bluuebunny/crossref_metadata_2025 huggingface dataset:
Simultaneous 3D Motion Detection, Long-Term Tracking and Model Reconstruction for Multi-Objects
Authors: Liu Sheng , Wang Yangqing , Dai Fengji , Yu Jingxiang
Published: June 2019

Motion detection and object tracking play important roles in unsupervised human–machine interaction systems. Nevertheless, the human–machine interaction would become invalid when the system fails to detect the scene objects correctly due to occlusion and limited field of view. Thus, robust long-term tracking of scene objects is vital. In this paper, we present a 3D motion detection and long-term tracking system with simultaneous 3D reconstruction of dynamic objects. In order to achieve the high precision motion detection, an optimization framework with a novel motion pose estimation energy function is provided in the proposed method by which the 3D motion pose of each object can be estimated independently. We also develop an accurate object-tracking method which combines 2D visual information and depth. We incorporate a novel boundary-optimization segmentation based on 2D visual information and depth to improve the robustness of tracking significantly. Besides, we also introduce a new fusion and updating strategy in the 3D reconstruction process. This strategy brings higher robustness to 3D motion detection. Experiments results show that, for synthetic sequences, the root-mean-square error (RMSE) of our system is much smaller than Co-Fusion (CF); our system performs extremely well in 3D motion detection accuracy. In the case of occlusion or out-of-view on real scene data, CF will suffer the loss of tracking or object-label changing, by contrast, our system can always keep the robust tracking and maintain the correct labels for each dynamic object. Therefore, our system is robust to occlusion and out-of-view application scenarios.
The Design of the Biomagnetic Field Sensor without Magnetic Shielding
Authors: Xu Ming , Han Changlin , Lu Hui Min , Xiao Junhao , Tang Jingsheng , Zhou Zongtan
Published: June 2019

Due to the extremely weak intensity of the biomagnetic field and the serious interference from the environmental magnetic field, the detection of the biomagnetic field becomes such challenging work. After analyzing the deficiencies in the current biomagnetic field sensors, this paper proposes and realizes a high-sensitivity magnetic field sensor, based on the giant magneto-impedance (GMI) effect. Taking advantage of the miniaturized magnetic probe, the multistage multiple amplification and the multiband interference suppression, our sensor mainly makes three achievements: the pT level magnetic resolution, the ability to detect the muscle magnetic field without the magnetic shielding and the resistibility to a small-range wobbling in the state of working, which makes it possible to detect the biomagnetic field by wearable sensors under natural conditions.
A New Impedance Controller Based on Nonlinear Model Reference Adaptive Control for Exoskeleton Systems
Authors: Gui Kai , Tan U-Xuan , Liu Honghai , Zhang Dingguo
Published: June 2019

Robotic exoskeletons are expected to show high compliance and low impedance for human–robot interactions (HRIs). Our study introduces a novel method based on nonlinear model reference adaptive control (MRAC) to reduce the inherent impedance and replace the traditional impedance controller in HRIs. The control law and adaptive law are designed according to a candidate Lyapunov function. A simple system identification and initialization method for the nonlinear MRAC is put forward, which provides a set of better initial values for the controller. From the results of simulation and experiment, our controller can reduce the mechanical impedance and achieve high compliance for HRI. The adaptive control and compliance control can be both achieved by the proposed nonlinear MRAC framework.
Multimedia-aided instruction in teaching basic life support to undergraduate nursing students
Authors: Junsawang Chuenjit , Jittivadhna Karnyupha , Luealamai Sutha , Pookboonmee Renu
Published: June 2019

Basic life support (BLS) knowledge is a necessity for nursing students, as they have to deal with cardiac arrest events during their professional career. Existing studies indicate poor BLS knowledge among health science students, including nursing students. Learning BLS requires an understanding of basic sciences, such as anatomy, physiology, and biochemistry, subjects perceived to be difficult, resulting in misconceptions. Hence, a multimedia-aided instruction on BLS, supplemented with cooperating learning groups, was developed to assist nursing students in gaining correct BLS knowledge. A pretest-posttest designed for single cooperating groups was employed to evaluate students’ achievements. Sixty-five undergraduate nursing students took the pretest and posttest that consisted of 10 open-ended questions, each designed to evaluate an aspect of their BLS knowledge. The results show significantly more students (60 vs. 20%) answered more questions correctly on the posttest compared with the pretest ( P value <0.05, Wilcoxon signed-rank test). Thus the multimedia-aided instruction package enhanced undergraduate nursing students’ understanding of BLS and also assisted to generate a positive perception of multimedia-aided instructions, supplemented with a cooperating learning group.
Effects of the Photosystem II Inhibitors CCCP and DCMU on Hydrogen Production by the Unicellular Halotolerant CyanobacteriumAphanothece halophytica
Authors: Pansook Sunisa , Incharoensakdi Aran , Phunpruch Saranya
Published: June 2019

The unicellular halotolerant cyanobacteriumAphanothece halophyticais a potential dark fermentative producer of molecular hydrogen (H2) that produces very little H2under illumination. One factor limiting the H2photoproduction of this cyanobacterium is an inhibition of bidirectional hydrogenase activity by oxygen (O2) obtained from splitting water molecules via photosystem II activity. The present study aimed to investigate the effects of the photosystem II inhibitors carbonyl cyanide m-chlorophenyl hydrazone (CCCP) and 3-(3,4-dichlorophenyl)-1,1-dimethylurea (DCMU) on H2production ofA.halophyticaunder light and dark conditions and on photosynthetic and respiratory activities. The results showed thatA.halophyticatreated with CCCP and DCMU produced H2at three to five times the rate of untreated cells, when exposed to light. The highest H2photoproduction rates,2.26 ± 0.24and3.63 ± 0.26  μmol H2 g−1dry weight h−1, were found in cells treated with 0.5μM CCCP and 50μM DCMU, respectively. Without inhibitor treatment,A.halophyticaincubated in the dark showed a significant increase in H2production compared with cells that were incubated in the light. Only CCCP treatment increased H2production ofA.halophyticaduring dark incubation, because CCCP functions as an uncoupling agent of oxidative phosphorylation. The highest dark fermentative H2production rate of39.50 ± 2.13  μmol H2 g−1dry weight h−1was found in cells treated with 0.5μM CCCP after 2 h of dark incubation. Under illumination, CCCP and DCMU inhibited chlorophyll fluorescence, resulting in a low level of O2, which promoted bidirectional hydrogenase activity inA.halophyticacells. In addition, only CCCP enhanced the respiration rate, further reducing the O2level. In contrast, DCMU reduced the respiration rate inA.halophytica.
miR-200c Modulates the Pathogenesis of Radiation-Induced Oral Mucositis
Authors: Tao Jingjing , Fan Mengjing , Zhou Difan , Hong Yiyang , Zhang Jing , Liu Hai , Sharma Sherven , Wang Guanyu , Dong Qinghua
Published: June 2019

Radiation-induced oral mucositis (RIOM) is one of the most common side effects of radiotherapy in cancer patients, especially in almost all head and neck cancer patients. It presents as severe pain and ulceration. The development of RIOM is composed of five stages: initiation, primary damage response, signal amplification, ulceration, and healing. However, the key regulators involved in the RIOM pathogenesis remain largely unknown. In this study, we reveal a novel role of miR-200c, a member of the miR-200 family, in modulating RIOM pathogenesis. Using a mouse model mimicking RIOM, we found that the miR-200 family numbers (miR-141, miR-200a, miR-200b, and miR-200c) except miR-429 were significantly induced during the RIOM formation. Besides, in RIOM mice, miR-200c expression level was also increased dramatically in the normal human keratinocytes (NHKs) after irradiation. Knockdown of miR-200c expression with miR-200c-3p-shRNA significantly reduced senescence phenotype and enhanced cell proliferation in NHKs after irradiation. The generation of reactive oxygen species (ROS) and p47 enzyme involved in ROS production was increased after irradiation but both were markedly reduced in NHKs by miR-200c inhibition. Knockdown of miR-200c expression in NHKs increased DNA double-strand break repair after irradiation compared with control NHKs. Furthermore, miR-200c inhibition repressed the production of proinflammatory cytokines (TGF-β, TNF-α, and IL-1α) via inhibiting NF-κB and Smad2 activation in NHKs exposed to IR. Additionally, miR-200c inhibition promoted NHK migration and increased the expression of molecules that regulate epithelial to mesenchymal transition, including Snail, Vimentin, Zeb1, and Bmi-1. These results not only identify the key role of miR-200c in the pathogenesis of RIOM but also provide a novel therapeutic target to treat RIOM.
Integrability and Multiple Limit Cycles in a Predator-Prey System with Fear Effect
Authors: Li Xinli , Zhang Ming
Published: June 2019

In this paper, a class of predator-prey systems with fear effect is investigated, the integrability conditions of the origin and the positive equilibrium are obtained, and the fact that three limit cycles can be bifurcated from the positive equilibrium is proved, so bistable phenomenon can occur for this system.
Lagrangian Relaxation for the Multiple Constrained Robust Shortest Path Problem
Authors: Pan Yiyong
Published: June 2019

The study focuses on a multiple constrained reliable path problem in which travel time reliability and resource constraints are collectively considered. Nonlinear optimization model is developed to model constrained robust shortest path problem. The dual nature of the proposed problem is deduced based on the Lagrangian duality theory. An efficient algorithm based on Lagrangian dual relaxation is designed to solve constrained robust shortest path problem. An extension problem that considers multiple constraints is discussed. Numerical studies indicate that the proposed algorithm is efficient in terms of obtaining the close‐to‐optimal solutions within reasonable computational times.
Transactional Sex and HIV Risk among Adolescent School Girls in Ethiopia: Mixed Method Study
Authors: Dana Liyuwork Mitiku , Adinew Yohannes Mehretie , Sisay Mitike Molla
Published: June 2019

Background. Young people in Sub-Saharan Africa are affected by HIV pandemic to a greater extent than elsewhere. Transactional sex among adolescent school girls with older men commonly called “sugar daddies” is one of the major factors fueling the spread of the infection due to the extended sexual network. Thus, this study aimed to assess the magnitude and factors associated with transactional sex among adolescent girls and “sugar daddies” in relation to HIV/AIDS. Methods. Mixed method cross-sectional study was done among 620 female students in Hawassa town, South Ethiopia, from September 2010 to May 2011. A structured questionnaire and in-depth interview check list were used to collect the quantitative and qualitative data, respectively. Survey participants were selected randomly from five preparatory schools whereas ten in-depth interview participants were recruited by a snowball sampling technique from the same schools. Data were entered using Epi-Info and analyzed by SPSS. A descriptive statistics followed by multivariable logistic regression analyses were conducted to identify factors associated with transactional sex with “sugar daddy’’. Both crude and adjusted odds ratios with 95% confidence interval were reported. We used OpenCode software for coding and categorizing the in-depth interviews and quotes that represent the informants opinion were used to support the quantitative findings. Results. A substantial number of female students, 71(11.5%), reported to have had transactional sex with older men. Most of the respondents who dated “sugar daddies” (93%) had multiple sexual partners concurrently and sequentially, and among them, only 22.7% had consistent condom use. Girls who were in older age group [OR (CI) 6.87 (3.48-13.58)], who had lost both parents [OR (CI) 2.99 (1.14-7.84)], had perceived less economic status [OR: 25.41; 95% CI: 7.80-82.76] and engaged in substance abuse [OR (CO) 5.8 (2.1-15.77)] had higher odds of practicing transactional sex with “sugar daddies”. In-depth interviewed participants also revealed that they were involved in transactional sex for monetary while having concurrent and subsequent sexual network with their schoolmates and other young partners. Conclusion. Transactional sex among female students was high, and the sexual network they had with the young men put young people in the network at risk of HIV and other sexually transmitted infections. Therefore, HIV prevention programs shall focus on transactional sex among adolescent school girls to halt transmission of HIV among the generation.
Coagulation of the Ionized Combustion Products in a Dust Flame of Aluminum Particles
Authors: Poletaev N. I. , Khlebnikova M. Y.
Published: June 2019

The addition-agent effect of atoms of alkali metals (K, Na, Li, and Cs) and halogens (Cl and I) introduced into the combustion zone of a dust flame of aluminum particles on the average size of Al2O3 nanoparticles is studied. A physical model of coagulation of a monodisperse aerosol is proposed. The model takes into account the formation of a complex plasma consisting of positive and negative ions, electrons, neutral gas molecules, and suspended particles of the condensed phase in the combustion zone. The effect of the forces of Coulomb repulsion of unipolarly charged Al2O3 particles as well as their possible attraction by ion wind on the constant of the coagulation rate is also taken into account. It is shown that at low ion concentrations in the plasma, the coagulation rate is determined by the Coulomb repulsion of the particles, and at ion concentrations greater than 1020 m−3 the coagulation rate is determined by the attraction of the particles by the ion wind. The results of calculations of the dependence of the average Al2O3 particle size on the concentration of the additives are in a good quantitative agreement with the experimental data. The combined effect of the additives and the equilibrium products of aluminum oxide (AlO, Al, and Al2O) evaporation on the concentration of positive and negative gas ions, electrons, and Al2O3 particle size in the condensation zone is analyzed. The peculiarities of the influence of the additives of electronegative gases (Cl and I atoms) on the coagulation rate of a thermally ionized aerosol and on the particle size of Al2O3 are considered.
Towards Fine Whole-Slide Skeletal Muscle Image Segmentation through Deep Hierarchically Connected Networks
Authors: Cui Lei , Feng Jun , Yang Lin
Published: June 2019

Automatic skeletal muscle image segmentation (MIS) is crucial in the diagnosis of muscle-related diseases. However, accurate methods often suffer from expensive computations, which are not scalable to large-scale, whole-slide muscle images. In this paper, we present a fast and accurate method to enable the more clinically meaningful whole-slide MIS. Leveraging on recently popular convolutional neural network (CNN), we train our network in an end-to-end manner so as to directly perform pixelwise classification. Our deep network is comprised of the encoder and decoder modules. The encoder module captures rich and hierarchical representations through a series of convolutional and max-pooling layers. Then, the multiple decoders utilize multilevel representations to perform multiscale predictions. The multiscale predictions are then combined together to generate a more robust dense segmentation as the network output. The decoder modules have independent loss function, which are jointly trained with a weighted loss function to address fine-grained pixelwise prediction. We also propose a two-stage transfer learning strategy to effectively train such deep network. Sufficient experiments on a challenging muscle image dataset demonstrate the significantly improved efficiency and accuracy of our method compared with recent state of the arts.
A Traffic Assignment Model Based on Link Densities
Authors: de Grange Louis , Marechal Matthieu , González Felipe
Published: June 2019

A new model is presented that determines the traffic equilibrium on congested networks using link densities as well as costs in a manner consistent with the fundamental traffic equation. The solution so derived satisfies Wardrop’s first principle. This density-based approach recognizes traffic flow reductions that may occur when network traffic congestion is high; also, it estimates queue lengths (i.e., the number of vehicles on saturated links), and it explicitly takes into account the maximum flow a link can handle, which is defined by the fundamental traffic equation. The model is validated using traffic microsimulations and implemented on a typical Nguyen-Dupuis network to compare it with a flow-based approach. System optimal assignment model based on link densities is also presented.
Case of a CD3 Negative Hepatosplenic T-Cell Lymphoma: Diagnostic and Therapeutic Challenges
Authors: Alder Laura , Graupner Scott , Lai Guanhua , Yazbeck Victor
Published: June 2019

Hepatosplenic T-cell lymphomas (TCLs) are a rare, aggressive subset of TCLs, accounting for less than 5% of all peripheral T-cell and natural killer (NK) cell lymphomas. We report the case of a CD3 negative hepatosplenic T-cell lymphoma in a 42-year-old female, who presented with left-sided abdominal pain. She underwent a liver biopsy that showed marked abnormal sinusoidal lymphoid infiltration. PET scan revealed increased splenic and pharyngeal lymph node uptake. Immunophenotype was remarkable for negative CD3, gamma delta T-cell receptor, and alpha beta-T-cell receptor expression. She received 6 cycles of DA-EPOCH, had primary refractory disease and then underwent palliative splenectomy secondary to painful necrosis. Then, she was started on pralatrexate as a single agent and then in combination with romidepsin as a potential bridge to an allogeneic stem cell transplantation from her sibling.
Notch/CXCR4 Partnership in Acute Lymphoblastic Leukemia Progression
Authors: Tsaouli Georgia , Ferretti Elisabetta , Bellavia Diana , Vacca Alessandra , Felli Maria Pia
Published: June 2019

Acute lymphoblastic leukemia (ALL) is the most common cancer among children. Recent advances in chemotherapy have made ALL a curable hematological malignancy. In children, there is 25% chance of disease relapse, typically in the central nervous system. While in adults, there is a higher chance of relapse. ALL may affect B-cell or T-cell lineages. Different genetic alterations characterize the two ALL forms. Deregulated Notch, either Notch1 or Notch3, and CXCR4 receptor signaling are involved in ALL disease development and progression. By analyzing their relevant roles in the pathogenesis of the two ALL forms, new molecular mechanisms able to modulate cancer cell invasion may be visualized. Notably, the partnership between Notch and CXCR4 may have considerable implications in understanding the complexity of T- and B-ALL. These two receptor pathways intersect other critical signals in the proliferative, differentiation, and metabolic programs of lymphocyte transformation. Also, the identification of the crosstalks in leukemia-stroma interaction within the tumor microenvironment may unveil new targetable mechanisms in disease relapse. Further studies are required to identify new challenges and opportunities to develop more selective and safer therapeutic strategies in ALL progression, possibly contributing to improve conventional hematological cancer therapy.
Visualization of Light Propagation with Multifocal Intraocular Lenses Using the Ouzo Effect
Authors: Eppig Timo , Rubly Kathrin , Rawer Antonia , Langenbucher Achim
Published: June 2019

The number of presbyopia correcting intraocular lenses (IOLs) is increasing and new technologies are constantly emerging with the aim of correcting the loss of accommodation after cataract surgery. Various optical designs have been proposed to implement multifocality or an extended depth of focus (EDOF). Depending on the optical principle of an implanted lens, the visual performance often is deteriorated by superposition of individual image planes and halos of varying intensity. This experimental study presents a concept to visualize the light fields and especially the halos of mono- and multifocal IOLs using the well known alcoholic beverage “ouzo” in order to obtain qualitative data on the imaging characteristics. We conclude that ouzo is a useful, cost effective, and nonpolluting medium for beam visualization and an alternative to fluorescein or milk, which could find an application for educational purposes.
Fast Two-Dimensional Direction-of-Arrival Estimation of Multiple Signals in Coprime Planar Array
Authors: Xu Haiyun , Zhang Yankui , Ba Bin , Wang Daming , Han Peng
Published: June 2019

Two-dimensional direction-of-arrival (DOA) estimation in coprime planar array involves problems that the complexity of spectral peak search is huge and the noncircular feature of signals is not considered. Considering that unitary estimating signal parameters via rotational invariance techniques (Unitary-ESPRIT) is a low complexity subspace algorithm, an approach to estimate DOA fast for multiple signals is proposed in this paper. We first apply Unitary-ESPRIT to solve one possible value of each signal. Given the relationship between the ambiguous values and real values, we then have all possible values belonging to each subarray. Through finding the common values of two subarrays, we finally obtain the highly precise true DOAs. Moreover, when the signals are noncircular, we present an improved method using noncircular Unitary-ESPRIT, which is favorable in terms of accuracy and degree of freedom. Simulation results demonstrate the effectiveness of our proposed methods.
Effects of Challenging Weather and Illumination on Learning-Based License Plate Detection in Noncontrolled Environments
Authors: Rio-Alvarez A. , de Andres-Suarez J. , Gonzalez-Rodriguez M. , Fernandez-Lanvin D. , López Pérez B.
Published: June 2019

License Plate Detection (LPD) is one of the most important steps of an Automatic License Plate Recognition (ALPR) system because it is the seed of the entire recognition process. In indoor controlled environments, there are many effective methods for detecting license plates. However, outdoors LPD is still a challenge due to the large number of factors that may affect the process and the results obtained. It is an evidence that a complete training set of images including as many as possible license plates angles and sizes improves the performance of every classifier. On this line of work, numerous training sets contain images taken under different weather conditions. However, no studies tested the differences in the effectiveness of different descriptors for these different conditions. In this paper, various classifiers were trained with features extracted from a set of rainfall images using different kinds of texture-based descriptors. The accuracy of these specific trained classifiers over a test set of rainfall images was compared with the accuracy of the same descriptor-classifier pair trained with features extracted from an ideal conditions images set. In the same way, we repeat the experiment with images affected by challenging illumination. The research concludes, on one hand, that including images affected by rain, snow, or fog in the training sets does not improve the accuracy of the classifier detecting license plates over images affected by these weather conditions. Classifiers trained with ideal conditions images improve the accuracy of license plate detection in images affected by rainfalls up to 19% depending on the kind of extracted features. However, on the other hand, results evidence that including images affected by low illumination regardless of the kind of the selected feature increases the accuracy of the classifier up to 29%.
Dutch Translation and Adaptation of the Treatment Beliefs Questionnaire for Chronic Pain Rehabilitation
Authors: Wittink Harriët , Oosterhaven Janke , Dekker Jos , Kruitwagen Cas , Devillé Walter , Ellens Else , Schroder Carin
Published: June 2019

Background. The Treatment Beliefs Questionnaire has been developed to measure patients’ beliefs of necessity of and concerns about rehabilitation. Preliminary evidence suggests that these beliefs may be associated with attendance of rehabilitation. The aim of this study was to translate and adapt the Treatment Beliefs Questionnaire for interdisciplinary pain rehabilitation and to examine the measurement properties of the Dutch translation including the predictive validity for dropout. Methods. The questionnaire was translated in 4 steps: forward translation from English into Dutch, achieving consensus, back translation into English, and pretesting on providers and patients. In order to establish structural validity, internal consistency, construct validity, and predictive validity of the questionnaire, 188 participants referred to a rehabilitation centre for outpatient interdisciplinary pain rehabilitation completed the questionnaire at the baseline. Dropout was measured as the number of patients starting, but not completing the programme. For reproducibility, 51 participants were recruited at another rehabilitation centre to complete the questionnaire at the baseline and one week later. Results. We confirmed the structural validity of the Treatment beliefs Questionnaire in the Dutch translation with three subscales, necessity, concerns, and perceived barriers. internal consistency was acceptable with ordinal alphas ranging from 0.66–0.87. Reproducibility was acceptable with ICC2,1 agreement ranging from 0.67–0.81. Hypotheses testing confirmed construct validity, similar to the original questionnaire. Predictive validity showed the questionnaire was unable to predict dropouts. Conclusion. Cross-cultural translation was successfully completed, and the Dutch Treatment Beliefs Questionnaire demonstrates similar psychometric properties as the original English version.
EVALUATE-AD and Tele-STAR: Novel Methodologies for Assessment of Caregiver Burden in a Telehealth Caregiver Intervention – A Case Study
Authors: Thomas Neil W.D.  , Lindauer Allison , Kaye Jeffrey 
Published: June 2019

Aims: We explored the relationship between objective and subjective measures of burden prior to and after a telehealth-based caregiver intervention. One caregiver participated in two studies, one to assess the feasibility of objective, home-based monitoring (EVALUATE-AD), the second to assess the feasibility of a caregiver education telehealth-based intervention, Tele-STAR. Methods: Subjective measures of burden and depression in Tele-STAR and objective measures related to daily activities of the caregiver in EVALUATE-AD were compared to examine trends between the different outcome measures. Results: While the caregiver reported an increase in distressing behaviors by her partner, burden levels did not significantly change during or after the Tele-STAR intervention, while objective measures of activity and sleep showed a slight decline. Conclusion: Unobtrusive home-based monitoring may provide a novel, objective method to assess the effectiveness of caregiver intervention programs.
Efferocytosis of Apoptotic Neutrophils Enhances Control of Mycobacterium tuberculosis in HIV-Coinfected Macrophages in a Myeloperoxidase-Dependent Manner
Authors: Andersson Anna-Maria , Larsson Marie , Stendahl Olle , Blomgran Robert
Published: June 2019

Tuberculosis remains a big threat, with 1.6 million deaths in 2017, including 0.3 million deaths among patients with HIV. The risk of developing active disease increases considerably during an HIV coinfection. Alveolar macrophages are the first immune cells to encounter the causative agent Mycobacterium tuberculosis, but during the granuloma formation other cells are recruited in order to combat the bacteria. Here, we have investigated the effect of efferocytosis of apoptotic neutrophils by M. tuberculosis and HIV-coinfected macrophages in a human in vitro system. We found that the apo­ptotic neutrophils enhanced the control of M. tuberculosis in single and HIV-coinfected macrophages, and that this was dependent on myeloperoxidase (MPO) and reactive oxygen species in an autophagy-independent manner. We show that MPO remains active in the apoptotic neutrophils and can be harnessed by infected macrophages. In addition, MPO inhibition removed the suppression in M. tuberculosis growth caused by the apoptotic neutrophils. Antimycobacterial components from apoptotic neutrophils could thus increase the microbicidal activity of macrophages during an M. tuberculosis/HIV coinfection. This cooperation between innate immune cells could thereby be a way to compensate for the impaired adaptive immunity against M. tuberculosis seen during a concurrent HIV infection.
Report of a Second Lebanese Family with Basel-Vanagaite-Smirin-Yosef Syndrome: Possible Founder Mutation
Authors: Nair Pratibha , Sabbagh Sandra , Bizzari Sami , Brunner Florian , Stora Samantha , Al-Ali Mahmoud T. , Gencik Martin , El-Hayek Stephany , Mégarbané André
Published: June 2019

Basel-Vanagaite-Smirin-Yosef syndrome (OMIM 616449) is a rare autosomal recessive genetic disorder characterized by severe developmental delay and variable craniofacial, neurological, cardiac, and ocular anomalies in the presence of variants in the MED25 gene. So far, only a handful of patients have been reported with this condition globally. Here, we report an additional Lebanese family with 2 affected siblings presenting with severely delayed psychomotor and language development as well as craniofacial anomalies. By whole-exome sequencing (WES), a homozygous variant was found in the MED25 gene, c.518T>C, predicted to result in a p.Ile173Thr change in the MED25 protein. This change has recently been reported in another Lebanese family. Review of the literature, the importance of this mutation in the Lebanese population, and the possibility that this condition may be underdiagnosed and only effectively detected using molecular techniques such as WES are discussed.
Importância de uma regulamentação específica com as definições e classificações dos produtos comercializados como suplementos alimentares, alimentos funcionais e nutracêuticos
Authors: Santos Julia Rodrigues Martins Pastor dos , Albert André Luis Mazzei , Leandro Katia Christina
Published: June 2019

Este artigo trata da importância de a legislação brasileira regulamentar o termo “suplemento alimentar”, a fim de se adequar às legislações internacionais e ao cenário desse mercado, marcado por constantes inovações tecnológicas e,  consequentemente, uma ampla variedade de produtos. São descritas as leis e resoluções de diretoria colegiada publicadas pela Agência Nacional de Vigilância Sanitária para o registro desses produtos, que são classificados legalmente como alimentos. O artigo apresenta, ainda, as classificações de legislações internacionais e os casos de adulterações.
Regulação de profissões de saúde na perspectiva do direito comparado: as diferentes estratégias regulatórias de Argentina, Paraguai, Uruguai, Canadá e Austrália
Authors: Aith Fernando Mussa Abujamra
Published: June 2019

Este número da Revista de Direito Sanitário apresenta, em seu tema em debate, os modelos jurídicos de regulação de profissões de saúde adotados por Argentina, Paraguai, Uruguai, Austrália e Canadá. Os artigos publicados oferecem um quadro extremamente claro e didático sobre como cada um desses países está enfrentando os seus desafios de regulação das profissões de saúde no mundo contemporâneo.
Targeting Nonpulmonary Vein Sources in Persistent Atrial Fibrillation Identified by Noncontact Charge Density Mapping
Authors: Willems Stephan , Verma Atul , Betts Timothy R. , Murray Steven , Neuzil Petr , Ince Hüseyin , Steven Daniel , Sultan Arian , Heck Patrick M. , Hall Mark C. , Tondo Claudio , Pison Laurent , Wong Tom , Boersma Lucas V. , Meyer Christian , Grace Andrew
Published: June 2019

Background:

Identification and elimination of nonpulmonary vein targets may improve clinical outcomes in patients with persistent atrial fibrillation (AF). We report on the use of a novel, noncontact imaging and mapping system that uses ultrasound to reconstruct atrial chamber anatomy and measures timing and density of dipolar, ionic activation (ie, charge density) across the myocardium to guide ablation of atrial arrhythmias.

Methods:

The prospective, nonrandomized UNCOVER AF trial (Utilizing Novel Dipole Density Capabilities to Objectively Visualize the Etiology of Rhythms in Atrial Fibrillation) was conducted at 13 centers across Europe and Canada. Patients with persistent AF (>7 days, <1 year) aged 18 to 80 years, scheduled for de novo catheter ablation, were eligible. Before pulmonary vein isolation, AF was mapped and then iteratively remapped to guide each subsequent ablation of charge density–identified targets. AF recurrence was evaluated at 3, 6, 9, and 12 months using continuous 24-hour ECG monitors. The primary effectiveness outcome was freedom from AF >30 seconds at 12 months for a single procedure with a secondary outcome being acute procedural efficacy. The primary safety outcome was freedom from device/procedure-related major adverse events.

Results:

Between October 2016 and April 2017, 129 patients were enrolled, and 127 underwent mapping and catheter ablation. Acute procedural efficacy was demonstrated in 125 patients (98%). At 12 months, single procedure freedom from AF on or off antiarrhythmic drugs was 72.5% (95% CI, 63.9%–80.3%). After 1 or 2 procedures, freedom from AF was 93.2% (95% CI, 87.1%–97.0%). A total of 29 (23%) retreatments because of arrhythmia recurrence were performed with average time from index procedure to first retreatment being 7 months. The primary safety outcome was 98% with no device-related major adverse events reported.

Conclusions:

This novel ultrasound imaging and charge density mapping system safely guided ablation of nonpulmonary vein targets in persistent AF patients with 73% single procedure and 93% second procedure freedom from AF at 12 months.

Clinical Trial Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02825992 EU/NCT02462980 CN.
Inhibition of Angiopoietin-Like Protein 3 With a Monoclonal Antibody Reduces Triglycerides in Hypertriglyceridemia
Authors: Ahmad Zahid , Banerjee Poulabi , Hamon Sara , Chan Kuo-Chen , Bouzelmat Aurelie , Sasiela William J. , Pordy Robert , Mellis Scott , Dansky Hayes , Gipe Daniel A. , Dunbar Richard L.
Published: June 2019

Background:

Hypertriglyceridemia is associated with increased cardiovascular risk and may be caused by impaired lipoprotein clearance. Angiopoietin-like protein 3 (ANGPTL3) inhibits lipoprotein lipase activity, increasing triglycerides and other lipids. Evinacumab, an ANGPTL3 inhibitor, reduced triglycerides in healthy human volunteers and in homozygous familial hypercholesterolemic individuals. Results from 2 Phase 1 studies in hypertriglyceridemic subjects are reported here.

Methods:

Subjects with triglycerides >150 but ≤450 mg/dL and low-density lipoprotein cholesterol ≥100 mg/dL (n=83 for single ascending dose study [SAD]; n=56 for multiple ascending dose study [MAD]) were randomized 3:1 to evinacumab:placebo. SAD subjects received evinacumab subcutaneously at 75/150/250 mg, or intravenously at 5/10/20 mg/kg, monitored up to day 126. MAD subjects received evinacumab subcutaneously at 150/300/450 mg once weekly, 300/450 mg every 2 weeks, or intravenously at 20 mg/kg once every 4 weeks up to day 56 with 6 months of follow-up. The primary outcomes were incidence and severity of treatment-emergent adverse events. Efficacy analyses included changes in triglycerides and other lipids over time.

Results:

In the SAD, 32 (51.6%) versus 9 (42.9%) subjects on evinacumab versus placebo reported treatment-emergent adverse events. In the MAD, 21 (67.7%) versus 9 (75.0%) subjects on subcutaneously evinacumab versus placebo and 6 (85.7%) versus 1 (50.0%) on intravenously evinacumab versus placebo reported treatment-emergent adverse events. No serious treatment-emergent adverse events or events leading to death or treatment discontinuation were reported. Elevations in alanine aminotransferase (7 [11.3%] SAD), aspartate aminotransferase (4 [6.5%] SAD), and creatinine phosphokinase (2 [3.2%) SAD, 1 [14.3%] MAD) were observed with evinacumab (none in the placebo groups), which were single elevations and were not dose-related. Dose-dependent reductions in triglycerides were observed in both studies, with maximum reduction of 76.9% at day 3 with 10 mg/kg intravenously (
P
<0.0001) in the SAD and of 83.1% at day 2 with 20 mg/kg intravenously once every 4 weeks (
P
=0.0003) in the MAD. Significant reductions in other lipids were observed with most evinacumab doses versus placebo.

Conclusion:

Evinacumab was well-tolerated in 2 Phase 1 studies. Lipid changes in hypertriglyceridemic subjects were similar to those observed with
ANGPTL3
loss-of-function mutations. Because the latter is associated with reduced cardiovascular risk, ANGPTL3 inhibition may improve clinical outcomes.

Clinical Trial Registration:

https://www.clinicaltrials.gov
. Unique identifiers: NCT01749878 and NCT02107872.
Prevalence and Risk Factors of Brain Infarcts and Associations With Cognitive Performance in Tenants of Marginal Housing
Authors: Zhou Lily W. , Panenka William J. , Jones Andrea A. , Gicas Kristina M. , Thornton Allen E. , Heran Manraj K. S. , Volders David , Lang Donna J. , Vertinsky Alexandra Talia , Rauscher Alexander , Su Wayne , Barr Alasdair M. , MacEwan Gordon William , Honer William G. , Field Thalia S.
Published: June 2019

Background

Homeless and vulnerably housed individuals are at increased risk for multimorbidity compared with the general population. We assessed prevalence of brain infarcts on neuroimaging and associations with vascular risk factors and cognitive performance in a prospective study of residents living in marginal housing.

Methods and Results

Two hundred twenty‐eight participants underwent structured clinical interviews, targeted clinical, laboratory, and neuropsychological assessments, and magnetic resonance imaging with T
1
, T
2
‐fluid‐attenuated inversion recovery and susceptibility‐weighted images. Subjects underwent cognitive testing to assess premorbid
IQ
, verbal learning and memory, inhibition, sustained attention, mental flexibility, and decision making. In this sample (mean age 44.0 years [
SD
9.4], 77% male), prevalence of conventional vascular risk factors was lower than in the general population apart from tobacco use (94%). Ten‐year Framingham risk for any cardiovascular event was 11.4%±9.2%. Brain infarcts were present in 25/228 (11%). All were ischemic (40% cortical, 56% lacunar, 4% both). Participants with infarcts were older than those without (48.9±9.4 versus 43.4±9.2,
P
=0.006). In a multivariable regression analysis, only age remained a significant predictor of brain infarcts (odds ratio 1.08, 95%
CI
1.02–1.14,
P
=0.004). After controlling for age and education, the presence of infarct was a significant predictor of impaired decision making on the Iowa Gambling Task of decision making (β −28.2, 95%
CI
−42.7 to −14.1,
P
<0.001).

Conclusions

Prevalence of infarcts on neuroimaging in this disadvantaged, community‐dwelling cohort was much higher than expected for age and was associated with impaired decision making. Further research is needed to identify individuals at highest risk who may benefit from targeted preventative strategies.
Identification of Differential Roles of MicroRNA‐33a and ‐33b During Atherosclerosis Progression With Genetically Modified Mice
Authors: Koyama Satoshi , Horie Takahiro , Nishino Tomohiro , Baba Osamu , Sowa Naoya , Miyasaka Yui , Kuwabara Yasuhide , Nakao Tetsushi , Nishiga Masataka , Nishi Hitoo , Nakashima Yasuhiro , Nakazeki Fumiko , Ide Yuya , Kimura Masahiro , Tsuji Shuhei , Ruiz Rodriguez Randolph , Xu Sijia , Yamasaki Tomohiro , Otani Chiharu , Watanabe Toshimitsu , Nakamura Tomoyuki , Hasegawa Koji , Kimura Takeshi , Ono Koh
Published: June 2019

Background

Micro
RNA
(miR)‐33 targets cholesterol transporter
ATP
‐binding cassette protein A1 and other antiatherogenic targets and contributes to atherogenic progression. Its inhibition or deletion is known to result in the amelioration of atherosclerosis in mice. However, mice lack the other member of the miR‐33 family, miR‐33b, which exists in humans and other large mammals. Thus, precise evaluation and comparison of the responsibilities of these 2 miRs during the progression of atherosclerosis has not been reported, although they are essential.

Methods and Results

In this study, we performed a comprehensive analysis of the difference between the function of miR‐33a and miR‐33b using genetically modified mice. We generated 4 strains with or without miR‐33a and miR‐33b. Comparison between mice with only miR‐33a (wild‐type mice) and mice with only miR‐33b (miR‐33a
−/−
/miR‐33b
+/+
) revealed the dominant expression of miR‐33b in the liver. To evaluate the whole body atherogenic potency of miR‐33a and miR‐33b, we developed apolipoprotein E–deficient/miR‐33a
+/+
/miR‐33b
−/−
mice and apolipoprotein E–deficient/miR‐33a
−/−
/miR‐33b
+/+
mice. With a high‐fat and high‐cholesterol diet, the apolipoprotein E–deficient/miR‐33a
−/−
/miR‐33b
+/+
mice developed increased atherosclerotic plaque versus apolipoprotein E–deficient/miR‐33a
+/+
/miR‐33b
−/−
mice, in line with the predominant expression of miR‐33b in the liver and worsened serum cholesterol profile. By contrast, a bone marrow transplantation study showed no significant difference, which was consistent with the relevant expression levels of miR‐33a and miR‐33b in bone marrow cells.

Conclusions

The miR‐33 family exhibits differences in distribution and regulation and particularly in the progression of atherosclerosis; miR‐33b would be more potent than miR‐33a.
The Dilemma With the Soy Protein Health Claim
Authors: Petersen Kristina S.
Published: June 2019

See Article
Jenkins et al
Eye Opener in Stroke
Authors: Nguyen Hung , Lee Jea Young , Sanberg Paul R. , Napoli Eleonora , Borlongan Cesar V.
Published: June 2019

Background and Purpose—

Retinal ischemia is a major cause of visual impairment in stroke patients, but our incomplete understanding of its pathology may contribute to a lack of effective treatment. Here, we investigated the role of mitochondrial dysfunction in retinal ischemia and probed the potential of mesenchymal stem cells (MSCs) in mitochondrial repair under such pathological condition.

Methods—

In vivo, rats were subjected to middle cerebral artery occlusion then randomly treated with intravenous MSCs or vehicle. Laser Doppler was used to evaluate the blood flow in the brain and the eye, while immunohistochemical staining assessed cellular degeneration at days 3 and 14 poststroke. In vitro, retinal pigmented epithelium cells were exposed to either oxygen-glucose deprivation or oxygen-glucose deprivation and coculture with MSCs, and subsequently, cell death and mitochondrial function were examined immunocytochemically and with Seahorse analyzer, respectively.

Results—

Middle cerebral artery occlusion significantly reduced blood flow in the brain and the eye accompanied by mitochondrial dysfunction and ganglion cell death at days 3 and 14 poststroke. Intravenous MSCs elicited mitochondrial repair and improved ganglion cell survival at day 14 poststroke. Oxygen-glucose deprivation similarly induced mitochondrial dysfunction and cell death in retinal pigmented epithelium cells; coculture with MSCs restored mitochondrial respiration, mitochondrial network morphology, and mitochondrial dynamics, which likely attenuated oxygen-glucose deprivation-mediated retinal pigmented epithelium cell death.

Conclusions—

Retinal ischemia is closely associated with mitochondrial dysfunction, which can be remedied by stem cell-mediated mitochondrial repair.
An emended description of Piper cochleatum and a new species of Piper (Piperaceae) from the Amazonian slopes of the Colombian Andes
Authors: TRUJILLO CALDERÓN WILLIAM , JARAMILLO M. ALEJANDRA
Published: June 2019

Piper cochleatum is restored as a distinct species from Piper obtusilimbum, provided with an emended description, and an epitype is designated. The taxon Piper lineatipilosum is also newly synonymized under P. cochleatum. In addition, a new species, Piper caranoense is described from the Andean premontane forests on the Amazonian (eastern) slopes in Colombia. Piper caranoense can be distinguished from Piper cordulatum based on its sarmentose habit and pinnately nerved leaves in the lower third vs. shrubs or small trees with pinnately nerved leaves throughout. An illustration of each species is presented and the morphological differences with similar species are discussed in detail.
Gymnosporia sekhukhuniensis (Celastraceae), a new species from South Africa
Authors: JORDAAN MARIE , VAN WYK ABRAHAM E.
Published: June 2019

Gymnosporia sekhukhuniensis, a new species from north-eastern South Africa, is described, illustrated, mapped, and compared with closely related species. It belongs to Gymnosporia sect. Buxifoliae, more specifically Group 1, the members of which are characterized by the capsules being (2)3(4)-valved, rugose or verrucose, and the seeds partially covered by the aril. The new species has a restricted distribution range and is near-endemic to the Sekhukhuneland Centre of Endemism. This biogeographical region rich in restricted-range plants is more or less congruent with surface outcrops of mafic and ultramafic igneous rocks belonging to the Rustenburg Layered Suite of the eastern Bushveld Complex. The range of the new species shows marginal intrusion into the far northern part of the nearby Wolkberg Centre of Endemism, where it is associated with dolomites of the Malmani Subgroup. Gymnosporia sekhukhuniensis is a suffrutex mainly associated with rocky outcrops in open savannah. Diagnostic characters include its dwarf habit (up to 1.6 m tall), capsules that are relatively small (5–8 mm long), woody, scaly-rugose, with hard pointed apices, and leaves that are very laxly arranged on the stems, with some often present on the thorns. Also included is a key to the 10 currently accepted species in G. sect. Buxifoliae Group 1. The taxonomic significance of capsule and seed characters for demarcating sections and species in the genus Gymnosporia is emphasized.
Review of certain lectotype designations in Hinda (Coleoptera, Coccinellidae, Hyperaspinae), primarily those deposited in Museum für Naturkunde der Humboldt-Universität, Berlin, Germany
Authors: DE ALMEIDA LÚCIA MASSUTTI , MILLÉO JULIANNE , GORDON ROBERT D.
Published: June 2019

Type specimens of Hinda in the Zoologisches Museum der Humboldt Universität, Berlin, Germany, and other institutions were studied. Lectotypes and paralectotypes of Hinda quindecimmaculata Weise (1895) and of H. modesta Weise (1910) are designated. An error by Almeida and Milléo (2000) in designating a lectotype for Hinda regularis Erichson (1847) is corrected. Known geographical distributions of H. modesta and H. humerata are expanded.