bluuebunny/crossref_metadata_2025 huggingface dataset:
Annual Research Review: Attention deficit hyperactivity disorder late birthdate effect common in both high and low prescribing international jurisdictions: a systematic review
Authors: Whitely Martin , Raven Melissa , Timimi Sami , Jureidini Jon , Phillimore John , Leo Jonathan , Moncrieff Joanna , Landman Patrick
Published: October 2018

Background

Multiple studies have found that the youngest children in a classroom are at elevated risk of being diagnosed with, or medicated for, ADHD. This systematic review was conducted to investigate whether this late birthdate effect is the norm and whether the strength of effect is related to the absolute risk of being diagnosed/medicated.

Methods

A literature search of the PubMed and ERIC databases and snowball and grey literature searching were conducted.

Results

A total of 19 studies in 13 countries covering over 15.4 million children investigating this relationship were identified. Three other studies exploring related topics were identified. The diversity of methodologies prevented a meta‐analysis. Instead a systematic review of the 22 studies was conducted.

A total of 17 of the 19 studies found that the youngest children in a school year were considerably more likely to be diagnosed and/or medicated than their older classmates. Two Danish studies found either a weak or no late birth date effect. There was no consistent relationship between per‐capita diagnosis or medication rates and the strength of the relative age effect, with strong effects reported in most jurisdictions with comparatively low rates.

Conclusions

It is the norm internationally for the youngest children in a classroom to be at increased risk of being medicated for ADHD, even in jurisdictions with relatively low prescribing rates. A lack of a strong effect in Denmark may be accounted for by the common practice of academic ‘redshirting’, where children judged by parents as immature have a delayed school start. Redshirting may prevent and/or disguise late birthdate effects and further research is warranted. The evidence of strong late birthdate effects in jurisdictions with comparatively low diagnosis/medication rates challenges the notion that low rates indicate sound diagnostic practices.
Perspectives of online surveys in dermatology
Authors: Arafa A.E. , Anzengruber F. , Mostafa A.M. , Navarini A.A.
Published: October 2018

The striking rise in the Internet utilization worldwide has led to major changes in the methods of data collection and processing. Online surveying has been used to assess different health services, explore patients’ perceptions and measure interventions. The discipline of dermatology is one of the fields that gained benefits from surveying patients and dermatologists online; however, some disadvantages such as the low response rate and participation bias were suggested. This review summarizes the applications of online surveying in dermatology and discusses the methods of enhancing response to online surveys. It also offers a guide for dermatologists to formulate their online surveys and avoid the possibility of bias. The role of social network in data collection and the concerns about anonymity and data security have been discussed.
Logics, Leaders, Lab Coats: A Multi‐Level Study on How Institutional Logics are Linked to Entrepreneurial Intentions in Academia
Authors: Klingbeil Caren , Semrau Thorsten , Ebers Mark , Wilhelm Hendrik
Published: October 2018

Situated in the context of academia, this study integrates ideas from institutional theory, person‐environment fit theory and leadership research to conceptualize and examine the cross‐level link between the organizational‐level institutional logic of research commercialization and the entrepreneurial intentions of researchers. Multi‐level analyses based on a sample of 254 researchers working for 85 research group leaders in 49 German research institutes reveal that two distinct attributes of research group leaders – that is, their track records of entrepreneurial behaviour and their entrepreneurial intentions – play a significant role in transmitting the organizational‐level logic to the individual level. We also observe a complementary interaction between organizational‐level commercialization logic and the entrepreneurial track records of leaders. We discuss how these findings advance our understanding of science commercialization through academic entrepreneurship and how they inform institutional theory and theory development in other domains of entrepreneurship research.
Changes in daily manifestations of Openness to Experience during intensive cognitive‐behavioral treatment
Authors: Forgeard Marie , Herzhoff Kathrin , Jayawickreme Eranda , Tsukayama Eli , Beard Courtney , Björgvinsson Thröstur
Published: October 2018

Objective

Research examining relationships between trait Openness to Experience, psychopathology, and well‐being has produced contradictory findings. Examining temporary manifestations of Openness may provide further insight into the interplay between Openness and symptoms in clinical populations.

Method

The present study validated a brief new measure to assess daily Openness in 271 adults (Mage = 34 years, 52% women, 83% White) taking part in 7 days of intensive treatment for acute psychopathology. Participants also completed a daily measure of depressive symptoms.

Results

Participants overall experienced a significant but small increase in daily Openness during treatment. Two latent classes best characterized initial levels and trajectories of Openness in this sample: medium/increase (86% of sample) and low/decrease (14%). Daily Openness negatively related to depressive symptoms over the entire course of treatment and at the daily level. Daily Openness, however, did not predict depressive symptoms from one day to the next (or vice versa).

Conclusions

Results of this study contribute to the scientific understanding of positive personality change during challenging life circumstances. Future research could examine whether targeting Openness as part of treatment holds clinical value. Findings are limited by this study’s short time frame and the lack of ethnoracial diversity in this sample.
Ethical conflict and moral distress in veterinary practice: A survey of North American veterinarians
Authors: Moses Lisa , Malowney Monica J. , Wesley Boyd Jon
Published: October 2018

Background

Concerns about ethical conflicts, moral distress, and burnout in veterinary practice are steadily increasing. Root causes of these problems have not been rigorously identified. Little research has been done to evaluate the existence of moral distress in North American veterinarians or to explore its impact on career sustainability and poor well‐being.

Hypothesis/Objectives

Ethical conflict and resultant moral distress are common occurrences in contemporary veterinary practice and negatively impact daily practice life, but may not be identified or labeled by veterinarians as such.

Animals

No animals were used in this study.

Methods

Mixed methods sequential explanatory design; confidential and anonymous on‐line sampling of 889 veterinarians in North America.

Results

A majority of respondents reported feeling conflict over what care is appropriate to provide. Over 70% of respondents felt that the obstacles they faced that prevented them from providing appropriate care caused them or their staff moderate to severe distress. Seventy‐nine percent of participants report being asked to provide care that they consider futile. More than 70% of participants reported no training in conflict resolution or self‐care.

Conclusions and Clinical Importance

Veterinarians report widespread ethical conflict and moral distress across many practice types and demographics. Most veterinarians have little to no training on how to decrease the impact of these problems. Ethical conflict and resulting moral distress may be an important source of stress and poor well‐being that is not widely recognized or well defined. Well‐researched and effective tools used to decrease moral distress in human healthcare could be adapted to ameliorate this problem.
A note on “raising the mandatory retirement age and its effect on long‐run income and Pay As You Go (PAYG) pensions”
Authors: Tanaka Jumpei
Published: October 2018

Fanti (2014, Metroeconomica, 65, 619–645) showed that raising the mandatory retirement age always reduces capital accumulation and may lower per young income and pension benefit, under the assumption that old labor and young labor are perfect substitutes (or equivalently, the elasticity of substitution is infinite). We reexamine his analysis by assuming that the two labors are imperfect substitutes (the elasticity of substitution is finite), and prove that his results no longer hold when the elasticity of substitution is not sufficiently high.
TIR‐NB‐LRR immune receptor SOC3 pairs with truncated TIR‐NB protein CHS1 or TN2 to monitor the homeostasis of E3 ligase SAUL1
Authors: Liang Wanwan , van Wersch Solveig , Tong Meixuezi , Li Xin
Published: October 2018

Intracellular nucleotide binding (NB) and leucine‐rich repeat (NLR) proteins function as immune receptors to recognize effectors from pathogens. They often guard host proteins that are the direct targets of those effectors. Recent findings have revealed that a typical NLR sometimes cooperates with another atypical NLR for effector recognition.

Here, by using the CRISPR/Cas9 gene editing method, knockout analysis and biochemical assays, we uncovered differential pairings of typical Toll Interleukin1 receptor (TIR) type NLR (TNL) receptor SOC3 with atypical truncated TIR‐NB (TN) proteins CHS1 or TN2 to guard the homeostasis of the E3 ligase SAUL1.

Overaccumulation of SAUL1 is monitored by the SOC3−TN2 pair, while SAUL1's disappearance is guarded by the SOC3−CHS1 pair. SOC3 forms a head‐to‐head genomic arrangement with CHS1 and TN2, indicative of transcriptional co‐regulation.

Such intricate cooperative interactions can probably enlarge the recognition spectrum and increase the functional flexibility of NLRs, which can partly explain the overwhelming occurrence of NLR gene clustering in higher plants.
Association Between Polymorphisms in Dopamine‐Related Genes and Orthopedic Pain Expression in a Chinese Elderly Population
Authors: Chu Che‐Sheng , Chu Chin‐Liang , Liang Chih‐Kuang , Lu Ti , Lin Yu‐Te , Chou Ming‐Yueh , Chow Philip Chik‐Keung
Published: October 2018

Objectives

The dopaminergic pathway plays a vital role in pain expression. Here, our aim was to investigate the effects of polymorphisms in genes encoding the dopamine active transporter (SLC6A3) and dopamine receptor D2 (DRD2) on preoperative pain expression among patients preparing for orthopedic surgery.

Methods

Chinese elderly patients scheduled for orthopedic surgery were enrolled. The VAS was used to evaluate pain intensity (score range 0 to 10; 0 = no pain; 10 = worst pain possible). Depressive symptoms were evaluated via the 15‐item Geriatric Depression Scale. DNA was isolated from venous blood samples, and single‐nucleotide polymorphisms of SLC6A3 and DRD2 were genotyped. Multiple linear regressions analyses were carried out to adjust the results for confounders.

Results

A total of 294 patients with a mean age of 73.82 ± 8.03 years were enrolled in this study. After adjustment for confounders, rs393795 in SLC6A3 showed a significant association with preoperative VAS scores. Patients with the A/A genotype reported lower mean pain scores than did those with the A/C genotype (P = 0.026). Subsequent depression‐stratified analysis of rs6276 in DRD2 revealed that patients with the A/A genotype had higher pain scores than did those with the G/G genotype (P = 0.043). No associations were found for DRD2 rs6277 in the whole study population or depression‐stratified groups.

Conclusion

Genetic variations in SLC6A3 and DRD2 may play an important role in pain expression among the elderly prior to orthopedic surgery.
A vision for future work to focus on the “M” in integrated STEM
Authors: Stohlmann Micah
Published: October 2018

The integration of science, technology, engineering, and mathematics (STEM) education has received increased attention in the last decade. This is in part because of the need for students to increase in their STEM knowledge and competencies. Research is still needed to determine effective implementation models and curriculum for integrated STEM. Mathematics in particular has not received the focus it deserves with STEM integration. This paper discusses integration of STEM subjects that has a focus on mathematics (integrated steM); including summarizing and analyzing research done in the last ten years. A s.t.e.m. (Support, Topics, Emphasis, and Mathematical content) model for integrated steM research is presented to guide future research.
Actinomadura vinacea isolated from a nonhealing cutaneous wound in a cat
Authors: Wells Bridgette , Burnum Anne L. , Armstrong Juliet , Sanchez Susan , Stanton James B. , Camus Melinda S.
Published: October 2018

A 6‐year‐old, spayed female, domestic shorthair cat was presented to the University of Georgia Veterinary Teaching Hospital for a 3‐year history of a nonhealing wound on the right tarsus. The wound temporarily resolved with medical management, but intermittently recurred when antimicrobials were discontinued. At presentation, the wound had become refractory to antimicrobial therapy. Physical examination revealed a 1 cm diameter crust along the medial aspect of the right tarsus. Proximal to the crust, were 2 non‐painful, fluctuant swollen areas that were free of drainage. Cytologic evaluation revealed atypical granulated cells, and a mesenchymal neoplasm was interpreted as a top differential diagnosis. Histopathology revealed marked, chronic, multifocal, pyogranulomatous dermatitis with abundant intralesional colonies of gram‐positive, acid‐fast‐negative, filamentous bacteria. PCR and sequencing confirmed the infection to be caused by Actinomadura vinacea.
Emotions experienced when receiving a temporary deferral: perspectives from staff and donors
Authors: Gemelli Carley N. , Thijsen Amanda , Van Dyke Nina , Masser Barbara M. , Davison Tanya E.
Published: October 2018

Background and Objectives

Temporary deferrals negatively impact on donor retention. However, little is known about why donors are deterred from returning. One unexplored area is the emotions experienced by donors when deferred. This study investigated these emotions from the perspectives of both the front‐line staff involved in applying deferrals and deferred donors themselves, with the aim of identifying which emotions impact on donors’ intention to return.

Materials and Methods

Telephone interviews were conducted with front‐line staff who apply deferrals (n = 47) to explore perceived reasons for donor non‐return following a deferral. Findings informed a survey administered to donors who had received a temporary deferral 1 day prior (n = 397). The questionnaire included items about donors’ emotional reactions to receiving the deferral and intention to re‐donate.

Results

Staff reported that donors frequently had negative emotional responses to being deferred–particularly anger, frustration and rejection. Exploratory factor analysis of 31 emotions assessed in the donor survey revealed six factors. Deferred donors’ intention to re‐donate was negatively associated with anger‐related emotions and positively associated with calm‐related emotions. The association between emotions and intention was moderated by whether the deferral was applied in‐centre or during the pre‐donation telephone call.

Conclusion

Emotional reactions to receiving a deferral impact on donors’ intention to re‐donate, particularly among those deferred in‐centre. Blood collection staff may be able to address donors’ emotional responses to help diminish the impact of being deferred on donors’ intentions to return.
High-Resolution Structural Characterization of a New Adeno-associated Virus Serotype 5 Antibody Epitope toward Engineering Antibody-Resistant Recombinant Gene Delivery Vectors
Authors: Jose Ariana , Mietzsch Mario , Smith J. Kennon , Kurian Justin , Chipman Paul , McKenna Robert , Chiorini John , Agbandje-McKenna Mavis
Published: October 2018

Biologics based on recombinant AAVs (rAAVs) are increasingly becoming attractive human gene delivery vehicles, especially after the approval of Glybera in Europe and Luxturna in the United States. However, preexisting neutralizing antibodies against the AAV capsids in a large percentage of the human population limit wide-spread utilization of these vectors. To circumvent this problem, stealth vectors must be generated that are undetectable by these antibodies. This study details the high-resolution characterization of a new antigenic region on AAV5, a vector being developed for numerous delivery applications. The structure of AAV5 complexed with HL2476, a novel antibody, was determined by cryo-EM to 3.1-Å resolution. The resolution of the density map enabled the identification of interacting residues between capsid and antibody and the determinants of neutralization. Thus, the information obtained from this study can facilitate the generation of host immune escape vectors.
Contemporary Circulating Enterovirus D68 Strains Have Acquired the Capacity for Viral Entry and Replication in Human Neuronal Cells
Authors: Brown David M. , Hixon Alison M. , Oldfield Lauren M. , Zhang Yun , Novotny Mark , Wang Wei , Das Suman R. , Shabman Reed S. , Tyler Kenneth L. , Scheuermann Richard H.
Published: October 2018

Since the EV-D68 outbreak during the summer of 2014, evidence of a causal link to a type of limb paralysis (AFM) has been mounting. In this article, we describe a neuronal cell culture model (SH-SY5Y cells) in which a subset of contemporary 2014 outbreak strains of EV-D68 show infectivity in neuronal cells, or neurotropism. We confirmed the difference in neurotropism
in vitro
using primary human neuron cell cultures and
in vivo
with a mouse paralysis model. Using the SH-SY5Y cell model, we determined that a barrier to viral entry is at least partly responsible for neurotropism. SH-SY5Y cells may be useful in determining if specific EV-D68 genetic determinants are associated with neuropathogenesis, and replication in this cell line could be used as rapid screening tool for identification of neurotropic EV-D68 strains. This may assist with better understanding of pathogenesis and epidemiology and with the development of potential therapies.
Vehicle Information Influence Degree Screening Method Based on GEP Optimized RBF Neural Network
Authors: Yang Jingfeng , Zhang Nanfeng , Li Ming , Zheng Yanwei , Wang Li , Li Yong , Yang Ji , Xiang Yifei , Luo Lufeng
Published: October 2018

Due to the continuous progress in the field of vehicle hardware, the condition that a vehicle cannot load a complex algorithm no longer exists. At the same time, with the progress in the field of vehicle hardware, a number of studies have reported exponential growth in the actual operation. To solve the problem for a large number of data transmissions in an actual operation, wireless transmission is proposed for text information (including position information) on the basis of the principles of the maximum entropy probability and the neural network prediction model combined with the optimization of the Huffman encoding algorithm, from the exchange of data to the entire data extraction process. The test results showed that the text‐type vehicle information based on a compressed algorithm to optimize the algorithm of data compression and transmission could effectively realize the data compression, achieve a higher compression rate and data transmission integrity, and after decompression guarantee no distortion. Therefore, it is important to improve the efficiency of vehicle information transmission, to ensure the integrity of information, to realize the vehicle monitoring and control, and to grasp the traffic situation in real time.
Simultaneous Transepithelial Topography-Guided Photorefractive Keratectomy and Accelerated Cross-Linking in Keratoconus: 2-Year Follow-Up
Authors: Ahmet Sibel , Ağca Alper , Yaşa Dilek , Koç Ahmet Alperen , Toğaç Mesut , Yıldırım Yusuf , Yıldız Burçin Kepez , Demirok Ahmet
Published: October 2018

Purpose. To evaluate the visual, refractive, and topographic outcomes after simultaneous topography-guided transepithelial photorefractive keratectomy (transepithelial TG-PRK) using the Amaris Excimer laser platform and accelerated corneal cross-linking (CXL) in eyes with keratoconus.Materials and Methods. Patients with 2 years of follow-up were included in this retrospective case series. Manifest refraction (MR), uncorrected (UDVA) and corrected (CDVA) distance visual acuity, corneal topography, and pachymetry were evaluated at 1, 3, 6, 12, and 24 months after surgery. The root-mean-square of total higher-order aberrations (total HOA-RMS), coma (Coma-RMS), and spherical aberration (SA-RMS) were calculated for 4- and 6-mm diameters.Results. Forty-six eyes of 46 patients were included in the study. Stromal ablation was ≤50μin all patients. MR was −3.78±3.26 preoperatively and −1.39±1.82 postoperatively. Significant improvements were seen in the UDVA and Coma-RMS values at 1 month, CDVA and total HOA-RMS values at 3 months, and SA-RMS values at 1 year compared to preoperative levels. UDVA values further improved after 2 years, compared to the 1-year values. No patient lost two or more lines and keratoconus progression was not observed in any patient.Conclusion. Simultaneous transepithelial TG-PRK and accelerated CXL resulted in significant gains in CDVA without compromising CXL efficacy.
Preliminary Evaluation of Thulium Doped Fiber Laser in Pig Model of Liver Surgery
Authors: Janeczek Maciej , Świderski Jacek , Czerski Albert , Żywicka Bogusława , Bujok Jolanta , Szymonowicz Maria , Bilewicz Ewa , Dobrzyński Maciej , Korczyński Mariusz , Chrószcz Aleksander , Rybak Zbigniew
Published: October 2018

Partial liver resection is a treatment of choice for liver tumors; the range of parenchyma excision varies from a small part of the tissue surrounding the neoplasm up to 70% of the organ. One of the major concerns during liver resection is blood loss. Thulium lasers which are characterized by the length of emission wave corresponding to a peak absorption of water create a new possibility of cutting tissues efficiently with minimal thermal damage and concurrently providing a good hemostasis control. The aim of our study was to evaluate an impact of liver transection with thulium doped fiber laser on an intraoperative bleeding and histopathological changes during postoperative period in swine model. Ten animals were subjected to open surgery partial liver resection and an incision of liver tissue with an all-fiber, diode-pumped, and continuous-wave Tm3+-doped fiber laser emitting 37.4 W of output power at ~1.94 μm wavelength. The macroscopic and histopathological evaluation was performed intraoperatively as well as 7 and 14 days after surgery. Macroscopically almost no bleeding was observed during surgery and no signs of bleeding were stated after 7 and 14 days. Histopathological analysis of the transection margin revealed a thermal damage area ranging in depth from 620.23 ± 23.82 μm on the day of surgery to 1817.70 ± 211.98 μm after 7 days. In the samples taken intraoperatively and after 7 days a superficial zone of carbonization was visibly separated from the deeper changes. After 14 days one 765.35 μm deep zone characterized by a granulation was present. In conclusion, thulium doped fiber laser is efficacious in cutting with a narrow zone of thermal injury and provides a good hemostasis during liver transection, thus being a potential tool for oncotic liver surgery.
Elevated Serum Total Bilirubin Level Is Associated with Poor Outcomes in Pediatric Patients with Sepsis-Associated Liver Injury
Authors: Cui Yun , Shan Yijun , Chen Rongxin , Wang Chunxia , Zhang Yucai
Published: October 2018

Aims. The aim of this study was to assess the prognostic value of the serum total bilirubin (TBIL) level in pediatric patients with sepsis-associated liver injury (SALI).Methods. We performed a retrospective study of patients with SALI admitted to the pediatric intensive care unit (PICU) in Shanghai Children’s Hospital between December 2012 and December 2015. Serum TBIL concentration was determined within 72 h after PICU admission.Results. Seventy-two patients with SALI were included in this study. The overall mortality rate was 36.1% (26/72). The serum levels of TBIL of patients were significantly higher in the nonsurvivor group than the survivor group.Coxregression analysis indicated that the elevated serum TBIL level within 72 hours after admission was an independent risk factor of mortality in patients with SALI. Furthermore, the area under the receiver-operating characteristic (ROC) curve (AUC) for TBIL was 0.736 (95% confidence interval (CI): 0.614–0.858,P=0.001), in which the optimal cut-off value was 64.5 μmol/L. The combined index named “TBIL” and “TBA” showed an AUC of 0.745 (0.626–0.865) for predicting the prognosis in patients with SALI. In addition, the Kaplan–Meier curve indicated that the 28-day survival rate was significantly lower in patients with higher serum TBIL levels (≥64.5 μmol/L) or higher value of TBIL and TBA (≥−0.8902).Conclusions. Elevated serum TBIL level is associated with poor outcomes in pediatric SALI.
Determinants of Change in Glycemic Status in Individuals with Prediabetes: Results from a Nationwide Cohort Study in Germany
Authors: Paprott Rebecca , Scheidt-Nave Christa , Heidemann Christin
Published: October 2018

Previous studies investigating determinants of changes in glycemic status among individuals with prediabetes mainly focused on glucose-defined prediabetes. In this study, we examined determinants of a regression to normoglycemia or a progression to diabetes among individuals with HbA1c-defined prediabetes. The study included 817 participants (18–79 years) with prediabetes (HbA1c 5.7–6.4% (39–47 mmol/mol)) at baseline. Glycemic status at follow-up was categorized as diagnosed diabetes (self-reported physician diagnosis or antidiabetic medication), undiagnosed diabetes (HbA1c ≥ 6.5% (≥48 mmol/mol)), prediabetes (as defined at baseline), and normoglycemia (HbA1c < 5.7% (<39 mmol/mol)). Determinants of glycemic changes were identified by multinomial logistic regression (OR (95% CI)), with those remaining in the prediabetic state as reference. During a mean follow-up time of 12.0 years, 33.8% of the participants reverted to normoglycemia, 7.2% progressed to undiagnosed diabetes, 12.8% progressed to diagnosed diabetes, and 46.2% remained prediabetic. Determinants of a regression to normoglycemia were female sex (male vs. female: 0.67 (0.46; 0.98)) and higher HDL cholesterol levels (1.17 (1.02; 1.35) per 10 mg/dl). Determinants of a progression to undiagnosed or diagnosed diabetes were higher values of BMI (1.10 (1.02; 1.18); 1.13 (1.06; 1.21) per kg/m2), waist circumference (1.04 (1.01; 1.07); 1.06 (1.03; 1.09) per cm), alanine aminotransferase (1.06 (1.03; 1.09); 1.07 (1.03; 1.10) per U/l), and gamma-glutamyl transferase (1.02 (1.00; 1.03); 1.03 (1.01; 1.04) per U/l). Higher age (1.04 (1.02; 1.06) per year), female sex (male vs. female: 0.56 (0.33; 0.97)), and parental history of diabetes (yes vs. no: 1.82 (1.05; 3.15)) were further associated with a progression to diagnosed diabetes, whereas higher triglyceride levels (1.03 (1.01; 1.06) per 10 mg/dl) were associated with a progression to undiagnosed diabetes. In conclusion, among the investigated determinants, potentially modifiable anthropometric and metabolic markers were associated with glycemic changes in individuals with HbA1c-defined prediabetes. The findings of this study demonstrate the need for more refined case finding strategies for diabetes prevention.
Epidermal Growth Factor Receptor Gene in Non-Small-Cell Lung Cancer: The Importance of Promoter Polymorphism Investigation
Authors: Jurišić Vladimir , Obradovic Jasmina , Pavlović Sonja , Djordjevic Nataša
Published: October 2018

Recently, epidermal growth factor receptor (EGFR) was a key molecule in investigation of lung cancer, and it was a target for a new therapeutic strategy, based on molecular analyses. In this review, we have summarized some issues considering the role of EGFR in lung cancer, its coding gene, and its promoter gene polymorphisms (SNPs) -216G/T and -191C/A in non-small-cell lung cancer (NSCLC). The position of the SNPs indicates their significant role in EGFR regulation. The accumulation of knowledge regarding SNPs lately suggests their significant and important role in the onset of carcinogenesis, the prediction of the onset of metastases, the response to therapy with TKI inhibitors, and the onset of toxic effects of the applied therapy. Based on this, we suggest further studies of the relationship of clinical significance to SNPs in patients with lung tumors.
Randomized, Double‐Blind, Placebo‐Controlled Study of Modified Erzhi Granules in the Treatment of Menopause‐Related Vulvovaginal Atrophy
Authors: Chen Ranran , Song Dianrong , Zhang Wei , Fan Guanwei , Zhao Yingqiang , Gao Xiumei
Published: October 2018

Objective. To evaluate the clinical therapeutic efficacy and safety of modified Erzhi granules (MEG) in patients with menopause‐related vulvovaginal atrophy (VVA). Methods. This randomized, double‐blind, placebo‐controlled study comprised two groups, including the treatment and control groups. Patients receive MEG and placebo for 12 weeks, respectively. Vaginal health score (VHS), vaginitis score, vaginal maturation index (VMI), female sexual function index (FSFI), and modified Kupperman Index (modified KI) were used as efficacy endpoints and assessed at baseline, 4, 8, and 12 weeks during administration, and 4 weeks after drug withdrawal. At baseline and 12 weeks, serum estradiol (E2), follicle stimulating hormone (FSH), pelvic ultrasound, breast ultrasound, and other safety parameters were measured, recording adverse events. Results. At 12 weeks, VHS, percentage of superficial cells in the vaginal epithelium and FSFI were significantly increased, while vaginitis score, percentage of basal cells in the vaginal epithelium, and modified KI were significantly decreased in comparison with baseline and control group (all P<0.05); these differences persisted for up to 4 weeks after drug withdrawal. The placebo group showed no significant change during treatment compared with baseline values (p>0.05). Serum E2 and FSH levels, endometrial thickness, and breast thickness in all patients were within the normal ranges before and after treatment, with no serious adverse reactions observed. Conclusion. MEG significantly alleviates menopause‐related vulvovaginal atrophy, with no overt adverse effects on the endometrium, breast, hepatic, and renal functions.
Prevalence of Depression and Its Associated Factors among Orphan Children in Orphanages in Ilu Abba Bor Zone, South West Ethiopia
Authors: Shiferaw Gemechu , Bacha Lemi , Tsegaye Dereje
Published: October 2018

Introduction. Orphans are the special group of children who are generally deprived and prone to develop psychiatric disorders even those reared in well-run institutions. These children and adolescents living as orphans or in stigmatized environments are vulnerable because of the loss of parent figures. The HIV/AIDS epidemic has contributed to a drastic increase in the number of orphans and vulnerable children and other causes in sub-Saharan Africa. However, little is known about the prevalence of depression and associated factors among orphanage children in areas such as Ethiopia. Objective. The aim of this study was to assess the prevalence of depression and its associated factors among orphans in Ilu Abba Bor Zone orphanages, 2016. Methods. An institutional based cross-sectional study was conducted among orphan children in orphanages at Mettu and Gore. A total of 220 orphans were included from the two orphanages and make the response rate of 98.2%. Pretested semistructured questionnaire was used for interviewing the study participants. The collected data were coded, entered into EPI-INFO 7.0. Software, and exported to SPSS version 20 for statistical analysis. The strength of association between variables was assessed using crude and Adjusted Odds Ratio by running logistic regression and the cut-off point for declaring statistical significance was P- value <0.05 or 95% confidence interval which does not contain the null value. Results. A total of 216 orphan children were interviewed with response rate of 98.2%. The overall prevalence of depression was 24.1%. The mean age of participants was 14.2 years ± 9.90 SDs and range from 11 to 17 years. Sex [Adjusted Odds Ratio = 3.29, 95% CI (1.41, 7.46)]; age [Adjusted Odds Ratio=2.09,95% CI (3.7; 5.01)]; duration of stay in foster care [Adjusted Odds Ratio= 2.08 (1.01; 8.33)]; previous physical abuse [Adjusted Odds Ratio= 3.1 (2.1; 5.06)]; having medical illness [Adjusted Odds Ratio=1.94,95% CI (2.01;3.56)]; orphan status [Adjusted Odds Ratio=2.5,95% CI (1.62; 3.56)]; and suicidal tendency [Adjusted Odds Ratio= 4.8 (3.41; 9.03)] were independent predictors of depression among orphans in orphanages. Conclusion and Recommendations. Prevalence of depression was high among orphans and this finding suggests that screening for depression and mental and psychological care should be integrated into routine health care provided to orphans and that there is a further need to establish preventive measures against depression.
Cytotoxicological Investigation of the Essential Oil and the Extracts of Cotula cinerea and Salvia verbenaca from Morocco
Authors: Guaouguaou Fatima-Ezzahrae , Bebaha Mohamed Alien Ahl , Taghzouti Khalid , Bouyahya Abdelhakim , Bakri Youssef , Dakka Nadia , Es-Safi Nour Eddine
Published: October 2018

The objective of this work was to investigate the cytotoxicological effect of the extracts (hexane, ethyl acetate, and n-butanol) of Cotula cinerea and Salvia verbenaca in addition to the essential oil of Cotula cinerea. These plants are widely used in the Moroccan traditional folk medicine. The cytotoxic effect was explored against two cancer cell lines, Vero and RD, using the colorimetric MTT assay. The obtained results showed that the cytotoxicity differed according to the used extract with an efficient effect of Cotula cinerea extracts compared to Salvia verbenaca. A potent cytotoxicity was thus observed for the Cotula cinerea hexane extract which inhibited the growth of RD cell line at the lowest IC50 value (57.21±3.43 µg/mL). This was followed by the ethyl acetate extract and the essential oil with moderate effects against RD cell line and showed IC50 values of 187.52±6.27 µg/mL and 173.05±4.46 µg/mL, respectively. On the other hand, different results were obtained and Cotula cinerea essential oil was the most cytotoxic with the lowest IC50 value (72.72±2.18 µg/mL) against Vero cell line. In the same conditions, higher concentrations were needed in the case of Salvia verbenaca extracts. The results of this study showed thus that Cotula cinerea essential oil and hexane extract showed significant cytotoxic effects against RD and Vero cell lines, respectively, and could be considered as novel source of antitumor agents. This study is expected to be beneficial for clinical and traditional applications for Cotula cinerea as a remedy against cancer and opens new perspectives for further investigations on other types of cancer cell lines.
Technetium-99 Conjugated with Methylene Diphosphonate Ameliorates Glucocorticoid Induced Osteoporosis by Inhibiting Osteoclastogenesis
Authors: Shi Lianjie , Ning Ying , Xu Liling , Li Jianhong , Zhang Xuewu
Published: October 2018

Technetium-99 conjugated with methylene diphosphonate (99Tc-MDP) is an effective anti-inflammatory drug in treating rheumatoid arthritis (RA) for over 15 years in China. However, as a special form of bisphosphonate, the antiosteoporotic effect of99Tc-MDP is unclear. We systematically investigated the effects of99Tc-MDP on cancellous and cortical bone, respectively, in glucocorticoid induced osteoporosis (GIO) animal models. Forty-eight Sprague-Dawley rats were randomly divided into six groups: blank, negative control, high dose, medium dose, low dose, and positive control groups. After dexamethasone was given to all groups except the blank group to induce osteoporosis, the rats in different groups were treated with saline, MDP, or different doses of99Tc-MDP. After treatment, all rats were sacrificed, and their tibiae and femora were analyzed with microcomputed tomography (micro-CT), histology and biomechanics. Micro-CT analyses showed that (1)99Tc-MDP reversed glucocorticoid induced bone microarchitecture destruction by increasing BV/TV, Tb.Th, and Tb.N and decreasing BS/BV, Tb.Sp, and TBPf; (2) effect of99Tc-MDP increased as its dosage increased; and (3)99Tc-MDP could improve cortical bone thickness while MDP failed to do so. Micro-CT spatial structure analysis and histology also yielded consistent results, indicating that99Tc-MDP increased trabecular number and connectivity morphologically. Secondly, biomechanics revealed that99Tc-MDP can enhance the extrinsic stiffness of bone by changing bone geometry. Finally,99Tc-MDP could inhibit osteoclastogenesis in PBMCs in human. In conclusion,99Tc-MDP exerted antiosteoporotic effect by improving both cancellous and cortical bone, as well as increasing extrinsic bone stiffness which might be attributed to the its inhibition of osteoclast differentiation. The antiosteoporotic effect of99Tc-MDP may suggest a potential clinical application for patients with GIO.
Investigating the Factors Affecting the Properties of Coral Sand Treated with Microbially Induced Calcite Precipitation
Authors: Deng Wenni , Wang Yue
Published: October 2018

Microbial‐induced carbonate precipitation (MICP) can be used to cement coral sand to improve its engineering properties to protect coastal structures. In this study, a series of laboratory tests were conducted to test the effect of the MICP method by using an ureolytic bacterium (Sporosarcina pasteurii). In order to determine the activity of bacteria, the growth properties of the microbial strain were observed under different culture conditions (different pH and temperature). The effect of partial size distribution and nutrient concentration on the soil permeability and unconfined compressive strength was then examined in coral sand. The results showed that the pH had less effect on the bacteria growth compared to temperature. The bacteria can growth well at pH over 8 and temperature higher than 20°C. The well‐degraded soil has higher unconfined compressive strength (1.91–2.61 MPa) than poor‐degraded soil (1.31 MPa). The similar trend was also found in permeability reduction. The unconfined compressive strength increased as the biocement solution concentration increased to 1 mol/L and then decreased at 1.5 mol/L.
Energy Dissipation and Local, Story, and Global Ductility Reduction Factors in Steel Frames under Vibrations Produced by Earthquakes
Authors: Reyes-Salazar Alfredo , Bojórquez Edén , Bojorquez Juan , Valenzuela-Beltran Federico , Llanes-Tizoc Mario D.
Published: October 2018

Ductility plays a central role in seismic analysis and design of steel buildings. A numerical investigation regarding the evaluation of energy dissipation, ductility, and ductility reduction factors for local, story, and global structural levels is conducted. Some steel buildings and strong motions, which were part of the SAC Steel Project, are used. Bending local ductility capacity (µLϕ) of beams can reach values of up to 20, as shown in experimental investigations. The values are larger for medium than for low‐rise buildings, reflecting the effect of the structural complexity on µLϕ. Most of the dissipated energy occurs on beams; however, resultant stresses at columns are also significantly reduced by beam yielding. A value of 1/3 is proposed for the ratio of global to local ductility; thus, if local ductility capacity is stated as the basis for the design, global ductility capacity can be calculated by using this ratio. It is implicitly assumed in seismic codes that the magnitude of the global ductility reduction factor is about 4; according to the results found in this paper, it is not justified; a value of 3 is observed to be more reasonable. According to the well‐known ratio of the ductility reduction factor to ductility, this ratio should be unity for the models under consideration; the results of this study indicate that, for global response parameters, a value of 3/4 is more appropriate and that, for local response parameters, values larger than 2 can be reached; the implication of this is that using simplified methods like the static equivalent lateral force may result in nonconservative designs from a global structural point of view, but in conservative designs from a local point of view. A value of 8 is proposed for the ratio of the global ductility reduction factor to the global normalized energy.
Incremental Prognostic Value of Right Ventricular Strain in Patients With Acute Decompensated Heart Failure
Authors: Hamada-Harimura Yoshie , Seo Yoshihiro , Ishizu Tomoko , Nishi Isao , Machino-Ohtsuka Tomoko , Yamamoto Masayoshi , Sugano Akinori , Sato Kimi , Sai Seika , Obara Kenichi , Yoshida Ikuo , Aonuma Kazutaka ,   for the ICAS-HF Investigators
Published: October 2018

Background:

Although 2-dimensional strain analyses based on speckle tracking echocardiography have been used to detect myocardial deformation, the prognostic impact of 2-dimensional strain is unclear in patients with acute decompensated heart failure (HF). We investigated whether left ventricular and right ventricular (RV) strain parameters assessed by speckle tracking echocardiography provide incremental prognostic information in hospitalized patients because of acute decompensated HF.

Methods and Results:

Six hundred eighteen patients (age, 72±13 years; 38% women; ejection fraction, 46±16%) hospitalized for acute decompensated HF underwent clinical and echocardiographic evaluation just before discharge. We performed strain analyses of left ventricular global longitudinal strain and left ventricular global circumferential strain. We also analyzed RV longitudinal strain only from the free wall (RV-fwLS) and from all segments of the RV global longitudinal strain wall by using Tomtec software. The primary composite end point was cardiovascular death and readmission for HF. There were 34.8% cardiac events during a median follow-up of 427 days. In multivariate Cox models, among echocardiographic parameters, only impaired RV-fwLS (≥−13.1%; hazard ratio, 1.51; 95% CI, 1.12–2.04;
P
=0.01) was independently associated with cardiac events. Adding RV-fwLS to clinical risk evaluation (age, New York Heart Association class III/IV, blood urea nitrogen, and brain natriuretic peptide) markedly improved prognostic utility and consequently increased net reclassification improvement by 0.30 (
P
=0.01).

Conclusions:

RV-fwLS is an independent predictor of cardiac events in acute decompensated HF and provides greater prognostic power than standard echocardiographic parameters.
Cardiovascular Phenotype of Elevated Blood Pressure Differs Markedly Between Young Males and Females
Authors: Nardin Chiara , Maki-Petaja Kaisa M. , Miles Karen L. , Yasmin  , McDonnell Barry J. , Cockcroft John R. , Wilkinson Ian B. , McEniery Carmel M. ,   on behalf of the Enigma Study Investigators*, Benedict Samantha , Dhakam Zahid , Day Lisa , Hickson Stacey , Middlemiss Jessica , Munnery Maggie , Pusalkar Pawan , Retallick Christopher , Sabit Ramsey , Sharman James , Smith Jane , Woodcock-Smith Jean , Thomas Edna , Wallace Sharon
Published: October 2018

Blood pressure (BP) in young adults predicts BP in later life. We aimed to identify metabolic, hemodynamic, and autonomic characteristics associated with raised BP in young adults and whether these differ between males and females. Three thousand one hundred forty-five healthy subjects, aged 18 to 40 years, were grouped according to sex and BP category following the recent reclassification of BP as part of American Heart Association/American College of Cardiology 2017 guidelines. All individuals undertook a lifestyle and medical history questionnaire and detailed metabolic, hemodynamic, and autonomic assessments. Stage 1 hypertension and normal BP were the most common BP phenotypes in males (29%) and females (68%), respectively. In both sexes, cardiac output was positively associated with increasing BP category (
P
<0.001 for both). Similar positive trends were observed for heart rate and stroke volume in males (
P
<0.001 for both) and heart rate in females (
P
<0.001). Unlike in males, peripheral vascular resistance, aortic pulse wave velocity, and augmentation index were significantly increased in hypertensive females (
P
<0.001 for all) compared with the other BP categories. Most heart rate variability indices decreased across the BP categories, particularly in males. In young adults, metabolic and hemodynamic abnormalities associated with hypertension are already present at the elevated BP stage and the overall phenotype differed markedly between sexes. Whereas a cardiac phenotype was associated with elevated BP and hypertension in males, a vascular phenotype, characterized by elevated peripheral vascular resistance, aortic pulse wave velocity, and augmentation index, was dominant in females.
The Ongoing Saga of Optimal Blood Pressure Level in Patients With Diabetes Mellitus and Coronary Artery Disease
Authors: Deedwania Prakash
Published: October 2018

See Article by
White et al
.
Women Who Have Ischemic Strokes Have a Higher Burden of Left Atrial Fibrosis Than Men
Authors: Fonseca Ana Catarina , Marto João Pedro , Alves Pedro N. , Inácio Nuno , Viana-Baptista Miguel , Pinho e Melo Teresa , Ferro José M. , Almeida Ana G.
Published: October 2018

Background and Purpose—

Women with atrial fibrillation (AF) have a higher risk of stroke than men who have AF. Atrial fibrosis is a marker of atrial disease that precedes the appearance of AF increasing the risk of ischemic stroke. We aimed to determine whether female sex is independently associated with left atrial fibrosis in stroke patients.

Methods—

We prospectively included a consecutive sample of ischemic stroke patients aged over 50 years of age. Late gadolinium enhancement cardiac magnetic resonance imaging was performed to quantify the severity of left atrial fibrosis and the wall pattern of its distribution. A multivariable linear regression analysis was performed to determine whether female sex was independently associated with left atrial fibrosis after adjusting for potential confounders namely AF and age.

Results—

One hundred twenty-four patients were deemed eligible; 117 patients were included (7 were excluded because of cardiomyopathy identified by cardiac magnetic resonance imaging). All had usable cardiac magnetic resonance imaging data. Fifty-three patients (45.3%) were women. Women were older and were less frequently treated with angiotensin-converting-enzyme inhibitors. Ninety-one patients had any degree of atrial fibrosis. Women had a higher percentage of atrial fibrosis than men—median (interquartile range)—18% (17) versus 10% (20). In a multivariable linear regression model adjusted for demographics, medications, AF, comorbidities, and cardiac parameters, female sex was found to be independently associated with left atrial fibrosis. Women were found to have more 4.70% of left atrial fibrosis than men (95% CI, 0.70–8.71%;
P
=0.02) after controlling for confounders.

Conclusions—

Female sex was found to be independently associated with left atrial fibrosis after controlling for confounders such as AF and age. Further studies are needed to understand if this contributes to the increased stroke risk related to AF in women compared with men.