bluuebunny/crossref_metadata_2025 huggingface dataset:
Homological characterizations of almost Dedekind domains
Authors: Zhou Dechuan , Kim Hwankoo , Wang Fanggui , Hu Kui
Published: May 2019

Let [Formula: see text] be a commutative ring. In this paper, a class of almost projective modules is introduced. An [Formula: see text]-module [Formula: see text] is said to be almost projective if [Formula: see text] for any [Formula: see text]-module [Formula: see text], where [Formula: see text] is a maximal ideal of [Formula: see text]. It is shown that an [Formula: see text]-module [Formula: see text] satisfying that [Formula: see text] is free over [Formula: see text] for any maximal ideal [Formula: see text] of [Formula: see text] is exactly almost projective. As applications, we characterize almost Dedekind domains in terms of almost projectivity and certain divisibility, respectively.
On group modules
Authors: Tamer Koşan M. , Žemlička Jan
Published: May 2019

The paper is focused on questions when some homological and submodule-chain conditions satisfied by a module [Formula: see text] are preserved by the group module [Formula: see text]. Namely, it is proved for a group [Formula: see text] and an [Formula: see text]-module [Formula: see text] that [Formula: see text] is flat if and only if [Formula: see text] is flat, and [Formula: see text] is artinian if and only if [Formula: see text] is artinian and [Formula: see text] is finite, which are two questions raised by Yiqiang Zhou: On Modules Over Group Rings, Noncommutative Rings and Their Applications LENS July 1-4, 2013.
Investigating the Impact of Using Knowledge Management on Organisational Agility through Competitive Intelligence and Strategic Thinking
Authors: Tooranloo Hossein Sayyadi , Saghafi Sepideh
Published: May 2019

Agility is a necessary condition, which is known as the main factor for the success of corporations to compete. In this sense, organisations have to determine their strategic priorities and accordingly develop and implement appropriate strategies in order to preserve their growth and survival. Meanwhile, managers play an important role in the process of strategic planning and making decisions related to their way of thinking. In addition, the existence of competitive intelligence plan for organisations has a striking role to optimally use the existing opportunities and using knowledge management (KM) in the organisation provides a platform to do so. This work aims to study the impact of using knowledge management on organisational agility as a case study in the ceramic and tile industry of the provinces of Yazd and Kerman. The data was collected using questionnaires. The structural equation modelling was used to analyse the research hypotheses using LISREL software. The results of the study showed that knowledge management application has a positive and significant effect on agility through using competitive intelligence and strategic thinking.
The Impact of ERP System on Academic Performance: A Case Study Approach
Authors: Shatat Ahmad Saleh , Al Burtamani Wadha Abdullah Humaid
Published: May 2019

Enterprise Resource Planning (ERP) system is a very powerful solution to many academic and non-academic institutions in case it has been implemented and used effectively. Otherwise, the system will interrupt several business processes. This research paper investigates the impact of ERP system on academic performance at Sohar University. A survey questionnaire is distributed to several academic stakeholders to investigate the impact of ERP system on academic performance within the University context. A total of 110 questionnaires was received from the key academic stakeholders to examine the relationship between the three core ERP modules i.e. the students’ information module, the financial module, and human resource module. The research outcomes indicate that there is a relationship between the three modules and the academic performance. However, only students’ information module and financial management module demonstrate a significant impact on academic performance, though the human resource module shows no impact on the academic performance at Sohar University. This study is a single case study approach, which might limit the findings to be generalized on other education institutes, but it gives a chance to other researchers to do multiple case studies in other Universities in the region.
Theoretical assessment of the impact of desert aerosols on the dynamical transmission of meningitidis serogroup A
Authors: Oumar Bah A. , Lam M. , Bah A. , Bowong S.
Published: May 2019

This paper has been motivated by the following biological question: how influential are desert aerosols in the transmission of meningitidis serogroup A (MenA)? A mathematical model for the dynamical transmission of MenA is considered, with the aim of investigating the impact of desert aerosols. Sensitivity analysis of the model has been performed in order to determine the impact of related parameters on meningitis outbreak. We derive the basic reproduction number [Formula: see text]. We prove that there exists a threshold parameter [Formula: see text] such that when [Formula: see text], the disease-free equilibrium is globally asymptotically stable (GAS). However, when [Formula: see text], the model exhibits the phenomenon of backward bifurcation. At the endemic level, we show that the number of infectious individuals in the presence of desert aerosols is larger than the corresponding number without the presence of desert aerosols. In conjunction with the inequality [Formula: see text] where [Formula: see text] is the basic reproduction number without desert aerosols, we found that the ingestion of aerosols by carriers will increase the endemic level, and the severity of the outbreak. This suggests that the control of MenA passes through a combination of a large coverage vaccination of young susceptible individuals and the production of a vaccine with a high level of efficacy as well as respecting the hygienic rules to avoid the inhalation of desert aerosols. Theoretical results are supported by numerical simulations.
Global stability and Hopf bifurcation of an eco-epidemiological model with time delay
Authors: Lu Jinna , Zhang Xiaoguang , Xu Rui
Published: May 2019

In this paper, an eco-epidemiological model with time delay representing the gestation period of the predator is investigated. In the model, it is assumed that the predator population suffers a transmissible disease and the infected predators may recover from the disease and become susceptible again. By analyzing corresponding characteristic equations, the local stability of each of feasible equilibria and the existence of Hopf bifurcations at the disease-free and coexistence equilibria are established, respectively. By means of Lyapunov functionals and LaSalle’s invariance principle, sufficient conditions are obtained for the global stability of the coexistence equilibrium, the disease-free equilibrium and the predator-extinct equilibrium of the system, respectively.
Stationary distribution and periodic solution of stochastic chemostat models with single-species growth on two nutrients
Authors: Gao Miaomiao , Jiang Daqing , Hayat Tasawar
Published: May 2019

In this paper, we consider two chemostat models with random perturbation, in which single species depends on two perfectly substitutable resources for growth. For the autonomous system, we first prove that the solution of the system is positive and global. Then we establish sufficient conditions for the existence of an ergodic stationary distribution by constructing appropriate Lyapunov functions. For the non-autonomous system, by using Has’minskii theory on periodic Markov processes, we derive it admits a nontrivial positive periodic solution. Finally, numerical simulations are carried out to illustrate our main results.
Calculating the cardinality of some classes of binary matrices using bitwise operations — A polynomial algorithm
Authors: Yordzhev Krasimir
Published: May 2019

Let [Formula: see text] be the set of all [Formula: see text] binary matrices with exactly [Formula: see text] units in each row and each column, [Formula: see text]. A matrix [Formula: see text] will be called primitive, if there is no [Formula: see text] submatrix of [Formula: see text] that belongs to the set [Formula: see text], [Formula: see text]. The article describes a polynomial algorithm, which works in time [Formula: see text] for verifying whether a [Formula: see text]-matrix is primitive. The work applies this algorithm for finding all primitive [Formula: see text]-matrices which rows and columns are in lexicographically nondecreasing order (semi-canonical binary matrices) for some integers [Formula: see text] and [Formula: see text].
CLIMATE CLUBS VERSUS SINGLE COALITIONS: THE AMBITION OF INTERNATIONAL ENVIRONMENTAL AGREEMENTS
Authors: HAGEN ACHIM , EISENACK KLAUS
Published: May 2019

We investigate whether global cooperation on emissions abatement can be improved if asymmetric countries agree to sign one out of several environmental agreements. The analysis is based on a two-stage game theoretical model. Conditions for stable coalitions and the resulting global emissions are determined. We allow for multiple coalitions with all countries being different, and analyze the effects in the cases of increasing marginal damages from emissions and of decreasing marginal benefits of emissions. We find that in the case of decreasing marginal benefits and constant marginal damages, admitting multiple coalitions increases the number of cooperating countries and reduces emissions (compared to the standard case with a single coalition). For increasing marginal damages and constant marginal benefits, however, multiple stable coalitions cannot coexist. If both damages and benefits are nonlinear, admitting multiple coalitions can decrease emissions. The paper thus contributes to the emerging discussion on the scope and limits of climate clubs.
FACTORS INFLUENCING RICE FARMERS’ ADAPTATION STRATEGIES TO CLIMATE CHANGE AND EXTREME WEATHER EVENT IMPACTS IN BANGLADESH
Authors: MAYA KHADIYA AKTAR , SARKER MD. ABDUR RASHID , GOW JEFF
Published: May 2019

Introduction: Climate change has emerged as a major threat to Bangladesh. Higher and fluctuating temperatures and changes in rainfall caused by climate change and extreme weather events have reduced crop production. A better understanding of the local dimensions of vulnerability is therefore essential to develop appropriate adaptation measures that can alleviate these adverse impacts. Purpose and methods: The main purpose of this study was to identify the determinants of Aman rice farmers’ choice of adaptation strategies to climate change and weather in Khulna district, Bangladesh. About 100 farm households susceptible to salinity intrusion, extreme temperatures and drought were surveyed, and these data were supplemented by major climate data of the district for 65 years (1948–2013). A binary logistic regression was then utilized to estimate the factors that influence households’ choice of adaptation strategies. Results and Conclusions: About 97% of farmers perceived that the climate had changed over the past 30 years while only 3% did not. Further, 97% believed that rainfall had decreased and reduced rice production, yet the data show this not to be the case with a significant increase in rainfall observed in the area in the study period. About 89% of farmers have undertaken some form(s) of adaptation and they were further asked about their main adaptation type. Family size, annual income, farmer-to-farmer extension and access to subsidies have a positive and significant impact on rice farmers’ adaptation strategies to climate and weather change effects. Farm size and credit access had a negative and significant impact on adaptation. Four variables: age, education, household assets and occupation were not statistically significant in explaining adaption strategies. The chief adaptation strategies of farmers are cultivation of salinity-tolerant rice, rice variety switching, replanting of rice, changing planting dates, conversion of rice paddy to fish production and use of different crop varieties in alternate years.
Morphological, Biochemical, and Climatological Analysis of Three Moroccan Henna Verities
Authors: El Massoudi Soukaina , Benidir Meryem , Chabir Rachida , Benjelloun Meryem , El Ghadraoui Lahsen , Errachidi Faouzi
Published: May 2019

In this study, we aimed to evaluate planted Henna in three sites in Morocco, namely, Alnif, Tafraoute Sidi Ali, and Tazzarine. Morphometric study shows that Tafraoute Sidi Ali Henna variety has highest geometric and weight parameters (length of 27.48 mm, width of 10.92 mm, specific mass of 25.1 mg/leaf, leaf area of 51, 53 mm2, and rib’s number of 9.41) when compared to Alnif and Tazzarine varieties. On the other hand, biochemical analysis shows that Tazzarine Henna variety, in the first rank, is characterized by high levels of total sugars (11.27 g/100 g), reducing sugars (5.59 g/100 g), proteins (4.4 g/100g), lipids (3.05 g/100g), phenolic compounds (31.9 g/100 g), flavonoids (5.68 g/100 g), and tannins (5.5 g/100 g). Chromatographic study shows that Tazzarine Henna variety is rich in monocyclic and polycyclic phenolic compounds. Climatic conditions analysis shows that the morphometric and biochemical diversity is related to hydrous and thermal profiles of studied sites. As a conclusion of this work, we can recommend the use of morphometric analysis and phytochemical and chromatographic analysis to determine the quality of Henna in Morocco and elsewhere.
Medicinally Important Herbal Flowers in Sri Lanka
Authors: Gunawardana S. L. A. , Jayasuriya W. J. A. B. N.
Published: May 2019

Background. The plant kingdom is rich with a numerous number of plants with various medical properties which can be used to treat various medical issues. Sri Lanka is a country full of biodiversity which is gifted with many plant resources. It has a rich history of traditional medicine systems consisting of Ayurveda, Unani, and Deshiya Chikitsa, where these plant resources are used as remedies for the diseases. In the traditional medicine system, various plant parts such as leaves, roots, fruits, flowers, and bark are used to treat disease conditions. Although less attention is paid to the medicinal importance of the flowers, some of them have been used to treat many diseases from the ancient time. Some properties of the flowers may differ from the properties of the other plant parts. For example,Sesbania grandiflora(Katuru murunga) flowers have shown anticancer properties against various cell models whereas some flowers have shown antispermatogenic properties. Flowers ofWoodfordia floribunda(Militta) are added as fermenting agents in the preparation of Arishtas in Ayurveda. Also the most popular Clove oil is obtained from the flower buds ofSyzygium aromaticum(Karabu-neti) which is used to treat toothaches since it has antibiotic and antiseptic properties. This article gives an overview of herbal flowers used in the traditional medicine system of Sri Lanka and their pharmacological importance.Method. A comprehensive literature survey was done on the medicinally important flowers in Sri Lanka. Data was collected from Libraries of Ayurveda in Sri Lanka and from scientific databases.Results. According to the survey many flowers are used as astringent, cardiac tonic, and febrifuge. Also some flowers are used to treat dysentery, diarrhoea, and indigestion. Some flowers are useful in the treatment of bleeding piles while some are useful in the treatment of asthma and bronchitis.Conclusion. It was revealed that there are many flowers with valuable therapeutic effects. Traditional medicine systems prevailing in Sri Lanka have made use of these flowers with therapeutic effects to cure so many diseases. The review of medicinally important herbal flowers provides knowledge and pharmacological leads which will help for the wellbeing of the human beings. Although there are phytochemical studies done to identify the chemical compounds on some flowers, chemical composition of many flowers remains unrevealed. So further studies need to be done to identify the chemical composition of these flowers.
Chronic Myeloid Leukemia in a Patient Receiving Tofacitinib: A Case Report and Literature Review
Authors: Medawar Georgio , Chahrouri Joseph , Said Rabih
Published: May 2019

Background. Tofacitinib is a new oral Janus kinase inhibitor that has shown promising clinical benefit in various rheumatologic diseases. However, many concerns related to the development of malignancies have been reported with its use. Case Presentation. A 43-year-old female patient received tofacitinib for refractory rheumatoid arthritis (RA). Two years after 5 mg bid daily dosing, the patient developed chronic myelogenous leukemia (CML), for which she received imatinib and tofacitinib was discontinued. She then remained in remission for rheumatoid arthritis and within the expected milestone outcome for her CML. Conclusion. This is the first reported case of CML after the use of tofacitinib. This event is of particular interest knowing the possible benefits tofacitinib carries in the treatment of CML demonstrated in a few studies.
An Improved Uncertainty Measure Theory Based on Game Theory Weighting
Authors: He Hujun , Tian Chong , Jin Gang , An Le
Published: May 2019

In the application of uncertainty measure theory, the determination method of index weight mainly includes the subjective weight determination method and the objective weight determination method. The subjective weight determination method has the disadvantages affected by the subjective preference of the decision‐maker. The objective weight determination method often ignores the participation degree of the decision‐maker, and when using the uncertainty measure evaluation model to perform multi‐index classification evaluation, the credible degree recognition criterion is often used as the attribute recognition of the object to be measured, because the credible degree is taken by the subjective people, and the different values of different people have a great influence on the evaluation results. In order to solve the above problems in the uncertainty measure theory, this paper used the combination weighting of game theory to determine the optimal weight. At the same time, the credible degree recognition criterion was improved on the basis of the concept of minimum uncertainty measure distance, and a game theory‐improved uncertainty measure optimization model was proposed. Finally, the validity of the model was proven by a case.
Hyponatremic Seizures and Adrenal Hypoplasia Congenita in a Neonate with Congenital Diaphragmatic Hernia
Authors: Verma Sourabh , Purrier Sheryl , Breidbart Emily , Pappas John G. , Mally Pradeep V. , Randis Tara M.
Published: May 2019

Congenital diaphragmatic hernia (CDH) in neonates may occur as an isolated finding, in association with other anomalies, or as part of a genetic syndrome. We report the first case of an infant with CDH who presented with hyponatremic seizures due to adrenal hypoplasia congenita (AHC). The patient underwent repair of CDH defect. After an uncomplicated postoperative course while on discharge planning, he developed a seizure episode associated with severe hyponatremia and hyperkalemia. Extensive diagnostic workup revealed an NR0B1 gene variant confirming the diagnosis of X-linked AHC. The patient was eventually discharged home on hydrocortisone, fludrocortisone, and salt supplements. There are a few case reports of adrenal insufficiency in neonates with CDH, manifesting with symptoms before and immediately after reparative surgery. Clinical presentation of our patient was unique in manifesting as neonatal seizure secondary to severe hyponatremia after a stable postoperative phase. The patient’s electrolytes and hemodynamic status remained stable before, during, and after surgery for CDH. This case underlines the importance of taking detailed family history and continued vigilance for signs and symptoms of adrenal insufficiency in infants with repaired CDH by pediatricians and intensivists.
The Viscosity Effect of Masticated Natural vs. Synthetic Isoprene Rubber on Toughening of Polylactic Acid
Authors: Phattarateera Supanut , Pattamaprom Cattaleeya
Published: May 2019

This study investigated the different viscosity effects of natural isoprene rubber (NR) compared to the synthetic one (IR) on toughening of polylactic acid (PLA). Here, 15 wt% rubber was melt blended with PLA in an internal mixer at 180°C and 50 rpm. It was found that the addition of these rubbers led to a significant increase in the tensile toughness and impact strength. These rubbers were masticated at 50°C and at 200 rpm for various mastication times to reduce their molecular weights. A too-long mastication time was found to adversely affect the impact strength and tensile toughness due to the fast agglomeration of rubber particles. At a comparable viscosity, it was remarkable that the impact strength of PLA/NR was higher than that of PLA/IR regardless of the similar chemical structures probably because the presence of nonrubber components including proteins and lipids could enhance the interfacial interaction between NR and the PLA matrix.
Multifunctional TRPV1 Ion Channels in Physiology and Pathology with Focus on the Brain, Vasculature, and Some Visceral Systems
Authors: Storozhuk Maksim V. , Moroz Olesia F. , Zholos Alexander V.
Published: May 2019

TRPV1 has been originally cloned as the heat and capsaicin receptor implicated in acute pain signalling, while further research has shifted the focus to its importance in chronic pain caused by inflammation and associated with this TRPV1 sensitization. However, accumulating evidence suggests that, apart from pain signalling, TRPV1 subserves many other unrelated to nociception functions in the nervous system. In the brain, TRPV1 can modulate synaptic transmission via both pre- and postsynaptic mechanisms and there is a functional crosstalk between GABA receptors and TRPV1. Other fundamental processes include TRPV1 role in plasticity, microglia-to-neuron communication, and brain development. Moreover, TRPV1 is widely expressed in the peripheral tissues, including the vasculature, gastrointestinal tract, urinary bladder, epithelial cells, and the cells of the immune system. TRPV1 can be activated by a large array of physical (heat, mechanical stimuli) and chemical factors (e.g., protons, capsaicin, resiniferatoxin, and endogenous ligands, such as endovanilloids). This causes two general cell effects, membrane depolarization and calcium influx, thus triggering depending on the cell-type diverse functional responses ranging from neuronal excitation to secretion and smooth muscle contraction. Here, we review recent research on the diverse TRPV1 functions with focus on the brain, vasculature, and some visceral systems as the basis of our better understanding of TRPV1 role in different human disorders.
Compressive Sensing Based Channel Estimation for Massive MIMO Communication Systems
Authors: Waseem Athar , Naveed Aqdas , Ali Sardar , Arshad Muhammad , Anis Haris , Qureshi Ijaz Mansoor
Published: May 2019

Massive multiple-input multiple-output (MIMO) is believed to be a key technology to get 1000x data rates in wireless communication systems. Massive MIMO occupies a large number of antennas at the base station (BS) to serve multiple users at the same time. It has appeared as a promising technique to realize high-throughput green wireless communications. Massive MIMO exploits the higher degree of spatial freedom, to extensively improve the capacity and energy efficiency of the system. Thus, massive MIMO systems have been broadly accepted as an important enabling technology for 5th Generation (5G) systems. In massive MIMO systems, a precise acquisition of the channel state information (CSI) is needed for beamforming, signal detection, resource allocation, etc. Yet, having large antennas at the BS, users have to estimate channels linked with hundreds of transmit antennas. Consequently, pilot overhead gets prohibitively high. Hence, realizing the correct channel estimation with the reasonable pilot overhead has become a challenging issue, particularly for frequency division duplex (FDD) in massive MIMO systems. In this paper, by taking advantage of spatial and temporal common sparsity of massive MIMO channels in delay domain, nonorthogonal pilot design and channel estimation schemes are proposed under the frame work of structured compressive sensing (SCS) theory that considerably reduces the pilot overheads for massive MIMO FDD systems. The proposed pilot design is fundamentally different from conventional orthogonal pilot designs based on Nyquist sampling theorem. Finally, simulations have been performed to verify the performance of the proposed schemes. Compared to its conventional counterparts with fewer pilots overhead, the proposed schemes improve the performance of the system.
A Study on the Development of a Korean Metabolic Syndrome Questionnaire Using Blood Stasis Clinical Data
Authors: Kang Byoung-Kab , Jang Soobin , Ko Mi Mi , Jung Jeeyoun
Published: May 2019

Objective. The aims of this study were to extract clinical indicators related to metabolic diseases using the Blood Stasis Questionnaires I and II (BSQ-I and II) developed in 2013 and 2014, respectively, and to develop a BSQ on metabolic syndrome (BSQ-MS). Methods. A total of 2,158 patients, comprising 1,214 from 7 traditional Korean medical hospitals in 2013 and 944 from 3 traditional Korean medical hospitals in 2014, were asked to complete the BSQ-I and BSQ-II. For the 370 patients who met the metabolic syndrome criteria, reliability and validity of the BSQ-MS were assessed using Cronbach’s alpha, while prediction accuracy was determined by logistic regression. Results. The BSQ-MS included a total of 15 clinical signs and symptoms. It showed satisfactory internal consistency (Cronbach’s α coefficient=0.70) and validity, with significant differences in mean scores between the blood stasis (14.09±6.14) and non-blood stasis (9.09±5.60) subject groups. The cut-off value of BSQ-MS score was 9 points, the area under the receiver operating characteristic curve was approximately 77%, the sensitivity and specificity of the diagnostic accuracy according to the cut-off value were 82.9% and 49.7%, respectively, and the sensitivity and specificity of the prediction accuracy by logistic regression were 72.2% and 71.6%, respectively. Conclusion. These results suggest that the BSQ-MS is an appropriate instrument for estimating blood stasis in patients with metabolic syndrome, although its sensitivity for diagnosis according to the cut-off value is low.
Probiotics for Alleviating Alcoholic Liver Injury
Authors: Gu Zelin , Liu Yanlong , Hu Shumeng , You Ying , Li Wancong , Wang Yuhua
Published: May 2019

Many animal experiments and clinical trials showed that probiotics are effective for the treatment of alcoholic liver disease. Alcohol disrupts the composition of intestinal flora; probiotics modulate the gut microbiota and reverse alcohol-associated intestinal barrier dysfunction by decreasing intestinal mucosal permeability and preventing intestinal bacteria from translocating. Probiotics enhance immune responses and reduce the levels of alcohol-induced inflammatory cytokines and reactive oxygen species (ROS) production in the liver and intestine. Probiotics also increase fatty acid β-oxidation and reduce lipogenesis, combating alcohol-induced hepatic steatosis. In this review, we summarize the current knowledge regarding the mechanism of action of probiotics for reducing the effects of alcoholic liver disease.
Comparison of the Effects of Yokukansan and Yokukansankachimpihange on Glutamate Uptake by Cultured Astrocytes and Glutamate-Induced Excitotoxicity in Cultured PC12 Cells
Authors: Kawakami Zenji , Omiya Yuji , Mizoguchi Kazushige
Published: May 2019

The traditional Japanese Kampo medicine yokukansan (YKS) is effective for behavioral and psychological symptoms of dementia (BPSD) in patients with Alzheimer’s disease. As the pharmacological mechanisms, YKS is known to protect astrocytes from thiamine-deficiency (TD)-induced decreased glutamate (Glu) uptake and neuron model cells (PC 12 cells) from Glu-induced death. Yokukansankachimpihange (YKSCH) is an alternative formula to YKS, in which Citrus unshiu peel and Pinellia tuber are added to the YKS components, and is sometimes used to treat BPSD, but its pharmacological properties remain unknown. This study aims to investigate the cellular pharmacological effects of YKS and YKSCH on glutamatergic pathways, compare their efficacy, and determine the differences and similarities in the activities between these formulations. First, we examined the effects of YKS and YKSCH on Glu uptake by cultured astrocytes under TD conditions. We observed significant ameliorative effects of YKS and YKSCH on the TD-induced decrease in Glu uptake, with a 50% effective dose of 8.9 ± 1.8 μg/mL and 45.3 ± 9.2 μg/mL, respectively. Second, using cultured PC12 cells as a model for neurons, we examined the effects of YKS and YKSCH on Glu-induced cell death. We observed that YKS and YKSCH had significant inhibitory effects on Glu-induced cell death, with a 30% effective dose of 51.4 ± 20.8 μg/mL and 49.2 ± 11.0 μg/mL, respectively. Thus, while YKSCH was less effective than YKS in ameliorating the TD-induced decrease in Glu uptake by astrocytes, the two drugs showed similar inhibitory effects on Glu-induced PC12 cell death. These findings are important for understanding the differences and similarities in pharmacological actions between these drugs.
Identification and Characterization ofEscherichia coli,SalmonellaSpp.,Clostridium perfringens, andC. difficileIsolates from Reptiles in Brazil
Authors: Ramos Carolina Pantuzza , Santana Jordana Almeida , Morcatti Coura Fernanda , Xavier Rafael Gariglio Clark , Leal Carlos Augusto Gomes , Oliveira Junior Carlos Augusto , Heinemann Marcos Bryan , Lage Andrey Pereira , Lobato Francisco Carlos Faria , Silva Rodrigo Otávio Silveira
Published: May 2019

Considering the increasing popularity of reptiles as pets and their possible role as reservoirs of pathogenic microorganisms, the aim of this study was to isolateEscherichia coli, Salmonellaspp., Clostridium perfringens, andC. difficilestrains from reptiles in Brazil and to characterize the isolated strains. The characterization was based on phylogenetic typing ofE. coli, identification of virulence genes ofE. coli, C. perfringens,andC. difficile, serotyping ofSalmonellaspp., ribotyping and MLST ofC. difficileand antimicrobial susceptibility test of pathogenic strains. Cloacal swabs were collected from 76 reptiles, of which 15 were lizards, 16 chelonians, and 45 snakes, either living in captivity, in the wild, or as companion animals.E. coliwas isolated from 52 (68.4%) reptiles, of which 46 (88.4%) were characterized as phylogroup B1. The virulence factor CNF1 ofE. coliwas found in seven (9.2%) sampled animals, whereas the gene of EAST1 was found in isolates from two (2.6%) reptiles. Three isolates positive for CNF1 were resistant to cephalothin, one of which was also resistant to ciprofloxacin, trimethoprim/sulfamethoxazole, and chloramphenicol, being then classified as multidrug resistant strain (MDR).Salmonella entericawas identified in 26 (34.2%) reptiles, of which 13 belonged to the subspeciesenterica.Serotypes such asS.Mbandaka,S.Panama,S. Infantis,S.Heidelberg, andS.Anatum were identified. One isolate ofS. entericasubsp.houtenaewas resistant to cephalothin and ciprofloxacin.C. perfringenstype A was isolated from six (7.8%) animals.C. difficilewas isolated from three (3.9%) reptiles. Two of these isolates were toxigenic and classified into ribotypes/MLST 081/ST9 and 106/ST42, which have been previously reported to infect humans. In conclusion, reptiles in Brazil can harbor toxigenicC. difficileand potentially pathogenicE. coliandSalmonella entericasubsp.enterica, thus representing a risk to human and animal health.
Unique Characteristics of Prepubertal Onset Systemic Lupus Erythematosus
Authors: Abdwani R. , Abdalla E. , Al-Zakwani I.
Published: May 2019

Objectives. The aim of this study was to investigate the influence of age at disease onset on disease expression and outcomes of pediatric systemic lupus erythematosus SLE (pSLE). Methods. A total of 103 patients with pSLE from Sultan Qaboos University Hospital, Oman, were retrospectively studied. Epidemiological, clinical phenotype, disease severity, serology, treatment, and outcome were compared among the three groups using univariate statistical tests. Results. The mean disease duration of the cohort was 9.8 ± 4.7 years. The patients were divided into three groups: prepubertal onset (n=39) with mean age at diagnosis of 5.1 ± 2.0 years and pubertal disease onset (n=29) with mean age at diagnosis of 10.8 ± 1.0 years as well as postpubertal disease onset (n=35) group with mean age at diagnosis of 15.3 ± 1.6 years. The prepubertal pSLE cohort demonstrates unique characteristics with increased frequency of familial SLE (61%) of which 49% were from first-degree relatives. Similarly, this group had distinctive clinical features, which included increased renal disease in pubertal and postpubertal groups, respectively (51% vs 23% vs 20%; p=0.039). Prepubertal, similar to pubertal group, had a higher incidence of cutaneous manifestations than in the postpubertal group (74% vs 69% vs 46%; p=0.029). Laboratory features in prepubertal group were distinct with increased frequency of positive anti-cardiolipin antibodies (47%), anti-glycoprotein antibodies (42%), ANCA (62%), and low complement levels (97%) compared to pubertal and postpubertal group. The prepubertal group also has the lowest frequency of positive SSA antibodies (18%) and SSB antibodies (5.1%). The overall mean SLEDAI score in pSLE cohort was 15.6 ± 18.5. The mean SLEDAI scores among the groups showed no significance difference (p=0.110). The overall SLICC DI ≥1 was 36% with a mean damage score of 0.76 ± 1.38. No significant differences in damage index (SLICC DI ≥1) were noted among the groups. Conclusions. Distinct clinical features were identified in prepubertal onset pSLE population of Arab ethnicity. Given the high rate of consanguineous marriage and high frequency of familial SLE in this cohort, these manifestations could be explained by higher frequency of genetic factors that influence the disease pathogenesis.
Soluble Urokinase Receptor Levels in Secondary Focal Segmental Glomerulosclerosis
Authors: Sun Pingping , Yu Lei , Huang Jing , Wang Suxia , Zou Wanzhong , Yang Li , Liu Gang
Published: May 2019

Background: Soluble urokinase receptor (suPAR) has been reported to be a possible permeability factor causing primary focal segmental glomerulosclerosis (FSGS) in recent years. We investigated the plasma and urinary suPAR levels in patients with 3 common types of secondary FSGS: Alport’s syndrome (Alport-FSGS), obesity-related FSGS, and diabetic nephropathy. Methods: Fifty-two secondary FSGS patients diagnosed by kidney biopsy, including 8 with Alport-FSGS, 20 with obesity-related FSGS, and 24 with diabetic nephropathy, were enrolled in the study in the period from January 2008 to June 2014 at the Renal Division, Peking University First Hospital. Fifty-six healthy donors and 74 patients with primary FSGS, 14 with minimal-change disease, and 29 with membranous nephropathy were used as healthy controls and disease controls, respectively. Plasma and urinary suPAR concentrations were measured with commercial ELISA kits, and their correlations with clinical and pathological data were analyzed. Results: Bothplasma and urinary suPAR levels in the total secondary FSGS group were significantly higher than in healthy controls (p < 0.0001 and p< 0.001, respectively). There was no significant difference in levels of plasma and urinary suPAR in the Alport-FSGS, obesity-related FSGS, and diabetic nephropathy groups (p = 0.64 and p = 0.72, respectively). The plasma suPAR level was not correlated with estimated glomerular filtration rate and urine protein. Conclusions: The levels of plasma and urinary suPAR in patients with Alport-FSGS, obesity-related FSGS, and diabetic nephropathy were increased. Plasma suPAR might be a pathogenetic participation factor or a useful marker of glomerular diseases with FSGS-associated podocytopathy but is not necessarily a circulating permeability factor.
A Case of Acquired Amegakaryocytic Thrombocytopenia with Anti-c-mpl Autoantibody: Comparison with Idiopathic Thrombocytopenic Purpura
Authors: Son Bora , Park Hee sue , Han Hye Sook , Kim Hee Kyung , Baek Seung Woo , Yang Yaewon , Lee Ki Hyeong , Kwon Jihyun
Published: May 2019

Acquired amegakaryocytic thrombocytopenia (AAMT) is a rare disease that causes severe bleeding. The pathogenesis and treatment of AAMT have not yet been defined. We report the case of a 60-year-old woman diagnosed with AAMT, who presented with severe thrombocytopenia, gastroin­testinal bleeding, and significantly reduced bone marrow megakaryocytes. The patient was treated with methylprednisolone, cyclosporin, and intravenous immunoglobulin. After 2 weeks of treatment, her platelet count started to increase, and her bone marrow megakaryocyte count had normalized 3 months after diagnosis. At the time of diagnosis, the patient was seropositive for anti-c-mpl antibody but was seen to be seronegative once the platelet count recovered. In contrast, anti-c-mpl antibodies were not detected in the serum of 3 patients with idiopathic thrombocytopenic purpura. This case study suggests that anti-c-mpl antibody plays an important role in the development of AAMT, and that intensive immunosuppressive treatment is required for autoantibody clearance and recovery of megakaryocyte count.
Use of Complementary and Alternative Medicines among Cancer Patients: A Single-Center Study
Authors: Gras Mathilde , Vallard Alexis , Brosse Christelle , Beneton Aurélie , Sotton Sandrine , Guyotat Denis , Fournel Pierre , Daguenet Elisabeth , Magné Nicolas , Morisson Stéphanie
Published: May 2019

Purpose: It is usual for cancer patients to use complementary and alternative medicines (CAMs) and yet the literature evaluating their efficacy in cancer patients is very limited. The objective of the present study was to report on the nature, frequency of use, and patient-reported outcome of CAMs in a single-center study. Methods: All the consecutive patients treated between November 2017 and June 2018 at the Lucien Neuwirth Cancer Institute (France) were screened. Their reasons for using CAMs and their usage habits were collected. Patients evaluated their benefit. Results: Of the 209 patients screened, 200 patients were included. CAMs ranged from osteopathy, homeopathy, acupuncture, healing touch, magnetism, naturopathy, suction cups, Chinese medicine, reflexology, to hypnosis. CAMs were widely used (n = 166, 83%), the first being osteopathy (n = 99, 49.5%), the second homeopathy (n = 78, 39.0%), and finally acupuncture (n = 76, 38.0%). Whatever the CAM, high satisfaction rates were reported (median satisfaction: 61–81%). CAMs were mainly used to prevent/treat side effects of anticancer treatments (81.2% for healing touch), increase well-being (55.4% for naturopathy), improve the immune system (16.9% for homeopathy), and treat cancer (n = 3, 5.1% for homeopathy). Patients could easily consider using CAMs, as up to 50.8% would have accepted a consultation. Conclusions: The reasons for using CAMs differed among patients. They praised CAMs and kept asking for more information although there is limited evidence about their efficacy in the literature. Thus, prospective randomized controlled trials exploring the safety and efficacy of CAMs in cancer patients are needed.
Arterial Stiffness as a Risk Factor for Subclinical Coronary Artery Calcification in Predialysis Chronic Kidney Disease: From the KNOW-CKD Study
Authors: Hyun Young Youl , Kim Hyang , Oh Kook-Hwan , Ahn Curie , Park Sue K. , Chae Dong Wan , Han Seung Hyeok , Kim Yong-Soo , Lee Sung Woo , Kim Chang Seong , Lee Kyu-Beck
Published: May 2019

Background/Aims: Both arterial stiffness and coronary artery calcification (CAC) are important predictors of cardiovascular disease in the general population and in chronic kidney disease (CKD) patients. Recent studies on arterial stiffness and CAC in subjects with preserved renal function have verified the association between the two. However, the relationship is not well evaluated in CKD patients. Methods: This cross-sectional study analyzed 1,385 predialysis CKD patients from the KNOW-CKD cohort. Participants were divided into four groups according to brachial-ankle pulse wave velocity (baPWV) quartile. Coronary artery calcium scores (CACS) were assessed using cardiac computed tomography and CAC was defined as a CACS >100. Results: CAC prevalence was higher in the higher baPWV groups (6.4, 9.8, 23.7, and 43.8% for the 1st to 4th quartiles of baPWV, respectively, p < 0.001). In Tobit regression analyses that were fully adjusted for traditional and renal cardiovascular risk factors, the CACS ratio comparing the highest and lowest baPWV quartiles was 3.03 (95% CI, 1.59–6.87). Similarly, the OR for CAC in the highest baPWV quartile compared to the lowest quartile was 1.98 (95% CI, 1.09–3.60) in a fully adjusted multivariate logistic model. Results were consistent across analyses with different cutoffs for CAC or with different clinically relevant subgroups. Conclusion: Increased arterial stiffness measured by high baPWV was associated with CAC in a predialysis CKD cohort. Longitudinal studies are needed to determine the effect of arterial stiffness on the development or progression of CAC in CKD.
Improving Toothbrushing with a Smartphone App: Results of a Randomized Controlled Trial
Authors: Alkilzy Mohammad , Midani Rama , Höfer Margarita , Splieth Christian
Published: May 2019

Objectives: Performing proper toothbrushing is a complicated process for children. Therefore, the aim of this study was to investigate the effect of a smartphone app for improving manual toothbrushing via a gravitation sensor. Methods: In this prospective, controlled, single-blinded, randomized clinical trial, 49 children (mean age 5.1 ± 0.6 years, 27 female) were randomly assigned to test (n = 26) and control (n = 23) groups. All children were provided with manual toothbrushes with an integrated gravitation sensor and they received oral health instructions. Only the children of the test group got an additional smartphone app to visualize and reward proper brushing in form and time. At baseline and recalls after 6 and 12 weeks, plaque and gingival indices (QHI, PBI) were recorded for analysis between the two groups. Results: At baseline, there were no significant differences between the test and control group regarding plaque and gingival indices (QHI: 2.36 ± 0.7 and 2.42 ± 0.8; p = 0.94; PBI: 0.42 ± 0.2 and 0.47 ± 0.3; p = 0.59). At the 6- and 12-week recalls, the test group showed statistically ­significantly better oral health indices than the controls (6-week recall, QHI: 0.8 ±0.5 and 1.88 ± 0.9; p < 0.001; PBI: 0.08 ± 0.1 and 0.26 ± 0.2; p < 0.001; 12-week recall, QHI: 0.44 ± 0.5 and 1.49 ± 0.7; p < 0.001; PBI: 0.05 ± 0.18 and 0.21 ± 0.1; p < 0.001). Conclusion: The results highlight the enormous possibilities of a toothbrushing application via the smartphone, at least for medium-term oral hygiene improvement in preschool children and even after excluding the app. The long-term effect should also be investigated to exclude the expected novelty effect.
Transcultural Adaptation and Validation of the Voice Handicap Index-10 into the Serbian Language
Authors: Maksimovic Jadranka , Vukasinovic Milan , Vlajinac Hristina , Jotic Ana , Djukic Vojko , Marinkovic Jelena , Krejovic-Trivic Sanja , Milovanovic Jovica
Published: May 2019

Background: The Voice Handicap Index-10 (VHI-10) is used in clinics because of its validity and ease of use by patients. Objectives: The aim of this paper was to evaluate the internal consistency, reliability, and clinical validity of the Serbian version of the VHI-10. Method: In this cross-sectional study, we translated the original English version of the VHI-10 into Serbian, after which it was back-translated into English. The Serbian version of the VHI-10 was completed by 161 patients with voice disorders, divided into 4 groups according disease etiology (structural, neurological, functional, and inflammatory) and 73 healthy control subjects. Results: The VHI-10 internal consistency was 0.88. Spearman’s rank correlation coefficient for VHI-10 test-retest reliability was ρ = 0.991 (p< 0.001). Patients with voice disorders had higher median total VHI-10 scores compared with controls (p< 0.001). The patients’ Grade, Instability, Roughness, Breathiness, Asthenia, and Strain (GIRBAS) scale scores were significantly correlated with the VHI-10 test scores (ρ = 0,682, p < 0.001) and VHI-10 retest scores (ρ = 0.716, p < 0.001). Conclusion: The Serbian version of the VHI-10 had good validity and reliability and can be used by Serbian patients with voice disorders.
Nicht metastasiertes Nierenzellkarzinom mit Tumorthrombus: Sunitinib und Sorafenib in der neoadjuvanten Therapie
Authors: Büchler Jakob
Published: May 2019

Objectives: The purpose of this work was to investigate the effect of sorafenib or sunitinib as neoadjuvant therapy on the survival outcomes of renal cell carcinoma (RCC) with tumor thrombus. Methods: A total of 92 RCC patients with tumor thrombus were included in this 2-center retrospective research from January 2007 to December 2014. Sorafenib and sunitinib were administered as neoadjuvant therapy in 9 patients and 14 patients, respectively, and 69 patients constituted non-neoadjuvant therapy groups. The Kaplan-Meier method was used to estimate the recurrence-free survival (RFS) and overall survival (OS). Log-rank test was used to compare the survival outcomes of patients with or without neoadjuvant therapy. Results: The overall median RFS and OS time for all 92 patients were 28 months (95% CI 17-39 months) and 42 months (95% CI 30-54 months). Patients with neoadjuvant therapy had no significantly longer median RFS (30 vs. 28 months, p = 0.376) and OS (45 vs. 42 months, p = 0.702) than those without neoadjuvant therapy. Conclusions: Neoadjuvant therapy of sorafenib or sunitinib might not improve survival outcomes for high risk RCC patients with tumor thrombus. Thus, neoadjuvant therapy for RCC with tumor thrombus should be considered cautiously.
A Proposal to Redefine Pathologic Complete Remission as Endpoint following Neoadjuvant Chemotherapy in Early Breast Cancer
Authors: Dediu Mircea , Zielinski Christoph
Published: May 2019

Many analyses of the efficacy of neoadjuvant treatment (NAT) for early breast cancer including a meta-analysis derived from 10 randomized trials came to the conclusion that patients who would achieve pathologic complete response (pCR) following NAT would experience significant improvement in disease-free and overall survival (OS). Thus, pCR was proposed as a surrogate endpoint for OS, with pCR representing a robust prognostic marker for survival at an individual level. In the current analysis, we argue that OS following NAT-induced pCR might have reflected the initial prognosis of patients mainly defined – among other factors – by the initial pathological lymph node status while being largely independent on the type of administrated treatment, thus pleading against the pCR surrogacy hypothesis. We therefore propose to redefine pCR as a surrogate endpoint of NAT trials by the involvement of additional biologic parameters.