bluuebunny/crossref_metadata_2025 huggingface dataset:
Análisis de la relación de la innovación empresarial con la financiación en Colombia
Authors: Rivera Godoy Jorge Alberto
Published: November 2015

Este artículo examina si las empresas innovadoras tienen un patrón de financiación diferente al de las empresas no innovadoras, y analiza la relación entre actividades de innovación y fuentes de financiación a la luz de la teoría económica. Se realizan test estadísticos con base en la información de la Encuesta Empresarial del Banco Mundial del año 2010 y se encuentra que las empresas innovadoras hacen un uso diferente de las fuentes de financiación (recursos internos, financiación bancaria y crédito de proveedores en la financiación del capital de trabajo) al que hacen las empresas no innovadoras. Las principales fuentes de financiación de las empresas innovadoras son los recursos propios y la deuda bancaria. Se sugiere profundizar estos hallazgos con encuestas y estudios de caso.
Crisis financiera, racionamiento de crédito y relación bancaria de las pyme españolas
Authors: MENDIZABAL ZUBELDIA ALAITZ , LERTXUNDI LERTXUNDI AITZIBER
Published: November 2015

Este artículo estudia la relación bancaria y el racionamiento de crédito a
las PYME en crisis financieras, así como su evolución y variaciones; para
el análisis estadístico se utiliza el Contraste de Igualdad de Medias. Se
constata, por un lado, un aumento significativo del número de relaciones
bancarias de las PYME y del racionamiento de crédito que padecen, y, por
otro, una disminución en el nivel de confianza con las entidades bancarias.
En posteriores trabajos se sugiere analizar la evolución de la incidencia
de la relación bancaria en el racionamiento de crédito durante la crisis.
Hacia una arqueología de la administración
Authors: Jurado Jurado Juan Carlos
Published: November 2015

La administración nació con las obras escritas de Taylor (1911) y Fayol (1916), sin embargo, ello es resultado de procesos acecidos durante la Revolución Industrial (1780-1900) (momento arqueológico). Como objeto de este artículo se analiza el papel que tuvieron, durante ese período, los escritos de los empresarios acerca de sus prácticas de organización del trabajo en las industrias, en la formación de la administración. Se hace una revisión hermenéutico-crítica de bibliografía primaria y secundaria y se halla que antes de tales obras existió una tradición de los empresarios por expresar textualmente sus conocimientos empíricos (prácticas administrativas), de allí que la escritura fuera fundamental en la conformación de la administración como una práctica productora de su propio saber teórico (práctica discursiva).
The ambient acoustic environment in Laguna San Ignacio, Baja California Sur, Mexico
Authors: Seger Kerri D. , Thode Aaron M. , Swartz Steven L. , Urbán R. Jorge
Published: November 2015

Each winter gray whales (Eschrichtius robustus) breed and calve in Laguna San Ignacio, Mexico, where a robust, yet regulated, whale-watching industry exists. Baseline acoustic environments in LSI's three zones were monitored between 2008 and 2013, in anticipation of a new road being paved that will potentially increase tourist activity to this relatively isolated location. These zones differ in levels of both gray whale usage and tourist activity. Ambient sound level distributions were computed in terms of percentiles of power spectral densities. While these distributions are consistent across years within each zone, inter-zone differences are substantial. The acoustic environment in the upper zone is dominated by snapping shrimp that display a crepuscular cycle. Snapping shrimp also affect the middle zone, but tourist boat transits contribute to noise distributions during daylight hours. The lower zone has three source contributors to its acoustic environment: snapping shrimp, boats, and croaker fish. As suggested from earlier studies, a 300 Hz noise minimum exists in both the middle and lower zones of the lagoon, but not in the upper zone.
The Institutional Work of Own the Podium in Developing High-Performance Sport in Canada
Authors: Dowling Mathew , Smith Jimmy
Published: November 2015

This investigation examined how Own the Podium (OTP) has contributed to the ongoing development of highperformance sport in Canada. In adopting an institutional work perspective, we contend that OTP’s continuance has not been the sole product of Canada’s success at the Olympic and Paralympic Games or lobbying efforts to secure additional funding. Rather, OTP’s permanence can also be explained as the by-product of the activities and actions of OTP itself and its supporting stakeholders to embed and institutionalize both the organization specifically and high-performance sport more generally in the Canadian sport landscape. In short, OTP’s continued existence can, in part, be explained by ongoing institutional work. To support our contentions, we draw on and analyze documentation that was either produced by, or significant to the development of, OTP. Our analysis identifies a number of OTP-related practices (e.g., tiering, hiring of high-performance advisors, and the creation and support of new high-performance sport programs) that have further institutionalized OTP and the norms, routines, and practices associated with high-performance sport. More broadly, our investigation draws attention to the importance of individual and collective actors in shaping institutional settings in sport.
Novel Immunomodulatory Flagellin-Like Protein FlaC in Campylobacter jejuni and Other
Campylobacterales
Authors: Faber Eugenia , Gripp Eugenia , Maurischat Sven , Kaspers Bernd , Tedin Karsten , Menz Sarah , Zuraw Aleksandra , Kershaw Olivia , Yang Ines , Rautenschlein Silke , Josenhans Christine
Published: November 2015

Flagellins not only are important for bacterial motility but are major bacterial proteins that can modulate host responses via Toll-like receptor 5 (TLR5) or other pattern recognition receptors.
Campylobacterales
colonizing the intestinal tracts of different host species harbor a gene coding for an unusual flagellin, FlaC, that is not involved in motility but is secreted and possesses a chimeric amino acid sequence composed of TLR5-activating and non-TLR5-activating flagellin sequences.
Campylobacter jejuni
FlaC activates cells to increase in cytokine expression in chicken and human cells, promotes cross-tolerance to TLR4 ligands, and alters chicken cecal microbiota. We propose that FlaC is a secreted effector flagellin that has specifically evolved to modulate the immune response in the intestinal tract in the presence of the resident microbiota and may contribute to bacterial persistence. The results also strengthen the role of the flagellar type III apparatus as a functional secretion system for bacterial effector proteins.
Stridor: a rare presentation of oesophageal malignancy
Authors: Bartolo Kyra , Fsadni Peter
Published: November 2015

A middle-aged ex-smoker, with a history of curative surgery for oesophageal squamous cell carcinoma 7 years earlier, presented to the casualty department at Mater Dei Hospital with stridor and a 2-week history of progressively worsening dyspnoea. A thoracic CT scan showed the presence of a posterior mediastinal mass involving the upper half of the stomach and posterior wall of the trachea. Histology of an exophytic ulcerating lesion at 25 cm of the oesophagus was that of squamous cell carcinoma. Bronchoscopy performed to ascertain the cause of the stridor showed the trachea to be 70% occluded. The patient showed symptomatic improvement with radiotherapy and intravenous dexamethasone; however, he passed away a few weeks later due to respiratory failure secondary to tracheal occlusion.
Bug on the back: vertebral osteomyelitis secondary to fluoroquinolone resistantSalmonella typhiin an immunocompetent patient
Authors: Shrestha Pragya , Mohan Sachin , Roy Satyajeet
Published: November 2015

AlthoughSalmonellaosteomyelitis is commonly seen in immunocompromised patients, it may occasionally affect an immunocompetent host. Symptoms are usually non-specific, such as fever, abdominal or back pain; hence it should be considered in the differential diagnosis of patients with a history of travel to endemic regions. Fluoroquinolone resistance is rising and non-responsive patients should be treated with ampicillin, trimethoprim-sulfamethoxazole and ceftriaxone. We present a case of acute T8-T11 osteomyelitis with cord compression caused by a fluoroquinolone resistant strain ofSalmonella typhi.
Penetrating neck injury from a screwdriver: can the No Zone approach be applied to Zone I injuries?
Authors: Bhatt Nikita R , McMonagle Morgan
Published: November 2015

The newer approach to management of penetrating neck injuries (PNI) involves the No Zone approach: comprehensive physical examination combined with CT angiography for triage to effectively identify or exclude vascular and aerodigestive injury. This approach, however, has a low negative exploration rate; there is risk of missing occult injuries especially Zone I and III PNI. We report a case of a patient with PNI to Zone I of the neck who was haemodynamically stable at presentation; CT scan revealed complete occlusion of the common carotid artery. Immediate surgical exploration revealed an occult hypopharyngeal injury in addition to the arterial trauma, which was missed on the CT scan. Hence the No Zone approach needs cautious clinical application, especially in Zone I injuries.
Independent associations of polymorphisms in vitamin D binding protein (GC) and vitamin D receptor (VDR) genes with obesity and plasma 25OHD3 levels demonstrate sex dimorphism
Authors: Almesri Norah , Das Nagalla S. , Ali Muhallab E. , Gumaa Khalid , Giha Hayder Ahmed
Published: November 2015

We investigated a possible association between polymorphisms in vitamin D binding protein (GC) and vitamin D receptor (VDR) genes and obesity in Bahraini adults. For this purpose, 406 subjects with varying body mass indexes (BMIs) were selected. Plasma levels of 25-hydroxyvitamin D3 (25OHD3) were measured by chemiluminescence immunoassay. Six single nucleotide polymorphisms, 2 in the VDR gene (rs731236 TC and rs12721377 AG) and 4 in the GC gene (rs2282679 AC, rs4588 CA, rs7041 GT, and rs2298849 TC), were genotyped by real-time polymerase chain reaction. We found that the rs7041 minor allele (G) and rare genotype (GG) were associated with higher BMI (p = 0.007 and p = 0.012, respectively), but they did not influence 25OHD3 levels. However, the minor alleles of rs2282679 (A) and rs4588 (C) were associated with low 25OHD3 plasma levels (p = 0.039 and p = 0.021, respectively), but not with BMI. Having categorized the subjects based on their sex, we found that (i) rs7041 GG associated with high BMI in females (p = 0.003), (ii) rs4588 CC associated with high BMI in females (p = 0.034) and low 25OHD3 levels in males (p = 0.009), and (iii) rs12721377 AA associated with low 25OHD3 levels in females (p = 0.039). Notably, none of the common haplotypes (6 in the GC gene and 3 in the VDR gene) were associated with BMI. Therefore, polymorphisms in the GC (rs2282679, rs4588, rs7041) and VDR (rs12721377) genes were independently associated with obesity and 25OHD3 levels with a clear sex dimorphism.
Influence of elevation and site productivity on conifer distributions across Alaskan temperate rainforests
Authors: Caouette J.P. , Steel E.A. , Hennon P.E. , Cunningham P.G. , Pohl C.A. , Schrader B.A.
Published: November 2015

We investigated the influence of landscape factors on the distribution and life stage stability of coastal tree species near the northern limit of their ranges. Using data from 1465 forest inventory plots, we estimated probability of occurrence and basal area of six common conifer species across three broad latitudinal regions of coastal Alaska. By also comparing models across life stages of each species (seedlings, saplings, mature trees, and dead trees), we explored trends in population stability at this leading edge of climate change. Elevation had a stronger influence on the probability of tree species occurrence than on basal area; site productivity impacted both estimated odds of presence and estimated basal area for most species in at least some regions. Interestingly, there were fairly dramatic differences across species in the degree to which the modeled probability of occurrence differed across the four life stages. Western redcedar (Thuja plicata Donn ex D. Don), for example, showed relatively stable distributions but other species appear to be in flux, e.g., yellow-cedar (Callitropsis nootkatensis (D. Don) D.P. Little), which has experienced widespread mortality at low elevations. Differential effects of elevation on live versus dead basal area suggest that mountain hemlock (Tsuga mertensiana (Bong.) Carrière) and yellow-cedar are shifting upslope in some regions and that Sitka spruce (Picea sitchensis (Bong.) Carrière) is shifting downslope in the Northwest region.
A version of Kac’s lemma on first return times for suspension flows
Authors: Varandas Paulo
Published: November 2015

In this paper, we study the mean return times to a given set for suspension flows. In the discrete time setting, this corresponds to the classical version of Kac’s lemma [11] that the mean of the first return time to a set with respect to the normalized probability measure is one. In the case of suspension flows we provide formulas to compute the mean return time. Positive measure sets on cross sections are also considered. In particular, this varies linearly with continuous reparametrizations of the flow and takes into account the mean escaping time from the original set. Relation with entropy and returns to positive measure sets on cross sections is also considered.
Team Building in Multidisciplinary Client-Sponsored Project Courses
Authors: Pastel Robert , Seigel Marika , Zhang Wei , Mayer Alex
Published: November 2015

Experience working in multidisciplinary teams is important both to prepare Computer Science (CS) students for industry and to improve their communication with teammates from disciplines other than their own. This article describes the evolution and results of collaborations among three courses: an undergraduate CS course about user interface design and implementation, an undergraduate Scientific and Technical Communication (STC) course about usability and instructions writing, and a graduate CS/Human Factors course about user-interface evaluation and usability testing. Students from all three courses work with scientists to complete the scientist-sponsored citizen science Android applications (apps). Students from the undergraduate CS and STC courses form multidisciplinary teams to design and implement apps, while the graduate students consult with the teams by evaluating and user-testing the apps. The collaboration's effectiveness was assessed using student surveys, interviews, and evaluations of student work. This article compares the collaboration within the teams and the coordination with the scientists across two years of activities in order to determine the effectiveness of course modifications. The article concludes with recommendations for improving the collaboration within teams and the coordination with clients in multidisciplinary course projects.
Learning Perceptual Causality from Video
Authors: Fire Amy , Zhu Song-Chun
Published: November 2015

Perceptual causality is the perception of causal relationships from observation. Humans, even as infants, form such models from observation of the world around them [Saxe and Carey 2006]. For a deeper understanding, the computer must make similar models through the analogous form of observation: video. In this article, we provide a framework for the unsupervised learning of this perceptual causal structure from video. Our method takes action and object status detections as input and uses heuristics suggested by cognitive science research to produce the causal links perceived between them. We greedily modify an initial distribution featuring independence between potential causes and effects by adding dependencies that maximize information gain. We compile the learned causal relationships into a Causal And-Or Graph, a probabilistic and-or representation of causality that adds a prior to causality. Validated against human perception, experiments show that our method correctly learns causal relations, attributing status changes of objects to causing actions amid irrelevant actions. Our method outperforms Hellinger’s χ
2
-statistic by considering hierarchical action selection, and outperforms the treatment effect by discounting coincidental relationships.
Accessibility layers
Authors: Guerreiro Tiago
Published: November 2015

Enabling access to a computing device is likely to have a huge impact in the quality of life of a person. Every once in a while, new technologies are devised and impact the way we communicate, work and even, how we have fun. Paradigmatically, it is often the case that a new technology empowers the general able-bodied user and fosters exclusion of people with disabilities. The emergence of touch-based smartphones as the
de facto
mobile interaction gadget created a gap between those that were able to use the device as it was deployed in the market and those that were not able to do so. The potential usages of these devices exploded and users that were at that time able to use mobile phones with physical keypads similarly to their peers, saw themselves living in the past of mobile interaction, from one day to the other. This was the case of blind people when smartphones started to dominate the market
circa
2007.
Using sparse interpolation to solve multivariate diophantine equations
Authors: Monagan Michael , Tuncer Baris
Published: November 2015

Suppose that we seek to factor a multivariate polynomial
a
ε
R
= Z[
x
1
, ...,
x
n
] and
a
=
fg
with
f, g
in
R
. The multivariate Hensel lifting algorithm (MHL) developed by Wang [1] uses a prime number
p
and an ideal
I
= 〈
x
2
− α
2
, ...,
x
n
− α
n
〉 of Z

p

[
x
1
, ...,
x
n
] where α
2
, α
3
, ..., α
n
ε Z
p
is an evaluation point chosen by the algorithm.
Integration in terms of exponential integrals and incomplete gamma functions
Authors: Hebisch Waldemar
Published: November 2015

Indefinite integration means that given
f
in some set we want to find
g
from possibly larger set such that
f
=
g
'. When
f
and
g
are required to be elementary functions due to work of among others Risch, Rothstein, Trager, Bronstein (see [1] for references) integration problem is now solved at least in theory. In his thesis Cherry gave algorithm to integrate transcendental elementary functions in terms of exponential integrals. In [2] he gave algorithm to integrate transcendental elementary functions in so called reduced fields in terms of error functions. Knowles [3] and [4] extended this allowing also liovillian integrands and weakened restrictions on the field containing integrands. We extend previous results allowing incomplete gamma function Γ(
a
,
x
) with rational
a
. Also, our theory can handle algebraic extensions and is complete jointly (and not only separately for Ei and erf). In purely transcendental case our method should be more efficient and easier to implement than [2]. In fact, it seems that no system currently implements algorithm from [2], while partial implementation of our method in FriCAS works well enough to be turned on by default. With our approach non-reduced case from [2] can be handled easily. We hope that other classes of special functions can be handled in a similar way, in particular irrational case of incomplete gamma function and polylogarithms (however polylogarithms raise tricky theoretical questions).
A Nationwide Cross-Sectional Survey of UK Breast Surgeons’ Views on the Management of Ductal Carcinoma In Situ
Authors: Mannu Gurdeep S. , Bettencourt-Silva Joao H. , Ahmed Farid , Cunnick Giles
Published: November 2015

Background. There is wide variation in the management of Ductal Carcinoma In Situ (DCIS) nationwide. We aimed to investigate whether the attitudes of surgeons towards different aspects of DCIS treatment varied by seniority of surgeon or by geographical region within the UK.Materials and Methods. A nationwide online survey targeted at UK breast surgeons was undertaken. The anonymous survey contained questions regarding demographics of respondents and specific questions regarding DCIS management that were identified as areas of uncertainty during a systematic search of the literature.Results. Responses from 80 surgeons were obtained. Approximately 57% were male and the majority were consultant or specialist registrar. Approximately 63% of participants were based in district general hospitals with all training deaneries represented. Surgeons’ views on the prognosis and management of DCIS varied geographically across the UK and terminology for DCIS varied with surgeon seniority. Surgeons’ views particularly differed from national guidance on indications for SLNB, tamoxifen, and follow-up practice.Conclusion. Our survey reaffirms that, irrespective of national guidelines and attempts at uniformity, there continues to be a wide variety of views amongst breast surgeons regarding the ideal management of DCIS. However, by quantifying this variation, it may be possible to take it into account when examining long-term trends in nationwide treatment data.
Facial Involuntary Movements and Respiratory Failure in CANOMAD, Responsive to IVIG Therapy
Authors: Johnson Kate , Malkan Ashish , Shaffi Mohamed
Published: November 2015

CANOMAD is a rare chronic neuropathy, characterized by chronic sensory ataxia and intermittent brain stem symptoms due to antidisialosyl antibodies. The disorder results in significant morbidity but is poorly understood and often misdiagnosed. We describe a unique case of CANOMAD, associated with involuntary movements of the face; patient reported exacerbations with citrus and chocolate and respiratory muscle weakness. Our patient was initially misdiagnosed with Miller Fisher Syndrome, highlighting the need for vigilance should neurological symptoms recur in patients initially diagnosed with a Guillain Barre variant. Moreover, the optimal treatment is unknown. This patient responded remarkably to intravenous immunoglobulin and has been maintained on this treatment, without further exacerbations.
Kinematics and Mechanical Properties of Knees following Patellar Replacing and Patellar Retaining Total Knee Arthroplasty
Authors: Huang Rongying , Liu Yanqiang , Zhu Jun
Published: November 2015

Knee injury is a common medical issue. A full understanding of the kinematics and mechanical properties of knees following total knee arthroplasty (TKA) repair utilizing patellar replacement (only the base of the patella is replaced) versus patellar retaining surgical techniques is still lacking. In the current paper, we investigated magnetic resonance (MR) imaging data from knees repaired by these two methods and evaluated total knee models created using imaging reconstruction technology that simulated gait conditions. Results revealed that patellar replacement had little influence on tibiofemoral kinematics, although the tibia-surface equivalent stress increased slightly. By contrast, patellar replacement had a significant influence on the patellofemoral joint; patellar internal rotation, external rotation, and medial-lateral translation were all increased. Moreover, the stress distribution on patellar prostheses was altered, resulting in an increased surface maximal equivalent stress on the corresponding area. Moreover, during the gait cycle, we found that the area with maximal equivalent stress shifted its position. Finally, the patellofemoral joint showed decreased motion stability. From the view of kinematics and mechanics, this paper suggests that patella should be retained during TKA if it is possible. The present study presented approaches and technologies for evaluating kinematics and mechanical properties of total knee joint after TKA under gait loads.
Local Relationship between Global-Flash Multifocal Electroretinogram Optic Nerve Head Components and Visual Field Defects in Patients with Glaucoma
Authors: Moon Chan Hee , Han Jungwoo , Ohn Young-Hoon , Park Tae Kwann
Published: November 2015

Purpose. To investigate the local relationship between quantified global-flash multifocal electroretinogram (mfERG) optic nerve head component (ONHC) and visual field defects in patients with glaucoma.Methods. Thirty-nine patients with glaucoma and 30 normal controls were enrolled. The ONHC amplitude was measured from the baseline to the peak of the second positive deflection of the induced component. The ONHC amplitude was normalized by dividing ONHC amplitude by the average of seven largest ONHC amplitudes. The ONHC amplitude ratio map and ONHC deficiency map were constructed. The local relationship between the ONHC measurements and visual field defects was evaluated by calculating the overlap between the ONHC deficiency maps and visual field defect plots.Results.The mean ONHC amplitude measurements of patients with glaucoma (6.01±1.91 nV/deg2) were significantly lower than those of the normal controls (10.29±0.94 nV/deg2) (P<0.001). The average overlap between the ONHC deficiency map and visual field defect plot was 71.4%. The highest overlap (75.0%) was between the ONHC ratios less than 0.5 and the total deviations less than 5%.Conclusions.The ONHC amplitude was reduced in patients with glaucoma compared to that in normal controls. Loss of the ONHC amplitude from the global-flash mfERG showed a high local agreement with visual field defects in patients with glaucoma.
Does Ramadan Fasting Adversely Affect Cognitive Function in Young Females?
Authors: Ghayour Najafabadi Mahboubeh , Rahbar Nikoukar Laya , Memari Amir , Ekhtiari Hamed , Beygi Sara
Published: November 2015

We examined the effects of Ramadan fasting on cognitive function in 17 female athletes. Data were obtained from participants of two fasting (n=9) and nonfasting (n=8) groups at three periods of the study (before Ramadan, at the third week in Ramadan, and after Ramadan). Digit span test (DST) and Stroop color test were employed to assess short-term memory and inhibition/cognitive flexibility at each time point. There were no significant changes for DST and Stroop task 1 in both groups, whereas Stroop task 2 and task 3 showed significant improvements in Ramadan condition (p<0.05). Interference indices did not change significantly across the study except in post-Ramadan period of fasting group (p<0.05). Group × week interaction was significant only for error numbers (p<0.05). Athletes in nonfasting showed a significant decrease in number of errors in Ramadan compared to baseline (p<0.05). The results suggest that Ramadan fasting may not adversely affect cognitive function in female athletes.
Familial Aggregation and Segregation Analysis in Families Presenting Autoimmunity, Polyautoimmunity, and Multiple Autoimmune Syndrome
Authors: Castiblanco John , Sarmiento-Monroy Juan Camilo , Mantilla Ruben Dario , Rojas-Villarraga Adriana , Anaya Juan-Manuel
Published: November 2015

Studies documenting increased risk of developing autoimmune diseases (ADs) have shown that these conditions share several immunogenetic mechanisms (i.e., the autoimmune tautology). This report explored familial aggregation and segregation of AD, polyautoimmunity, and multiple autoimmune syndrome (MAS) in 210 families. Familial aggregation was examined for first-degree relatives. Segregation analysis was implemented as in S.A.G.E. release 6.3. Data showed differences between late- and early-onset families regarding their age, age of onset, and sex. Familial aggregation of AD in late- and early-onset families was observed. For polyautoimmunity as a trait, only aggregation was observed between sibling pairs in late-onset families. No aggregation was observed for MAS. Segregation analyses for AD suggested major gene(s) with no clear discernible classical known Mendelian transmission in late-onset families, while for polyautoimmunity and MAS no model was implied. Data suggest that polyautoimmunity and MAS are not independent traits and that gender, age, and age of onset are interrelated factors influencing autoimmunity.
Actinomyces naeslundii: An Uncommon Cause of Endocarditis
Authors: Cortes Christopher D. , Urban Carl , Turett Glenn
Published: November 2015

Actinomycesrarely causes endocarditis with 25 well-described cases reported in the literature in the past 75 years. We present a case of prosthetic valve endocarditis (PVE) caused byActinomyces naeslundii. To our knowledge, this is the first report in the literature of endocarditis due to this organism and the second report of PVE caused byActinomyces.
Keloidal Scleroderma: Case Report and Review
Authors: Kassira Sama , Jaleel Tarannum , Pavlidakey Peter , Sami Naveed
Published: November 2015

Objective. We report a rare case of keloidal scleroderma and provide an analysis of similar cases.Results. A 41 year-old woman presented with dark brown, indurated, exophytic nodules over the chest along with smaller hyperpigmented plaques scattered over the abdomen, with concomitant sclerodactyly. The clinical, laboratory, and pathological findings were consistent with a diagnosis of keloidal scleroderma. The patient was treated with methotrexate, resulting in reduced firmness of her plaques and no new lesions. A literature review of previously reported cases was performed using keywords including keloidal morphea, keloidal scleroderma, nodular morphea, and nodular scleroderma. In our review, the majority of patients were African American and female. 91% of cases had nodular lesions with distribution on the trunk. The majority of patients exhibited sclerodactyly and pulmonary involvement was reported in 28%1. The majority of patients were ANA positive (63%) and only 10% demonstrated anti-SCL-70 positivity.Conclusion. Keloidal scleroderma is a rare presentation, which can often be clinically confused with keloid and scar formation. Due to this being a rare variant, our knowledge of treatment options and efficacy is limited. Methotrexate could be considered as an initial treatment option for patients with progressive keloidal scleroderma.
Plasma Exchange for the Recurrence of Primary Focal Segmental Glomerulosclerosis in Adult Renal Transplant Recipients: A Meta-Analysis
Authors: Vlachopanos Georgios , Georgalis Argyrios , Gakiopoulou Harikleia
Published: November 2015

Background. Posttransplant recurrence of primary focal segmental glomerulosclerosis (rFSGS) in the form of massive proteinuria is not uncommon and has detrimental consequences on renal allograft survival. A putative circulating permeability factor has been implicated in the pathogenesis leading to widespread use of plasma exchange (PLEX). We reviewed published studies to assess the role of PLEX on treatment of rFSGS in adults.Methods. Eligible manuscripts compared PLEX or variants with conventional care for inducing proteinuria remission (PR) in rFSGS and were identified through MEDLINE and reference lists. Data were abstracted in parallel by two reviewers.Results. We detected 6 nonrandomized studies with 117 cases enrolled. In a random effects model, the pooled risk ratio for the composite endpoint of partial or complete PR was 0,38 in favour of PLEX (95% CI: 0,23–0,61). No statistical heterogeneity was observed among included studies (I2=0%,p= 0,42). On average, 9–26 PLEX sessions were performed to achieve PR. Renal allograft loss due to recurrence was lower (range: 0%–67%) in patients treated with PLEX.Conclusion. Notwithstanding the inherent limitations of small, observational trials, PLEX appears to be effective for PR in rFSGS. Additional research is needed to further elucidate its optimal use and impact on long-term allograft survival.
Giant Hypopharyngeal Fibrovascular Polyp: A Case Report and Review of the Relevant Literature
Authors: Haytoglu Suheyl , Tuhanioglu Birgul , Bozkurttan Abdurrahman , Arikan Osman Kursat
Published: November 2015

Fibrovascular polyps occur most commonly in the cervical esophagus and are extremely rare in the hypopharynx. In this paper, we report a case of fibrovascular polyp of a 52-year-old female, who presented with progressive dysphagia and weight loss and regurgitating a mass from her mouth. By the endoscopic examination, a polyp covered by normal mucosa with a wide stalk was detected at the hypopharynx. The pedicle of the mass was identified under general anesthesia and the 13 × 3 × 2 cm mass was completely resected perorally. Histopathological examination of the tumor showed oedematous subepithelial fibrous stroma, surrounded by squamous epithelium and containing many congested vascular structures. No recurrence was detected over one year of follow-up. This case highlights the need for clinicians to be aware of this rare entity and to develop the best approach to patient management.
The Correlation of the Tinnitus Handicap Inventory with Depression and Anxiety in Veterans with Tinnitus
Authors: Hu Jinwei , Xu Jane , Streelman Matthew , Xu Helen , Guthrie O’neil
Published: November 2015

Objective. The mechanisms of tinnitus are known to alter neuronal circuits in the brainstem and cortex, which are common to several comorbid conditions. This study examines the relationship between tinnitus and anxiety/depression.Subjects and Methods. Ninety-one male veterans with subjective tinnitus were enrolled in a Veterans Affairs Tinnitus Clinic. The Tinnitus Handicap Inventory (THI) was used to assess tinnitus severity. ICD-9 codes for anxiety/depression were used to determine their prevalence. Pure tone averages (PTA) were used to assess hearing status.Results. Descriptive analyses revealed that 79.1% of the 91 tinnitus sufferers had a diagnosis of anxiety, 59.3% had depression, and 58.2% suffered from both anxiety/depression. Patients with anxiety had elevated total THI scores as compared to patients without anxiety (p<0.05). Patients with anxiety or depression had significantly increased Functional and Emotional THI scores, but not Catastrophic THI score. Significant positive correlations were illustrated between the degree of tinnitus and anxiety/depression (p<0.05). There were no differences in PTA among groups.Conclusions. A majority of patients with tinnitus exhibited anxiety and depression. These patients suffered more severe tinnitus than did patients without anxiety and depression. The data support the need for multidisciplinary intervention of veterans with tinnitus.
NDVI Variation and Its Responses to Climate Change on the Northern Loess Plateau of China from 1998 to 2012
Authors: Ning Tingting , Liu Wenzhao , Lin Wen , Song Xiaoqiang
Published: November 2015

This study analyzed temporal and spatial changes of normalized difference vegetation index (NDVI) on the northern Loess Plateau and their correlation with climatic factors from 1998 to 2012. The possible impacts of human activities on the NDVI changes were also explored. The results showed that (1) the annual maximum NDVI showed an upward trend. The significantly increased NDVI and decreasing severe desertification areas demonstrate that the vegetation condition improved in this area. (2) Over the past decades, climate tended to be warmer and drier. However, the mean temperature significantly decreased and precipitation slightly increased from 1998 to 2012, especially in spring and summer, which was one of the major reasons for the increase in the annual maximum NDVI. Compared to temperature, vegetation was more sensitive to precipitation changes in this area. The NDVI and annual precipitation changes were highly synchronous over the first half of the year, while a 1-month time lag existed between the two variables during the second half of the year. (3) Positive human activities, including the “Grain for Green” program and successful environmental treatments at coal mining bases, were some of the other factors that improved the vegetation condition.
Biodegradable PTLGA Terpolymers versus Collagen Implants Used as an Adjuvant in Trabeculectomy in Rabbit Eye
Authors: Niu Weiran , Shen Guanglin , Yuan Yuanzhi , Ma Xiaoping , Li Suming , Wang Jingzhao , Fan Zhongyong , Liao Lan
Published: November 2015

Purpose. To evaluate the effectiveness and safety of three biodegradable terpolymers prepared from L-lactide, trimethylene carbonate, and glycolide (PTLGA) as an aid for trabeculectomy compared with the Ologen (OLO).Methods. Trabeculectomy was carried out on rabbits with implantation made from OLO or three PTLGA terpolymers. Intraocular pressure (IOP) was recorded 1, 2, 3, and 6 months postoperatively and bleb evaluations were performed using ultrasound biomicroscopy (UBM) 3 months after surgery, optical coherence tomography (OCT) every month, and transmission electron microscopy (TEM) six months after surgery followed by histological examination 1, 2, 3, and 6 months postoperatively.Result. IOP was significantly reduced in all groups after surgery. There were no significant differences in the IOL between groups at any time after implantation. There was no significant difference between the groups examined by OCT, UBM, and TEM. Exposure of the implant was observed in one eye from the OLO group and one eye in the P1. Subconjunctiva hyperblastosis was observed in one eye from group P3 and two eyes from the OLO group.Conclusions. Subconjunctival implantation of filtering devices made from PTLGA may present a safe and effective additional surgical tool for the treatment of filtering surgery. Fewer complications were observed in the group with P2 implants compared to other groups.
Interleukin‐1β Affects MDAMB231 Breast Cancer Cell Migration under Hypoxia: Role of HIF‐1α and NFκB Transcription Factors
Authors: Filippi Irene , Carraro Fabio , Naldini Antonella
Published: November 2015

Inflammation and tumor hypoxia are intimately linked and breast cancer provides a typical example of an inflammation‐linked malignant disease. Indeed, breast cancer progression is actively supported by inflammatory components, including IL‐1β, and by the hypoxia‐inducible factor‐ (HIF‐) 1α. In spite of many attempts where the role of either IL‐1β or HIF‐1α was evaluated, detailed mechanisms for their effects on breast cancer cell migration under hypoxia are still unclear. We here report that IL‐1β increased MDAMB231 cell migration under hypoxic conditions along with HIF‐1α accumulation and upregulation of CXCR1, which is transcriptionally regulated by HIF‐1α, as well as an increased expression of CXCL8 and NFκB. In addition, IL‐1β‐induced cell migration in hypoxia was not affected when HIF‐1α was inhibited by either siRNA or Topotecan, well known for its inhibitory effect on HIF‐1α. Of interest, HIF‐1α inhibition did not reduce NFκB and CXCL8 expression and the reduction of IL‐1β‐induced cell migration under hypoxia was achieved only by pharmacological inhibition of NFκB. Our findings indicate that inhibition of HIF‐1α does not prevent the migratory program activated by IL‐1β in hypoxic MDAMB231 cells. They also suggest a potential compensatory role of NFκB/CXCL8 pathway in IL‐1β‐induced MDAMB231 cell migration in a hypoxic microenvironment.
The Role of the Craniocervical Junction in Craniospinal Hydrodynamics and Neurodegenerative Conditions
Authors: Flanagan Michael F.
Published: November 2015

The craniocervical junction (CCJ) is a potential choke point for craniospinal hydrodynamics and may play a causative or contributory role in the pathogenesis and progression of neurodegenerative diseases such as Alzheimer’s disease, Parkinson’s disease, MS, and ALS, as well as many other neurological conditions including hydrocephalus, idiopathic intracranial hypertension, migraines, seizures, silent-strokes, affective disorders, schizophrenia, and psychosis. The purpose of this paper is to provide an overview of the critical role of the CCJ in craniospinal hydrodynamics and to stimulate further research that may lead to new approaches for the prevention and treatment of the above neurodegenerative and neurological conditions.
Morbid Obesity as Early Manifestation of Occult Hypothalamic-Pituitary LCH with Delay in Treatment
Authors: Keates-Baleeiro Jennifer , Rincon Marielisa
Published: November 2015

Morbid obesity presents unique challenges in managing additional disease processes. A 16-year-old male with a history of central diabetes insipidus (DI) and hypothyroidism developed destructive lesions in both his right mandible and brain, which were not discovered until the patient presented for tinnitus, 8 years after his initial diagnosis with DI. Langerhans cell histiocytosis (LCH) was diagnosed on pathologic biopsy. The patient’s initial body mass index (BMI) was 54.5 kg/m2so a unique treatment approach with single agent cladribine (2-CdA) was offered as traditional steroid therapy could worsen his endocrine dysfunction. The patient presented with neurodegenerative sequelae from the central LCH, possibly due to a delay in diagnosis and therapy. This case highlights difficulties in managing obese patients in an oncology setting and provides an illustrative case of how obesity may mask other comorbid conditions. Close supervision of complex obese patients with coordinated endocrinology and oncology care is vital. For the primary care practitioner, monitoring abrupt changes in BMI with serial cranial imaging may lead to a prompt diagnosis and prevention of further neurodegenerative effects. The use of 2-CdA was found to successfully bring the patient’s LCH into remission without the additional risks of steroid therapy in a morbidly obese patient.
Histamine Induces Alzheimer’s Disease-Like Blood Brain Barrier Breach and Local Cellular Responses in Mouse Brain Organotypic Cultures
Authors: Sedeyn Jonathan C. , Wu Hao , Hobbs Reilly D. , Levin Eli C. , Nagele Robert G. , Venkataraman Venkat
Published: November 2015

Among the top ten causes of death in the United States, Alzheimer’s disease (AD) is the only one that cannot be cured, prevented, or even slowed down at present. Significant efforts have been exerted in generating model systems to delineate the mechanism as well as establishing platforms for drug screening. In this study, a promising candidate model utilizing primary mouse brain organotypic (MBO) cultures is reported. For the first time, we have demonstrated that the MBO cultures exhibit increased blood brain barrier (BBB) permeability as shown by IgG leakage into the brain parenchyma, astrocyte activation as evidenced by increased expression of glial fibrillary acidic protein (GFAP), and neuronal damage-response as suggested by increased vimentin-positive neurons occur upon histamine treatment. Identical responses—a breakdown of the BBB, astrocyte activation, and neuronal expression of vimentin—were then demonstrated in brains from AD patients compared to age-matched controls, consistent with other reports. Thus, the histamine-treated MBO culture system may provide a valuable tool in combating AD.
Preoperative Peripheral Blood Count in Breast Carcinoma: Predictor of Prognosis or a Routine Test
Authors: Rana Amrit Pal Singh , Kaur Manjit , Zonunsanga B. , Puri Arun , Kuka Amarjit Singh
Published: November 2015

Background.Peripheral blood count is the first investigation to be done in every patient before surgery. As strong relationship exists between cancer and immune response of the body, clinical stage at presentation and altered hematological parameters can influence the progression of cancer and vice versa.Settings and Design.It is a case control study of total 50 cases (35 cases of carcinoma breast and 15 cases of benign breast disease).Methods.A case control study was carried out; 35 cases of breast cancer patients were taken prior to surgery and chemotherapy with 15 cases of benign breast disease as control. Clinical staging according to the tumor, node, and metastasis classification (TNMc) was done and was correlated with complete blood count (CBC).Results.All the cancer patients were females with overall mean age of47.96±13.84years. Amongst all altered blood parameters, correlation of absolute lymphocytic count (pvalue 0.001) with TNMc staging was found significant. Particularly, decrease in absolute leucocytic count was observed with increase in stage of breast carcinoma.Conclusions. The stage-specific mean values of absolute lymphocytic counts of preoperative breast cancer patients can be used as an economical tool to know the evolution of disease.
Long Noncoding RNA Regulation of Pluripotency
Authors: Rosa Alessandro , Ballarino Monica
Published: November 2015

Pluripotent stem cells (PSCs) represent a unique kind of stem cell, as they are able to indefinitely self‐renew and hold the potential to differentiate into any derivative of the three germ layers. As such, human Embryonic Stem Cells (hESCs) and human induced Pluripotent Stem Cells (hiPSCs) provide a unique opportunity for studying the earliest steps of human embryogenesis and, at the same time, are of great therapeutic interest. The molecular mechanisms underlying pluripotency represent a major field of research. Recent evidence suggests that a complex network of transcription factors, chromatin regulators, and noncoding RNAs exist in pluripotent cells to regulate the balance between self‐renewal and multilineage differentiation. Regulatory noncoding RNAs come in two flavors: short and long. The first class includes microRNAs (miRNAs), which are involved in the posttranscriptional regulation of cell cycle and differentiation in PSCs. Instead, long noncoding RNAs (lncRNAs) represent a heterogeneous group of long transcripts that regulate gene expression at transcriptional and posttranscriptional levels. In this review, we focus on the role played by lncRNAs in the maintenance of pluripotency, emphasizing the interplay between lncRNAs and other pivotal regulators in PSCs.
Energy Efficient Wireless Sensor Network Modelling Based on Complex Networks
Authors: Xiao Lin , Wu Fahui , Yang Dingcheng , Zhang Tiankui , Zhu Xiaoya
Published: November 2015

The power consumption and energy efficiency of wireless sensor network are the significant problems in Internet of Things network. In this paper, we consider the network topology optimization based on complex network theory to solve the energy efficiency problem of WSN. We propose the energy efficient model of WSN according to the basic principle of small world from complex networks. Small world network has clustering features that are similar to that of the rules of the network but also has similarity to random networks of small average path length. It can be utilized to optimize the energy efficiency of the whole network. Optimal number of multiple sink nodes of the WSN topology is proposed for optimizing energy efficiency. Then, the hierarchical clustering analysis is applied to implement this clustering of the sensor nodes and pick up the sink nodes from the sensor nodes as the clustering head. Meanwhile, the update method is proposed to determine the sink node when the death of certain sink node happened which can cause the paralysis of network. Simulation results verify the energy efficiency of the proposed model and validate the updating of the sink nodes to ensure the normal operation of the WSN.