bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic strategy in segmentation defect of the vertebrae: a retrospective study of 73 patients
Authors: Lefebvre Mathilde , Dieux-Coeslier Anne , Baujat Geneviève , Schaefer Elise , Judith Saint-Onge , Bazin Anne , Pinson Lucile , Attie-Bitach Tania , Baumann Clarisse , Fradin Melanie , Pierquin Genevieve , Julia Sophie , Quélin Chloé , Doray Bérénice , Berg Sylvie , Vincent-Delorme Catherine , Lambert Laetitia , Bachmann Nadine , Lacombe Didier , Isidor Bertrand , Laurent Nicole , Joelle Roume , Blanchet Patricia , Odent Sylvie , Kervran Dominique , Leporrier Nathalie , Abel Carine , Segers Karine , Guiliano Fabienne , Ginglinger-Fabre Emmanuelle , Selicorni Angelo , Goldenberg Alice , El Chehadeh Salima , Francannet Christine , Demeer Benedicte , Duffourd Yannis , Thauvin-Robinet Christel , Verloes Alain , Cormier-Daire Valerie , Riviere Jean Baptiste , Faivre Laurence , Thevenon Julien
Published: February 2018

Background

Segmentation defects of the vertebrae (SDV) are non-specific features found in various syndromes. The molecular bases of SDV are not fully elucidated due to the wide range of phenotypes and classification issues. The genes involved are in the Notch signalling pathway, which is a key system in somitogenesis. Here we report on mutations identified in a diagnosis cohort of SDV. We focused on spondylocostal dysostosis (SCD) and the phenotype of these patients in order to establish a diagnostic strategy when confronted with SDV.

Patients and methods

We used DNA samples from a cohort of 73 patients and performed targeted sequencing of the five known SCD-causing genes (DLL3,MESP2,LFNG,HES7andTBX6) in the first 48 patients and whole-exome sequencing (WES) in 28 relevant patients.

Results

Ten diagnoses, including four biallelic variants inTBX6, two biallelic variants inLFNGandDLL3, and one inMESP2andHES7, were made with the gene panel, and two diagnoses, including biallelic variants inFLNBand one variant inMEOX1,were made by WES. The diagnostic yield of the gene panel was 10/73 (13.7%) in the global cohort but 8/10 (80%) in the subgroup meeting the SCD criteria; the diagnostic yield of WES was 2/28 (8%).

Conclusion

After negative array CGH, targeted sequencing of the five known SCD genes should only be performed in patients who meet the diagnostic criteria of SCD. The low proportion of candidate genes identified by WES in our cohort suggests the need to consider more complex genetic architectures in cases of SDV.
Tobacco industry misappropriation of American Indian culture and traditional tobacco
Authors: D’Silva Joanne , O’Gara Erin , Villaluz Nicole T
Published: February 2018

Objective

Describe the extent to which tobacco industry marketing tactics incorporated American Indian culture and traditional tobacco.

Methods

A keyword search of industry documents was conducted using document archives from the Truth Tobacco Documents Library. Tobacco industry documents (n=76) were analysed for themes.

Results

Tobacco industry marketing tactics have incorporated American Indian culture and traditional tobacco since at least the 1930s, with these tactics prominently highlighted during the 1990s with Natural American Spirit cigarettes. Documents revealed the use of American Indian imagery such as traditional headdresses and other cultural symbols in product branding and the portrayal of harmful stereotypes of Native people in advertising. The historical and cultural significance of traditional tobacco was used to validate commercially available tobacco.

Conclusions

The tobacco industry has misappropriated culture and traditional tobacco by misrepresenting American Indian traditions, values and beliefs to market and sell their products for profit. Findings underscore the need for ongoing monitoring of tobacco industry marketing tactics directed at exploiting Native culture and counter-marketing tactics that raise awareness about the distinction between commercial and traditional tobacco use. Such efforts should be embedded within a culturally sensitive framework to reduce the burden of commercial tobacco use.
Effect of vegetation control, harvest intensity, and soil disturbance on 20-year jack pine stand development
Authors: Fleming R.L. , Leblanc J.-D. , Weldon T. , Hazlett P.W. , Mossa D.S. , Irwin R. , Primavera M.J. , Wilson S.A.
Published: February 2018

Currently, there are uncertainties regarding the impacts and (or) efficacy of biomass harvesting and silvicultural practices on stand production on coarse-textured boreal soils. Replicated factorial field experiments examining effects of complete vegetation control (repeated glyphosate application) following operational stem-only harvest with disc trenching (SOT), operational whole-tree harvest with (WTT) and without (WT) disc trenching, and whole-tree harvest with complete forest floor removal by blading (WTB) and blading followed by compaction (WTBC) were installed on four sandy northern Ontario jack pine (Pinus banksiana Lamb.) sites. Over 20 years, WTB improved planted-tree survival but decreased longer term stand productivity in comparison with other harvest intensity – soil disturbance treatments. Vegetation control improved tree growth and stand productivity initially, but over time, benefits declined substantially. SOT and WTT had similar impacts on stand production. Disc trenching improved initial planted-tree growth (WTT vs. WT), particularly without vegetation control. Jack pine natural regeneration was greatest with SOT, accounting for 25% of stand biomass at year 20. Stand structure effects included increased size inequality of naturals with WTB and reduced size inequality and asymmetry of naturals with vegetation control. Overall, impacts of forest floor removal and natural regeneration on stand development have become increasingly important over time compared with those of vegetation control.
Corneal Debridement Combined with Intrastromal Voriconazole for Recalcitrant Fungal Keratitis
Authors: Sun Yajie , Sun Zhuo , Chen Yukai , Deng Guohua
Published: February 2018

Background. To analyze the therapeutic effects of corneal debridement combined with intrastromal voriconazole in recalcitrant fungal keratitis. Methods. This is a retrospective study. Fourteen patients with recalcitrant fungal keratitis were treated by corneal debridement combined with intrastromal voriconazole (50 μg/0.1 ml). This paper reviews and analyzes the patients’ basic state, surgical intervention, medicinal treatment, and outcomes. Results. The mean sizes of infiltration and ulcer were (5.54 ± 1.32)mm and (3.46 ± 1.03)mm, respectively, and the mean depth was (315.43 ± 57.72)μm. Twelve of the patients had satellite lesion, and 2 suffered hypopyon. After intrastromal voriconazole, the size of infiltration decreased significantly to (4.32 ± 1.10)mm (P<0.001), but there was no significant change in ulcer size ((3.36 ± 0.92)mm, P=0.082). Thirteen patients were cured after corneal debridement. The mean healing time was (15.38 ± 7.38) days. Excluding one cured patient with optic nerve atrophy and one patient for whom the treatment failed, the mean best-corrected visual acuity after healing was (0.23 ± 0.18)LogMAR, a significant improvement compared to pretreatment (0.87 ± 0.57(LogMAR), P=0.01). The mean corneal astigmatism was (1.3 ± 1.6)D of 12 cured patients after healing and (1.0 ± 0.7)D at final follow-up, and there was no significant difference (P=0.374). Conclusions. Corneal debridement combined with intrastromal voriconazole is a secure and effective treatment for recalcitrant fungal keratitis.
Reliable Approach for EM Scattering Calculation from Sea Surface Covered with Foams Based on MFBM and VRT Theory
Authors: Song Tao , Tong Chuang-Ming , Cong Li-Li , Peng Peng
Published: February 2018

A reliable approach based on modified facet-based model and Vector Radiative Transfer theory is presented to calculate electromagnetic scattering from a particular electrically large sea surface superimposed with foams, which can handily give both monostatic and bistatic scattering results and could be applied to synthetic aperture radar imagery simulation. The facet model is derived from Fuks’ first-order small perturbation method function, and then the Kirchhoff model is introduced to revise the results in view of the dependency on cut-off wave number at near vertical incidence angles. Additionally, the contributions of foams are taken into consideration on the basis of Vector Radiative Transfer theory. The accuracy and superiority of this proposed approach are demonstrated in comparison with traditional facet model, which illustrates that the results of this approach agree better with experimental results. Moreover, several examples are given to verify that the proposed approach is of more significance at large incidence angles and high wind speed.
Comparison between Amblyopia Treatment with Glasses Only and Combination of Glasses and Open-Type Binocular “Occlu-Pad” Device
Authors: Iwata Yo , Handa Tomoya , Ishikawa Hitoshi , Goseki Toshiaki , Shoji Nobuyuki
Published: February 2018

We evaluated amblyopia treatment, comparing training with glasses only and training with glasses and the Occlu-pad, a binocular open-type amblyopia training device. Forty-six children (4.8±1.1 years) diagnosed with anisometropic amblyopia, all wearing complete correction glasses, were treated either with glasses only, or with glasses in combination with the Occlu-pad (training time: 2 days a week, 30 minutes per day). We compared visual acuity scores at 3 and 6 months after treatment had started, and examined the compliance rate for the Occlu-pad training. Three months as well as 6 months after amblyopia treatment started, the “Occlu-pad treatment group” showed significantly improved visual acuity, compared to the “Glasses treatment group” (at both 3 and 6 months: p<0.0001). The compliance rate for using the Occlu-pad was 88.4±18.7% after 3 months and 69.6±19.5%, after 6 months. There was no significant correlation between the training time using the Occlu-pad and improvement in visual acuity (3 months: p=0.97; 6 months: p=0.55). The compliance rate for months 4 to 6 was significantly lower than that for months 1 to 3 (p=0.003). Amblyopia treatment using the Occlu-pad device in combination with glasses led to a better effect than treatment with glasses alone.
Spatial Fluctuating Pressure Calculation of Underwater Counter Rotating Propellers under Noncavitating Condition
Authors: Hou L. X. , Hu A. K.
Published: February 2018

The spatial fluctuating pressure field (FPF) of counter rotating propeller (CRP) under noncavitating condition is investigated. The hydrodynamic performance and pressure distributions on the blade surfaces are obtained through low-order potential-based panel method, which is also used to analyze the hydrodynamic interaction between the front and rear propellers of CRP as well as the hydrodynamic interference between any solid surface and propeller. The interaction between the given solid spherical surface and propeller is used to simulate the spatial FPF of propeller, and the fluctuating pressure induced by a propeller over one revolution is analyzed in frequency domain through fast Fourier transform. The method proposed is validated through two given propellers by comparing the calculation results with test data. The FPFs of the front and rear propellers are calculated and compared with that of the corresponding single propeller. The result shows that the CRP produces weaker FPF compared with the single propeller.
Analysis and Control of the Singular System Model of Aphid Ecosystems
Authors: Liu Jingna , Zhang Tie , Zhao Lichun , Liu Bing , Wei Xueying
Published: February 2018

Considering the change of the parameter related to the natural enemy population and the impact on the aphid populations in the fold catastrophe manifold, the singular system model of aphid ecosystems is proposed. Combining singular system theory with catastrophe theory, the corresponding dynamics behaviors and the existence conditions of the impasse points are given by using the qualitative analysis. The biological significance of the analytical results is also discussed. The controllers are designed to make the aphid populations stabilize the refuge level by releasing natural enemy. Some numerical simulations are carried out to prove the results.
In Vitro Wound Healing Potential of Stem Extract of Alternanthera sessilis
Authors: Muniandy Katyakyini , Gothai Sivapragasam , Tan Woan Sean , Kumar S. Suresh , Mohd Esa Norhaizan , Chandramohan Govindasamy , Al-Numair Khalid S. , Arulselvan Palanisamy
Published: February 2018

Impaired wound healing is one of the serious problems among the diabetic patients. Currently, available treatments are limited due to side effects and cost effectiveness. In line with that, we attempted to use a natural source to study its potential towards the wound healing process. Therefore, Alternanthera sessilis (A. sessilis), an edible and medicinal plant, was chosen as the target sample for the study. During this investigation, the wound closure properties using stem extract of A. sessilis were analyzed. Accordingly, we analyzed the extract on free radical scavenging capacity and the cell migration of two most prominent cell types on the skin, human dermal fibroblast (NHDF), keratinocytes (HaCaT), and diabetic human dermal fibroblast (HDF‐D) to mimic the wound healing in diabetic patients. The bioactive compounds were identified using gas chromatography‐mass spectrometry (GC‐MS). We discovered that the analysis exhibited a remarkable antioxidant, proliferative, and migratory rate in NHDF, HaCaT, and HDF‐D in dose‐dependent manner, which supports wound healing process, due to the presence of wound healing associated phytocompounds such as Hexadecanoic acid. This study suggested that the stem extract of A. sessilis might be a potential therapeutic agent for skin wound healing, supporting its traditional medicinal uses.
Updating Stiffness and Hysteretic Damping Matrices Using Measured Modal Data
Authors: Jiang Jiashang , Yuan Yongxin
Published: February 2018

A new direct method for the finite element (FE) matrix updating problem in a hysteretic (or material) damping model based on measured incomplete vibration modal data is presented. With this method, the optimally approximated stiffness and hysteretic damping matrices can be easily constructed. The physical connectivity of the original model is preserved and the measured modal data are embedded in the updated model. The numerical results show that the proposed method works well.
Polymer‐Cement Mortar with Quarry Waste as Sand Replacement
Authors: Gómez-Balbuena D. N. , López-Lara T. , Hernandez-Zaragoza J. B. , Ortiz-Mena R. G. , Navarro-Rojero M. G. , Horta-Rangel J. , Salgado-Delgado R. , Castano V. M. , Rojas-Gonzalez E.
Published: February 2018

The activities of carved Quarry extraction generate problems of landscape pollution such is the case of solid waste discharged into open land dumps in central Mexico. This article presents the technological application of this solid waste in a new polymeric material with properties similar to those of a traditional mortar. It is concluded that the polymeric material uses low amounts of cement with respect to the traditional mortar, and it is elaborated with the recycled quarry as they are presented in its granulometry. The polymer used favored a low water/cement ratio (0.3) which did not allow to decrease resistance due to the fine nature of the materials (residues and cement) in addition to maintaining the workability of the material. The quarry residue was classified as silt with low plasticity and was characterized by X‐ray diffraction and Fluorescence to identify 76% of SiO2, which is why it was used as a stone aggregate even though the fines content was approximately 93%. The maximum compression resistance obtained at 28 days were 8 Mpa with the polymer/solid ratios of 0.10, water/solids of 0.30, and quarry/solids of 0.67. Linear equations were analyzed for more representative values with R squared adjustment.
Synthesis of Copper Oxide Aided by Selective Corrosion in Cu Foils
Authors: Arroyo Roberto Baca
Published: February 2018

Copper oxide films aided by selective corrosion have been synthesized. Using copper (Cu) foils of commercial printed circuit boards (PCBs), chemical attack in small areas on Cu surfaces and their oxidation with heating process in air atmosphere at low temperature have allowed to produce Cu oxide layers. Phase formation of Cu oxide samples was validated by X‐ray diffraction studies, and their conduction properties were registered and evaluated by current‐voltage curves. Stability analysis of the Cu oxide samples was conducted by a correlation profile between average strain and Cu oxide percentage grown, which confirms that the structure defects dependent on plastic deformation define the existence of both CuO and Cu2O phases beneficial to mitigate corrosion and advance in Cu oxide‐based devices to build electronic circuits as components on PCBs.
Asynchronous Channel-Hopping Scheme under Jamming Attacks
Authors: Kim Yongchul , Oh Young-Hyun , Kang Jungho
Published: February 2018

Cognitive radio networks (CRNs) are considered an attractive technology to mitigate inefficiency in the usage of licensed spectrum. CRNs allow the secondary users (SUs) to access the unused licensed spectrum and use a blind rendezvous process to establish communication links between SUs. In particular, quorum-based channel-hopping (CH) schemes have been studied recently to provide guaranteed blind rendezvous in decentralized CRNs without using global time synchronization. However, these schemes remain vulnerable to jamming attacks. In this paper, we first analyze the limitations of quorum-based rendezvous schemes called asynchronous channel hopping (ACH). Then, we introduce a novel sequence sensing jamming attack (SSJA) model in which a sophisticated jammer can dramatically reduce the rendezvous success rates of ACH schemes. In addition, we propose a fast and robust asynchronous rendezvous scheme (FRARS) that can significantly enhance robustness under jamming attacks. Our numerical results demonstrate that the performance of the proposed scheme vastly outperforms the ACH scheme when there are security concerns about a sequence sensing jammer.
Posttraumatic Proximal Radioulnar Synostosis after Closed Reduction for a Radial Neck and Olecranon Fracture
Authors: Keller Patrick R. , Cole Heather A. , Stutz Christopher M. , Schoenecker Jonathan G.
Published: February 2018

Posttraumatic proximal radioulnar synostosis (PPRUS) is a severe complication of radial head and neck fractures known to occur after severe injury or operative fixation. Cases of PPRUS occurring after minimally displaced, nonoperatively treated radial neck injuries are, by contrast, extremely rare. Here, we present a pediatric case of PPRUS that developed after a nonoperatively treated minimally displaced radial neck fracture with concomitant olecranon fracture. While more cases are needed to establish the association between this pattern of injury and PPRUS, we recommend that when encountering patients with a minimally displaced radial neck fracture and a concomitant elbow injury, the rare possibility of developing proximal radioulnar synostosis should be considered.
Prevalence of Cannabis Use Disorder and Associated Factors among Cannabis Young Adult Users at Shashemene Town, Oromia Region, Ethiopia, 2016
Authors: Tullu Mikiyas , Azale Telake , Abebaw Dessie , Solomon Haddis , Habtamu Yodit
Published: February 2018

Introduction. Cannabis users are at high risk of developing cannabis use disorder which is a problematic pattern of cannabis use leading to clinically significant impairment or distress. Objective. To assess the magnitude of cannabis use disorder and associated factors among young adults using cannabis at Shashemene Town, Oromia Region, Ethiopia. Methods. A cross-sectional study was conducted at Shashemene Town, from May to June 2016. Young adults aged 18–25 who use cannabis and are permanent residents of Shashemene were included in the study. Using single proportion formula, 423 participants were selected using exponential discriminative snow ball sampling. Result. This study revealed that the magnitude of cannabis use disorder was 42.2%. The most contributing factors that remained to be statistically significant with cannabis use disorder were common mental disorder (AOR = 2.125, 95% CI: 1.218, 3.708), current cigarette smoking (AOR = 6.118, 95% CI: 2.13, 17.575), and current use of shisha (AOR = 4.313, 95% CI: 2.427, 7.664). Conclusion. The magnitude of cannabis use disorder among young adults using cannabis was high.
Cathelicidin LL-37 Affects Surface and Intracellular Toll-Like Receptor Expression in Tissue Mast Cells
Authors: Agier Justyna , Brzezińska-Błaszczyk Ewa , Żelechowska Paulina , Wiktorska Magdalena , Pietrzak Jacek , Różalska Sylwia
Published: February 2018

Undoubtedly, mast cells take part in host defense against microorganisms as they are numerous at the portal of infection, they release many proinflammatory and antimicrobial mediators, and they express pattern recognition receptors, such as TLRs. These receptors play a key role in recognition and binding molecules associated with microorganisms and molecules associated with damage. Cathelicidins exhibit direct antimicrobial activities against a broad spectrum of microbes by perturbing their cell membranes. Accumulating evidence suggests a role for these molecules in supporting cell activation. We examined the impact of human cathelicidin LL-37 on tissue mast cell TLR expression and distribution. Depending on context, we show that LL-37 stimulation resulted in minor to major effects on TLR2, TLR3, TLR4, TLR5, TLR7, and TLR9 expression. Confocal microscopy analysis showed that, upon stimulation, TLRs may translocate from the cell interior to the surface and conversely. FPR2 and EGFR inhibitors reduced the increase in expression of selected receptors. We also established that LL-37 acts as a powerful inducer of CCL3 and ROS generation. These results showed that in response to LL-37, mast cells enhance the capability to detect invading pathogens by modulation of TLR expression in what may be involved FPR2 or EGFR molecules.
Fuzzy-Based Optimal Adaptive Line-of-Sight Path Following for Underactuated Unmanned Surface Vehicle with Uncertainties and Time-Varying Disturbances
Authors: Mu Dongdong , Wang Guofeng , Fan Yunsheng , Bai Yiming , Zhao Yongsheng
Published: February 2018

This paper investigates the path following control problem for an underactuated unmanned surface vehicle (USV) in the presence of dynamical uncertainties and time-varying external disturbances. Based on fuzzy optimization algorithm, an improved adaptive line-of-sight (ALOS) guidance law is proposed, which is suitable for straight-line and curve paths. On the basis of guidance information provided by LOS, a three-degree-of-freedom (DOF) dynamic model of an underactuated USV has been used to design a practical path following controller. The controller is designed by combining backstepping method, neural shunting model, neural network minimum parameter learning method, and Nussbaum function. Neural shunting model is used to solve the problem of “explosion of complexity,” which is an inherent illness of backstepping algorithm. Meanwhile, a simpler neural network minimum parameter learning method than multilayer neural network is employed to identify the uncertainties and time-varying external disturbances. In particular, Nussbaum function is introduced into the controller design to solve the problem of unknown control gain coefficient. And much effort is made to obtain the stability for the closed-loop control system, using the Lyapunov stability theory. Simulation experiments demonstrate the effectiveness and reliability of the improved LOS guidance algorithm and the path following controller.
Improvement Activity of 1-Deoxynojirimycin in the Growth of Dairy Goat Primary Mammary Epithelial Cell through Upregulating LEF-1 Expression
Authors: Ji Shengyue , Liu Ming , Zhang Yuping , Zhang Hongfu
Published: February 2018

LEF-1/wnt10b is one of the most important signaling pathways regulating mammary gland growth and development and is also a potential target for molecular breeding. In this work, 1-deoxynojirimycin (DNJ), a natural alkaloid extracted from plant mulberry or microorganism, was found to have a positive activity in primary breast epithelial cell growth of dairy goats. The findings showed that, compared to the control, 6 μM DNJ in the DMEM/F12 mediumin vitrogreatly improved the density of dairy goat breast epithelial cell and significantly increased the LEF-1 mRNA level (P<0.01) and thus enhanced cell growth. In addition, DNJ displayed a similar function in alleviating the growth suppression of epithelial cell and the decrease of LEF-1 mRNA level resulting from lentiviral-mediated LEF-1 knockdown. Simultaneously, no significant change of the mRNA levels of IGF-1 and Fgf10, the other two key regulators in mammary gland growth and development, could be detected. Furthermore, the mammary duct of DNJ-fed mouse illustrated a better development accompanied with a higher LET-1 mRNA level than that of the control. In conclusion, DNJ could improve breast epithelial cell growth through upregulating LEF-1 expression, which supplied a new means in studying mammary gland growth and development.
Novel Model for Cascading Failure Based on Degree Strength and Its Application in Directed Gene Logic Networks
Authors: Zhang Yulin , Zhao Maoxian , Su Jionglong , Lu Xiao , Lv Kebo
Published: February 2018

A novel model for cascading failures in a directed logic network based on the degree strength at a node was proposed. The definitions of in-degree and out-degree strength of a node were initially reconsidered, and the load at a nonisolated node was proposed as the ratio of in-degree strength to out-degree strength of the node. The cascading failure model based on degree strength was applied to the logic network for three types of cancer including adenocarcinoma of lung, prostate cancer, and colon cancer based on their gene expression profiles. In order to highlight the differences between the three networks by the cascading failure mechanism, we used the largest-scale cascades and the cumulative cascade probability to depict the damage. It was found that the cascading failures caused by hubs are usually larger. Furthermore, the result shows that propagations against the networks were correlated with the structures motifs of connected logical doublets. Finally, some genes were selected based on cascading failure mechanism. We believe that these genes may be involved in the occurrence and development of three types of cancer.
The Association between Glomerular Filtration Rate Estimated Using Different Equations and Mortality in the Japanese Community-Based Population: The Yamagata (Takahata) Study
Authors: Kabasawa Asami , Konta Tsuneo , Suzuki Natsuko , Kamei Keita , Watanabe Sayumi , Araumi Akira , Matsuki Eri , Kon Soichiro , Oyama Midori , Ichikawa Kazunobu , Ishizawa Kenichi , Ueno Yoshiyuki , Yamashita Hidetoshi , Kayama Takamasa , Kubota Isao
Published: February 2018

Background. To evaluate renal function, the indices of estimated glomerular filtration rate (eGFR) obtained using several equations, including the Japanese versions of the serum creatinine-based MDRD equation (eGFRcreat), Chronic Kidney Disease Epidemiology Collaboration equation (eGFR-EPI), and serum cystatin C-based equation (eGFRcys), are utilized. This study prospectively examined the association between these eGFR values and all-cause mortality during a 12-year observational period in a community-based population. Methods and Results. The subjects of this study were 1312 participants undergoing a health checkup, aged ≥40 years. In the total population, the mean eGFR values (mL·min−1·1.73 m−2) were 81.5 for eGFRcreat, 78.1 for eGFR-EPI, and 76.6 for eGFRcys. There were 141 deaths during the observation period, and the area under the receiver operating characteristic curve for predicting mortality was 0.59 for eGFRcreat, 0.67 for eGFR-EPI, and 0.70 for eGFRcys (all P<0.01). In the Cox proportional analysis adjusted for age and sex, eGFRcys, but not eGFRcreat and eGFR-EPI, showed a significant association with all-cause mortality (per 15 mL·min−1·1.73 m−2 decrease: hazard ratio 1.40, 95% confidence interval 1.18–1.67). Conclusions. This study revealed that eGFRcys showed lower values than eGFRcreat and eGFR-EPI and was significantly associated with all-cause mortality in the Japanese community-based population.
Pancreatic Beta Cell Death: Novel Potential Mechanisms in Diabetes Therapy
Authors: Rojas Joselyn , Bermudez Valmore , Palmar Jim , Martínez María Sofía , Olivar Luis Carlos , Nava Manuel , Tomey Daniel , Rojas Milagros , Salazar Juan , Garicano Carlos , Velasco Manuel
Published: February 2018

Purpose of Review. Describing the diverse molecular mechanisms (particularly immunological) involved in the death of the pancreatic beta cell in type 1 and type 2 diabetes mellitus. Recent Findings. Beta cell death is the final event in a series of mechanisms that, up to date, have not been entirely clarified; it represents the pathophysiological mechanism in the natural history of diabetes mellitus. These mechanisms are not limited to an apoptotic process only, which is characteristic of the immune-mediated insulitis in type 1 diabetes mellitus. They also include the action of proinflammatory cytokines, the production of reactive oxygen species, DNA fragmentation (typical of necroptosis in type 1 diabetic patients), excessive production of islet amyloid polypeptide with the consequent endoplasmic reticulum stress, disruption in autophagy mechanisms, and protein complex formation, such as the inflammasome, capable of increasing oxidative stress produced by mitochondrial damage. Summary. Necroptosis, autophagy, and pyroptosis are molecular mechanisms that modulate the survival of the pancreatic beta cell, demonstrating the importance of the immune system in glucolipotoxicity processes and the potential role for immunometabolism as another component of what once known as the “ominous octet.”
Gender/Sex as a Social Determinant of Cardiovascular Risk
Authors: O’Neil Adrienne , Scovelle Anna J. , Milner Allison J. , Kavanagh Anne
Published: February 2018

The social gradient for cardiovascular disease (CVD) onset and outcomes is well established. The American Heart Association’s Social Determinants of Risk and Outcomes of Cardiovascular Disease Scientific Statement advocates looking beyond breakthroughs in biological science toward a social determinants approach that focuses on socioeconomic position, race and ethnicity, social support, culture and access to medical care, and residential environments to curb the burden of CVD going forward. Indeed, the benefits of this approach are likely to be far reaching, enhancing the positive effects of advances in CVD related to prevention and treatment while reducing health inequities that contribute to CVD onset and outcomes. It is disappointing that the role of gender has been largely neglected despite being a critical determinant of cardiovascular health. It is clear that trajectories and outcomes of CVD differ by biological sex, yet the tendency for sex and gender to be conflated has contributed to the idea that both are constant or fixed with little room for intervention. Rather, as distinct from biological sex, gender is socially produced. Overlaid on biological sex, gender is a broad term that shapes and interacts with one’s cognition to guide norms, roles, behaviors, and social relations. It is a fluid construct that varies across time, place, and life stage. Gender can interact with biological sex and, indeed, other social determinants, such as ethnicity and socioeconomic position, to shape cardiovascular health from conception, through early life when health behaviors and risk factors are shaped, into adolescence and adulthood. This article will illustrate how gender shapes the early adoption of health behaviors in childhood, adolescence, and young adulthood by focusing on physical activity, drinking, and smoking behaviors (including the influence of role modeling). We will also discuss the role of gender in psychosocial stress with a focus on trauma from life events (childhood assault and intimate partner violence) and work, home, and financial stresses. We conclude by exploring potential biological pathways, with a focus on autonomic functioning, which may underpin gender as a social determinant of cardiovascular health. Finally, we discuss implications for cardiovascular treatment and awareness campaigns and consider whether gender equality strategies could reduce the burden of CVD for men and women at the population level.
Association of Spontaneous Preterm Delivery and Future Maternal Cardiovascular Disease
Authors: Minissian Margo B. , Kilpatrick Sarah , Eastwood Jo-Ann , Robbins Wendie A. , Accortt Eynav E. , Wei Janet , Shufelt Chrisandra L. , Doering Lynn V. , Merz C. Noel Bairey
Published: February 2018

Cardiovascular disease (CVD) risk factors are well established. However, little is known about a woman’s cardiovascular response to pregnancy, which appears to be an early marker of future maternal CVD risk. Spontaneous preterm delivery (sPTD) has been associated with a ≤3-fold increased risk of maternal CVD death later in life compared with having a term delivery. This review focuses on 3 key areas to critically assess the association of sPTD and future maternal CVD risk: (1) CVD risk factors, (2) inflammatory biomarkers of interest, and (3) specific forms of vascular dysfunction, such as endothelial function and arterial stiffness, and mechanisms by which each may be linked to sPTD. The association of sPTD with subsequent future maternal CVD risk suggests that a woman’s abnormal response to pregnancy may serve as her first physiological stress test. These findings suggest that future research is needed to understand why women with sPTD may be at risk for CVD to implement effective interventions earlier in a woman’s life.
Genetics, Lifestyle, and Low-Density Lipoprotein Cholesterol in Young and Apparently Healthy Women
Authors: Balder Jan-Willem , Rimbert Antoine , Zhang Xiang , Viel Martijn , Kanninga Roan , van Dijk Freerk , Lansberg Peter , Sinke Richard , Kuivenhoven Jan Albert
Published: February 2018

Background:

Atherosclerosis starts in childhood but low-density lipoprotein cholesterol (LDL-C), a causal risk factor, is mostly studied and dealt with when clinical events have occurred. Women are usually affected later in life than men and are underdiagnosed, undertreated, and understudied in cardiovascular trials and research. This study aims at a better understanding of lifestyle and genetic factors that affect LDL-C in young women.

Methods:

We randomly selected for every year of age 8 women with LDL-C ≤1st percentile (≤50 mg/dL) and 8 women with LDL-C ≥99th percentile (≥186 mg/dL) from 28 000 female participants aged between 25 to 40 years of a population-based cohort study. The resulting groups include 119 and 121 women, respectively, of an average 33 years of age. A gene-sequencing panel was used to assess established monogenic and polygenic origins of these phenotypes. Information on lifestyle was extracted from questionnaires. A healthy lifestyle score was allocated based on a recently developed algorithm.

Results:

Of the women with LDL-C ≤1st percentile, 19 (15.7%) carried mutations that are causing monogenic hypocholesterolemia and 60 (49.6%) were genetically predisposed to low LDL-C on the basis of an extremely low weighted genetic risk score. In comparison with control groups, a healthier lifestyle was not associated with low LDL-C in women without genetic predispositions. Among women with LDL-C ≥99th percentile, 20 women (16.8%) carried mutations that cause familial hypercholesterolemia, whereas 25 (21%) were predisposed to high LDL-C on the basis of a high-weighted genetic risk score. The women in whom no genetic origin for hypercholesterolemia could be identified were found to exhibit a significantly unfavorable lifestyle in comparison with controls.

Conclusions:

This study highlights the need for early assessment of the cardiovascular risk profile in apparently healthy young women to identify those with LDL-C ≥99th percentile for their age: first, because, in this study, 17% of the cases were molecularly diagnosed with familial hypercholesterolemia, which needs further attention; second, because our data indicate that an unfavorable lifestyle is significantly associated with severe hypercholesterolemia in genetically unaffected women, which may also need further attention.
Pregnancy Outcomes in Women With Rheumatic Mitral Valve Disease
Authors: van Hagen Iris M. , Thorne Sara A. , Taha Nasser , Youssef Ghada , Elnagar Amro , Gabriel Harald , ElRakshy Yahia , Iung Bernard , Johnson Mark R. , Hall Roger , Roos-Hesselink Jolien W.
Published: February 2018

Background:

Cardiac disease is 1 of the major causes of maternal mortality. We studied pregnancy outcomes in women with rheumatic mitral valve disease.

Methods:

The Registry of Pregnancy and Cardiac Disease is an international prospective registry, and consecutive pregnant women with cardiac disease were included. Pregnancy outcomes in all women with rheumatic mitral valve disease and no prepregnancy valve replacement is described in the present study (n=390). A maternal cardiac event was defined as cardiac death, arrhythmia requiring treatment, heart failure, thromboembolic event, aortic dissection, endocarditis, acute coronary syndrome, and hospitalization for other cardiac reasons or cardiac intervention. Associations between patient characteristics and cardiac outcomes were checked in a 3-level model (patient–center–country).

Results:

Most patients came from emerging countries (75%). Mitral stenosis (MS) with or without mitral regurgitation (MR) was present in 273 women, isolated MR in 117. The degree of MS was mild in 20.9%, moderate in 39.2%, severe in 19.8%, and severity not classified in the remainder. Maternal death during pregnancy occurred in 1 patient with severe MS. Hospital admission occurred in 23.1% of the women with MS, and the main reason was heart failure (mild MS 15.8%, moderate 23.4%, severe 48.1%;
P
<0.001). Heart failure occurred in 23.1% of patients with moderate or severe MR. An intervention during pregnancy was performed in 16 patients, 14 had percutaneous balloon mitral commissurotomy, and 2 had surgical valve replacement (1 for MS, 1 for MR). In multivariable modeling, prepregnancy New York Heart Association class >1 was an independent predictor of maternal cardiac events. Follow-up at 6 months postpartum was available for 53%, and 3 more patients died (1 with severe MS, 1 with moderate MS, 1 with moderate to severe MR).

Conclusions:

Although mortality was only 1.9% during pregnancy, ≈50% of the patients with severe rheumatic MS and 23% of those with significant MR developed heart failure during pregnancy. Prepregnancy counseling and considering mitral valve interventions in selected patients are important to prevent these complications.
Predictors of Thrombolysis Administration in Mild Stroke
Authors: Asdaghi Negar , Wang Kefeng , Ciliberti-Vargas Maria A. , Gutierrez Carolina Marinovic , Koch Sebastian , Gardener Hannah , Dong Chuanhui , Rose David Z. , Garcia Enid J. , Burgin W. Scott , Zevallos Juan Carlos , Rundek Tatjana , Sacco Ralph L. , Romano Jose G.
Published: February 2018

Background and Purpose—

Mild stroke is the most common cause for thrombolysis exclusion in patients acutely presenting to the hospital. Thrombolysis administration in this subgroup is highly variable among different clinicians and institutions. We aim to study the predictors of thrombolysis in patients with mild ischemic stroke in the FL-PR CReSD registry (Florida-Puerto Rico Collaboration to Reduce Stroke Disparities).

Methods—

Among 73 712 prospectively enrolled patients with a final diagnosis of ischemic stroke or TIA from January 2010 to April 2015, we identified 7746 cases with persistent neurological symptoms and National Institutes of Health Stroke Scale ≤5 who arrived within 4 hours of symptom onset. Multilevel logistic regression analysis with generalized estimating equations was used to identify independent predictors of thrombolytic administration in the subgroup of patients without contraindications to thrombolysis.

Results—

We included 6826 cases (final diagnosis mild stroke, 74.6% and TIA, 25.4%). Median age was 72 (interquartile range, 21); 52.7% men, 70.3% white, 12.9% black, 16.8% Hispanic; and median National Institutes of Health Stroke Scale, 2 (interquartile range, 3). Patients who received thrombolysis (n=1281, 18.7%) were younger (68 versus 72 years), had less vascular risk factors (hypertension, diabetes mellitus, and dyslipidemia), had lower risk of prior vascular disease (myocardial infarction, peripheral vascular disease, and previous stroke), and had a higher presenting median National Institutes of Health Stroke Scale (4 versus 2). In the multilevel multivariable model, early hospital arrival (arrive by 0–2 hours versus ≥3.5 hours; odds ratio [OR], 8.16; 95% confidence interval [CI], 4.76–13.98), higher National Institutes of Health Stroke Scale (OR, 1.87; 95% CI, 1.77–1.98), aphasia at presentation (OR, 1.35; 95% CI, 1.12–1.62), faster door-to-computed tomography time (OR, 1.81; 95% CI, 1.53–2.15), and presenting to an academic hospital (OR, 2.02; 95% CI, 1.39–2.95) were independent predictors of thrombolysis administration.

Conclusions—

Mild acutely presenting stroke patients are more likely to receive thrombolysis if they are young, white, or Hispanic and arrive early to the hospital with more severe neurological presentation. Identification of predictors of thrombolysis is important in design of future studies to assess the use of thrombolysis for mild stroke.
Ministry of Health Clinical Practice Guidelines: Chronic Obstructive Pulmonary Disease
Authors: Lim TK , Chee CB , Chow P , Chua GSW , Eng SK , Goh SK , Kng KK , Lim WH , Ng TP , Ong TH , Seah STA , Tan HY , Tee KH , Palanichamy V , Yeung MT
Published: February 2018

The Ministry of Health (MOH) has updated the Clinical Practice Guidelines on Chronic Obstructive Pulmonary Disease (COPD) to provide doctors and patients in Singapore with evidence-based treatment for COPD. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the MOH Clinical Practice Guidelines on COPD, for the information of SMJ readers. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: https://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_medical.html. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.
Can Polarization Be Positive? Conflict and Institutional Development in Africa
Authors: LeBas Adrienne
Published: February 2018

Can political polarization, typically viewed as detrimental for political development, have positive effects on institution-building and democratization in the long run? This article argues that the overall impact of polarization on a political system is determined by two factors: the character of preexisting identity cleavages and the balance of forces between groups on either side of the political divide. Where there exists a history of formal group exclusion or differential citizenship rights, political polarization is more likely to result in large-scale violence and democratic breakdown. Where power is strongly imbalanced, on the other hand, polarization is unlikely to be sustained, and the status quo ante will be retained. When these two conditions are absent, however, a relatively high degree of polarization can have surprising institution-building effects for new democracies. The article illustrates these arguments with reference to four key cases in sub-Saharan Africa.
Examining the Effects of Individual-Level and Neighborhood-Level Characteristics on the Variability of Substance Use Rates and Changes
Authors: Jones Adrian M. , Adams Richard E.
Published: February 2018

We use social learning, self-control, and social disorganization theories to explain substance use among urban adolescents. Using a sample of 2,048 adolescents and young adults from the Project in Human Development in Chicago Neighborhoods, we develop and test longitudinal growth models that examine how respondent and neighborhood characteristics relate to rates and changes of tobacco, alcohol, marijuana, and hard drug use. We find empirical support for social learning and self-control theories in relation to substance use rates, but no support for social disorganization theory. In addition, we find evidence that deviant peers, self-control, and concentrated disadvantage are associated with respondent changes in substance use. We discuss these findings in relation to the three theories that informed our study.
An Integrative Synthesis of Literature on Disproportionality in Special Education
Authors: Cruz Rebecca A. , Rodl Janelle E.
Published: February 2018

Research studies have historically indicated that students from racially and ethnically diverse backgrounds are overidentified for special education, suggesting bias in referral, assessment, and placement practices. Other studies, however, have suggested that students from racially and ethnically diverse backgrounds are not overrepresented in special education or may be underidentified for services. There is a perceptual interpretive element in defining the problem of disproportionality, as the use of different data sets and analyses impact how both the problem and results are interpreted. The purpose of this manuscript was to examine the ways in which current studies analyze disproportionality through statistical methods, and to compare those analyses based on the conceptualization of covariates. An integrative systematic review of the literature builds on previous works that examine the issue of disproportionality.
You want me to talk to whom? Explorations in fear and faith from the underside of the Bible
Authors: LaBoy Felicia Howell
Published: February 2018

This article utilizes an African American/womanist biblical hermeneutic that focuses on the intersectionality of the key players in the text to conduct an exegetical analysis of Philip’s encounter with the Ethiopian official found in Acts 8:26–40. Likening Philip’s encounter with the Ethiopian eunuch to the experience of racial ethnic scholars, this article also summarizes the process by which they “speak truth to power” in predominantly white academic institutions. Finally, this article argues that this process can serve as a model for how the theological academy might enable the Christian Church to speak to increasingly disenfranchised, but once privileged, whites in an increasingly post-Christian and more diverse North American society.
Further Evaluation of a Practitioner Model for Increasing Eye Contact in Children With Autism
Authors: Rapp John T. , Cook Jennifer L. , Nuta Raluca , Balagot Carissa , Crouchman Kayla , Jenkins Claire , Karim Sidrah , Watters-Wybrow Chelsea
Published: February 2018

Cook et al. recently described a progressive model for teaching children with autism spectrum disorder (ASD) to provide eye contact with an instructor following a name call. The model included the following phases: contingent praise only, contingent edibles plus praise, stimulus prompts plus contingent edibles and praise, contingent video and praise, schedule thinning, generalization assessments, and maintenance evaluations. In the present study, we evaluated the extent to which modifications to the model were needed to train 15 children with ASD to engage in eye contact. Results show that 11 of 15 participants acquired eye contact with the progressive model; however, eight participants required one or more procedural modifications to the model to acquire eye contact. In addition, the four participants who did not acquire eye contact received one or more modifications. Results also show that participants who acquired eye contact with or without modifications continued to display high levels of the behavior during follow-up probes. We discuss directions for future research with and limitations of this progressive model.