bluuebunny/crossref_metadata_2025 huggingface dataset:
A Multiobjective Genetic Algorithm for the Localization of Optimal and Nearly Optimal Solutions Which Are Potentially Useful: nevMOGA
Authors: Pajares Alberto , Blasco Xavier , Herrero Juan M. , Reynoso-Meza Gilberto
Published: October 2018

Traditionally, in a multiobjective optimization problem, the aim is to find the set of optimal solutions, the Pareto front, which provides the decision‐maker with a better understanding of the problem. This results in a more knowledgeable decision. However, multimodal solutions and nearly optimal solutions are ignored, although their consideration may be useful for the decision‐maker. In particular, there are some of these solutions which we consider specially interesting, namely, the ones that have distinct characteristics from those which dominate them (i.e., the solutions that are not dominated in their neighborhood). We call these solutions potentially useful solutions. In this work, a new genetic algorithm called nevMOGA is presented, which provides not only the optimal solutions but also the multimodal and nearly optimal solutions nondominated in their neighborhood. This means that nevMOGA is able to supply additional and potentially useful solutions for the decision‐making stage. This is its main advantage. In order to assess its performance, nevMOGA is tested on two benchmarks and compared with two other optimization algorithms (random and exhaustive searches). Finally, as an example of application, nevMOGA is used in an engineering problem to optimally adjust the parameters of two PI controllers that operate a plant.
Aortic Arch Floating Thrombus Complicated by Distal Embolization in a Patient with Malignancy
Authors: Tigkiropoulos Konstantinos , Karamanos Dimitrios , Tympanidou Marianthi , Saratzis Nikolaos , Lazaridis Ioannis
Published: October 2018

Free floating thrombus of aortic arch in a minimally atherosclerotic or nonaneurysmal aorta is a rare disease entity which carries a potential risk of distal embolization with catastrophic consequences. We present the case of a 52-years-old patient with ovarian cancer and aortic arch floating thrombus who initially managed with low molecular weight heparin and eventually undergone surgical thrombectomy of left external iliac and common femoral artery due to acute ischemia of left lower leg.
Catestatin Induces Glucose Uptake and GLUT4 Trafficking in Adult Rat Cardiomyocytes
Authors: Gallo Maria Pia , Femminò Saveria , Antoniotti Susanna , Querio Giulia , Alloatti Giuseppe , Levi Renzo
Published: October 2018

Catestatin is a cationic and hydrophobic peptide derived from the enzymatic cleavage of the prohormone Chromogranin A. Initially identified as a potent endogenous nicotinic–cholinergic antagonist, Catestatin has recently been shown to act as a novel regulator of cardiac function and blood pressure and as a cardioprotective agent in both pre- and postconditioning through AKT-dependent mechanisms. The aim of this study is to investigate the potential role of Catestatin also on cardiac metabolism modulation, particularly on cardiomyocytes glucose uptake. Experiments were performed on isolated adult rat cardiomyocytes. Glucose uptake was assessed by fluorescent glucose incubation and confocal microscope analysis. Glut4 plasma membrane translocation was studied by immunofluorescence experiments and evaluation of the ratio peripheral vs internal Glut4 staining. Furthermore, we performed immunoblot experiments to investigate the involvement of the intracellular pathway AKT/AS160 in the Catestatin dependent Glut4 trafficking. Our results show that 10 nM Catestatin induces a significant increase in the fluorescent glucose uptake, comparable to that exerted by 100 nM Insulin. Moreover, Catestatin stimulates Glut4 translocation to plasma membrane and both AKT and AS160 phosphorylation. All these effects were inhibited by Wortmannin. On the whole, we show for the first time that Catestatin is able to modulate cardiac glucose metabolism, by inducing an increase in glucose uptake through Glut4 translocation to the plasma membrane and that this mechanism is mediated by the AKT/AS160 intracellular pathway.
Frailty in Survival Analysis of Widowhood Mortality
Authors: Ytterstad Elinor
Published: October 2018

Heterogeneity between individuals has attracted attention in the literature of survival analysis for several decades. Widowed individuals also differ; some are more frail than others and thereby have a higher risk of dying. The traditional hazard rate in a survival model is a measure of population risk and does not provide direct information on the unobservable individual risk. A frailty model is developed and applied on a large Norwegian data set of 452 788 widowed individuals. The model seemed to fit the data well, for both widowers and widows in all age groups. The random frailty term in the model is significant, meaning that widowed persons may have individual hazard rates.
An Optimization Study of Polyacrylamide-Polyethylenimine-Based Polymer Gel for High Temperature Reservoir Conformance Control
Authors: Amir Zulhelmi , Mohd Saaid Ismail , Mohamed Jan Badrul
Published: October 2018

This paper presents optimization formulation of organically crosslinked polymer gel for high temperature reservoir conformance control using response surface methodology (RSM). It is always desirable to approach an optimal polymer gel formulation study with adequate performance information related to viscosity and gelation time to minimize excessive water production. In this paper, the effects of polymer and crosslinker concentrations and their influences on gelation time and viscosity were investigated. Central composite design (CCD) was used to determine the optimized organically crosslinked polymer gel formulation. Concentrations of two main raw materials, namely, polyacrylamide (PAM) and polyethylenimine (PEI), were varied in a suitable range. This was to obtain the formulation with the desirable two vital responses, which are viscosity and gelation time. It was found that the results fitted the quadratic equation. Statistically, the quadratic model is reliable and adequate perfectly the variability of the responses obtained from the experimental data. In addition, gelation time and gel viscosity may be controlled by adjusting both polymer and crosslinker concentrations. The optimum formulated organically crosslinked polymer gel with significant desirability factor conditions was achieved at 1.5% w/v of PAM and 0.3% v/v of PEI.
Disparities in the Diagnosis of Hypertrophic Obstructive Cardiomyopathy: A Narrative Review of Current Literature
Authors: Burns Joseph , Jean-Pierre Philippe
Published: October 2018

Hypertrophic obstructive cardiomyopathy (HOCM) is a disorder of abnormal thickening of the myocardium that affects 0.2% of the population. HOCM is a frequently implicated cause of sudden cardiac death (SCD) in young athletes. In this manner, this condition has the capacity for tremendous emotional, social, financial, and medical burdens for families and communities across the country. Multiple factors including genetics and hormonal elements are believed to play a role in the development of this cardiomyopathy. HOCM is an autosomal dominant trait with variable expressivity. It is associated with several genetic changes in the myosin heavy chain genes. Current treatment includes optimization of cardiac risk factors and medical management with beta-adrenergic blockade with definitive treatment of surgical intervention to reduce cardiac workload. The demographic most likely to be diagnosed with HOCM based upon clinical registry data is Caucasian boys and men. However, a growing body of data supports increased prevalence in African American populations and percentages equal to, if not higher than, Caucasian males in Hispanic populations. Similarly, males of African American ethnicity that participate in basketball are the most likely demographic to be affected by HOCM based on the data available from the National Collegiate Athletic Association (NCAA). Further, though rates of diagnosis may be up to 1.5 times higher in males than in females, an increasing number of studies demonstrate an increased prevalence of HOCM in females, often presenting with worse symptoms and an increased incidence of disease progression. Similarly, data suggest that age of diagnosis is associated with various prognostic factors including annual mortality. In addition, consideration of the social determinants of health undoubtedly impacts the rate of diagnosis, access to care, and HOCM-related complications in underserved populations. Effective screening including auscultation and electrocardiography (EKG) with confirmatory echocardiography in these communities supports equitable surveillance and management of HOCM.
Development of IgY-Based Sandwich ELISA as a Robust Tool for Rapid Detection and Discrimination of ToxigenicVibrio cholerae
Authors: Bayat Mahdiye , Khabiri Alireza , Hemati Behzad
Published: October 2018

Background. The conventional methods for diagnosis ofVibrio choleraeare time consuming, complicated, and expensive. Development of rapid detection tests is critical for prevention and management of cholera. This study aimed to introduce two sensitive sandwich ELISAs based on avian antibodies (IgY) targeting outer membrane protein W (OmpW) and cytotoxin B (CtxB) antigens ofV. cholerae.Methods. The sequences ofompWandctxBgenes were cloned into pET28a vector.Escherichia coliBL21 (DE3) was transformed with the recombinant vectors, and gene expression was induced by IPTG. The expressed proteins were purified by affinity chromatography using Ni-NTA resins. Two groups of white Leghorn chickens were immunized by recombinant proteins, and the generated antibodies were purified from egg yolks of chickens by PEG precipitation. The antibodies were used for the development ofα-OmpW andα-CtxB ELISAs.Results. The expression and purification yielded 59 and 38 mg of recombinant OmpW and CtxB, respectively, per one liter of bacterial culture. PEG precipitation and purification of egg yolk antibodies yielded on average (±SD) 66.5 ± 1.80 and 50.9 ± 2.23 mg of purifiedα-OmpW andα-CtxB per egg, respectively. The analytical sensitivity ofα-OmpW ELISA was 103 cfu/mL ofV. choleraeand that ofα-CtxB ELISA was 33 pg/mL of recombinant cytotoxin B. The two developed ELISAs did not show any cross-reactivity to any tested bacteria grown in common conditions.Discussion. The current study is the first report on using IgY for detection ofV. cholerae. The developed ELISAs were shown to have considerable analytical sensitivity and specificity. Therefore, the assays can be one of the convenient methods for sensitive and specific detection of toxigenicV. choleraestrains in clinical and environmental samples.
Variational Problems with Partial Fractional Derivative: Optimal Conditions and Noether’s Theorem
Authors: Jiang Jun , Feng Yuqiang , Li Shougui
Published: October 2018

In this paper, the necessary and sufficient conditions of optimality for variational problems with Caputo partial fractional derivative are established. Fractional Euler-Lagrange equations are obtained. The Legendre condition and Noether’s theorem are also presented.
Klebsiella pneumoniae Orbital Cellulitis: Clinical Manifestations and Outcomes in a Tertiary Medical Center in Taiwan
Authors: Yen Chieh-Hung , Wu Shu-Ya , Liao Yi-Lin
Published: October 2018

Purpose. To report six cases of Klebsiella pneumoniae orbital cellulitis without preceding endophthalmitis. Method. Retrospective chart review. Results. We reported four females and two males admitted to our hospital for Klebsiella pneumoniae orbital cellulitis proven by computed tomographies and bacterial cultures from May 1995 to March 2017. Proptosis, conjunctival congestion, and chemosis and limitation of ocular motility were present in all six patients. Four patients had decreased visual acuities, and three of them recovered completely after treatment. The origin of the infection was sinus in four patients, skin wound in one patient, and sepsis presumably caused by a dental procedure in one patient. Three of all six patients had underlying diabetes mellitus. Two patients had orbital cellulitis before they were diagnosed of diabetes during hospital stay. Conclusion. Diabetes may be a risk factor of Klebsiella pneumoniae orbital cellulitis, especially for those of nonsinus origin.
Hypogonadotropic Hypogonadism and Kleefstra Syndrome due to a Pathogenic Variant in the EHMT1 Gene: An Underrecognized Association
Authors: Torga Ana Patricia , Hodax Juanita , Mori Mari , Schwab Jennifer , Quintos Jose Bernardo
Published: October 2018

Kleefstra syndrome is a genetic condition characterized by intellectual disability, childhood hypotonia, and facial dysmorphisms. Genital anomalies such as micropenis, cryptorchidism, and hypospadias have been reported in 30-40% of males diagnosed with the disease. However, endocrinological investigations have been limited. We describe a case of an adolescent male with Kleefstra syndrome due to a pathogenic variant in the EHMT1 gene whose workup for isolated micropenis is suggestive of a partial hypogonadotropic hypogonadism. A possible endocrine mechanism of the genital anomaly associated with Kleefstra syndrome is discussed.
Prevalence and Determinants of Significant Liver Fibrosis by Vibration-Controlled Transient Elastography in Thai Chronic Hepatitis B Patients
Authors: Sirinawasatien Apichet , Techasirioangkun Thanaya , Thongsri Siriporn
Published: October 2018

Aims. To describe the prevalence of significant liver fibrosis by ultrasound-based vibration-controlled transient elastography (VCTE; FibroScan®) and to identify the determinants of significant liver fibrosis in Thai chronic hepatitis B patients. Methods. A cross-sectional study of consecutive chronic hepatitis B patients performed VCTE and followed up at Rajavithi Hospital, Bangkok, Thailand, was conducted between 1 January, 2013, and 31 December, 2016. Liver fibrosis was defined as minimal (METAVIR F0-1) by VCTE < 7.2 kPa and significant (METAVIR F2-4) by VCTE ≥ 7.2 kPa. VCTE assessments and medical records were retrospectively reviewed. The prevalence and determinants of significant liver fibrosis were analyzed. Results. A total of 206 eligible patients were included; 120 patients (58.3%) were female. The mean age was 50 years (SD 12.4 years), and 32.5% had a body mass index ≥ 25. The prevalences of minimal (F 0-1) and significant fibrosis (F2-4) were 74.3% and 25.7%, respectively. The prevalence of hepatitis B e antigen negative (HBeAg -ve) was 83%. The median serum hepatitis B virus viral load was 4,340 IU/mL (range 20-271,883,036). Significant determinants of significant fibrosis (F2-4) were male gender (aOR 3.24 [95%CI: 1.36-7.72]) and high aspartate transaminase (AST) level (aOR 5.71 [95%CI: 2.03-16.04]). Conclusion. Around one-quarter of the Thai patients with chronic viral hepatitis B had significant liver disease defined by VCTE, requiring further evaluation for specific treatment for hepatitis B virus. Determinants of significant liver fibrosis were male gender and high AST level.
Validation of Housekeeping Genes as Reference for Reverse-Transcription-qPCR Analysis in Busulfan-Injured Microvascular Endothelial Cells
Authors: Ju Wen , Smith Alhaji Osman , Sun Tiantian , Zhao Pingping , Jiang Yan , Liu Lu , Zhang Ting , Qi Kunming , Qiao Jianlin , Xu Kailin , Zeng Lingyu
Published: October 2018

Endothelial cells (ECs) could express some important cytokines and signal molecules which play a key role in normal hematopoiesis and repopulation. Busulfan-induced vascular endothelial injury is an important feature after hematopoietic stem cell transplantation (HSCT). But the molecular mechanism of how the injured ECs affect hematopoietic reconstruction is still unknown. It is possibly through modulation of the change of some gene expression. RT-qPCR is one of the most popular methods used to accurately determine gene expression levels, based on stable reference gene (RG) selection from housekeeping genes. So our aim is to select stable RGs for more accurate measures of mRNA levels during Busulfan-induced vascular endothelial injury. In this study, 14 RGs were selected to investigate their expression stability in ECs during 72 hours of EC injury treated with Busulfan. Our results revealed extreme variation in RG stability compared by five statistical algorithms. ywhaz and alas1 were recognized as the two idlest RGs on account of the final ranking, while the two most usually used RGs (gapdh and actb) were not the most stable RGs. Next, these data were verified by testing signalling pathway genes ctnnb1, robo4, and notch1 based on the above four genes ywha, alas1, gapdh, and actb. It shows that the normalization of mRNA expression data using unstable RGs greatly affects gene fold change, which means the reliability of the biological conclusions is questionable. Based on the best RGs used, we also found that robo4 is significantly overexpressed in Busulfan-impaired ECs. In conclusion, our data reaffirms the importance of RGs selection for the valid analysis of gene expression in Busulfan-impaired ECs. And it also provides very useful guidance and basis for more accurate differential expression gene screening and future expanding biomolecule study of different drugs such as cyclophosphamide and fludarabine-injured ECs.
Pore Damage Properties and Permeability Change of Coal Caused by Freeze‐Thaw Action of Liquid Nitrogen
Authors: Li Bo , Zhang Lulu , Wei Jianping , Ren Yongjie
Published: October 2018

A laboratory test was conducted to investigate the effect of the freeze‐thaw action of liquid nitrogen on the pore structure and permeability of coal rock. First, coal rock samples with similar sound velocities and permeabilities were selected. These samples were prepared in different water saturation levels and subjected to nuclear magnetic resonance (NMR) test before and after the freeze‐thaw action. Furthermore, the freeze‐thaw cycle of liquid nitrogen, freezing time, and water saturation of coal rocks were controlled in permeability test. Results showed that the pore diameter, porosity, and permeability of the coal rocks increase after the freeze‐thaw action of liquid nitrogen. These characteristics increase further with the increase of water saturation. The fracturing mechanisms of the freeze‐thaw action of liquid nitrogen were summarized in two aspects, phase change of pore water and cold shock, and cold shock was mainly discussed. The results indicate that the effect of cold shock is still crucial at low water saturation, but it is limited by the degree of temperature drop. In general, freeze‐thaw action of liquid nitrogen can cause damage to pore structure, promote the formation of fracture networks, and consequently improve the permeability of coal rock.
The Influence of Type 1 Diabetes Mellitus on Dental Caries and Salivary Composition
Authors: Ferizi Lulëjeta , Dragidella Fatmir , Spahiu Lidvana , Begzati Agim , Kotori Vjosa
Published: October 2018

Diabetes mellitus is the most common chronic disease that affects the oral health. The aim of the study is to evaluate the dental caries, salivary flow rate, buffer capacity, and Lactobacilli in saliva in children with type 1 diabetes mellitus compared to the control group.Methods.The sample consisted of 160 children of 10 to 15 years divided into two groups: 80 children with type 1 diabetes mellitus and 80 children as a control group. Dental caries was assessed using the DMFT index for permanent dentition. Stimulated saliva was collected among all children. Salivary flow rate and buffer capacity were measured, and the colonies ofLactobacillusin saliva were determined. The observed children have answered a number of questions related to their dental visits and parents’ education. The data obtained from each group were compared statistically using the chi-square test and Mann–WhitneyU-test. The significant level was set atp<0.05.Results. DMFT in children with type 1 diabetes was significantly higher than that in the control group (p<0.001). Diabetic children have a low level of stimulated salivary flow rate compared to control children (0.86 ± 0.16 and 1.10 ± 0.14). The buffer capacity showed statistically significant differences between children with type 1 diabetes and control group (p<0.001). Also, children with type 1 diabetes had a higher count and a higher risk ofLactobacilluscompared to the control group (p<0.05andp<0.001).Conclusion. The findings we obtained showed that type 1 diabetes mellitus has an important part in children’s oral health. It appears that children with type 1 diabetes are exposed to a higher risk for caries and oral health than nondiabetic children.
Comparing Sensitivity and Specificity of Addenbrooke’s Cognitive Examination-I, III and Mini-Addenbrooke’s Cognitive Examination in Parkinson’s Disease
Authors: Lucza Tivadar , Ascherman Zsuzsanna , Kovács Márton , Makkos Attila , Harmat Márk , Juhász Annamária , Janszky József , Komoly Sámuel , Kovács Norbert , Dorn Krisztina , Karádi Kázmér
Published: October 2018

Background. Parkinson’s disease (PD) is the second most common neurodegenerative disorder characterized by numerous motor and nonmotor symptoms. Neurocognitive disorders (NCD) are one of the most troublesome problems and their diagnosis is often challenging. Methods. We compared the sensitivity and specificity of several versions of Addenbrooke Cognitive Examination (ACE, ACE-III, and Mini-ACE) on 552 subjects with PD. Normal cognition, mild and major NCD were judged in accordance with the respective criteria of the Diagnostic and Statistical Manual of Mental Disorders 5th edition. Subsequently, we applied the receiver operation characteristic (ROC) analysis in comparison of different education levels. Results. For subjects with education level 0–8 and 9–12 years, the ACE-III had the best discriminating capabilities for mild NCD (cut-off scores: 83.5 and 85.5 points, respectively), while Mini-ACE was the best for subjects having education > 12 years (cut-off score: 25.5 points). For detecting major NCD, ACE-III had the best diagnostic accuracy in all levels of education (cut-off scores: 70.5, 77.5, and 78.5 points for subjects having education level 0–8, 9–12, and >12 years, respectively). Conclusion. ACE-III and its nested version, the Mini-ACE, had the best screening abilities for detecting mild and major NCD in PD.
Physical‐Layer Channel Authentication for 5G via Machine Learning Algorithm
Authors: Chen Songlin , Wen Hong , Wu Jinsong , Chen Jie , Liu Wenjie , Hu Lin , Chen Yi
Published: October 2018

By utilizing the radio channel information to detect spoofing attacks, channel based physical layer (PHY‐layer) enhanced authentication can be exploited in light‐weight securing 5G wireless communications. One major obstacle in the application of the PHY‐layer authentication is its detection rate. In this paper, a novel authentication method is developed to detect spoofing attacks without a special test threshold while a trained model is used to determine whether the user is legal or illegal. Unlike the threshold test PHY‐layer authentication method, the proposed AdaBoost based PHY‐layer authentication algorithm increases the authentication rate with one‐dimensional test statistic feature. In addition, a two‐dimensional test statistic features authentication model is presented for further improvement of detection rate. To evaluate the feasibility of our algorithm, we implement the PHY‐layer spoofing detectors in multiple‐input multiple‐output (MIMO) system over universal software radio peripherals (USRP). Extensive experiences show that the proposed methods yield the high performance without compromising the computing complexity.
Protective Effects of Silymarin and Silibinin against DNA Damage in Human Blood Cells
Authors: Fernandes Veloso Borges Flávio , Ribeiro e Silva Carolina , Moreira Goes Wanessa , Ribeiro Godoy Fernanda , Craveiro Franco Fernanda , Hollanda Véras Jefferson , Luiz Cardoso Bailão Elisa Flávia , de Melo e Silva Daniela , Gomes Cardoso Clever , Divino da Cruz Aparecido , Chen-Chen Lee
Published: October 2018

Silymarin (SM), a standardized extract derived fromSilybum marianum(L.) Gaertn, is primarily composed of flavonolignans, with silibinin (SB) as its major active constituent. The present study aimed to evaluate the antigenotoxic activities of SM and SB using the alkaline comet assay in whole blood cells and to assess their effects on the expression of genes associated with carcinogenesis and chemopreventive processes. Different concentrations of SM or SB (1.0, 2.5, 5.0, and 7.5 mg/ml) were used in combination with the DNA damage-inducing agent methyl methanesulfonate (MMS, 800μM) to evaluate their genoprotective potential. To investigate the role of SM and SB in modulating gene expression, we performed quantitative real-time PCR (qRT-PCR) analysis of five genes that are known to be involved in DNA damage, carcinogenesis, and/or chemopreventive mechanisms. Treatment with SM or SB was found to significantly reduce the genotoxicity of MMS, upregulate the expression ofPTENandBCL2, and downregulate the expression ofBAXandABL1. We observed no significant changes inETV6expression levels following treatment with SM or SB. In conclusion, both SM and SB exerted antigenotoxic activities and modulated the expression of genes related to cell protection against DNA damage.
Usefulness of Pelvic Radiographs in the Initial Trauma Evaluation with Concurrent CT: Is Additional Radiation Exposure Necessary?
Authors: Misiura Anne K. , Nanassy Autumn D. , Urbine Jacqueline
Published: October 2018

Trauma patients in a Level I Pediatric Trauma Center may undergo CT of the abdomen and pelvis with concurrent radiograph during initial evaluation in an attempt to diagnose injury. To determine if plain digital radiograph of the pelvis adds additional information in the initial trauma evaluation when CT of the abdomen and pelvis is also performed, trauma patients who presented to an urban Level I Pediatric Trauma Center between 1 January 2010 and 7 February 2017 in whom pelvic radiograph and CT of the abdomen and pelvis were performed within 24 hours of each other were analyzed. A total of 172 trauma patients had pelvic radiograph and CT exams performed within 24 hours of each other. There were 12 cases in which the radiograph missed pelvic fractures seen on CT and 2 cases in which the radiograph suspected a fracture that was not present on subsequent CT. Furthermore, fractures in the pelvis were missed on pelvic radiographs in 12 of 35 cases identified on CT. Sensitivity of pelvic radiograph in detecting fractures seen on CT was 65.7% with a 95% confidence interval of 47.79-80.87%. Results suggest that there is no added diagnostic information gained from a pelvic radiograph when concurrent CT is also obtained, a practice which exposes the pediatric trauma patient to unnecessary radiation.
A Natural Diffusion Distance and Equivalence of Local Convergence and Local Equicontinuity for a General Symmetric Diffusion Semigroup
Authors: Goldberg Maxim J. , Kim Seonja
Published: October 2018

In this paper, we consider a general symmetric diffusion semigroup Ttft≥0 on a topological space X with a positive σ-finite measure, given, for t>0, by an integral kernel operator: Ttf(x)≜∫X‍ρt(x,y)f(y)dy. As one of the contributions of our paper, we define a diffusion distance whose specification follows naturally from imposing a reasonable Lipschitz condition on diffused versions of arbitrary bounded functions. We next show that the mild assumption we make, that balls of positive radius have positive measure, is equivalent to a similar, and an even milder looking, geometric demand. In the main part of the paper, we establish that local convergence of Ttf to f is equivalent to local equicontinuity (in t) of the family Ttft≥0. As a corollary of our main result, we show that, for t0>0, Tt+t0f converges locally to Tt0f, as t converges to 0+. In the Appendix, we show that for very general metrics D on X, not necessarily arising from diffusion, ∫X‍ρt(x,y)D(x,y)dy→0  a.e., as t→0+. R. Coifman and W. Leeb have assumed a quantitative version of this convergence, uniformly in x, in their recent work introducing a family of multiscale diffusion distances and establishing quantitative results about the equivalence of a bounded function f being Lipschitz, and the rate of convergence of Ttf to f, as t→0+. We do not make such an assumption in the present work.
Allometric Equations for Estimating Silk Oak (Grevillea robusta) Biomass in Agricultural Landscapes of Maragua Subcounty, Kenya
Authors: Owate Omamo Augustine , Mware Mugo Joseph , Kinyanjui Mwangi James
Published: October 2018

Grevillea robusta is widely interplanted with crops in Maragua subcounty, a practice that enhances biomass quantities in farmlands. However, quick tools for estimating biomass of such trees are lacking resulting in undervaluation of the farm product. This study sought to develop allometric equations for estimating tree biomass using diameter at breast height (DBH) and tree height as predictor variables. Tree biomass was computed using thirty-three (33) trees randomly selected from 12 one hectare plots established in each of the four agroecological zones (AEZs). DBH of all Grevillea robusta trees per plot was measured and three trees were selected for destructive sampling to cover the variety of tree sizes. Regression analysis was used to develop equations relating DBH/tree height to biomass based on linear, exponential, power, and polynomial functions. The polynomial and the power equations had the highest R2, lowest SEE, and MRE values, while DBH was the most suitable parameter for estimating tree biomass. The tree stem, branches, foliage, and roots biomass comprised 56.89%, 14.11%, 6.67%, and 22.32% of the total tree biomass, respectively. The mean tree biomass density (12.430±1.84 ton ha−1) showed no significant difference (p=0.09) across AEZs implying no difference in G. robusta agroforestry stocks across the AEZ. The allometric equations will support marketing of tree products by farmers and therefore better conservation and management of the tree resource.
Newer Perspectives of Mechanisms for Euglycemic Diabetic Ketoacidosis
Authors: Yu Xiaofang , Zhang Saifei , Zhang Long
Published: October 2018

Euglycemic diabetic ketoacidosis (EDKA) was considered a rare condition with its specific definition and precipitating factors. However, with the wide use of sodium glucose cotransporter 2 (SGLT-2) inhibitors, the newest class of antidiabetic agents, EDKA has come back into the spotlight. Relevant cases are increasingly being reported along with insights into the mechanism of EDKA. It seems increasingly clear that EDKA is more common than we used to believe. The SGLT-2 inhibitor-associated EDKA also indicates a necessary review of our previous understanding of “diabetic” ketoacidosis, since the SGLT-2 inhibitor predisposes patients to DKA in a “starvation” way. Actually, there are growing reports about starvation-induced ketoacidosis as well. The previously “exclusive” nomenclature and cognition of these entities need to be reexamined. That the hormonal interactions in DKA may differ from the severity of insulin deficiency also may have served in the scenario of EDKA. The SGLT-2 inhibitors are newly approved in China. The main purpose of this work is to have a better understanding of the situation and update our knowledge with a focus on the pathogenesis of EDKA.
The Microbiome and Preterm Birth: A Change in Paradigm with Profound Implications for Pathophysiologic Concepts and Novel Therapeutic Strategies
Authors: Staude Birte , Oehmke Frank , Lauer Tina , Behnke Judith , Göpel Wolfgang , Schloter Michael , Schulz Holger , Krauss-Etschmann Susanne , Ehrhardt Harald
Published: October 2018

Preterm birth poses a global challenge with a continuously increasing disease burden during the last decades. Advances in understanding the etiopathogenesis did not lead to a reduction of prematurely born infants so far. A balanced development of the host microbiome in early life is key for the maturation of the immune system and many other physiological functions. With the tremendous progress in new diagnostic possibilities, the contribution of microbiota changes to preterm birth and the acute and long-term sequelae of prematurity have come into the research focus. This review summarizes the latest advances in the understanding of microbiomes in the amniotic cavity and the female lower genital tract and how changes in microbiota structures contribute to preterm delivery. The exhibition of these highly vulnerable infants to the hostile environment in the neonatal intensive care unit necessarily entails the rapid colonization with a nonbalanced microbiome in a situation where the organism is still very prone and at an early stage of development. The global research efforts to decipher pathologic changes will pave the way to new pre- and postnatal therapeutic concepts.
Assessment of Knowledge, Attitude, and Practice about Biomedical Waste Management and Associated Factors among the Healthcare Professionals at Debre Markos Town Healthcare Facilities, Northwest Ethiopia
Authors: Deress Teshiwal , Hassen Fatuma , Adane Kasaw , Tsegaye Aster
Published: October 2018

Background. Healthcare activities restore health and save lives at the same time; however, they can generate hazardous biomedical wastes to a human being or the environment. Generation and disposal of biomedical wastes have become an emerging problem worldwide. Objective. To assess knowledge, attitude, and practice about biomedical waste management and associated factors among healthcare professionals in Debre Markos town healthcare facilities, northwest Ethiopia. Methods. A cross-sectional study was employed, and data were collected through structured self-administered questionnaire and observational checklist. Data were entered into the Epi-data 3.1 software and exported into SPSS version 20 for analysis. Bivariate and multivariate logistic regression analyses were computed. Variables with a P value of <0.05 in the multivariate logistic regression analysis were considered to explain the presence of statistically significant associations. Result. Among 296 healthcare professionals studied, 168 (56.8%), 196 (66.2%), and 229 (77.4%) had adequate knowledge, favorable attitude, and adequate practice score, respectively. Regarding associated factors, MSc and MD+ (AOR: 4, 95% CI: (1.37, 149.52)), BSc holders (AOR: 2.53, 95% CI: (1.47, 4.38)), and availability of color-coded bins (AOR: 7.68, 95% CI: (3.30, 17.89)) were identified more likely to contribute for adequate knowledge, favorable attitude, and adequate practice scores, respectively. Conclusion. The level of knowledge, attitude, and practice scores were not satisfactory. Majority of the healthcare professionals did not access biomedical waste management training. Educational level, use of visual aid, and availability of color-coded bins in the department were identified as a factor for biomedical waste management. Regular training should be given to healthcare professionals.
Robust Nonlinear Partial Least Squares Regression Using the BACON Algorithm
Authors: Kerkri Abdelmounaim , Allal Jelloul , Zarrouk Zoubir
Published: October 2018

Partial least squares regression (PLS regression) is used as an alternative for ordinary least squares regression in the presence of multicollinearity. This occurrence is common in chemical engineering problems. In addition to the linear form of PLS, there are other versions that are based on a nonlinear approach, such as the quadratic PLS (QPLS2). The difference between QPLS2 and the regular PLS algorithm is the use of quadratic regression instead of OLS regression in the calculations of latent variables. In this paper we propose a robust version of QPLS2 to overcome sensitivity to outliers using the Blocked Adaptive Computationally Efficient Outlier Nominators (BACON) algorithm. Our hybrid method is tested on both real and simulated data.
Topographic Asymmetry Indices: Correlation between Inferior Minus Superior Value and Index of Height Decentration
Authors: Wahba Sherine S. , Roshdy Maged M. , Fikry Ramy R. , Abdellatif Mona K. , Abodarahim Abdulrahman M.
Published: October 2018

Purpose. To investigate the correlation between decentration index (index of height decentration, IHD) automatically calculated by the Pentacam HR software and the manually calculated inferior minus superior (I‐S) value.Setting. Al Watany Eye Hospital, Cairo, Egypt.Methods. In a retrospective study, history taking, clinical examination, and rotating Scheimpflug camera scanning (by Oculyzer II equivalent to Pentacam HR) were done to 128 eyes: 82 normal, 24 forme fruste keratoconus FFKC (apparently normal cornea with evident keratoconus in the fellow eye), and 22 keratoconus (KC). All cases of corneal scars or previous corneal surgeries were excluded. The (I‐S) value was calculated manually from 10 points astride the horizontal meridian. The IHD is calculated automatically by the device software 1.17r119.Results. The mean (±SD) of (I‐S) value in normal, FFKC, and KC eyes were 0.30 ± 0.93, 0.11 ± 2.03, and 4.62 ± 3.89, respectively, and those of IHD were 0.008 ± 0.004, 0.011 ± 0.005, 0.066 ± 0.067, respectively. The two indices were highly correlated (p<0.0001) with a correlation coefficient (r2 = 0.874). Deduced regression formulae linking the two indices were calculated.Conclusions. The two topographic decentration indices are highly correlated. Deduced formulae were proposed linking them.
Interactions between the Cyclooxygenase Metabolic Pathway and the Renin-Angiotensin-Aldosterone Systems: Their Effect on Cardiovascular Risk, from Theory to the Clinical Practice
Authors: Gawrys Jakub , Gawrys Karolina , Szahidewicz-Krupska Ewa , Derkacz Arkadiusz , Mochol Jakub , Doroszko Adrian
Published: October 2018

Coronary artery disease (CAD) and stroke are the most common and serious long-term complications of hypertension. Acetylsalicylic acid (ASA) significantly reduces their incidence and cardiovascular mortality. The RAAS activation plays an important role in pathogenesis of CVD, resulting in increased vascular resistance, proliferation of vascular-smooth-muscle-cells, and cardiac hypertrophy. Drugs acting on the renin-angiotensin-aldosterone system (RAAS) are demonstrated to reduce cardiovascular events in population with cardiovascular disease (CVD). The cyclooxygenase inhibitors limit the beneficial effect of RAAS-inhibitors, which in turn may be important in subjects with hypertension, CAD, and congestive heart failure. These observations apply to most of nonsteroidal anti-inflammatory drugs and ASA at high doses. Nevertheless, there is no strong evidence confirming presence of similar effects of cardioprotective ASA doses. The benefit of combined therapy with low-doses of ASA is—in some cases—significantly higher than that of monotherapy. So far, the significance of ASA in optimizing the pharmacotherapy remains not fully established. A better understanding of its influence on the particular CVD should contribute to more precise identification of patients in whom benefits of ASA outweigh the complication risk. This brief review summarizes the data regarding usefulness and safety of the ASA combination with drugs acting directly on the RAAS.
Blood Lactate or Lactate Clearance: Which Is Robust to Predict the Neurological Outcomes after Cardiac Arrest? A Systematic Review and Meta-Analysis
Authors: Zhou Bao-Chun , Zhang Zheng , Zhu Jian-Jun , Liu Li-Jun , Liu Chun-Feng
Published: October 2018

Aims. Lactate and lactate clearance were supposed to be associated with cardiac arrest outcomes, but studies obtained different results. Thus, we conducted this meta-analysis to investigate the association between lactate or lactate clearance and neurological outcomes and their usefulness for prediction of neurological outcomes. Methods. We conducted a systematic search in PubMed, Web of science, EMBASE, Medline, and Google Scholar until May 1, 2018, for relevant studies. Studies reporting lactate, lactate clearance on admission, or other time points after admission associated with neurological outcomes were included in our analysis. Pooled effect date was shown as weighed mean difference (WMD) and 95% confidence interval (CI). To measure the usefulness of lactate on admission to predict neurological outcomes, we also pooled the data of diagnostic test. Results. 23 studies involving 6720 cardiac arrest (CA) patients were included. Results from our analysis indicated that patients with good neurological outcomes tended to have a lower lactate level on admission (WMD: -2.66 mmol/L, 95%CI: -3.39 to -1.93) and 12h, 24h, and 48h after admission (P<0.001). Furthermore, the pooled AUC for lactate level on admission to predict neurological outcomes was 0.77 (95%CI: 0.73-0.80). However, a significant association between lactate clearance and neurological outcomes was only found in 24h but not 12h lactate clearance rate. Conclusions. Lactate levels on admission and all time points up to 48h were associated with neurological outcomes after CA, whereas the association between lactate clearance and neurological outcomes was not so stable. Lactate was a more robust surrogate marker than lactate clearance to predict neurological outcomes after CA.
Tongue Image Database Construction Based on the Expert Opinions: Assessment for Individual Agreement and Methods for Expert Selection
Authors: Qi Zhen , Tu Li-ping , Luo Zhi-yu , Hu Xiao-juan , Zeng Ling-zhi , Jiao Wen , Ma Xu-xiang , Jing Cong-cong , Wang Wei-jian , Zhang Zhi-feng , Xu Jia-tuo
Published: October 2018

This study aims at introducing a method for individual agreement evaluation to identify the discordant raters from the experts’ group. We exclude those experts and decide the best experts selection method, so as to improve the reliability of the constructed tongue image database based on experts’ opinions. Fifty experienced experts from the TCM diagnostic field all over China were invited to give ratings for 300 randomly selected tongue images. Gwet’s AC1 (first‐order agreement coefficient) was used to calculate the interrater and intrarater agreement. The optimization of the interrater agreement and the disagreement score were put forward to evaluate the external consistency for individual expert. The proposed method could successfully optimize the interrater agreement. By comparing three experts’ selection methods, the interrater agreement was, respectively, increased from 0.53 [0.32‐0.75] for original one to 0.64 [0.39‐0.80] using method A (inclusion of experts whose intrarater agreement>0.6), 0.69 [0.63‐0.81] using method B (inclusion of experts whose disagreement score=“0”), and 0.76 [0.67‐0.83] using method C (inclusion of experts whose intrarater agreement>0.6& disagreement score=“0”). In this study, we provide an estimate of external consistency for individual expert, and the comprehensive consideration of both the internal consistency and the external consistency for each expert would be superior to either one in the tongue image construction based on expert opinions.
Function, Structure, and Transport Aspects of ZIP and ZnT Zinc Transporters in Immune Cells
Authors: Bin Bum-Ho , Seo Juyeon , Kim Sung Tae
Published: October 2018

Zinc is an important trace metal in immune systems, and zinc transporters are involved in many immune responses. Recent advances have revealed the structural and biochemical bases for zinc transport across the cell membrane, with clinical implications for the regulation of zinc homeostasis in immune cells like dendritic cells, T cells, B cells, and mast cells. In this review, we discuss the function, structure, and transport aspects of two major mammalian zinc transporter types, importers and exporters. First, Zrt-/Irt-like proteins (ZIPs) mediate the zinc influx from the extracellular or luminal side into the cytoplasm. There are 14 ZIP family members in humans. They form a homo- or heterodimer with 8 transmembrane domains and extra-/intracellular domains of various lengths. Several ZIP members show specific extracellular domains composed of two subdomains, a helix-rich domain and proline-alanine-leucine (PAL) motif-containing domain. Second, ZnT (zinc transporter) was initially identified in early studies of zinc biology; it mediates zinc efflux as a counterpart of ZIPs in zinc homeostasis. Ten family members have been identified. They show a unique architecture characterized by a Y-shaped conformation and a large cytoplasmic domain. A precise, comprehensive understanding of the structures and transport mechanisms of ZIP and ZnT in combination with mice experiments would provide promising drug targets as well as a basis for identifying other transporters with therapeutic potential.
3D Deep Learning from CT Scans Predicts Tumor Invasiveness of Subcentimeter Pulmonary Adenocarcinomas
Authors: Zhao Wei , Yang Jiancheng , Sun Yingli , Li Cheng , Wu Weilan , Jin Liang , Yang Zhiming , Ni Bingbing , Gao Pan , Wang Peijun , Hua Yanqing , Li Ming
Published: October 2018

Identification of early-stage pulmonary adenocarcinomas before surgery, especially in cases of subcentimeter cancers, would be clinically important and could provide guidance to clinical decision making. In this study, we developed a deep learning system based on 3D convolutional neural networks and multitask learning, which automatically predicts tumor invasiveness, together with 3D nodule segmentation masks. The system processes a 3D nodule-centered patch of preprocessed CT and learns a deep representation of a given nodule without the need for any additional information. A dataset of 651 nodules with manually segmented voxel-wise masks and pathological labels of atypical adenomatous hyperplasia (AAH), adenocarcinomas in situ (AIS), minimally invasive adenocarcinoma (MIA), and invasive pulmonary adenocarcinoma (IA) was used in this study. We trained and validated our deep learning system on 523 nodules and tested its performance on 128 nodules. An observer study with 2 groups of radiologists, 2 senior and 2 junior, was also investigated. We merged AAH and AIS into one single category AAH-AIS, comprising a 3-category classification in our study. The proposed deep learning system achieved better classification performance than the radiologists; in terms of 3-class weighted average F1 score, the model achieved 63.3% while the radiologists achieved 55.6%, 56.6%, 54.3%, and 51.0%, respectively. These results suggest that deep learning methods improve the yield of discriminative results and hold promise in the CADx application domain, which could help doctors work efficiently and facilitate the application of precision medicine.

Significance:

Machine learning tools are beginning to be implemented for clinical applications. This study represents an important milestone for this emerging technology, which could improve therapy selection for patients with lung cancer.