surrounding non-wetlands. Precipitation and surface runoff flux decreased due to serious wetland degradation, indicating that wetland degradation or expansion had close relation with regional precipitation. Once peat soils were converted to meadow soils or Aeolian sandy soils, soil organic carbon (SOC) would decline linearly. Correlation and regression analyses showed that there were significant correlations between wetland landscape areas and the annual average air temperature, the average air temperature in growing seasons, and the evaporation in growing seasons (P<0.05).
Efficient Haplotype Block Partitioning and Tag SNP Selection Algorithms under Various Constraints
Authors: Chen Wen-Pei , Hung Che-Lun , Lin Yaw-Ling
Published: November 2013

Patterns of linkage disequilibrium plays a central role in genome-wide association studies aimed at identifying genetic variation responsible for common human diseases. These patterns in human chromosomes show a block-like structure, and regions of high linkage disequilibrium are called haplotype blocks. A small subset of SNPs, called tag SNPs, is sufficient to capture the haplotype patterns in each haplotype block. Previously developed algorithms completely partition a haplotype sample into blocks while attempting to minimize the number of tag SNPs. However, when resource limitations prevent genotyping all the tag SNPs, it is desirable to restrict their number. We propose two dynamic programming algorithms, incorporating many diversity evaluation functions, for haplotype block partitioning using a limited number of tag SNPs. We use the proposed algorithms to partition the chromosome 21 haplotype data. When the sample is fully partitioned into blocks by our algorithms, the 2,266 blocks and 3,260 tag SNPs are fewer than those identified by previous studies. We also demonstrate that our algorithms find the optimal solution by exploiting the nonmonotonic property of a common haplotype-evaluation function.
Synergistic Activities of MET/RON Inhibitor BMS-777607 and mTOR Inhibitor AZD8055 to Polyploid Cells Derived from Pancreatic Cancer and Cancer Stem Cells
Authors: Zeng Jun-Ying , Sharma Sharad , Zhou Yong-Qing , Yao Hang-Ping , Hu Xing , Zhang Ruiwen , Wang Ming-Hai
Published: November 2013

Tyrosine kinase inhibitor BMS-777067 is an inhibitor of RON/MET receptor tyrosine kinases currently under clinical trials. Here, we report the synergistic activity of BMS-777607 in combination with mTOR inhibitor AZD8055 in killing chemoresistant pancreatic cancer and cancer stem cells. Treatment of pancreatic cancer L3.6pl cells with BMS-777607 alone inhibited clonogenic growth and moderately induced apoptotic death. However, BMS-777607 caused extensive polyploidy in L3.6pl cells through inhibition of aurora kinase B activity, independent of RON expression. In contrast, L3.6pl-derived cancer stem cells were highly resistant to BMS-777607–induced growth inhibition and apoptosis. The effect of BMS-777607 on induction of cancer stem cell polyploidy was also weak. BMS-777607–induced polyploidy features a predominant cell population with 8N chromosome content in both L3.6pl and cancer stem cells. These cells also showed decreased sensitivity toward chemotherapeutics by increased survival of IC50 values in response to doxorubicin, cisplatin, methotrexate, 5-fluorouracial, and gemcitabine. Among a panel of chemical inhibitors that target different signaling proteins, we found that BMS-777607 in combination with mTOR inhibitor AZD8055 exerted synergistic effects on L3.6pl and cancer stem cells. More than 70% of L3.6pl and cancer stem cells lost their viability when both inhibitors were used. Specifically, BMS-777607 in combination with inhibition of mTORC2, but not mTORC1, was responsible for the observed synergism. Our findings demonstrate that BMS-777607 at therapeutic doses exerts inhibitory activities on pancreatic cancer cells but also induces polyploidy insensitive to chemotherapeutics. Combination of BMS-777607 with AZD8055 achieves the maximal cytotoxic effect on pancreatic cancer and cancer stem cells. Mol Cancer Ther; 13(1); 37–48. ©2013 AACR.
The History and Philosophy of Inflammatory Bowel Disease
Authors: Rogler Gerhard
Published: November 2013

Many interesting statements about inflammatory bowel diseases (IBD) and also Crohn's disease have been made in recent years in journals and scientific meetings. They have influenced our thinking and the perception of the diseases. Among these statements is the notion that IBDs are ‘relatively new diseases', that ‘IBD is rather a syndrome than a disease' or that with the new insights into pathophysiology, ‘we will be able to discriminate many different Crohn's diseases based on genetic risk factors'. A look into history and philosophy may help to clarify misconceptions and prove that many of these statements are either wrong or misleading. People suffered from symptoms that are suggestive of Crohn's disease centuries before the disease concept evolved in the early 19th century and before Burrill B. Crohn could describe a complex of symptoms he suggested to be a so far non-identified disease. Early concepts on the pathophysiology of CD were not so different to present-time theories as it may be assumed. ‘Pre-ideas' and basic concepts were leading the search for a cause of Crohn's disease and IBD. With respect to pathophysiology, we have to accept that most likely we will never come up with one unifying concept (‘the cause of IBD') as different scientific schools and think-collectives exist. Therefore, the ‘classical adaptive immunologists' and the ‘innate immunologist' as well as scientists focused on barrier function or the microbiome will never completely understand each other and each other's concepts. As for many other diseases, several different pathophysiological concepts existed in parallel and will do so in the future as it is impossible to prove the exclusive ‘truth' of one of the concepts for reasons that will be further discussed below. This means on the other hand that none of the concepts on pathophysiology of IBD we have at present will ever unequivocally be proven to be wrong.
Innate Immune Functions of α-Defensins in the Small Intestine
Authors: Bevins Charles L.
Published: November 2013

The intestinal mucosa interfaces with a complex, dense community of microorganisms, including hundreds of species of resident microbiota and many transient microbes entering from food- and water-borne sources. In the small intestine, Paneth cells (specialized secretory epithelial cells) produce abundant quantities of α-defensins and several other antibiotic peptides. Human Paneth cells make two α-defensins: HD5 and HD6. Data from in vivo models indicate that Paneth cell α-defensins play a pivotal role in defense from food- and water-borne pathogens in the intestine. The mechanism by which these two α-defensins protect from enteric pathogens is quite distinct. HD5 is a potent antimicrobial that kills target microbes by membrane disruption, whereas HD6 is newly discovered to self-assemble to form fibrils and nanonets that surround and entangle bacteria. Recent data suggest that HD5 also serves to help shape the composition of the colonizing microbiota. Studies in humans suggest that reduced expression of HD5 and HD6 is a fundamental feature of ileal Crohn's disease. Mechanistically, the link between reduced Paneth cell α-defensin expression and ileal Crohn's disease pathogenesis may be a result of the weakened mucosal antimicrobial defense and/or alterations in the composition of commensal microbiota.
Diagnostics and Prognostics of Inflammatory Bowel Disease with Fecal Neutrophil-Derived Biomarkers Calprotectin and Lactoferrin
Authors: Sipponen Taina
Published: November 2013

Crohn's disease (CD), ulcerative colitis (UC), and colitis unclassified, collectively defined as inflammatory bowel disease (IBD), are the consequence of chronic inflammatory reactions in the gastrointestinal tissue. Endoscopy with biopsies is the mainstay in the diagnosis of this inflammation and is also important in the assessment of disease activity and monitoring of treatment. Furthermore, mucosal healing is increasingly becoming a therapeutic target for treatment of IBD and the golden standard of assessing it is endoscopy. However, due to the costs, invasiveness, and to limited endoscopic capacity, the need is strong for reliable surrogate markers of intestinal inflammation. Bowel contents, being in close contact with intestinal mucosa, can take up molecules that are measurable from stool samples and thus can serve as markers of inflammation. The fecal neutrophil-derived biomarkers, especially calprotectin and lactoferrin, have several features of an ideal test for detecting intestinal inflammation: they are noninvasive, simple, and low in cost. The utility of these biomarkers in distinguishing IBD from noninflammatory conditions such as irritable bowel syndrome is well documented. They correlate closely with endoscopic activity both in CD and UC. They allow serial monitoring of disease activity and of treatment success, and can even serve in predicting clinical relapse in unsymptomatic patients or sustained remission after induction with TNF-α-blocking agents. In this review an overview will be given to the role of fecal neutrophil-derived biomarkers calprotectin and lactoferrin in diagnostics and prognostics of IBD.
Differences between Treatment Guidelines - Germany
Authors: Herrlinger Klaus R.
Published: November 2013

When looking at different treatment guidelines the topics most debated for Crohn's disease are the following: (a) the use of mesalamine for remission induction and maintenance in mild to moderate Crohn's disease; (b) the early use of anti-TNF antibodies in Crohn's disease with or without classical immunomodulators for remission induction, and (c) remission induction in steroid-refractory disease with anti-TNF antibodies or calcineurin inhibitors. The topics mentioned above will be discussed with regard to the statements of the German Gastroenterology Association (DGVS) on the basis of the underlying evidence.
Lecithin as a Therapeutic Agent in Ulcerative Colitis
Authors: Stremmel Wolfgang , Gauss Annika
Published: November 2013

Lecithin [phosphatidylcholine (PC)] was shown to account for more than 70% of total phospholipids within the intestinal mucus layer. It is arranged in lamellar membranes (surfactant-like particles) and establishes a hydrophobic barrier preventing invasion of the colonic commensal microbiota. In ulcerative colitis (UC), the mucus PC content was demonstrated to be reduced by about 70%, irrespective of the presence of inflammation. This may be of primary pathogenetic significance allowing bacteria to enter the mucus and induce mucosal inflammation. Therefore, a new therapeutic strategy is being developed to substitute the missing mucus PC content in UC. Indeed, a delayed-release PC formulation was able to compensate the lack of PC and improve the inflammatory activity. In randomized controlled studies, delayed-release PC was proven to be clinically and endoscopically effective, which now awaits a phase III authority approval trial.
Reduced Inequality in Access to Stroke Unit Care over Time: A 15-Year Follow-Up of Socioeconomic Disparities in Sweden
Authors: Glader Eva-Lotta , Edlund Hilda , Sukhova Maria , Asplund Kjell , Norrving Bo , Eriksson Marie ,   for the Riks-Stroke Collaboration
Published: November 2013

Background: Despite the compelling scientific evidence on the superiority of stroke unit care, far from all acute stroke patients have access to stroke unit care. In congruence with what has been observed when other new methods are introduced in health care, we hypothesized that there has been an inequality in the buildup phase of stroke units but that the gradients between patient groups have decreased as the total capacity of stroke unit care has increased. The purpose of this study was to explore if patients in a national sample who were socioeconomically disadvantaged (low education or low income) had reduced access to stroke unit care and if differences varied over time. Methods: All patients 18-74 years of age registered between 1995 and 2009 in Riks-Stroke, the Swedish stroke register, were included. The Stroke Unit Trialists' definition of a stroke unit has been adopted by Riks-Stroke and hospitals participating in the registry. Basic patient characteristics, stroke risk factors, process and outcome variables are recorded in Riks-Stroke. Socioeconomic data were accessed from Statistics Sweden. Multiple logistic regression analyses were used to calculate odds ratios (ORs) for stroke unit care between prespecified patient subgroups. Results: A total of 319,240 stroke patients were included in Riks-Stroke during the years 1995-2009, and 124,173 were aged between 18 and 74 years; they were included in the final analyses. After adjustment for confounders in a multiple regression model, women were treated in stroke units slightly less often [OR 0.97, 95% confidence interval (CI) 0.95-0.99]. There were no statistically significant associations between stroke unit care and age or between stroke unit care and cohabiting or living alone. The highest level of education predicted access to stroke unit care (secondary vs. primary school: OR 1.04, 95% CI 1.01-1.07; university vs. primary school: OR 1.06, 95% CI 1.02-1.10). Differences according to level of education diminished over time (p = 0.001). Income was not independently associated with stroke unit care, and over time the proportion of patients treated in stroke units increased at a similar rate in all income groups (p = 0.12). Conclusions: Even in a country with modest socioeconomic differences in the general population and public financing of all acute hospital care, socioeconomic inequalities in access to stroke unit care were evident during the early years, but they diminished as the total capacity for stroke unit care increased.
Low Serum n-3 Polyunsaturated Fatty Acid/n-6 Polyunsaturated Fatty Acid Ratio Predicts Neurological Deterioration in Japanese Patients with Acute Ischemic Stroke
Authors: Suda Satoshi , Katsumata Toshiya , Okubo Seiji , Kanamaru Takuya , Suzuki Kentaro , Watanabe Yoko , Katsura Ken-ichiro , Katayama Yasuo
Published: November 2013

Background: Epidemiological and clinical trials have shown that n-3 polyunsaturated fatty acids (PUFAs) reduce the incidence of coronary heart disease or stroke. However, the association between PUFAs and acute-phase stroke has not yet been thoroughly studied. We investigated the impact of serum PUFAs on early neurological deterioration (END) in patients with acute ischemic stroke. Methods: In this retrospective study, we enrolled 281 Japanese patients (mean age: 75 ± 13 years; 165 males) with acute ischemic stroke diagnosed within 24 h of onset. General blood examinations, including PUFAs (n-3 PUFAs: eicosapentaenoic acid, EPA, and docosahexaenoic acid, DHA, and n-6 PUFAs: arachidonic acid, AA), were performed on admission. Other risk factors and comorbidities were also examined. END was defined as a ≥2-point increase in the National Institutes of Health Stroke Scale (NIHSS) score within a 72-hour period. Statistical significance between the END and non-END group was assessed using Wilcoxon rank sum tests or Student's t tests for categorical variables. Multiple logistic regression analyses were performed to identify predictors of END. Results: END was observed in 75 patients (26.7%). Diabetes mellitus (p = 0.003), high-sensitivity C-reactive protein (hs-CRP) level (p < 0.001), prior stroke (p = 0.035), ischemic heart disease (p = 0.029), EPA/AA ratio (p = 0.003), DHA/AA ratio (p = 0.002), EPA+DHA/AA ratio (p = 0.002), diagnosis of small vessel disease (p = 0.004) and admission NIHSS score (p < 0.001) were significantly associated with END. We used separate multiple logistic regression analyses for the EPA/AA, DHA/AA and EPA+DHA/AA ratios, because EPA and DHA are considered covariant factors (r = 0.544; p < 0.0001). Multiple logistic regression analyses showed that END was positively associated with diabetes mellitus, hs-CRP level and NIHSS score on admission, and negatively associated with the EPA/AA ratio (odds ratio, OR: 0.18; 95% confidence interval, CI: 0.05-0.58; p = 0.003), DHA/AA ratio (OR: 0.045; 95% CI: 0.006-0.30; p = 0.001), EPA+DHA/AA ratio (OR: 0.45; 95% CI: 0.26-0.74; p = 0.002) and diagnosis of small vessel disease. Conclusions: Our data suggest that a low serum n-3 PUFA/n-6 PUFA ratio on admission may predict neurological deterioration in Japanese patients with acute ischemic stroke. Large-scale prospective studies are further required to clarify the role of PUFAs in the acute phase of ischemic stroke.
A Case of Stage IV Non-Small Cell Lung Cancer Treated with Korean Medicine Therapy Alone
Authors: Lee Dong-hyun , Seong Shin , Kim Sung-su , Han Jae-bok
Published: November 2013

This report presents a case that shows a significant anticancer effect of Korean medicine therapy (KMT). A 79-year-old man, who was diagnosed as stage Ⅳ non-small cell lung cancer (NSCLC) in December 2012, was treated with KMT including intravenous pharmacopunctures and oral herbal medicine from February 22, 2013, until September 2013 without any surgical intervention, chemotherapy or radiotherapy. The intravenous pharmacopunctures were the wild ginseng pharmacopuncture, Cordyceps sinensis pharmacopuncture and Trichosanthes kirilowii pharmacopuncture. The oral herbal medicine used was soramdan, made of cultivated wild ginseng. The effectiveness of this therapy was evaluated with computed tomography and the Eastern Cooperative Oncology Group (ECOG) performance scale. The size of the tumor mass was markedly decreased and the ECOG performance scale was also improved. These results suggest that KMT alone can be an effective method to treat NSCLC.
A Randomized Controlled Trial to Assess Adherence to Allergic Rhinitis Treatment following a Daily Short Message Service (SMS) via the Mobile Phone
Authors: Wang Kuiji , Wang Chengshuo , Xi Lin , Zhang Yuan , Ouyang Yuhui , Lou Hongfei , Zhang Wei , Zhang Luo
Published: November 2013

Background: Short message service (SMS) has been suggested as an effective method to improve adherence to medical therapy in some chronic diseases. However, data on the effects of SMS interventions to allergic rhinitis (AR) treatment is limited at present. We aimed to assess whether a daily SMS reminder could improve AR patients' adherence to medication and treatment outcomes. Methods: Fifty outpatients with AR were randomized to either receive (SMS group) or not (control group) a daily SMS reminder on their cell phone to take intranasal corticosteroid treatment for 30 days. The primary study outcomes were self-reported adherence to medication, clinic attendance rate, and severity of AR symptoms using a visual analogue scale (VAS). Secondary outcomes were changes in nasal patency (minimum cross-sectional area, nasal cavity volume, and nasal airway resistance) and exhaled nasal nitric oxide levels. Results: Self-reported adherence to medication in the SMS group (15/25, 60%), was significantly higher than in the control group (7/25, 28%, p = 0.02). Similarly, the clinic attendance rate in the SMS group (72%) was significantly higher than in the control group (40%, p = 0.02). Although the VAS score improved significantly from baseline in both study groups, the improvement in the SMS group was significantly greater than in the control group (4.38 ± 4.38 vs. 8.74 ± 6.54, p = 0.031). No significant differences were observed between the two groups for the secondary outcomes. Conclusions: A daily SMS reminder may be an effective intervention to improve adherence to medication and treatment outcomes in AR patients.
Tolerability and Clinical Outcome of Coseasonal Treatment with Escherichia coli Strain Nissle 1917 in Grass Pollen-Allergic Subjects
Authors: Dölle Sabine , Berg Jennifer , Rasche Claudia , Worm Margitta
Published: November 2013

Background: Nonpathogenic Escherichia coli strain Nissle 1917 (EcN) has immunomodulatory properties and can act on different cells which are important for the allergic immune response. Herein, we investigated the efficacy and tolerability of EcN in subjects with grass pollen-dependent allergic rhinoconjunctivitis. Methods: Grass pollen-allergic subjects were randomly allocated to receive EcN in a double-blind, placebo-controlled manner. The treatment was performed from 2 months before onset until the end of one grass pollen season (in total: 6 months). The clinical symptom score and the intake of symptomatic medications were assessed. A skin prick test and grass pollen-specific immunoglobulin (Ig) E and IgA were evaluated before and after treatment. Results: Our results show that coseasonal treatment with EcN in grass pollen-allergic subjects was not superior to placebo as assessed using the symptom-medication score (p = 0.257). Interestingly, an increase [median (range)] in grass pollen-specific IgA was detectable in the EcN group [20,556 LU/ml (1,812-60,800)] versus placebo [5,246 LU/ml (944-50,467)] (p = 0.048). Conclusions: The results indicate that 6 months of coseasonal nonspecific immunomodulation by EcN is not sufficient to achieve clinical efficacy in grass pollen-allergic subjects. Future approaches in which such immunomodulators are combined with an allergen-specific protocol might enhance the clinical efficacy of the allergen-specific treatment.
A Computerized Asthma-Specific Quality of Life: A Novel Tool for Reflecting Asthma Control and Predicting Exacerbation
Authors: Kim Mi-Ae , Ye Young-Min , Park Jung-Won , Lee Jae-Hyun , Lee Soo-Keol , Kim Cheol-Woo , Jung Ki-Suck , Kim Joo-Hee , Yoo Hye-Soo , Kim Seung-Hyun , Shin Yoo Seob , Nahm Dong-Ho , Park Hae-Sim ,   on behalf of the Premier Researchers Aiming New Era in Asthma and Allergic Diseases (PRANA) Study Group
Published: November 2013

Background: Proper assessment of health-related quality of life is essential to achieve and maintain a controlled status in asthmatic patients. We developed our own computerized asthma-specific quality-of-life (cA-QOL) questionnaire based on in-depth interviews with adult asthmatic patients. In this study, we evaluated this cA-QOL in terms of the Asthma Control Test (ACT) score and Global Initiative for Asthma (GINA) guidelines as well as asthma exacerbation, and compared it with the asthma-related quality-of-life questionnaire (AQLQ). Methods: We conducted a multicenter, prospective, observational study in 133 adult asthmatic patients recruited from 5 university hospitals in South Korea, who were randomized into 2 groups according to the operating order of the cA-QOL and AQLQ. At every visit (3-month interval), physicians evaluated asthma control status with monitoring spirometry. The self-administered cA-QOL, AQLQ(S) and ACT were completed. Results: The cA-QOL scores correlated significantly with ACT and AQLQ(S) scores (r = 0.814, p < 0.001; r = 0.900, p < 0.001). The cA-QOL score was significantly lower where the ACT score was <19, in the patients with an uncontrolled asthma status according to the GINA guidelines and in those with asthma exacerbation (p < 0.001, respectively). A multivariate analysis showed that this cA-QOL was a significant parameter associated with an uncontrolled asthma status and asthma exacerbation (p < 0.001, p = 0.045, p = 0.019, respectively). Conclusion: The cA-QOL is a valid tool for reflecting current asthma control status and for assessment to predict the future risk of asthma exacerbation in adult asthmatics.
Supplementation with Probiotics in the First 6 Months of Life Did Not Protect against Eczema and Allergy in At-Risk Asian Infants: A 5-Year Follow-Up
Authors: Loo Evelyn X.L. , Llanora Genevieve V. , Lu Qingshu , Aw Marion M. , Lee Bee Wah , Shek Lynette P.
Published: November 2013

Background: Healthy gut microflora is essential for oral tolerance and immunity. A promising approach to preventing allergic diseases in genetically at-risk infants is to introduce administration of probiotics early in life when their immune system is still relatively immature. Objective: In this follow-up study, we aim to determine if early-life supplementation with strains of probiotics has any long-term effect on allergic outcomes. Methods: We analyzed the charts and electronic databases of the PROMPT (Probiotics in Milk for the Prevention of Atopy Trial) study cohort. This cohort consisted of 253 infants at risk for allergy who were administered cow's milk supplemented with or without probiotics from the first day of life to the age of 6 months. The cohort was then followed up until the children were 5 years old and clinical outcomes were assessed. Results: Of the 253 children recruited into the study, 220 (87%) completed the follow-up. At the age of 5 years, there were no significant differences between the groups in the proportion of children who had developed any asthma, allergic rhinitis, eczema, food allergy and sensitization to inhalant allergens. Similar growth rates were observed in both groups. Conclusions: The supplementation of probiotics in early childhood did not play a role in the prevention of allergic diseases. Clinical/Key Message: Early-life supplementation with probiotics did not change allergic outcomes at 5 years of age.
Allergic Contact Dermatitis Induced by Textile Necklace
Authors: Nygaard Uffe , Kralund Henrik Højgrav , Sommerlund Mette
Published: November 2013

Allergic contact dermatitis to textile dyes is considered to be a rare phenomenon. A recent review reported a prevalence of contact allergy to disperse dyes between 0.4 and 6.7%. The relevance of positive patch testing was not reported in all studies. Textile dye allergy is easily overlooked and is furthermore challenging to investigate as textile dyes are not labelled on clothing. In this report, we present a case of allergic contact dermatitis to a textile necklace. The patch test showed strong reactions to the necklace and the azo dyes Disperse Orange 1 and Disperse Yellow 3. Despite the European legislation and the reduced use of disperse dyes in Third World countries, disperse azo dyes still induce new cases of allergic contact dermatitis.
Deficiency of NOX1/Nicotinamide Adenine Dinucleotide Phosphate, Reduced Form Oxidase Leads to Pulmonary Vascular Remodeling
Authors: Iwata Kazumi , Ikami Kanako , Matsuno Kuniharu , Yamashita Toshiharu , Shiba Dai , Ibi Masakazu , Matsumoto Misaki , Katsuyama Masato , Cui Wenhao , Zhang Jia , Zhu Kai , Takei Norio , Kokai Yasuo , Ohneda Osamu , Yokoyama Takahiko , Yabe-Nishimura Chihiro
Published: November 2013

Objective—

Involvement of reactive oxygen species derived from nicotinamide adenine dinucleotide phosphate, reduced form (NADPH) oxidase has been documented in the development of hypoxia-induced model of pulmonary arterial hypertension (PAH). Because the PAH-like phenotype was demonstrated in mice deficient in
Nox1
gene (Nox1
−/Y
) raised under normoxia, the aim of this study was to clarify how the lack of NOX1/NADPH oxidase could lead to pulmonary pathology.

Approach and Results—

Spontaneous enlargement and hypertrophy of the right ventricle, accompanied by hypertrophy of pulmonary vessels, were demonstrated in Nox1
−/Y
9 to 18 weeks old. Because an increased number of α-smooth muscle actin-positive vessels were observed in Nox1
−/Y
, pulmonary arterial smooth muscle cells (PASMCs) were isolated and characterized by flow cytometry and terminal deoxynucleotidyl transferase dUTP nick end labeling staining. In Nox1
−/Y
PASMCs, the number of apoptotic cells was significantly reduced without any change in the expression of endothelin-1, and hypoxia-inducible factors HIF-1α and HIF-2α, factors implicated in the pathogenesis of PAH. A significant decrease in a voltage-dependent K
+
channel, Kv1.5 protein, and an increase in intracellular potassium levels were demonstrated in Nox1
−/Y
PASMCs. When a rescue study was performed in Nox1
−/Y
crossed with transgenic mice overexpressing rat
Nox1
gene, impaired apoptosis and the level of Kv1.5 protein in PASMCs were almost completely recovered in Nox1
−/Y
harboring the
Nox1
transgene.

Conclusions—

These findings suggest a critical role for NOX1 in cellular apoptosis by regulating Kv1.5 and intracellular potassium levels. Because dysfunction of Kv1.5 is among the features demonstrated in PAH, inactivation of NOX1/NADPH oxidase may be a causative factor for pulmonary vascular remodeling associated with PAH.
New Automated Assay of Small Dense Low-Density Lipoprotein Cholesterol Identifies Risk of Coronary Heart Disease
Authors: Tsai Michael Y. , Steffen Brian T. , Guan Weihua , McClelland Robyn L. , Warnick Russell , McConnell Joseph , Hoefner Daniel M. , Remaley Alan T.
Published: November 2013

Objective—

Coronary heart disease (CHD) is the leading cause of death in the United States, yet assessing risk of its development remains challenging. The present study evaluates a new automated assay of small dense low-density lipoprotein cholesterol content (sdLDL-C) and whether sdLDL-C is a risk factor for CHD compared with LDL-C or small LDL particle concentrations derived from nuclear magnetic resonance spectroscopy.

Approach and Results—

sdLDL-C was measured using a new automated enzymatic method, and small LDL concentrations were obtained by nuclear magnetic resonance in 4387 Multi-Ethnic Study of Atherosclerosis participants. Cox regression analysis estimated hazard ratios for developing CHD for 8.5 years after adjustments for age, race, sex, systolic blood pressure, hypertension medication use, high-density lipoprotein cholesterol, and triglycerides. Elevated sdLDL-C was a risk factor for CHD in normoglycemic individuals. Those in the top sdLDL-C quartile showed higher risk of incident CHD (hazard ratio, 2.41;
P
=0.0037) compared with those in the bottom quartile and indicated greater CHD risk than the corresponding quartile of LDL-C (hazard ratio, 1.75;
P
=0.019). The association of sdLDL-C with CHD risk remained significant when LDL-C (<2.57 mmol/L) was included in a multivariate model (hazard ratio, 2.37;
P
=0.012). Nuclear magnetic resonance–derived small LDL concentrations did not convey a significant risk of CHD. Those with impaired fasting glucose or diabetes mellitus showed higher sdLDL-C and small LDL concentrations but neither was associated with higher CHD risk in these individuals.

Conclusions—

This new automated method for sdLDL-C identifies risk for CHD that would remain undetected using standard lipid measures, but only in normoglycemic, nondiabetic individuals.