bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing the Association between Serum Ferritin, Transferrin Saturation, and C-Reactive Protein in Northern Territory Indigenous Australian Patients with High Serum Ferritin on Maintenance Haemodialysis
Authors: Majoni Sandawana William , Lawton Paul D. , Barzi Federica , Cass Alan , Hughes Jaquelyne T.
Published: January 2017

Objective. To determine the significance of high serum ferritin observed in Indigenous Australian patients on maintenance haemodialysis in the Northern Territory, we assessed the relationship between ferritin and transferrin saturation (TSAT) as measures of iron status and ferritin and C-reactive protein (CRP) as markers of inflammation.Methods. We performed a retrospective cohort analysis of data from adult patients (≥18 years) on maintenance haemodialysis (>3 months) from 2004 to 2011.Results. There were 1568 patients. The mean age was 53.9 (11.9) years. 1244 (79.3%) were Indigenous. 44.2% (n=693) were male. Indigenous patients were younger (mean age [52.3 (11.1) versus 57.4 (15.2),p<0.001]) and had higher CRP [14.7 mg/l (7–35) versus 5.9 mg/l (1.9–17.5),p<0.001], higher median serum ferritin [1069 µg/l (668–1522) versus 794.9 µg/l (558.5–1252.0),p<0.001], but similar transferrin saturation [26% (19–37) versus 28% (20–38),p=0.516]. We observed a small positive correlation between ferritin and TSAT (r2=0.11,p<0.001), no correlation between ferritin and CRP (r2= 0.001,p<0.001), and positive association between high serum ferritin and TSAT (p<0.001), Indigenous ethnicity (p<0.001), urea reduction ratio (p=0.001), and gender (p<0.001) after adjustment in mixed regression analysis.Conclusion. Serum ferritin and TSAT may inadequately reflect iron status in this population. The high ferritin was poorly explained by inflammation.
Acute Hemorrhagic Edema of Infancy after Coronavirus Infection with Recurrent Rash
Authors: Chesser Hannah , Chambliss Jeffrey M. , Zwemer Eric
Published: January 2017

Purpura, particularly when accompanied by fever, is a worrisome finding in children. Acute hemorrhagic edema of infancy (AHEI) is a benign type of small-vessel leukocytoclastic vasculitis that presents with progressive purpura and has an excellent prognosis. Patients with AHEI present with large, target-like purpuric plaques affecting the face, ear lobes, and extremities. While the rapid onset of these skin findings can be dramatic, the child with AHEI is usually well appearing with reassuring laboratory testing. We describe a case of a previously healthy 8-month-old female who presented with progressive purpura in a nondependent distribution, low-grade fevers, and extremity swelling. An extensive workup was performed prior to making the diagnosis of AHEI. Coronavirus was implicated as the likely triggering pathogen, and the patient suffered a recurrence of purpuric rash and swelling several weeks after her initial presentation.
Challenge Analysis and Schemes Design for the CFD Simulation of PWR
Authors: Chen Guangliang , Zhang Zhijian , Tian Zhaofei , Li Lei , Dong Xiaomeng
Published: January 2017

CFD simulation for a PWR is an important part for the development of Numerical Virtual Reactor (NVR) in Harbin Engineering University of China. CFD simulation can provide the detailed information of the flow and heat transfer process in a PWR. However, a large number of narrow flow channels with numerous complex structures (mixing vanes, dimples, springs, etc.) are located in a typical PWR. To obtain a better CFD simulation, the challenges created by these structural features were analyzed and some quantitative regularity and estimation were given in this paper. It was found that both computing resources and time are in great need for the CFD simulation of a whole reactor. These challenges have to be resolved, so two schemes were designed to assist/realize the reduction of the simulation burden on resources and time. One scheme is used to predict the combined efficiency of the simulation conditions (configuration of computing resources and application of simulation schemes), so it can assist the better choice/decision of the combination of the simulation conditions. The other scheme is based on the suitable simplification and modification, and it can directly reduce great computing burden.
Comparison of Effects of Different Statins on Contrast‐Induced Acute Kidney Injury in Rats: Histopathological and Biochemical Findings
Authors: Wang Xiao-lei , Zhang Tuo , Hu Liu-hua , Sun Shi-qun , Zhang Wei-feng , Sun Zhe , Shen Ling-hong , He Ben
Published: January 2017

Statins are a promising new strategy to prevent contrast‐induced acute kidney injury (CI‐AKI). In this study we compared the ameliorative effect of different statins in a rat model of CI‐AKI. Sprague‐Dawley rats were divided into five groups: control group; CI‐AKI group; CI‐AKI + rosuvastatin group (10 mg/kg/day); CI‐AKI + simvastatin group (80 mg/kg/day); and CI‐AKI + atorvastatin group (20 mg/kg/day). CI‐AKI was induced by dehydration for 72 hours, followed by furosemide intramuscular injection 20 minutes before low‐osmolar contrast media (CM) intravenous injection. Statins were administered by oral gavage once daily for 3 consecutive days before CM injection and once 4 hours after CM injection. Rats were sacrificed 24 hours after CM injection, and renal function, kidney histopathology, nitric oxide (NO) metabolites, and markers of oxidative stress, inflammation, and apoptosis were evaluated. The results showed that atorvastatin and rosuvastatin but not simvastatin ameliorated CM‐induced serum creatinine elevation and histopathological alterations. Atorvastatin and rosuvastatin showed similar effectiveness against CM‐induced oxidative stress, but simvastatin was less effective. Atorvastatin was most effective against NO system dysfunction and cell apoptosis, whereas rosuvastatin was most effective against inflammation. Our findings indicate that statins exhibit differential effects in preventing CI‐AKI when given at equivalent lipid‐lowering doses.
Solution of Effective-Mass Dirac Equation with Scalar-Vector and Pseudoscalar Terms for Generalized Hulthén Potential
Authors: Arda Altuğ
Published: January 2017

We find the exact bound state solutions and normalization constant for the Dirac equation with scalar-vector-pseudoscalar interaction terms for the generalized Hulthén potential in the case where we have a particular mass functionm(x). We also search the solutions for the constant mass where the obtained results correspond to the ones when the Dirac equation has spin and pseudospin symmetry, respectively. After giving the obtained results for the nonrelativistic case, we search then the energy spectra and corresponding upper and lower components of Dirac spinor for the case of PT-symmetric forms of the present potential.
Analysis on Driving Effect of the Urbanization Development Speed on Water Resources Conflict
Authors: Wu Xiaoyuan , Xu Changxin , Pang Qinghua
Published: January 2017

This paper aims to research the driving effect of the urbanization development speed on water resources conflict by building the risk stress coupling analysis model of urbanization development speed and water conflict. Firstly, we use the nonlinear fuzzy comprehensive adjustment (FCA) measure model based on entropy weight method to determine the level of urbanization and water resources conflict risk, then construct the coupling coordination degree function of urbanization speed and water conflict risk pressure, and calculate the coupling coordination degree. Secondly, we determine the level of water resources conflict according to the coupling coordination degree to obtain the trigger threshold value of water resources conflict and analyze the coupling results. Lastly, we start the instance analysis with Beijing City, Tianjin City, and Hebei Province region in Haihe river basin of China, as an example, by analyzing the influence of the urbanization speed on water resource conflict and by obtaining the threshold value of water resources conflict caused by the effect of water consumption of gross domestic product (GDP) per 10 thousand Yuan and annual per capita domestic water consumption on the urbanization development speed, expressed in interval number.
Assessing the Impacts of the 2009/2010 Drought on Vegetation Indices, Normalized Difference Water Index, and Land Surface Temperature in Southwestern China
Authors: Zhang Xiaoqiang , Yamaguchi Yasushi , Li Fei , He Bin , Chen Yaning
Published: January 2017

Droughts are projected to increase in severity and frequency on both regional and global scales. Despite the increasing occurrence and intensity of the 2009/2010 drought in southwestern China, the impacts of drought on vegetation in this region remain unclear. We examined the impacts of the 2009/2010 drought in southwestern China on vegetation by calculating the standardized anomalies of Normalized Difference Vegetation Index (NDVI), Enhanced Vegetation Index (EVI), Normalized Difference Water Index (NDWI), and Land Surface Temperature (LST). The standardized anomalies of NDVI, EVI, and NDWI exhibited positively skewed frequency distributions, while the standardized anomalies of LST exhibited a negatively skewed frequency distribution. These results implied that the NDVI, EVI, and NDWI declined, while LST increased in the 2009/2010 drought-stricken vegetated areas during the drought period. The responses of vegetation to the 2009/2010 drought differed substantially among biomes. Savannas, croplands, and mixed forests were more vulnerable to the 2009/2010 drought than deciduous forest and grasslands, while evergreen forest was resistant to the 2009/2010 drought in southwestern China. We concluded that the 2009/2010 drought had negative impacts on vegetation in southwestern China. The resulting assessment on the impacts of drought assists in evaluating and mitigating its adverse effects in southwestern China.
Design of a Compact UWB Antenna with Triple Notched Bands Using Nonuniform Width Slots
Authors: Chen Xu , Xu Feng , Tan Xu
Published: January 2017

A compact printed UWB antenna with triple band-notched characteristics is proposed. Instead of conventional uniform width slots, two pairs of quarter-wavelength length nonuniform width slots are embedded into the radiating patch and the ground plane to achieve triple notched bands at 3.5, 5.5, and 8.1 GHz. A parameter study is performed to examine the effect of widths and lengths of the slots on the band-notched characteristics. It indicates that the centre frequencies and the bandwidth of notched bands can be controlled by tuning the physical parameters of the slots. Frequency domain measurements including return loss, antenna transfer function, group delay, and gain of the proposed antenna have been carried out. Corresponding results demonstrate that compact UWB antennas with multiple notched bands can be obtained by using nonuniform width slots.
A Single Dose of Beetroot Gel Rich in Nitrate Does Not Improve Performance but Lowers Blood Glucose in Physically Active Individuals
Authors: Vasconcellos Julia , Henrique Silvestre Diego , dos Santos Baião Diego , Werneck-de-Castro João Pedro , Silveira Alvares Thiago , Paschoalin Vânia M. Flosi
Published: January 2017

Background. Beetroot consumption has been proposed to improve exercise performance, since the nitrate content of this food is able to stimulate the synthesis of nitric oxide.Objective. The acute effect of 100 g of a beetroot gel containing ~10 mmol of nitrate was tested on the nitric oxide synthesis, on metabolic and biochemical parameters, and on performance in physically active individuals.Methods. Through a double blind, crossover, placebo-controlled study, 25 healthy runners ingested a single dose of beetroot and placebo gels. Participants performed an aerobic exercise protocol on a treadmill (3 min warm-up of 40% peak oxygen consumption, 4 min at 90% of gas exchange threshold I and 70% (Δ) maximal end speed until volitional fatigue).Results. Urinary levels of nitrite and nitrate increased after 90 min of beetroot gel ingestion. Plasma glucose concentrations lowered after the exercise and the decrease was maintained for 20 min. Systolic and diastolic blood pressures, serum cortisol, and blood lactate were not altered after the beetroot gel ingestion compared to a placebo gel.Conclusion. The single dose of beetroot gel provoked an increase of nitric oxide synthesis although no improvement on the physical performance of athletes during aerobic submaximal exercise was observed.
Two Different Cell Populations Is an Important Clue for Diagnosis of Primary Cutaneous Adenoid Cystic Carcinoma: Immunohistochemical Study
Authors: Alkan Banu Ince , Bozdogan Onder , Karadeniz Müjde , Bozdoğan Nazan
Published: January 2017

Primary cutaneous adenoid cystic carcinoma (PCACC) is a very rare malignancy. The differential diagnosis of PCACCs in pathology practice can be difficult and a group of primary and metastatic lesions, including adenoid basal cell carcinoma of the skin, should be considered in the differential diagnosis. Besides histomorphological clues, immunohistochemistry studies are very helpful in the differential diagnosis of PCACC. We report herein a case of PCACC with extensive immunohistochemical studies and review the literature from an immunohistochemistry perspective.
Experimental Verification of a Battery Energy Storage System for Integration with Photovoltaic Generators
Authors: Singh Rajkiran , Taghizadeh Seyedfoad , Tan Nadia M. L. , Mekhilef Saad
Published: January 2017

This paper presents the experimental verification of a 2 kW battery energy storage system (BESS). The BESS comprises a full-bridge bidirectional isolated dc-dc converter and a PWM converter that is intended for integration with a photovoltaic (PV) generator, resulting in leveling of the intermittent output power from the PV generator at the utility side. A phase-shift controller is also employed to manage the charging and discharging operations of the BESS based on PV output power and battery voltage. Moreover, a current controller that uses the d-q synchronous reference frame is proposed to regulate the dc voltage at the high-voltage side (HVS) to ensure that the voltage ratio of the HVS with low-voltage side (LVS) is equivalent to the transformer turns ratio. The proposed controllers allow fast response to changes in real power requirements and results in unity power factor current injection at the utility side. In addition, the efficient active power injection is achieved as the switching losses are minimized. The peak efficiency of the bidirectional isolated dc-dc converter is measured up to 95.4% during battery charging and 95.1% for battery discharging.
Treatment with Sildenafil and Donepezil Improves Angiogenesis in Experimentally Induced Critical Limb Ischemia
Authors: Constantinescu Ioana M. , Bolfa Pompei , Constantinescu Dan , Mironiuc Aurel I. , Gherman Claudia D.
Published: January 2017

Objectives. In this study, we aimed to demonstrate the role of sildenafil (an antagonist of phosphodiesterase type 5 (PDE-5)) and donepezil (a specific and reversible inhibitor of acetylcholinesterase (Ach)) in increasing ischemia-induced angiogenesis.Method. Critical limb ischemia was induced by ligation of the common femoral artery followed by ligation of the common iliac artery. The operated animals were divided into 3 groups: receiving sildenafil, receiving donepezil, and surgery alone; the contralateral lower limb was used as a negative control. The results were controlled based on clinical score and Doppler ultrasound. Gastrocnemius muscle samples were taken from all animals, both from the ischemic and nonischemic limb and were used for histopathological and immunohistochemical examination for the evaluation of the number of nuclei/field, endothelial cells (CD31), dividing cells (Ki-67), and vascular endothelial growth factor (VEGFR-3).Results. An increasing tendency of the number of nuclei/field with time was observed both in the case of sildenafil and donepezil treatment. The formation of new capillaries (the angiogenesis process) was more strongly influenced by donepezil treatment compared to sildenafil or no treatment. This treatment significantly influenced the capillary/fiber ratio, which was increased compared to untreated ligated animals. Sildenafil treatment led to a gradual increase in the number of dividing cells, which was significantly compared to the negative control group and compared to the ligation control group. The same effect (increase in the number of Ki-67 positive cells) was more obvious in the case of donepezil treatment.Conclusion. Donepezil treatment has a better effect in ligation-induced ischemia compared to sildenafil, promoting angiogenesis in the first place, and also arteriogenesis.
Speech Characteristics and Intelligibility in Adults with Mild and Moderate Intellectual Disabilities
Authors: Coppens-Hofman Marjolein C. , Terband Hayo , Snik Ad F.M. , Maassen Ben A.M.
Published: January 2017

Purpose: Adults with intellectual disabilities (ID) often show reduced speech intelligibility, which affects their social interaction skills. This study aims to establish the main predictors of this reduced intelligibility in order to ultimately optimise management. Method: Spontaneous speech and picture naming tasks were recorded in 36 adults with mild or moderate ID. Twenty-five naïve listeners rated the intelligibility of the spontaneous speech samples. Performance on the picture-naming task was analysed by means of a phonological error analysis based on expert transcriptions. Results: The transcription analyses showed that the phonemic and syllabic inventories of the speakers were complete. However, multiple errors at the phonemic and syllabic level were found. The frequencies of specific types of errors were related to intelligibility and quality ratings. Conclusions: The development of the phonemic and syllabic repertoire appears to be completed in adults with mild-to-moderate ID. The charted speech difficulties can be interpreted to indicate speech motor control and planning difficulties. These findings may aid the development of diagnostic tests and speech therapies aimed at improving speech intelligibility in this specific group.
Methotrexate Induces Apoptosis of Postpartum Placental Cytotrophoblasts
Authors: Yan Hao , Li Zhihua , Yan Zhonghai , Li Xiuying , Li Xiaomei , Yu Lin , Su Chunhong , Chen Dunjin
Published: January 2017

Background: Though methotrexate (MTX) is known to inhibit proliferation of trophoblasts derived from ectopic and intrauterine pregnancies, its action on trophoblasts derived from postpartum placenta remains questionable. This study was designed to ascertain the efficacy of MTX in inducing cell death of postpartum placental cytotrophoblasts (PPTC). Methodology: Primary human cytotrophoblasts were isolated from placentae of 1st and 2nd trimester intrauterine pregnancies and from postpartum placentae. The isolated trophoblasts were identified based on the expression of cytokeratin 7. MTX-induced inhibition of proliferation of cytotrophoblasts was detected by flow cytometry combined with the WST-1 assay. Secretion of HCG-β and invasiveness were evaluated to assess the effect of MTX on blocking the differentiated cellular function of cytotrophoblasts in relation to the gestational age. The efficacy of MTX in inducing apoptosis of cytotrophoblasts was estimated by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling. Results: MTX significantly inhibited the proliferation and differentiation of cytotrophoblasts. MTX-induced cell apoptosis of PPTC was confirmed by increased expression of Fas, FasL, Bax, cleaved caspases 3, 7, 8, and 9, and decreased expression of Bcl-2. Conclusion: MTX inhibits replication and differentiation of cytotrophoblasts and appears to be an efficient inducer of PPTC apoptosis.
The Effect of Loud Voice and Clear Speech on the Use of Vocal Fry in Women
Authors: Behrman Alison , Akhund Ali
Published: January 2017

Objective: This study investigated the effects of clear speech and loud voice on the use of vocal fry in women. Methods: Twenty healthy-voiced young women who used a moderate amount of vocal fry when reading aloud in conversational-style speech (defined as a minimum of three occurrences per sentence) also read the same stimuli in loud voice and clear speech. The occurrence of vocal fry was assessed in the three speaking styles. Intensity and fundamental frequency levels in each condition were obtained to help interpret the findings. Results: A statistically significant reduction in the use of vocal fry was found in loud and clear conditions compared to conversational style. However, a significantly greater reduction in use of vocal fry was obtained in clear speech than in loud voice. The increased intensity and mean F0 in loud and clear speech only partially explain the decrease in use of vocal fry. Conclusion: Women who use vocal fry in typical speech may persist in its use when speaking more loudly, although not when speaking more clearly. Apparently, different phonatory strategies are used for the two speaking styles. Further research is needed to clarify the laryngeal dynamics of clear speech.
Inhibition of Streptococcus mutans Growth and Biofilm Formation by Probiotics in vitro
Authors: Schwendicke Falk , Korte Franziska , Dörfer Christof E. , Kneist Susanne , Fawzy El-Sayed Karim , Paris Sebastian
Published: January 2017

To exert anticaries effects, probiotics are described to inhibit growth and biofilm formation of cariogenic bacteria such as Streptococcus mutans (SM). We screened 8 probiotics and assessed how SM growth or biofilm formation inhibition affects cariogenicity of probiotic-SM mixed-species biofilms in vitro. Growth inhibition was assessed by cocultivating probiotics and 2 SM strains (ATCC 20532/25175) on agar. Probiotics were either precultured before SM cultivation (exclusion), or SM precultured prior to probiotic cultivation (displacement). Inhibition of SM culture growth was assessed visually. Inhibition of SM biofilm formation on bovine enamel was assessed using a continuous-flow short-term biofilm model, again in exclusion or displacement mode. The cariogenicity of mixed-species biofilms of SM with the most promising growth and biofilm formation inhibiting probiotic strains was assessed using an artificial mouth model, and enamel mineral loss (ΔZ) was measured microradiographically. We found limited differences in SM growth inhibition in exclusion versus displacement mode, and in inhibition of SM 20532 versus 25175. Results were therefore pooled. Lactobacillus acidophilus LA-5 inhibited significantly more SM culture growth than most other probiotics. L. casei LC-11 inhibited SM biofilm formation similarly to other alternatives but showed the highest retention of probiotics in the biofilms (p < 0.05). Mineral loss from SM monospecies biofilms (ΔZ = 9,772, 25th/75th percentiles: 6,277/13,558 vol% × µm) was significantly lower than from mixed-species SM × LA-5 biofilms (ΔZ = 24,578, 25th/75th percentiles: 19,081/28,768 vol% × µm; p < 0.01) but significantly higher than from SM × LC-11 biofilms (ΔZ = 4,835, 25th/75th percentiles: 263/7,865 vol% × µm; p < 0.05). Probiotics inhibiting SM culture growth do not necessarily reduce the cariogenicity of SM-probiotic biofilms. Nevertheless, SM biofilm formation inhibition may be relevant in the reduction of cariogenicity.
Psychosocial Factors and Comorbidity Associated with Suicide Attempts: Findings in Patients with Bipolar Disorder
Authors: McGrady Angele , Lynch Denis , Rapport Daniel
Published: January 2017

Background: Suicidal attempts occur more frequently in patients with bipolar disorder compared to other mood disorders. The goal of this study is to identify psychosocial factors and comorbidity associated with this serious and life-threatening behavior. Sampling and Methods: Subjects were 121 patients evaluated and treated at a university outpatient psychiatric clinic. The patients' charts were examined to determine history of suicide attempts, demographic and psychosocial variables, and comorbid symptoms. Results: Forty-one percent of the subjects had attempted suicide. Patients who were younger at onset of illness (p = 0.02) and those who had been abused (p = 0.003) were more likely to attempt suicide. Suicide attempts were also more common in subjects with a history of alcohol abuse (p = 0.003) and those with psychotic symptoms (p = 0.02). Conclusions: Based on the results of this study, it is recommended that increased emphasis be placed on the psychosocial history and comorbid symptoms in patients with bipolar disorder. While asking about previous suicide attempts is the most accurate way to predict suicidal behavior, age of onset, past abuse, and overuse of alcohol may also be helpful. Since suicidal behavior in patients with bipolar disorder is relatively common, intensified efforts to predict this behavior may be life-saving.
Management of Type 2B von Willebrand Disease during Pregnancy
Authors: McLaughlin David , Kerr Ron
Published: January 2017

Type 2B von Willebrand disease is a rare bleeding condition resulting in thrombocytopenia and a reduction in large VWF multimers. It usually has an autosomal dominant pattern of inheritance. We report the management of a patient with type 2B von Willebrand disease, whose diagnosis was confirmed by demonstration of a R1306W mutation, through her first pregnancy. The patient's von Willebrand factor (VWF) antigen and VWF ristocetin cofactor levels rose throughout pregnancy, with an associated drop in the platelet count. The patient was successfully managed through labour to a surgical delivery with VWF concentrate, platelet transfusions and tranexamic acid. The patient delivered a male baby who was found to have inherited type 2B von Willebrand disease and had a significant cephalhaematoma at delivery. The baby was managed with VWF concentrate and platelet transfusions and made a full recovery. There is a lack of evidence to guide the best management of pregnant patients with type 2B von Willebrand disease. We adopted a pragmatic management plan, in keeping with other published case reports. To the best of our knowledge, this is the first case report in which the child was found to have inherited type 2B von Willebrand disease and encountered bleeding problems, making this case unique amongst the published literature.
Effects of Breathing and Apnoea during Sustained Inflations in Resuscitation of Preterm Infants
Authors: Lista Gianluca , Cavigioli Francesco , La Verde Paola Azzurra , Castoldi Francesca , Bresesti Ilia , Morley Colin J.
Published: January 2017

Background: A sustained inflation (SI) at birth in preterm babies may be ineffective unless the infants breathe. Gain in lung volume is associated with breathing during delivery room non-invasive management. Objective: To describe the breathing patterns of preterm infants during an SI and correlate to a calculated gain in lung volume. Methods: Retrospective observational study. Data collected from a respiratory function monitor during SI (25 cmH2O for 15 s then PEEP at 5 cmH2O) through a face mask in preterm infants (gestational age [GA] ≤31 weeks). Spontaneous breaths, inspiratory time (TI), inspiratory/expiratory tidal volume (Vti/Vte), and gain in lung volume were determined. Results: 30 SIs in 20 infants (mean GA 27 weeks; birth weight 825 g) were analysed and stratified in 2 groups according to spontaneous breathing: SIs without spontaneous breaths (apnoea: n = 11) and SIs with spontaneous breaths (breathing: n = 19). Mean GA was lower in the apnoea group versus the breathing group (25 vs. 27+5 weeks; p = 0.01). Mean birth weight was lower in the apnoea group versus the breathing group (683 vs. 860 g; p = ns). In the breathing group, the mean number of spontaneous breaths was 4 with a mean TI of 0.52 min, the mean Vti/kg was 5.9 mL/kg, and the mean Vte was 2.7 mL/kg. The calculated mean gain in lung volume was 7.5 mL/kg in the apnoea group and 17.8 mL/kg in the breathing group (p = 0.039). Conclusions: Actively breathing infants during an SI at birth showed a gain in lung volume higher than apnoeic infants. Spontaneous breathing during SI seems to be related to GA.
High-Dose Methotrexate and Cytarabine-Based Multi-Agent Chemotherapy (Modified Bonn Protocol) for Systemic Lymphoma with CNS Involvement
Authors: Umino Kento , Fujiwara Shin-ichiro , Sato Kazuya , Minakata Daisuke , Nakano Hirofumi , Yamasaki Ryoko , Kawasaki Yasufumi , Sugimoto Miyuki , Yamamoto Chihiro , Hatano Kaoru , Okazuka Kiyoshi , Oh Iekuni , Ohmine Ken , Suzuki Takahiro , Muroi Kazuo , Kanda Yoshinobu
Published: January 2017

The prognosis of patients with systemic lymphoma with central nervous system (CNS) involvement is very poor and there is no established standard therapy. We retrospectively analyzed 18 patients (4 untreated and 14 relapsed) with systemic lymphoma with CNS involvement who received methotrexate and cytarabine-based multiagent chemotherapy (modified Bonn protocol). Complete and partial responses were achieved in 56 and 22% of the patients, respectively. The 1-year overall survival (OS) and progression-free survival (PFS) was 81.0 and 39.2%, respectively. Patients with parenchymal involvement showed a better 1-year PFS than those with either leptomeningeal involvement or both. In a multivariate analysis, poor performance status (PS) was the only independent prognostic factor for the 1-year OS and PFS (HR 10.8, 95% CI 1.09-108, p = 0.042; HR 20.8, 95% CI 2.39-181, p = 0.006, respectively). Grade 4 neutropenia and thrombocytopenia occurred in 17 patients each (94%), but there were no grade 4 nonhematopoietic adverse events. The modified Bonn protocol resulted in relatively favorable response and survival, and provided clinical benefits to patients with good PS, in particular. This study demonstrated that the modified Bonn protocol could be a feasible and encouraging treatment approach for lymphoma with CNS and systemic involvement.
Bell's Palsy: Clinical Analysis of 372 Cases and Review of Related Literature
Authors: Zhao Hua , Zhang Xin , Tang Yin-da , Zhu Jin , Wang Xu-hui , Li Shi-ting
Published: January 2017

Objective: To analyze some clinical and epidemiologic aspects of Bell's palsy (BP) and to develop relevant correlations between existing data in literature and those obtained in this research. Methods: From January 2012 to December 2014, 372 consecutive patients diagnosed with BP were studied retrospectively. We reviewed the patients' data including gender, age, occupation, clinical manifestations, comorbid disease, and the rate of recurrence. Result: The highest incidence was identified in those between 39 and 50 years of age. BP was more frequent in warm seasons (spring and summer) with its incidence reaching a peak value in September. The seasonal incidence of BP was significantly higher in summer (p < 0.05). In addition, diabetes mellitus was the most common accompanying comorbid condition. Conclusion: The peak age when BP showed up was in the fourth decade of life and 55.1% of patients belonged to the male gender. BP has been observed to have the highest incidence during warm seasons (spring and summer). Diabetes mellitus was the most common comorbid condition accompanying BP. In addition, a recurrence was more likely to occur in the first 1.5 years after its first incidence.
Reversible Cerebral Vasoconstriction Syndrome with Intracranial Hypertension: Should Decompressive Craniectomy Be Considered
Authors: Mrozek Ségolène , Lonjaret Laurent , Jaffre Aude , Januel Anne-Christine , Raposo Nicolas , Boetto Sergio , Albucher Jean-François , Fourcade Olivier , Geeraerts Thomas
Published: January 2017

Background: Reversible cerebral vasoconstriction syndrome (RCVS) is a rare cause of intracerebral hemorrhage (ICH) causing intracranial hypertension. Methods: Case report. Results: We report a case of RCVS-related ICH leading to refractory intracranial hypertension. A decompressive craniectomy was performed to control intracranial pressure. We discuss here the management of RCVS with intracranial hypertension. Decompressive craniectomy was preformed to avoid the risky option of high cerebral perfusion pressure management with the risk of bleeding, hemorrhagic complications, and high doses of norepinephrine. Neurological outcome was good. Conclusion: RCVS has a complex pathophysiology and can be very difficult to manage in cases of intracranial hypertension. Decompressive craniectomy should probably be considered.
Durham Smith Vest-Over-Pant Technique: Simple Procedure for a Complex Problem (Post-Hypospadias Repair Fistula)
Authors: Gite Venkat A. , Patil Saurabh R. , Bote Sachin M. , Siddiqui Mohd. Ayub Karam Nabi , Nikose Jayant V. , Kandi Anitha J.
Published: January 2017

Objective: Urethrocutaneous fistula, which occurs after hypospadias surgery, is often a baffling problem and its treatment is challenging. The study aimed to evaluate the results of the simple procedure (Durham Smith vest-over-pant technique) for this complex problem (post-hypospadias repair fistula). Methods: During the period from 2011 to 2015, 20 patients with post-hypospadias repair fistulas underwent Durham Smith repair. Common age group was between 5 and 12 years. Site wise distribution of fistula was coronal 2 (10%), distal penile 7 (35%), mid-penile 7 (35%), and proximal-penile 4 (20%). Out of 20 patients, 15 had fistula of size <5 mm (75%) and 5 patients had fistula of size >5 mm (25%). All cases were repaired with Durham Smith vest-over-pant technique by a single surgeon. In case of multiple fistulas adjacent to each other, all fistulas were joined to form single fistula and repaired. Results: We have successfully repaired all post-hypospadias surgery urethrocutaneous fistulas using the technique described by Durham Smith with 100% success rate. Conclusion: Durham Smith vest-over-pant technique is a simple solution for a complex problem (post hypospadias surgery penile fistulas) in properly selected patients.
Targeting Hypoxia-Inducible Factors for the Treatment of Anemia in Chronic Kidney Disease Patients
Authors: Locatelli Francesco , Fishbane Steven , Block Geoffrey A. , Macdougall Iain C.
Published: January 2017

Background: Anemia, a common complication of chronic kidney disease (CKD), has previously been attributed primarily to decreased production of erythropoietin. More recently, it has become apparent that the etiology of anemia involves several other factors, most notably dysfunctional iron metabolism, mediated via increased hepcidin activity and reduced clearance. Current management of anemia in patients with advanced CKD is based on erythropoiesis-stimulating agents and iron supplementation, along with red blood cell transfusions when necessary; however, safety considerations associated with these therapies highlight the need to pursue alternative treatment options targeting other mechanisms such as hypoxia-inducible factors (HIFs) that act as central regulators of erythropoiesis by coordinating a series of graded hypoxic responses. Summary: This review discusses the discovery of the HIF pathway and its regulation via HIF prolyl hydroxylase enzymes in the context of erythropoiesis and iron metabolism. The rationale for targeting this pathway and the clinical development of HIF prolyl hydroxylase inhibitors are reviewed, with a commentary on the potential implications of this class of agents in CKD anemia management. Key Messages: Pharmacologic activation of the HIF pathway results in a transient pseudo-hypoxic state that stimulates erythropoiesis in CKD patients with anemia. Results from clinical studies of a number of HIF prolyl hydroxylase inhibitors are increasingly available and provide support for the continued evaluation of the risk-benefit ratio of this novel therapeutic approach to the treatment of anemia in CKD.
Relationship between Carnitine Pharmacokinetics and Fatigue in Patients Treated with Cisplatin-Containing Chemotherapy
Authors: Ikezaki Tomoaki , Suzuki Kensuke , Kambara Kenta , Inomata Minehiko , Okazawa Seisuke , Kajiura Shinya , Miwa Toshiro , Tanabe Kouichi , Kashii Tatsuhiko
Published: January 2017

Background: Approximately 70% of the patients who receive chemotherapy suffer from fatigue, which lowers their quality of life and also has a negative influence on therapeutic efficacy. Previous studies have suggested a relationship between blood carnitine levels and fatigue. We conducted a prospective observational study to examine the relationship between carnitine pharmacokinetics and chemotherapy-induced fatigue in patients receiving cancer chemotherapy regimens that include cisplatin. Patients and Methods: 11 patients receiving chemotherapy including cisplatin (60-80 mg/m2) were included in the study. We performed 24-h urine collections and took blood samples on day 1 (before the initiation of chemotherapy) and days 2, 3, 4, and 8 in order to measure the carnitine concentrations in the serum and urine. These were compared with measures of self-reported fatigue. The primary endpoint was the change in self-reported fatigue subscales from baseline to day 8. Results: Urinary carnitine concentrations differed significantly on days 2 and 3 (p = 0.003). The Functional Assessment of Chronic Illness Therapy-Fatigue scale version 4A score on day 8 indicated significantly higher levels of fatigue as compared to day 1 (p = 0.013). Conclusion: This study suggests that there is an association between urinary carnitine levels and self-reported fatigue.
The Development of Sayk's Cell Sedimentation Chamber: A Historical View on Clinical Cerebrospinal Fluid Diagnostics
Authors: Dahlmann Nathalie , Zettl Uwe K. , Kumbier Ekkehardt
Published: January 2017

Objective: The history of Sayk's cell sedimentation chamber is examined and reviewed in the context of clinically utilizable cerebrospinal fluid (CSF) cytology. Methods: A review of the literature was undertaken in PubMed and Google Scholar to search for primary and secondary sources on the history of CSF diagnosis. Moreover, documents in the archives of the Universities of Rostock and Jena, the Brain Research Institute of Cécile and Oskar Vogt in Düsseldorf and the Centre for Neurology at Rostock University were used. Results: The cell sedimentation chamber, developed by Johannes Sayk (1923-2005) at the beginning of the 1950s, enabled, for the first time, CSF cells to be presented with a quality comparable to the blood profile, with a low technological expenditure and using all staining methods suitable for haematological cells. The procedure could be performed quickly and cost efficiently, and therefore, it was easy to integrate it into clinical routine and it quickly became a widely used procedure. In Europe, it was considered the standard method for cytodiagnosis of CSF until the 1990s. Conclusions: The procedure revolutionised CSF diagnostics and paved the way for modern qualitative CSF cytology. In course of time, the cell sedimentation chamber was superseded by the cytocentrifuge.
“Nunca pensei sobre isso!”: vivências de trabalho na indústria metalmecânica
Authors: Rancan Maristela , Giongo Carmem Regina
Published: January 2017

É de fundamental importância entender as relações existentes entre o trabalho e os processos de saúde/doença mental, visando ao desenvolvimento de ações de prevenção e promoção da saúde do trabalhador. Diante da escassez de estudos que privilegiem esse aspecto entre os trabalhadores que atuam na indústria metalmecânica no Brasil, esta pesquisa tem o objetivo de analisar as vivências de trabalho de profissionais inseridos no contexto metalmecânico para compreender a dinâmica saúde/doença mental no trabalho. Através de um delineamento exploratório-descritivo, a pesquisa foi orientada teoricamente pela Psicodinâmica do Trabalho. Foram entrevistados individualmente oito trabalhadores da indústria metalmecânica da região de Caxias do Sul (RS), com idades entre 20 e 54 anos. Como instrumentwwwos de coleta de dados foram utilizados um questionário sociodemográfico e entrevista semiestruturada. Os dados foram examinados por análise de conteúdo. Os resultados apontaram claramente para o intenso processo de sofrimento e para o grande risco de adoecimento dos trabalhadores entrevistados, evidenciando a necessidade de problematizar e repensar as relações e a configuração do trabalho metalmecânico.
Proton Pump Inhibitors Decrease Soluble fms-Like Tyrosine Kinase-1 and Soluble Endoglin Secretion, Decrease Hypertension, and Rescue Endothelial Dysfunction
Authors: Onda Kenji , Tong Stephen , Beard Sally , Binder Natalie , Muto Masanaga , Senadheera Sevvandi N. , Parry Laura , Dilworth Mark , Renshall Lewis , Brownfoot Fiona , Hastie Roxanne , Tuohey Laura , Palmer Kirsten , Hirano Toshihiko , Ikawa Masahito , Kaitu’u-Lino Tu’uhevaha , Hannan Natalie J.
Published: January 2017

Preeclampsia is a severe complication of pregnancy. Antiangiogenic factors soluble fms-like tyrosine kinase-1 (sFlt-1) and soluble endoglin are secreted in excess from the placenta, causing hypertension, endothelial dysfunction, and multiorgan injury. Oxidative stress and vascular inflammation exacerbate the endothelial injury. A drug that can block these pathophysiological steps would be an attractive treatment option. Proton pump inhibitors (PPIs) are safe in pregnancy where they are prescribed for gastric reflux. We performed functional studies on primary human tissues and animal models to examine the effects of PPIs on sFlt-1 and soluble endoglin secretion, vessel dilatation, blood pressure, and endothelial dysfunction. PPIs decreased sFlt-1 and soluble endoglin secretion from trophoblast, placental explants from preeclamptic pregnancies, and endothelial cells. They also mitigated tumor necrosis factor-α–induced endothelial dysfunction: PPIs blocked endothelial vascular cell adhesion molecule-1 expression, leukocyte adhesion to endothelium, and disruption of endothelial tube formation. PPIs decreased endothelin-1 secretion and enhanced endothelial cell migration. Interestingly, the PPI esomeprazole vasodilated maternal blood vessels from normal pregnancies and cases of preterm preeclampsia, but its vasodilatory effects were lost when the vessels were denuded of their endothelium. Esomeprazole decreased blood pressure in a transgenic mouse model where human sFlt-1 was overexpressed in placenta. PPIs upregulated endogenous antioxidant defenses and decreased cytokine secretion from placental tissue and endothelial cells. We have found that PPIs decrease sFlt-1 and soluble endoglin secretion and endothelial dysfunction, dilate blood vessels, decrease blood pressure, and have antioxidant and anti-inflammatory properties. They have therapeutic potential for preeclampsia and other diseases where endothelial dysfunction is involved.
Abnormal Wave Reflections and Left Ventricular Hypertrophy Late After Coarctation of the Aorta Repair
Authors: Quail Michael A. , Short Rebekah , Pandya Bejal , Steeden Jennifer A. , Khushnood Abbas , Taylor Andrew M. , Segers Patrick , Muthurangu Vivek
Published: January 2017

Patients with repaired coarctation of the aorta are thought to have increased afterload due to abnormalities in vessel structure and function. We have developed a novel cardiovascular magnetic resonance protocol that allows assessment of central hemodynamics, including central aortic systolic blood pressure, resistance, total arterial compliance, pulse wave velocity, and wave reflections. The main study aims were to (1) characterize group differences in central aortic systolic blood pressure and peripheral systolic blood pressure, (2) comprehensively evaluate afterload (including wave reflections) in the 2 groups, and (3) identify possible biomarkers among covariates associated with elevated left ventricular mass (LVM). Fifty adult patients with repaired coarctation and 25 age- and sex-matched controls were recruited. Ascending aorta area and flow waveforms were obtained using a high temporal-resolution spiral phase-contrast cardiovascular magnetic resonance flow sequence. These data were used to derive central hemodynamics and to perform wave intensity analysis noninvasively. Covariates associated with LVM were assessed using multivariable linear regression analysis. There were no significant group differences (
P
≥0.1) in brachial systolic, mean, or diastolic BP. However central aortic systolic blood pressure was significantly higher in patients compared with controls (113 versus 107 mm Hg,
P
=0.002). Patients had reduced total arterial compliance, increased pulse wave velocity, and larger backward compression waves compared with controls. LVM index was significantly higher in patients than controls (72 versus 59 g/m
2
,
P
<0.0005). The magnitude of the backward compression waves was independently associated with variation in LVM (
P
=0.01). Using a novel, noninvasive hemodynamic assessment, we have shown abnormal conduit vessel function after coarctation of the aorta repair, including abnormal wave reflections that are associated with elevated LVM.
Vection Latency Is Reduced by Bone-Conducted Vibration and Noisy Galvanic Vestibular Stimulation
Authors: Weech Séamas , Troje Nikolaus F.
Published: January 2017

Studies of the illusory sense of self-motion elicited by a moving visual surround (‘vection’) have revealed key insights about how sensory information is integrated. Vection usually occurs after a delay of several seconds following visual motion onset, whereas self-motion in the natural environment is perceived immediately. It has been suggested that this latency relates to the sensory mismatch between visual and vestibular signals at motion onset. Here, we tested three techniques with the potential to reduce sensory mismatch in order to shorten vection onset latency: noisy galvanic vestibular stimulation (GVS) and bone conducted vibration (BCV) at the mastoid processes, and body vibration applied to the lower back. In Experiment 1, we examined vection latency for wide field visual rotations about the roll axis and applied a burst of stimulation at the start of visual motion. Both GVS and BCV reduced vection latency by two seconds compared to the control condition, whereas body vibration had no effect on latency. In Experiment 2, the visual stimulus rotated about the pitch, roll, or yaw axis and we found a similar facilitation of vection by both BCV and GVS in each case. In a control experiment, we confirmed that air-conducted sound administered through headphones was not sufficient to reduce vection onset latency. Together the results suggest that noisy vestibular stimulation facilitates vection, likely due to an upweighting of visual information caused by a reduction in vestibular sensory reliability.
Semiaquilegia guangxiensis (Ranunculaceae), a new species from the limestone areas of Guangxi, China, based on morphological and molecular evidence
Authors: HUANG YU-SONG , GUO JING , ZHANG QIANG , LU ZHAO-CEN , LIU YAN
Published: January 2017

A new species of Ranunculaceae, Semiaquilegia guangxiensis, is described and illustrated. The plant is morphologically similar to S. adoxoides, but it obviously differs from the latter by the following characteristics: stamens 20–30 (vs. 8–14 in S. adoxoides); staminodes ca. 10, half the length of the filaments (vs. ca. 2, as long as filaments in S. adoxoides); follicles ca. 1 cm long, ca. 3 mm wide (vs. 6–7 mm long, ca. 2 mm wide in S. adoxoides); seeds 1.5–2.5 mm long (vs. ca. 1 mm long in S. adoxoides). Its affinity to S. adoxoides and placement in Semiaquilegia are confirmed by phylogenetic analyses based on nuclear ITS and chloroplast trnL-F sequences.