bluuebunny/crossref_metadata_2025 huggingface dataset:
Severe Agranulocytosis following Simultaneous Administration of Chlorpromazine and Trimethoprim-Sulfamethoxazole in a Patient with Sepsis: A Possible Toxic Combination
Authors: Jha Anil , Ghoz Hassan , James Nicholas
Published: October 2016

Background. Chlorpromazine and trimethoprim-sulfamethoxazole (TMP/SMX) are two commonly prescribed medications by physicians. Either of those medications could cause fatal drug-induced agranulocytosis, with an unclear underlying mechanism. The likelihood of simultaneous prescription of both medications is high and could hypothetically result in severe agranulocytosis that is resistant to treatment. Case Presentation. We are presenting a case of a patient with psychosis on chlorpromazine who was prescribed TMP/SMX for a urinary tract infection. Consequently, the patient developed severe agranulocytosis and septicemia. Patient was managed by granulocyte colony-stimulating factor; however, the time to neutrophil recovery was delayed when compared to the average reported time published by previous studies. Conclusions. Simultaneous use of chlorpromazine and TMP/SMX is a possible toxic combination that could induce severe agranulocytosis. Further reports are needed to confirm this observation.
Activation of ALDH2 with Low Concentration of Ethanol Attenuates Myocardial Ischemia/Reperfusion Injury in Diabetes Rat Model
Authors: Kang Pin-Fang , Wu Wen-Juan , Tang Yang , Xuan Ling , Guan Su-Dong , Tang Bi , Zhang Heng , Gao Qin , Wang Hong-Ju
Published: October 2016

The aim of this paper is to observe the change of mitochondrial aldehyde dehydrogenase 2 (ALDH2) when diabetes mellitus (DM) rat heart was subjected to ischemia/reperfusion (I/R) intervention and analyze its underlying mechanisms. DM rat hearts were subjected to 30 min regional ischemia and 120 min reperfusion in vitro and pretreated with ALDH2 activator ethanol (EtOH); cardiomyocyte in high glucose (HG) condition was pretreated with ALDH2 activator Alda‐1. In control I/R group, myocardial tissue structure collapse appeared. Compared with control I/R group, left ventricular parameters, SOD activity, the level of Bcl‐2/Bax mRNA, ALDH2 mRNA, and protein expressions were decreased and LDH and MDA contents were increased, meanwhile the aggravation of myocardial structure injury in DM I/R group. When DM I/R rats were pretreated with EtOH, left ventricular parameters, SOD, Bcl‐2/Bax, and ALDH2 expression were increased; LDH, MDA, and myocardial structure injury were attenuated. Compared with DM + EtOH I/R group, cyanamide (ALDH2 nonspecific blocker), atractyloside (mitoPTP opener), and wortmannin (PI3K inhibitor) groups all decreased left ventricular parameters, SOD, Bcl‐2/Bax, and ALDH2 and increased LDH, MDA, and myocardial injury. When cardiomyocyte was under HG condition, CCK‐8 activity and ALDH2 protein expression were decreased. Alda‐1 increased CCK‐8 and ALDH2. Our findings suggested enhanced ALDH2 expression in diabetic I/R rats played the cardioprotective role, maybe through activating PI3K and inhibiting mitoPTP opening.
Electroacupuncture Ameliorates Learning and Memory and Improves Synaptic Plasticity via Activation of the PKA/CREB Signaling Pathway in Cerebral Hypoperfusion
Authors: Zheng Cai-Xia , Lu Min , Guo Ya-Bi , Zhang Feng-Xia , Liu Hua , Guo Feng , Huang Xiao-Lin , Han Xiao-Hua
Published: October 2016

Electroacupuncture (EA) has shown protective effects on cognitive decline. However, the underlying molecular mechanisms are ill‐understood. The present study was undertaken to determine whether the cognitive function was ameliorated in cerebral hypoperfusion rats following EA and to investigate the role of PKA/CREB pathway. We used a rat 2‐vessel occlusion (2VO) model and delivered EA at Baihui (GV20) and Dazhui (GV14) acupoints. Morris water maze (MWM) task, electrophysiological recording, Golgi silver stain, Nissl stain, Western blot, and real‐time PCR were employed. EA significantly (1) ameliorated the spatial learning and memory deficits, (2) alleviated long‐term potentiation (LTP) impairment and the reduction of dendritic spine density, (3) suppressed the decline of phospho‐CREB (pCREB) protein, brain‐derived neurotrophic factor (BDNF) protein, and microRNA132 (miR132), and (4) reduced the increase of p250GAP protein of 2VO rats. These changes were partially blocked by a selective protein kinase A (PKA) inhibitor, N‐[2‐(p‐bromocinnamylamino)ethyl]‐5‐isoquinoline‐sulfonamide (H89), suggesting that the PKA/CREB pathway is potentially involved in the effects of EA. Moreover, any significant damage to the pyramidal cell layer of CA1 subregion was absent. These results demonstrated that EA could ameliorate learning and memory deficits and alleviate hippocampal synaptic plasticity impairment of cerebral hypoperfusion rats, potentially mediated by PKA/CREB signaling pathway.
An Anthropometric Risk Index Based on Combining Height, Weight, Waist, and Hip Measurements
Authors: Krakauer Nir Y. , Krakauer Jesse C.
Published: October 2016

Body mass index (BMI) can be considered an application of a power law model to express body weight independently of height. Based on the same power law principle, we previously introduced a body shape index (ABSI) to be independent of BMI and height. Here, we develop a new hip index (HI) whose normalized value is independent of height, BMI, and ABSI. Similar to BMI, HI demonstrates a U-shaped relationship to mortality in the Third National Health and Nutrition Examination Survey (NHANES III) population. We further develop a new anthropometric risk index (ARI) by adding log hazard ratios from separate nonlinear regressions of the four indicators, height, BMI, ABSI, and HI, against NHANES III mortality hazard. ARI far outperforms any of the individual indicators as a linear mortality predictor in NHANES III. The superior performance of ARI also holds for predicting mortality hazard in the independent Atherosclerosis Risk in Communities (ARIC) cohort. Thus, HI, along with BMI and ABSI, can capture the risk profile associated with body size and shape. These can be combined in a risk indicator that utilizes complementary information from height, weight, and waist and hip circumference. The combined ARI is promising for further research and clinical applications.
Scattering and Doppler Spectral Analysis for a Fast-Moving Target above Time-Varying Lossy Dielectric Sea Surface
Authors: Li Ke , Guo Lixin , Li Juan
Published: October 2016

A numerical electromagnetic method based on the physical optics with physical optics method (PO-PO) is employed to calculate backscattered returns from a missile-like target above sea surface. Surfaces are time-varying Monte Carlo simulations initialized as realizations of a Pierson–Moskowitz spectrum. The monostatic normalized radar cross section of composite model by the hybrid PO-PO method is calculated and compared with those by the conventional method of moments, as well as the runtime and memory requirements. The results are found to be in good agreement. The runtime shows that the hybrid PO-PO method enables large-scale time-varying Monte Carlo simulations. The numerical simulations of the Doppler spectrum from the fast-moving target above time-varying lossy dielectric sea surface are obtained, and the Doppler spectra of backscattered signals from this model are discussed for different incident angles, speed of flying target, wind speeds, incident frequencies, and target altitudes in detail. Finally, the coupling effects on Doppler spectra are analyzed. All the results are obtained at the incidence of horizontal polarization wave in this study.
Drosophila Enhancer of Rudimentary Homolog, ERH, Is a Binding Partner of RPS3, RPL19, and DDIT4, Suggesting a Mechanism for the Nuclear Localization of ERH
Authors: Tsubota Stuart I. , Phillips Anthony C.
Published: October 2016

The protein enhancer of rudimentary homolog, ERH, is a small, highly conserved protein that has been found in animals, plants, and protists. Genetic and biochemical interactions have implicated ERH in the regulation of pyrimidine biosynthesis, DNA replication, transcription, mRNA splicing, cellular proliferation, tumorigenesis, and the Notch signaling pathway. In vertebrates and insects, ERH is nuclearly localized; however, an examination of the ERH amino-acid sequence does not reveal any nuclear localization signals. In this paper we show that the first 24 amino acids contain sequences necessary and sufficient for nuclear localization. Through yeast two-hybrid screens, three new binding partners of ERH, RPS3, RPL19, and DDIT4, were identified. RPS3 was isolated from both human and Drosophila screens. These interactions suggest functions of ERH in cell growth, cancer, and DNA repair. The ERH sequences necessary for the interactions between ERH and RPS3 and RPL19 are mapped onto the same 24-amino-acid region in ERH which are necessary for nuclear localization, suggesting that ERH is localizing to the nucleus through binding to one of its DNA-binding partners, such as RPS3 or RPL19.
The Optimization Model for Interregional Power System Planning considering Carbon Emissions Trading and Renewable Energy Quota Mechanism
Authors: Ju Liwei , Tan Zhongfu , Li Huanhuan , Tan Qingkun , Zhang Xiangyu , Zhang Wei
Published: October 2016

In China, the rapid construction of ultra-high-voltage (UHV) transmission lines promotes interregional resource optimizing configuration and interregional power system planning. This paper analyzes external environment of interregional power system planning from geographical, technical, and policy environments. Then, the paper takes the minimum system investment cost as the optimization objective and constructs the optimization model of interregional power system planning considering carbon emissions trading (CET) and renewable energy quota mechanism (REQ). Finally, this paper sets base scenario, carbon emissions trading scenario, renewable energy quota mechanism scenario, and comprehensive scenario for case simulation. The results show that interregional power system planning could connect power grids in different regions, enlarge wind power consumption space, and relieve the inconformity problem between power resource and load demand. CET and REQ can increase the installed proportion of clean energy and reduce carbon dioxide emissions, but the cost of transmission lines construction and system reserve will increase correspondingly. The optimization effect of REQ on power system planning is better than CET. When they are both introduced, the power structure will reach the best, carbon dioxide emissions will achieve the minimum, and comprehensive benefits will become more balanced.
Synthesis of Cubic Phase-Co Microspheres by Mechanical Solid-State Reaction-Thermal Decomposition and Research on Its Growth Kinetics
Authors: Deng Ying , Zhang Yanhua , Peng Lingling , Jing Xiaolong , Chen Hui
Published: October 2016

Cubic phase cobalt (Co), which can be used as a key component for composite materials given its excellent ductility and internal structure, is not easy to obtain at room temperature. In this study, oxalic acid and cobalt nitrate are used as raw materials to synthesize the cobalt oxalate precursor, which has a stable structure with a five-membered chelate ring. Cobalt oxalate microspheres, having a high internal energy content, were prepared by using mechanical solid-state reaction in the presence of a surfactant, which can produce spherical micelles. The thermal decomposition of the precursor was carried out by maintaining it in a nitrogen atmosphere at 450°C for 3 h. At the end of the procedure, 100 nm cubic phase-Co microspheres, stable at room temperature, were obtained. Isothermal and nonisothermal kinetic mechanisms of cobalt grain growth were investigated. The cubic-Co grain growth activation energy, Q, was calculated in this study to be 71.47 kJ/mol. The required reaction temperature was low, making the production process simple and suitable for industrial applications.
Kinship Testing Based on SNPs Using Microarray System
Authors: Cho Sohee , Seo Hee Jin , Lee Jihyun , Yu Hyung Jin , Lee Soong Deok
Published: October 2016

Background: Kinship testing using biallelic SNP markers has been demonstrated to be a promising approach as a supplement to standard STR typing, and several systems, such as pyrosequencing and microarray, have been introduced and utilized in real forensic cases. The Affymetrix microarray containing 169 autosomal SNPs developed for forensic application was applied to our practical case for kinship analysis that had remained inconclusive due to partial STR profiles of degraded DNA and possibility of inbreeding within the population. Case Report: 169 autosomal SNPs were typed on array with severely degraded DNA of two bone samples, and the kinship compared to genotypes in a reference database of their putative family members. Results: Two bone samples remained unidentified through traditional STR typing with partial profiles of 10 or 14 of 16 alleles. Because these samples originated from a geographically isolated population, a cautious approach was required when analyzing and declaring true paternity only based on PI values. In a supplementary SNP typing, 106 and 78 SNPs were obtained, and the match candidates were found in each case with improved PI values than using only STRs and with no discrepant SNPs in comparison. Conclusion: Our case showed that the utility of multiple SNPs on array is expected in practical forensic caseworks with an establishment of reference database.
Severe Hypoxemia in a Healthy Donor for Allogeneic Hematopoietic Stem Cell Transplantation after Only the First Administration of Granulocyte-Colony Stimulating Factor
Authors: Yamamoto Keita , Doki Noriko , Senoo Yasushi , Najima Yuho , Kobayashi Takeshi , Kakihana Kazuhiko , Haraguchi Kyoko , Okuyama Yoshiki , Sakamaki Hisashi , Ohashi Kazuteru
Published: October 2016

Background: Granulocyte-colony stimulating factor (G-CSF) is widely used to mobilize peripheral blood stem cells (PBSCs) in healthy donors. A few reports have shown that some healthy donors developed acute respiratory distress syndrome or capillary leak syndrome after more than several rounds of G-CSF administration or leukapheresis. Case Report: We report the case of a healthy donor for allogeneic stem cell transplantation who developed severe hypoxemia 1 h after only the first administration of G-CSF. The donor was administered 10 μg/kg G-CSF (lenograstim) subcutaneously for PBSC mobilization. 1 h after the first administration of G-CSF, the donor suddenly presented with dry cough and dyspnea. The oxygen saturation by pulse oximetry (SpO2) in the room air was 88%. An electrocardiogram and chest radiography revealed no abnormalities. We excluded other causes of severe hypoxemia and diagnosed the donor with hypoxemia due to G-CSF administration, which was subsequently terminated. The donor was administered 2 l/min oxygen via a nasal cannula and 100 mg hydrocortisone intravenously. He subsequently recovered, and SpO2 in the room air returned to 98% 10 h after hypoxemia. Conclusion: These respiratory symptoms might be related to anaphylactoid or hypersensitivity reaction. The donors should be observed for at least 1 h after the first administration of G-CSF.
SUVmax and Tumour Location in PET-CT Predict Oncogene Status in Lung Cancer
Authors: Putora Paul M. , Szentesi Kinga , Glatzer Markus , Rodriguez Regulo , Müller Joachim , Baty Florent , Früh Martin
Published: October 2016

Background: In non-small cell lung cancer, anaplastic lymphoma kinase gene rearrangement (ALK+) and epidermal growth factor receptor mutations (EGFR+) are targetable with tyrosine kinase inhibitors. Patients and Methods: 27 patients with ALK+ tumours, who underwent positron emission tomography-computed tomography (PET-CT) prior to any treatment, were identified. 2 equally sized control groups based on consecutive patients with EGFR+ and EGFR/ALK wild-type (wt) were identified. The maximum standardized uptake value (SUVmax), tumour location (central vs. peripheral), as well as patient- and disease-specific characteristics were collected. Results: Mutation status was significantly associated with SUVmax (p < 0.008). The median SUVmax of the primary tumour in the lung for ALK+ patients (SUVmax 13) was significantly higher compared to that of the EGFR+ (SUVmax 9.8, p = 0.010) and the EGFR/ALKwt group (SUVmax 9.6, p = 0.022). No difference was observed between the EGFR+ and the EGFR/ALKwt group (p = 0.961). Mutation status was also associated with primary tumour location (p = 0.001). There was a significantly lower rate of central tumours in the EGFR+ group when compared to ALK+ tumours (15%, p = 0.002). Among EGFR/ALKwt tumours, 41% were central compared to 63% of ALK+ tumours (p = 0.235). Conclusion: On initial PET-CT, ALK+ primary lung tumours showed a higher SUVmax and were more frequently centrally located while peripheral tumours were more likely to be EGFR+.
Feasibility of a Newly Developed Thumb Control Device for Simultaneous Manipulation of the Endoscope and Treatment Devices in Endoscopic Submucosal Dissection: A Clinical Feasibility Study
Authors: Kikuchi Daisuke , Iizuka Toshiro , Yamada Akihiro , Nomura Kosuke , Kuribayashi Yasutaka , Kimura Ryusuke , Hoteya Shu , Kaise Mitsuru
Published: October 2016

Background/Aim: We developed a new device for the simultaneous manipulation of an endoscope and treatment devices, which we named the Smart Shooter®. The aim of this study was to validate the feasibility of using the Smart Shooter® in endoscopic submucosal dissection (ESD). Methods: This pilot feasibility study conducted between March and June 2014 involved 20 consecutive patients who underwent ESD for superficial gastrointestinal neoplasia. The primary endpoint was a serious adverse event during the ESD procedure. The secondary endpoints were completion rate of ESD using the Smart Shooter® and a mechanical problem with the Smart Shooter® during ESD. Results: A total of 20 patients underwent ESD for 23 lesions: 5 pharyngeal, 8 esophageal, 7 gastric, and 3 colonic lesions. There were no serious adverse events or mechanical problems during ESD. The completion rate of ESD using the Smart Shooter® was 82.6% (19/23). Conclusion: ESD using the Smart Shooter® appears to be technically feasible. Clinical trial registration: UMIN 000013710.
Spleen and Liver Stiffness Is Positively Correlated with the Risk of Esophageal Variceal Bleeding
Authors: Buechter Matthias , Kahraman Alisan , Manka Paul , Gerken Guido , Jochum Christoph , Canbay Ali , Dechêne Alexander
Published: October 2016

Background/Aims: Portal hypertension (PH) is a common complication of chronic liver disease and results in esophageal and gastric variceal bleeding, which is associated with a high mortality rate. Measurement of the hepatic venous pressure gradient (HVPG) is considered the gold standard for diagnosing PH and estimating the risk of varices and bleeding. In contrast, upper gastrointestinal (GI) endoscopy (UGE) can reliably demonstrate the presence of varices and bleeding. Both measures are invasive, and HVPG is mainly restricted to tertiary centers. Therefore, the development of noninvasive methods of assessing the severity of PH and the risk of variceal bleeding is warranted. Methods: We retrospectively examined the correlation of spleen stiffness (SSM) and liver stiffness measurements (LSM) with the incidence of variceal bleeding among 143 patients who underwent combined liver and spleen elastography between 2013 and 2015. Results: For 19 of 103 patients (16.8%), upper GI variceal bleeding was diagnosed and treated endoscopically. The median SSM of all patients was 35.3 kilopascals (kPa); the median LSM, 11.7 kPa. Patients with previous bleeding episodes had significantly higher SSM (75.0 kPa) and LSM (37.3 kPa) than those without a history of bleeding (SSM, 30.6 kPa; LSM, 8.2 kPa; p < 0.0001). Seventy-five patients (66.4%) underwent UGE in addition to SSM and LSM: 25 with no esophageal varices (EVs; SSM, 29.5 kPa; LSM, 11.4 kPa), 16 with EV grade 1 (SSM, 35.9 kPa; LSM, 33.4 kPa), 21 with EV grade 2 (SSM, 67.8 kPa; LSM, 27.0 kPa) and 13 with EV grade 3 (SSM, 75.0 kPa; LSM, 26.3 kPa). No statistically significant differences were found between respective grades of EV but were found between the presence and absence of varices. At a calculated cutoff level of 42.6 kPa (with application of 95% CI), SSM had sensitivity of 89% and specificity of 64% in determining the risk of bleeding, with a negative predictive value (NPV) of 0.97 (LSM sensitivity, 84%; LSM specificity, 80%; LSM NPV, 0.96 at LSM cutoff level of 20.8 kPa). When LSM (cutoff level, 20.8 kPa) and SSM (cutoff level, 42.6 kPa) were combined, the NPV was 1 (sensitivity, 100%; specificity, 55%). Conclusion: SSM and LSM as determined by FibroScan (a noninvasive method of detecting PH) is positively correlated with upper GI variceal bleeding (optimal SSM cutoff level, 42.6 kPa; optimal LSM cutoff level, 20.8 kPa). No patients with both SSM and LSM below cutoff levels had a history of bleeding complications.
Cardiovascular Profile of Propranolol after Multiple Dosing in Infantile Hemangioma
Authors: Salice Patrizia , Giovanni Bianchetti Mario , Giavarini Alessandra , Gondoni Erica , Cavalli Riccardo , Maria Colli Anna , Lombardi Federico
Published: October 2016

Propranolol is becoming the treatment of choice for complicated infantile hemangioma. We report here data on peripheral blood flow, O2-saturation, electrocardiographic PR-interval, left ventricular function, blood pressure and heart rate that were assessed before and during treatment for ≥4 weeks with propranolol 2 mg/kg of body weight daily in 67 infants <12 months of age in normal sinus rhythm and with structurally normal hearts. Management with propranolol was well tolerated in all and did not modify peripheral blood flow, O2-saturation, electrocardiographic PR-interval and left ventricular fractional shortening or ejection fraction. Absolute blood pressure levels were similar without and with propranolol. However, age-adjusted centile levels for both systolic and diastolic levels were significantly lower while on propranolol. The heart rate was significantly lower both when expressed as absolute value and when expressed as age-adjusted centile on treatment with propranolol. In conclusion, propranolol 2 mg/kg of body weight daily causes a statistically though not clinically relevant decrease in blood pressure and heart rate in cardially healthy infants affected by infantile hemangioma. Temporary discontinuation during acute febrile illnesses and during diarrheal diseases should be considered to prevent excessive hypotension.
There's More than Meets the Eye: Complex Associations of Daily Pain, Physical Symptoms, and Self-Efficacy with Activity in Middle and Older Adulthood
Authors: Curtis Rachel G. , Windsor Tim D. , Mogle Jacqueline A. , Bielak Allison A.M.
Published: October 2016

Background: Participation in activities is associated with a range of positive outcomes in adulthood. Research has shown that pain and physical symptoms are associated with less activity in older adults, whereas higher self-efficacy is associated with more activity. Such research tends to examine cross-sectional or long-term between-person change, limiting the opportunity to explore dynamic within-person processes that unfold over shorter time periods. Objectives: This study aimed to (1) replicate previous between-person associations of self-efficacy with engagement in activity and (2) examine whether daily variation in pain, physical symptoms, and self-efficacy corresponded with daily within-person variation in different types of activity. We predicted that participants would engage in less activity on days when they experienced more pain or physical symptoms than their average (a negative within-person association) and that participants would engage in more activity on days when self-efficacy was higher than average (a positive within-person association). Methods: This study used an online diary study to assess self- reported daily pain, physical symptoms, self-efficacy, and engagement in activity among 185 adults aged 51-84 years for up to 7 days. Multilevel modelling was used to examine whether between-person (average) and daily within-person variability in pain, physical symptoms, and self-efficacy were associated with social, physical, and mental activity. Results: In line with previous research, between-person self-efficacy was positively associated with social and physical activity. Supporting the hypotheses, within-person self-efficacy was also positively associated with social and physical activity. The results for pain and physical symptoms were less consistent. Between-person pain was positively associated with social activity. Age interactions indicated that within-person pain was negatively associated with social activity and positively associated with physical activity among older adults. Within-person physical symptoms were positively related to social and mental activity. Conclusion: Stable individual differences as well as short-term within-person variation in physical and psychological functioning are associated with day-to-day variation in activity. Between-person associations did not always reflect within-person associations (e.g., for pain). These complex associations may be influenced by a range of factors including the type of activity and how it is defined (e.g., specific activities and their difficulty), the type of physical symptoms experienced, and age.
The Course of Activities in Daily Living: Who Is at Risk for Decline after First Ever Stroke?
Authors: Wondergem Roderick , Pisters Martijn F. , Wouters Eveline J. , Olthof Nick , de Bie Rob A. , Visser-Meily Johanna M.A. , Veenhof Cindy
Published: October 2016

Background: Stroke is not only an acute disease, but for the majority of patients, it also becomes a chronic condition. There is a major concern about the long-term follow-up with respect to activities of daily living (ADL) in stroke survivors. Some patients seem to be at risk for decline after a first-ever stroke. The purpose of this study was to determine the course of ADL from 3 months after the first-ever stroke and onward and identify factors associated with decline in ADL. Methods: A systematic literature search of 3 electronic databases through June 2015 was conducted. Longitudinal studies evaluating changes in ADL from 3 months post stroke onward were included. Cohorts including recurrent strokes and transient ischemic attacks were excluded. Regarding the course of ADL, a meta-analysis was performed using random-effects model. A best evidence synthesis was performed to identify factors associated with decline in ADL. Results: Out of 10,473 publications, 28 unique studies were included. A small but significant improvement in ADL was found from 3 to 12 months post stroke (standardized mean difference (SMD) 0.17 (0.04-0.30)), which mainly seemed to occur between 3 and 6 months post stroke (SMD 0.15 (0.05-0.26)). From 1 to 3 years post stroke, no significant change was found. Five studies found a decline in ADL status over time in 12-40% of patients. Nine factors were associated with ADL decline. There is moderate evidence for being dependent in ADL and impaired motor function of the leg. Limited evidence was found associated with insurance status, living alone, age ≥80, inactive state and having impaired cognitive function, depression and fatigue with decline in ADL. Conclusion: Although on an average patients do not seem to decline in ADL for up to 3 years, there is considerable variation within the population. Some modifiable factors associated with decline in ADL were identified. However, more research is needed before patients at risk of deterioration in ADL can be identified.
Prognostic Significance of Preoperative Prognostic Nutritional Index in Epithelial Ovarian Cancer Patients Treated with Platinum-Based Chemotherapy
Authors: Miao Yi , Li Shuangdi , Yan Qin , Li Bilan , Feng Youji
Published: October 2016

Background: The aim of present study was to investigate the role of the prognostic nutritional index (PNI) used as a prognostic marker for predicting response and survival outcomes in patients with epithelial ovarian cancer (EOC) who are receiving platinum-based chemotherapy. Patients and Methods: Patients with a new diagnosis of EOC receiving postoperative platinum-based chemotherapy were identified. The PNI was calculated as 10 × serum albumin value (g/dl) + 0.005 × peripheral lymphocyte count (per mm3). Patients were divided into a platinum-resistant (P-R) group and a platinum-sensitive (P-S) group according to the chemotherapeutic response. A receiver operating characteristic (ROC) curve was used to calculate the optimal cut-off value for PNI to predict chemotherapeutic response and prognosis. Results: A total of 344 patients were enrolled. Area under the curve, sensitivity, and specificity of PIN < 45 to predict platinum resistance were: 0.688, 62.50%, and 83.47%, respectively. Patients with a lower PNI (< 45) had shorter progression-free survival (PFS) and overall survival (OS). PNI showed a significant association with PFS (hazard ratio (HR) 1.890, 95% confidence interval (CI) 1.396-2.560; p < 0.001) and OS (HR 1.747, 95% CI 1.293-2.360; p < 0.001). Conclusion: Our results suggest that PNI assessment could assist the identification of patients with a poor prognosis and has potential clinical value in predicting platinum resistance in patients with EOC.
Discordance between Lifestyle-Related Health Practices and Beliefs of People Living in Kuwait: A Community-Based Study
Authors: Alfadhli Suad , Al-Mazeedi Sabriyah , Bodner Michael E. , Dean Elizabeth
Published: October 2016

Objective: To examine the concordance between lifestyle practices and beliefs of people living in Kuwait, and between their lifestyle practices and established evidence-informed recommendations for health. Subjects and Methods: A cross-sectional interview questionnaire study was conducted using a convenience sample of 100 adults living in Kuwait (age range 19-75 years). The interview included sections on demographics, and lifestyle-related practices and beliefs related to smoking, diet/nutrition, physical activity/exercise, sleep, and stress. Diet/nutrition and physical activity/exercise benchmarks were based on international standards. Analyses included descriptive statistics and the χ2 test. Results: Beliefs about the importance of nutrition in lifestyle-related conditions were limited, and this was apparent in participants' dietary habits, e.g., low consumption of fruit/vegetables and multigrains: 16 (16%) and 9 (9%) met the recommended guidelines, respectively. Ninety-nine (99%) believed physical activity/exercise affects health overall, and 44 (44%) exercised regularly. Of the sample of 100, 20 (20%) exercised in accordance with evidence-based recommendations for maximal health. Compared with beliefs about other lifestyle-related behaviors/attributes, respondents believed nutrition contributed more than stress to heart disease, cancer, and stroke, and stress contributed more than nutrition to hypertension and diabetes. Conclusion: In this study, our findings showed a discrepancy between lifestyle-related practices and beliefs, and between each of these and evidence-based recommendations for maximal health, i.e., not smoking, several servings of fruit and vegetables and whole-grain foods daily, healthy weight, restorative sleep, and low-to-moderate stress levels.
Física em casa
Authors:   Universidade de São Paulo. Instituto de Física de São Carlos, Nunes Luis Antonio de Oliveira , Arantes Alessandra Riposati ,   Universidade de São Paulo. Instituto de Física de São Carlos
Published: October 2016

Este livro fornece material que estimule o leitor a conhecer os fascínios da eletricidade onde os conceitos complexos de Física são associados ao cotidiano.
Clinical Implications of Brief Device-Detected Atrial Tachyarrhythmias in a Cardiac Rhythm Management Device Population
Authors: Swiryn Steven , Orlov Michael V. , Benditt David G. , DiMarco John P. , Lloyd-Jones Donald M. , Karst Edward , Qu Fujian , Slawsky Mara T. , Turkel Melanie , Waldo Albert L.
Published: October 2016

Background:

The RATE Registry (Registry of Atrial Tachycardia and Atrial Fibrillation Episodes) is a prospective, outcomes-oriented registry designed to document the prevalence of atrial tachycardia and/or fibrillation (AT/AF) of any duration in patients with pacemakers and implantable cardioverter defibrillators (ICDs) and evaluate associations between rigorously adjudicated AT/AF and predefined clinical events, including stroke. The appropriate clinical response to brief episodes of AT/AF remains unclear.

Methods:

Rigorously adjudicated electrogram (EGM) data were correlated with adjudicated clinical events with logistic regression and Cox models.
Long episodes of AT/AF
were defined as episodes in which the onset and/or offset of AT/AF was not present within a single EGM recording.
Short episodes of AT/AF
were defined as episodes in which both the onset and offset of AT/AF were present within a single EGM recording.

Results:

We enrolled 5379 patients with pacemakers (N=3141) or ICDs (N=2238) at 225 US sites (median follow-up 22.9 months). There were 359 deaths. There were 478 hospitalizations among 342 patients for clinical events. We adjudicated 37 531 EGMs; 50% of patients had at least one episode of AT/AF. Patients with clinical events were more likely than those without to have long AT/AF (31.9% vs. 22.1% for pacemaker patients and 28.7% vs. 20.2% for ICD patients;
P
<0.05 for both groups). Only short episodes of AT/AF were documented in 9% of pacemaker patients and 16% of ICD patients. Patients with clinical events were no more likely than those without to have short AT/AF (5.1% vs. 7.9% for pacemaker patients and 11.5% vs. 10.4% for ICD patients;
P
=0.21 and 0.66, respectively).

Conclusions:

In the RATE Registry, rigorously adjudicated short episodes of AT/AF, as defined, were not associated with increased risk of clinical events compared with patients without documented AT/AF.

Clinical Trial Registration:

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00837798.
Selective Deletion of the Brain-Specific Isoform of Renin Causes Neurogenic Hypertension
Authors: Shinohara Keisuke , Liu Xuebo , Morgan Donald A. , Davis Deborah R. , Sequeira-Lopez Maria Luisa S. , Cassell Martin D. , Grobe Justin L. , Rahmouni Kamal , Sigmund Curt D.
Published: October 2016

The renin–angiotensin system (RAS) in the brain is a critical determinant of blood pressure, but the mechanisms regulating RAS activity in the brain remain unclear. Expression of brain renin (renin-b) occurs from an alternative promoter-first exon. The predicted translation product is a nonsecreted enzymatically active renin whose function is unknown. We generated a unique mouse model by selectively ablating the brain-specific isoform of renin (renin-b) while preserving the expression and function of the classical isoform expressed in the kidney (renin-a). Preservation of renal renin was confirmed by measurements of renin gene expression and immunohistochemistry. Surprisingly, renin-b–deficient mice exhibited hypertension, increased sympathetic nerve activity to the kidney and heart, and impaired baroreflex sensitivity. Whereas these mice displayed decreased circulating RAS activity, there was a paradoxical increase in brain RAS activity. Physiologically, renin-b–deficient mice exhibited an exaggerated depressor response to intracerebroventricular administration of losartan, captopril, or aliskiren. At the molecular level, renin-b–deficient mice exhibited increased expression of angiotensin-II type 1 receptor in the paraventricular nucleus, which correlated with an increased renal sympathetic nerve response to leptin, which was dependent on angiotensin-II type 1 receptor activity. Interestingly, despite an ablation of renin-b expression, expression of renin-a was significantly increased in rostral ventrolateral medulla. These data support a new paradigm for the genetic control of RAS activity in the brain by a coordinated regulation of the renin isoforms, with expression of renin-b tonically inhibiting expression of renin-a under baseline conditions. Impairment of this control mechanism causes neurogenic hypertension.
Hypomethylation of CYP11B2 in Aldosterone-Producing Adenoma
Authors: Yoshii Yoko , Oki Kenji , Gomez-Sanchez Celso E. , Ohno Haruya , Itcho Kiyotaka , Kobuke Kazuhiro , Yoneda Masayasu
Published: October 2016

The purpose of this study was to evaluate the DNA methylation levels of steroidogenic enzyme genes in aldosterone-producing adenoma (APA) and the effects of gene mutations in APA on the DNA methylation levels. DNA methylation array analysis was conducted using nonfunctioning adrenocortical adenoma (n=12) and APA (n=35) samples, including some with a
KCNJ5
mutation (n=21), an
ATP1A1
mutation (n=5), and without the known mutations (n=9). The quantitative polymerase chain reaction assay was performed for the detection of CYP11B2 and CYP11B1 expression levels in nonfunctioning adrenocortical adenoma and APA. We introduced the KCNJ5 T158A mutation using lentivirus delivery in the human adrenocortical 15 cell line, and analyzed the effects of the mutation on DNA methylation levels. We analyzed the 83 presumed DNA methylation sites of steroidogenic enzymes. In APA, we found 7 hypomethylated sites in
CYP11B2
and 1 hypomethylated and 6 hypermethylated sites in
CYP11B1
. There were no differences in the steroidogenic enzymes gene DNA methylation of peripheral leukocytes between nonfunctioning adrenocortical adenoma and APA. No
CYP11B2
methylation level was associated with CYP11B2 transcription levels in APA. All methylation sites, except for a CYP11B2 region, showed no difference among APAs with or without gene mutations. Human adrenocortical 15 cells with the KCNJ5 mutation showed no changes in
CYP11B2
or
CYP11B1
methylation levels compared with control cells. We demonstrated that
CYP11B2
in APA was extensively hypomethylated, and
CYP11B2
methylation in the region with hypomethylation was not induced by
KCNJ5
or
ATP1A1
mutations that cause aldosterone overproduction in APA and a
KCNJ5
mutation human adrenocortical 15 cells.
Use of Chronic Oral Anticoagulation and Associated Outcomes Among Patients Undergoing Percutaneous Coronary Intervention
Authors: Secemsky Eric A. , Butala Neel M. , Kartoun Uri , Mahmood Sadiqa , Wasfy Jason H. , Kennedy Kevin F. , Shaw Stanley Y. , Yeh Robert W.
Published: October 2016

Background

Contemporary rates of oral anticoagulant (
OAC
) therapy and associated outcomes among patients undergoing percutaneous coronary intervention (
PCI
) have been poorly described.

Methods and Results

Using data from an integrated health care system from 2009 to 2014, we identified patients on
OAC
s within 30 days of
PCI
. Outcomes included in‐hospital bleeding and mortality. Of 9566
PCI
s, 837 patients (8.8%) were on
OAC
s, and of these, 7.9% used non–vitamin K antagonist agents.
OAC
use remained stable during the study (8.1% in 2009, 9.0% in 2014;
P
=0.11), whereas use of non–vitamin K antagonist agents in those on
OAC
s increased (0% in 2009, 16% in 2014;
P
<0.01). Following
PCI
,
OAC
‐treated patients had higher crude rates of major bleeding (11% versus 6.5%;
P
<0.01), access‐site bleeding (2.3% versus 1.3%;
P
=0.017), and non–access‐site bleeding (8.2% versus 5.2%;
P
<0.01) but similar crude rates of in‐hospital stent thrombosis (0.4% versus 0.3%;
P
=0.85), myocardial infarction (2.5% versus 3.0%;
P
=0.40), and stroke (0.48% versus 0.52%;
P
=0.88). In addition, prior to adjustment,
OAC
‐treated patients had longer hospitalizations (3.9±5.5 versus 2.8±4.6 days;
P
<0.01), more transfusions (7.2% versus 4.2%;
P
<0.01), and higher 90‐day readmission rates (22.1% versus 13.1%;
P
<0.01). In adjusted models,
OAC
use was associated with increased risks of in‐hospital bleeding (odds ratio 1.50;
P
<0.01), 90‐day readmission (odds ratio 1.40;
P
<0.01), and long‐term mortality (hazard ratio 1.36;
P
<0.01).

Conclusions

Chronic
OAC
therapy is frequent among contemporary patients undergoing
PCI
. After adjustment for potential confounders,
OAC
‐treated patients experienced greater in‐hospital bleeding, more readmissions, and decreased long‐term survival following
PCI
. Efforts are needed to reduce the occurrence of adverse events in this population.
A Temporary Protection Regime in Line with International Law: Utopia or Real Possibility?
Authors: Ineli-Ciger Meltem
Published: October 2016

Temporary protection has long been a state response to mass influx situations offering persons seeking refuge immediate protection from refoulement and basic minimum treatment. Today, temporary protection is still relevant: Since 2011, Syrians in Turkey have been protected under a temporary protection regime. Despite this relevance, there is no structured legal framework regulating temporary protection at an international level. Furthermore, conformity of temporary protection regimes with the Refugee Convention, international law and human rights is largely undefined and unsettled. This article takes a step towards clarifying the relationship between temporary protection and international law by discussing whether states can implement a temporary protection regime which does not undermine the Refugee Convention, deprive temporarily protected persons of their basic human rights and lead to premature forced return of the protected persons. Building on the premise that such a temporary protection regime would be in line with international law, this article provides guidance to states on how they should regulate rights and entitlements of the temporarily protected persons, maximum time limit of protection and withdrawal of temporary protection.
Continuing Bonds in the Tōhoku Disaster Area
Authors: Horie Norichika
Published: October 2016

This paper is a report of qualitative and quantitative research on “continuing bonds” between the bereaved and the deceased in the areas affected by the Great East Japan Earthquake. The disaster victims recount that it is normal for them to have conversations with the deceased, and that maintaining continuing bonds with the deceased makes them feel better. Communities of grief, within which stories about the deceased are shared, have emerged among the bereaved. There appear to be two types of representation of, and relationship with, the dead: namely, as “familiar spirits” and “unfamiliar spirits.” The closeness of relationships within a community decides which type is dominant. Many victims consider their connection to the deceased to be stronger than their connection to the priests who facilitate these bonds. Finally, based on these findings, this paper examines how religious specialists have been engaged in spiritual care, and whether such care will be successful as a post-secular activity under the conditions of “recovery secularism.”
“Religious Revival” in the Political World in Contemporary Japan with Special Reference to Religious Groups and Political Parties
Authors: Date Kiyonobu
Published: October 2016

In the 1960s, the basic structure of linked religious organisations and political parties was formed, as can be seen from the rise of Kōmeitō, a political party founded by Sōka Gakkai, and the creation of the Shintō Political Association (SPA). In the 1970s, when Japan was undergoing high economic growth, the social status of Sōka Gakkai members was elevated, although the expansion of the group came to a halt. After Kōmeitō formed a coalition government with the Liberal Democratic Party (LDP) in the 1990s, the supporters for each party came to play complementary roles. Seeing the active involvement of these religious organisations in politics—though with a varying degree of media exposure—it is possible to say that public religion has reappeared in Japanese society. However, I would like to argue that this is not a sign of post-secular “religious revival.” It is rather the “depoliticisation” among Japanese people that makes the presence of religious organisations seem more conspicuous. This paper aims to redraw the configuration of religion and politics in postwar Japan chiefly by examining the relationship between the SPA and the LDP, and that between Sōka Gakkai and Kōmeitō.
Introducing Chaplaincy to Japanese Society
Authors: Kasai Kenta
Published: October 2016

This paper examines the meaning of the introduction of Clinical Pastoral Education (CPE) to Japan, as an example of one of the religious activities accepted in public space in a secular Japanese society. For over half a century, Christian clerics have tried to introduce the idea of chaplaincy to Japan, and Buddhists have attempted to develop a Buddhist form of hospice palliative care. The Japan Society for Spiritual Care was established in 2007 and began an accreditation process of ecumenically designed “spiritual caregivers,” bringing interested parties together in Japan for education, peer support, and continuous training in spiritual care. The outpouring of national grief in response to accidents or natural disasters encouraged sponsors to create CPE training institutions at some universities. Challenging the Japanese understanding of the separation of religion and state, the introduction of chaplaincy can be seen as a case of religious practice that is accepted in public space.
Study of the type material of Navicula egregia Hustedt and descriptions of two new aerial Microcostatus (Bacillariophyta) species from Central Europe
Authors: STANEK-TARKOWSKA JADWIGA , WETZEL CARLOS E. , NOGA TERESA , ECTOR LUC
Published: October 2016

The genus Microcostatus was described for the first time by Johansen & Sray in 1998. They established a new genus in the family Naviculaceae for Navicula krasskei. Subsequently, Lange-Bertalot proposed the transfer of further species from the genus Navicula to the Microcostatus. Species determination is very difficult using light microscopy since species are small and very similar to each other, and only ultrastructural features allow their placement in the genus. The aim of this paper was to describe morphologically and ecologically two new species of the genus Microcostatus from aerial habitats in Germany and Poland and compare their morphologies with the original gathering of Navicula egregia. Polish material was collected once a month from April to November 2013 at two sampling sites located in cultivated fields. For comparison, German original material from the Hustedt Collection was also observed. During this study, Microcostatus aerophilus sp. nov. and M. edaphicus sp. nov. were described, and M. egregius was also illustrated and discussed in detail. The species mentioned are very similar to each other under light microscopy. They differ slightly in dimension and number of striae. Only SEM observations showed morphological differences, such as the presence of conopeum or pseudoconopeum.