bluuebunny/crossref_metadata_2025 huggingface dataset:
The association between dietary zinc intake and risk of pancreatic cancer: a meta-analysis
Authors: Li Li , Gai Xuesong
Published: April 2017

Previous reports have suggested a potential association on dietary zinc intake with the risk of pancreatic cancer. Since the associations between different studies were controversial, we therefore conducted a meta-analysis to reassess the relationship between dietary zinc intake and pancreatic cancer risk. A comprehensive search from the databases of PubMed, Embase, Web of Science, and Medline was performed until January 31, 2017. Relative risk (RR) with 95% confidence intervals (CI) derived by using random effect model was used. Sensitivity analysis and publication bias were conducted. Our meta-analysis was based on seven studies involving 1659 cases, including two prospective cohort studies and five case–control studies. The total RR of pancreatic cancer risk for the highest versus the lowest categories of dietary zinc intake was 0.798 (0.621–0.984), with its significant heterogeneity among studies (I2=58.2%, P=0.026). The average Newcastle–Ottawa scale (NOS) score was 7.29, suggesting a high quality. There was no publication bias in the meta-analysis about dietary zinc intake on the risk of pancreatic cancer. Subgroup analyses showed that dietary zinc intake could reduce the risk of pancreatic cancer in case–control studies and among American populations. In conclusion, we found that highest category of dietary zinc intake can significantly reduce the risk of pancreatic cancer, especially among American populations.
Can't you hear me knocking: contact-dependent competition and cooperation in bacteria
Authors: Jones Allison M. , Low David A. , Hayes Christopher S.
Published: April 2017

Microorganisms are in constant competition for growth niches and environmental resources. In Gram-negative bacteria, contact-dependent growth inhibition (CDI) systems link the fate of one cell with its immediate neighbor through touch-dependent, receptor-mediated toxin delivery. Though discovered for their ability to confer a competitive growth advantage, CDI systems also play significant roles in intersibling cooperation, promoting both auto-aggregation and biofilm formation. In this review, we detail the mechanisms of CDI toxin delivery and consider how toxin exchange between isogenic sibling cells could regulate gene expression.
Phage therapy: awakening a sleeping giant
Authors: Roach Dwayne R. , Debarbieux Laurent
Published: April 2017

For a century, bacterial viruses called bacteriophages have been exploited as natural antibacterial agents. However, their medicinal potential has not yet been exploited due to readily available and effective antibiotics. After years of extensive use, both properly and improperly, antibiotic-resistant bacteria are becoming more prominent and represent a worldwide public health threat. Most importantly, new antibiotics are not progressing at the same rate as the emergence of resistance. The therapeutic modality of bacteriophages, called phage therapy, offers a clinical option to combat bacteria associated with diseases. Here, we discuss traditional phage therapy approaches, as well as how synthetic biology has allowed for the creation of designer phages for new clinical applications. To implement these technologies, several key aspects and challenges still need to be addressed, such as narrow spectrum, safety, and bacterial resistance. We will summarize our current understanding of how phage treatment elicits mammalian host immune responses, as well bacterial phage resistance development, and the potential impact each will have on phage therapy effectiveness. We conclude by discussing the need for a paradigm shift on how phage therapy strategies are developed.
Phage therapy: an alternative or adjunct to antibiotics?
Authors: McCallin Shawna , Brüssow Harald
Published: April 2017

Phage therapy is currently discussed as an alternative or adjunct to antibiotics whose activity is increasingly compromised by the emergence of antibiotic-resistant bacterial pathogens. The idea to use lytic bacterial viruses as antimicrobial agents is nearly a century old and is common practice in Eastern Europe. However, safety concerns and lack of controlled clinical trials proving the efficacy of phage therapy have hampered its wider medical use in the West. The present review analyzes safety aspects and compares successful with unsuccessful phage therapy clinical trials to identify potential factors determining success and failure of this approach.
Intra‐body microwave communication through adipose tissue
Authors: Asan Noor Badariah , Noreland Daniel , Hassan Emadeldeen , Redzwan Mohd Shah Syaiful , Rydberg Anders , Blokhuis Taco J. , Carlsson Per‐Ola , Voigt Thiemo , Augustine Robin
Published: April 2017

The human body can act as a medium for the transmission of electromagnetic waves in the wireless body sensor networks context. However, there are transmission losses in biological tissues due to the presence of water and salts. This Letter focuses on lateral intra‐body microwave communication through different biological tissue layers and demonstrates the effect of the tissue thicknesses by comparing signal coupling in the channel. For this work, the authors utilise the R‐band frequencies since it overlaps the industrial, scientific and medical radio (ISM) band. The channel model in human tissues is proposed based on electromagnetic simulations, validated using equivalent phantom and ex‐vivo measurements. The phantom and ex‐vivo measurements are compared with simulation modelling. The results show that electromagnetic communication is feasible in the adipose tissue layer with a low attenuation of ∼2 dB per 20 mm for phantom measurements and 4 dB per 20 mm for ex‐vivo measurements at 2 GHz. Since the dielectric losses of human adipose tissues are almost half of ex‐vivo tissue, an attenuation of around 3 dB per 20 mm is expected. The results show that human adipose tissue can be used as an intra‐body communication channel.
Improved output feedback controller design for the super‐lift re‐lift Luo converter
Authors: Jiang Wentao , Chincholkar Satyajit Hemant , Chan Chok‐You
Published: April 2017

In this study, the development of an improved output feedback controller for the positive output (P/O) super‐lift re‐lift Luo converter is presented. The main feature of the proposed controller is that despite the non‐minimum phase obstacle presented by the boost‐type dc–dc converter, the output voltage is regulated directly. Moreover, the structure of the proposed controller is such that it is insensitive to the load variations and there is no risk of saturation in the control law due to division by zero. The stability analysis of the closed‐loop controlled system is provided and the feasibility of the proposed controller is shown. The feasibility analysis shows that the ‘remaining dynamics’ for the controlled converter has only one equilibrium point which is always stable. Finally, some simulations as well as experimental results are also provided to illustrate the features of the proposed feedback control strategy.
Structural proprieties of the Al–Al4C3 nanocomposite produced via mechanical alloying and annealing
Authors: Bendoumia Meriem , Triaa Salim , Azzaz Mohamed
Published: April 2017

The Al–Al4C3 nanocomposite was produced via mechanical alloying of Al 6 wt% C mixture for a predetermined time (up to 20 h), followed by annealing. The structural evolution was characterised via X‐ray diffraction and transmission electron microscope equipped with electron energy loss spectrometer. In addition, focused ion beam–scanning electron microscopy was used for locating and analysing the reinforcing particles. During milling, the size of aluminium particles reached the nanometre scale with a 54 nm size. After annealing, carbide was homogeneously distributed in the nanostructured aluminium particles with an average size of 50 nm, result in an average hardness of 320 HV. This was observed for the powder that was mechanically milled for 20 h and that underwent annealing from room temperature to 540°C and was maintained at this temperature for 4 h.
Radial Column Excision and Four-Corner Fusion for the Treatment of Basal Thumb Arthritis and Scapholunate Advanced Collapse Wrist or Midcarpal Arthritis
Authors: Mandaleson Avanthi , Wagels Michael , Tham Stephen
Published: April 2017

Background The combination of trapeziometacarpal arthritis and intercarpal pattern of degenerative wrist arthritis is uncommon.

Purpose To report on the clinical and radiologic results of patients who have undergone radial column excision (scaphoidectomy and trapeziectomy) (RCE) and four-corner fusion (4CF). We describe the patterns of disease that present with basal thumb and midcarpal arthritis and treatment outcomes of a single-surgeon series.

Patients and Methods A consecutive series of seven patients underwent RCE and 4CF over a 2-year period, for basal thumb osteoarthritis with concurrent degenerative midcarpal wrist arthritis. Six patients were available for review. All six patients were women with a mean age of 73 years (range: 67–78; SD 4.6). Mean follow-up time was 48.2 months (34–59 months). Radiographic and clinical outcomes were recorded for all patients, to include wrist range of motion, key pinch, grip strength, and patient-rated wrist evaluation (PRWE).

Results There were no failures or revision procedures. The mean range of motion was flexion of 40 degrees (range: 30–40 degrees), extension of 30 degrees (range: 20–42 degrees), radial deviation of 18 degrees (range: 10–30 degrees), and ulnar deviation of 15 degrees (range: 0–25 degrees). The mean key pinch was 4.2 kg (range: 0.5–10, SD ± 3.5) and mean grip strength was 9.4 kg (range: 0–19, SD ± 8.9). The PRWE results in four patients were within normal values.

Conclusion RCE with 4CF resulted in acceptable clinical outcomes in four of six patients treated, with no failures at a mean follow-up of 48.2 months.

Level of Evidence Level IV, therapeutic study.
Analysis of CYP1B1 Gene Mutations in Patients with Primary Congenital Glaucoma
Authors: Chouiter Leila , Nadifi Sellama
Published: April 2017

Primary congenital glaucoma (PCG) is the most common type of infantile glaucoma, yet it remains a relatively rare disease, because the disease is often transmitted in an autosomal recessive pattern. However, PCG occurs up to 10 times more frequently in certain ethnic and geographical groups where consanguineous relationships are common. The aim of this study was to investigate the distribution of mutations in the cytochrome P450 1B1 gene (CYP1B1) in patients with PCG among different populations around the world from 2011 until May 2016. We referred to the electronic databases, such as Medline, Clinicalkey, Scopus, and ScienceDirect, to search for articles that were published in this area. Nineteen records were included in this qualitative synthesis. CYP1B1 mutations were assessed in 1,220 patients with PCG and identified in 41.6% of them. According to these studies, 99 mutations including 60 novel mutations were found. Nonsignificant difference in the sex ratio has been reported. This current review shows that consanguinity plays an important role in the PCG pathogenesis and transmission; however, sporadic mutations have been found in some cases. A difference in penetrance was highlighted by some mutations. The CYP1B1 mutations were mostly found in the Middle East and the Maghreb with a rate of 64.8 and 54.4%, respectively, followed by Europe (34.7%), Asia (21.3%), and finally the United States (14.9%). Founder mutations in different geographical areas have been discovered. For instance, the p.Gly61Glu, p.Arg390His, p.Gly61Glu, c.4,339delG, p.E387Lys, and p.Val320Leu were considered founder mutations for Iran/Saudi Arabia, Pakistan, Lebanon, Morocco, Europe, and Vietnam/South Korea, respectively. Many common mutations in different countries were found, such as in Morocco, where its mutations were similar to seven other countries. These findings suggest that the ethnic differences and the geographical distribution of PCG give us a large CYP1B1 mutation pattern. Genetic tests looking for founder and common mutations should be the first step in genetic screening for patients with PCG.
Shape resonances, virtual state, and Ramsauer-Townsend minimum in the low-energy electron collisions with benzene
Authors: Barbosa Alessandra Souza , Bettega Márcio H. F.
Published: April 2017

In this work, we revisit the low-energy electron scattering by benzene. We employed the Schwinger multichannel method implemented with pseudopotentials to carry out systematic cross section calculations with different schemes of polarization for the resonant and the totally symmetric irreducible representations within the D2h symmetry group. We present integral and differential cross sections for incident electron energies up to 12 eV and discuss the shape resonances and the presence of a Ramsauer-Townsend minimum and a virtual state in the former. We also discuss the relation of these physical phenomena with the different schemes of the polarization effects employed in our calculations. Finally, the comparison of our calculated integral and differential cross sections with the available data from the literature suggests improvement in the agreement between theory and experiment.
Nonlinear dynamics of turbulence driven magnetic islands. II. Numerical simulations
Authors: Agullo O. , Muraglia M. , Benkadda S. , Poyé A. , Dubuit N. , Garbet X. , Sen A.
Published: April 2017

The nonlinear dynamics of a turbulence driven magnetic island (TDMI) is investigated numerically in a reduced magnetohydrodynamic fluid model. The significance of identifying a characteristic signature of a TDMI for its experimental observation is discussed. The principal focus of our simulations is on the nature of the pressure profile flattening inside a TDMI, and we show that, in agreement with analytical predictions, a partial flattening occurs when the island size exceeds a critical value that is a function of the small scale interchange dynamics. We also present a model and test it numerically, which links explicitly the interchange turbulence and the island pressure flattening.
Vacuum ultraviolet radiation emitted by microwave driven argon plasmas
Authors: Espinho S. , Felizardo E. , Henriques J. , Tatarova E.
Published: April 2017

Vacuum ultraviolet (VUV) radiation emitted by microwave driven argon plasmas has been investigated at low-pressure conditions (0.36 mbar). A classical surface-wave sustained discharge at 2.45 GHz has been used as plasma source. VUV radiation has been detected by emission spectroscopy in the 30–125 nm spectral range. The spectrum exhibits atomic and ionic argon emissions with the most intense spectral lines corresponding to the atomic resonance lines, at 104.8 nm and 106.7 nm, and to the ion lines, at 92.0 nm and 93.2 nm. Emissions at lower wavelengths were also detected, including lines with no information concerning level transitions in the well-known NIST database (e.g., the atomic line at 89.4 nm). The dependence of the lines' intensity on the microwave power delivered to the launcher was investigated. The electron density was estimated to be around 1012 cm−3 using the Stark broadening of the hydrogen Hβ line at 486.1 nm. The main population and loss mechanisms considered in the model for the excited argon atom and ion states emitting in the VUV range are discussed. The experimental results were compared to self-consistent model predictions, and a good agreement was obtained.
Study on coherent coupling of multi-core PCFs
Authors: Chen Yue-E. , Shao Qiu-Feng
Published: April 2017

In this work, we used R-Soft software to simulate the coupling between multi-core photonic crystal fibers (PCFs) with different core diameters and distances. The simulation results show that the core distance within two wavelengths, different core diameters between the mode fields can be effectively coupled. The results are consistent with the evanescent wave propagation length of calculation. According to the designed structure based on the high temperature melting method, the multi-core PCF can be obtained by using two times technique of the optical fiber drawing tower. The core production of (2-, 7-, 19-core PCF) of coherent synthesis experiment, observed apparent interference fringes in the experiment, which shows that the mode fields of the multiple cores meet the coherent conditions. This article provides a theoretical basis and guidance to effectively achieve a coherent coupling for the further design and preparation of multi-core fibers (more than 19 cores).
Enhancement of minority carrier supply in a resonant-tunneling metal-insulator-silicon capacitor
Authors: Vexler M. I.
Published: April 2017

The effect of enhancement of the electron concentration in the near-surface quantum well owing to a resonant tunneling between the semiconductor and the metal is analyzed theoretically. The range of parameters (acceptor concentration and insulator thickness) wherein such an electron-supplying mechanism becomes plausible is defined. Generally, the supply effect can be expected for a doping between (5–6) × 1018 and (2–3) × 1019 cm−3, e.g., for the SiO2/p+−Si(1019 cm−3) structures with the oxide thickness exceeding ∼3 nm. The electron density provided due to a resonant tunneling can reach rather high values (∼1012 cm−2 and more). Consequently, the quasi-Fermi level in the well is substantially shifted approaching that of the semiconductor bulk. However, a deformation of the band diagram due to electron charge in the quantum well in the regimes close to activation of a resonant transport is small.
Electrical properties and oxygen functionalities in ethanol-treated and thermally modified graphene oxide
Authors: Scalese S. , Baldo S. , D'Angelo D. , Filice S. , Bongiorno C. , Reitano R. , Fazio E. , Conoci S. , La Magna A.
Published: April 2017

Graphene-based materials are among the most innovative and promising materials for the development of high-performance sensing devices, mainly due to the large surface area and the possibility to modify their reactivity by suitable functionalization. In the field of sensing applications, the peculiarities of innovative materials can be exploited only if chemical and physical properties are fully understood and correlated with each other. To this aim, in this work, graphene oxide (GO) and ethanol-treated GO (GOEt) were investigated from chemical and structural points of view. Electrical characterization was performed by depositing GO and GOEt between two electrodes by dielectrophoresis. All the investigations were repeated on GO materials after thermal treatment in a low temperature range (60 °C–300 °C). Furthermore, the electrical conductivity of GO was investigated by changing the temperature and the environment (air or N2) during the characterization: an increase in the conductivity of the as-deposited GO was observed when the device is cooled down and this effect is reversible with the temperature. GOEt and the thermally treated GO and GOEt show an opposite trend, confirming the key role of the oxygen functionalities in the conduction mechanisms and, therefore, in the conductivity of the GO layers.
Influence of neighboring coupling on metal-insulator-semiconductor (MIS) deep-depletion tunneling current via Schottky barrier height modulation mechanism
Authors: Yang Ming-Han , Hwu Jenn-Gwo
Published: April 2017

A metal-insulator-semiconductor (MIS) tunneling diode is a very promising sensor due to its deep depletion phenomenon. The coupling effect between two adjacent devices is therefore of importance. To study the MIS deep-depletion tunneling current coupling phenomenon, a device pattern of one centric circle coupled with one or two surrounding rings was devised. It was found that MIS(p) tunneling current with the Schottky barrier height modulation mechanism is enhanced just by locating more MIS(p) structures nearby or by shortening their relative distance, which can again be verified under light exposure. The MIS(n) structure was also fabricated for comparison. It was observed in MIS(n) that, with the lack of the Schottky barrier height modulation mechanism, tunneling current is greater and almost immune to light irradiance compared to MIS(p). Besides, the edge oxide of MIS(p) is removed to change its Schottky barrier height modulation capability. Significantly lower deep-depletion tunneling current and invulnerability to the adjacent minority condition were observed. Surprisingly, it offers smaller saturation voltage and better photosensitivity.
Nonlinear conjugate gradient methods in micromagnetics
Authors: Fischbacher J. , Kovacs Alexander , Oezelt Harald , Schrefl T. , Exl L. , Fidler J. , Suess D. , Sakuma N. , Yano M. , Kato A. , Shoji T. , Manabe A.
Published: April 2017

Conjugate gradient methods for energy minimization in micromagnetics are compared. The comparison of analytic results with numerical simulation shows that standard conjugate gradient method may fail to produce correct results. A method that restricts the step length in the line search is introduced, in order to avoid this problem. When the step length in the line search is controlled, conjugate gradient techniques are a fast and reliable way to compute the hysteresis properties of permanent magnets. The method is applied to investigate demagnetizing effects in NdFe12 based permanent magnets. The reduction of the coercive field by demagnetizing effects is μ0ΔH = 1.4 T at 450 K.
Dynamics of a class of fractional-order nonautonomous Lorenz-type systems
Authors: Zhang Xu
Published: April 2017

The dynamical properties of a class of fractional-order Lorenz-type systems with quasi-periodic time-varying parameters are studied, where the fractional derivative is defined in the sense of Caputo. The effective non-integer dimension β is the sum of all the fractional orders. Deferring from the fractional-order autonomous Lorenz systems, the present nonautonomous systems have two critical values, β* and β*, of the effective non-integer dimension, 0<β*<β*<3, under which there exist a transition from chaos to quasi-periodic dynamics for some β near β* and a transition from quasi-periodic motion to regular dynamics (diverging to infinity) for some β near β*. The 0-1 test is applied to verify the existence of such strange dynamics.
Lysibodies are IgG Fc fusions with lysin binding domains targetingStaphylococcus aureuswall carbohydrates for effective phagocytosis
Authors: Raz Assaf , Serrano Anna , Lawson Christine , Thaker Maneesha , Alston Tricia , Bournazos Stylianos , Ravetch Jeffrey V. , Fischetti Vincent A.
Published: April 2017

Significance

Antibiotic resistance is an ever-increasing problem; for certain pathogens, few treatment options remain. Vaccines and therapeutic antibodies represent important alternatives to antibiotics, yet despite extensive effort no approved vaccine is available forStaphylococcus aureus. Although wall carbohydrates are ideal immunotherapeutic targets due to their abundance and high level of conservation, their poor immunogenicity compared with conventional protein targets complicates the production of effective antibodies. The approach presented here fuses the high-affinity binding domains from bacteriophage lysins and autolysins that recognize specific cell wall carbohydrate epitopes to IgG Fc, creating effective therapeutic antibodies, or lysibodies. This approach is generalizable, allowing production of antibodies to poorly immunogenic carbohydrate epitopes of many Gram-positive pathogens. Lysibodies thus represent a broad class of anti-infectives.
Effect of cryogenic treatment on tribological behaviour of TiC composite coatings
Authors: Kılıçay Koray , Ulutan Mustafa
Published: April 2017

Plasma transferred arc (PTA) welding methods were used to produce titanium carbide (TiC) composite coating layers on the surface of 38MnVS6 steel and subsequently deep cryogenic treatment (DCT) was applied to the PTA coating layers. The effects of the TiC powder, different energy inputs (100 and 120A), and DCT on the microstructure and tribological performance were investigated. The microstructure of the composite coatings consisted of cubic TiC, unmelted TiC, and iron matrix. The alloyed and cryogenic treated surfaces exhibited decreases in the coefficient of friction (COF) and wear rate. The average COF of the steel substrate was determined to be 0.373, but for the TiC composite coating layers it varied between 0.236 and 0.33. PTA coating and DCT processes improved the wear resistance 4.5 times compared to the substrate.
The influence of scene context on parafoveal processing of objects
Authors: Castelhano Monica S , Pereira Effie J
Published: April 2017

Many studies in reading have shown the enhancing effect of context on the processing of a word before it is directly fixated (parafoveal processing of words). Here, we examined whether scene context influences the parafoveal processing of objects and enhances the extraction of object information. Using a modified boundary paradigm called the Dot-Boundary paradigm, participants fixated on a suddenly onsetting cue before the preview object would onset 4° away. The preview object could be identical to the target, visually similar, visually dissimilar or a control (black rectangle). The preview changed to the target object once a saccade toward the object was made. Critically, the objects were presented on either a consistent or an inconsistent scene background. Results revealed that there was a greater processing benefit for consistent than inconsistent scene backgrounds and that identical and visually similar previews produced greater processing benefits than other previews. In the second experiment, we added an additional context condition in which the target location was inconsistent, but the scene semantics remained consistent. We found that changing the location of the target object disrupted the processing benefit derived from the consistent context. Most importantly, across both experiments, the effect of preview was not enhanced by scene context. Thus, preview information and scene context appear to independently boost the parafoveal processing of objects without any interaction from object–scene congruency.
Twitchin kinase inhibits muscle activity
Authors: Matsunaga Yohei , Hwang Hyundoo , Franke Barbara , Williams Rhys , Penley McKenna , Qadota Hiroshi , Yi Hong , Morran Levi T. , Lu Hang , Mayans Olga , Benian Guy M.
Published: April 2017

Muscle sarcomeres contain giant polypeptides composed of multiple immunoglobulin and fibronectin domains and one or two protein kinase domains. Although binding partners for a number of this family’s kinase domains have been identified, the catalytic necessity of these kinase domains remains unknown. In addition, various members of this kinase family are suspected pseudokinases with no or little activity. Here we address catalytic necessity for the first time, using the prototypic invertebrate representative twitchin (UNC-22) from Caenorhabditis elegans. In in vitro experiments, change of a conserved lysine (K) that is involved in ATP coordination to alanine (A) resulted in elimination of kinase activity without affecting the overall structure of the kinase domain. The same mutation, unc-22(sf21), was generated in the endogenous twitchin gene. The unc-22(sf21) worms have well-organized sarcomeres. However, unc-22(sf21) mutants move faster than wild-type worms and, by optogenetic experiments, contract more. Wild-type nematodes exhibited greater competitive fitness than unc-22(sf21) mutants. Thus the catalytic activity of twitchin kinase has a role in vivo, where it inhibits muscle activity and is likely maintained by selection.
A Multicenter Cohort Comparison Study of the Safety, Efficacy, and Cost of Ticagrelor Compared to Clopidogrel in Aneurysm Flow Diverter Procedures
Authors: Moore Justin M. , Adeeb Nimer , Shallwani Hussain , Gupta Raghav , Patel Apar S. , Griessenauer Christoph J. , Youn Roy , Siddiqui Adnan , Ogilvy Christopher S. , Thomas Ajith J.
Published: April 2017

BACKGROUND

Thromboembolic and hemorrhagic complications are among the most feared adverse events in the endovascular treatment of aneurysms, and this is particularly the case for flow diverter devices. Dual antiplatelet therapy has become standard of care; however, the safety, efficacy, and cost profiles of newer antiplatelet agents are not well characterized in the neurovascular context.

OBJECTIVE

To compare the safety, efficacy, and cost of one of these newer agents, ticagrelor, to the most frequently used agent, clopidogrel.

METHODS

A multicenter, retrospective, cohort comparison study design of consecutively treated aneurysms with flow diverter embolization device and treated with either ticagrelor or clopidogrel was performed. Data were collected on patient demographics and risk factors, procedural details, antiplatelet treatment regime, complications, and angiographic and functional outcomes.

RESULTS

Fifty patients undergoing flow diverter device deployment and treatment with ticagrelor were compared to 53 patients undergoing flow diversion and treatment with clopidogrel. The patients’ age, sex, smoking status, aneurismal morphology and size, and procedural details did not differ between the 2 groups; neither did the rate of thromboembolic and hemorrhagic complications, angiographical, and functional outcomes. Ticagrelor was more expensive when compared to clopidogrel.

CONCLUSION

Ticagrelor is a safe and effective agent for prevention of thromboembolic complications following flow diverter deployment when compared to clopidogrel. However, ticagrelor remains significantly more expensive than clopidogrel, and, thus, we would advise ticagrelor be reserved for patients who are hyporesponsive to clopidogrel.
Decreased Microvascular Function in Tanzanian Children With Severe and Uncomplicated Falciparum Malaria
Authors: Yeo Tsin W. , Florence Salvatore M. , Kalingonji Ayam R. , Chen Youwei , Granger Donald L. , Anstey Nicholas M. , Mwaikambo Esther D. , Weinberg J. Brice
Published: April 2017

Microvascular function and oxygen consumption affect oxygen homeostasis but have not been assessed in African children with malaria. Microvascular function in Tanzanian children with severe malaria (SM) or uncomplicated malaria were 39% and 72%, respectively, of controls (P < .001). Uncomplicated malaria (P = .04), not SM (P = .06), children had increased oxygen consumption compared with controls.
Correlation of Flavor Profile to Sensory Analysis of Bread Produced with Different Saccharomyces cerevisiae Originating from the Baking and Beverage Industry
Authors: Heitmann Mareile , Zannini Emanuele , Axel Claudia , Arendt Elke
Published: April 2017

Aroma is an important quality parameter for wheat bread, and most of the aroma compounds in yeast‐fermented bread are caused by the fermentative action of yeast. In this study, the impact of various strains of Saccharomyces cerevisiae, originating from the beverage industry, were investigated on the aroma profile of wheat bread. Seven volatiles were analyzed by gas chromatography–mass spectrometry after thermal desorption (GC‐MS TD) from the bread crumb. The results showed yeast strain‐dependent production of aroma compounds. Descriptive sensory analysis resulted in an overall taste acceptance by the panelists for breads baked with S. cerevisiae baker's yeast, T‐58, and Blanc. The panel acceptance can be explained by the production of sensory‐active compounds such as 3‐methyl‐1‐butanol and 2,3‐butandiol. Furthermore, the panelists preferred bread samples with a less bitter (r = –0.934, P < 0.01) and less cheesy taste (r = –0.865, P < 0.03). Also the visual aspects play an important role, shown by correlation between the specific volume and the overall appearance (r = 0.928, P < 0.01). Aroma profile analysis offers a tool for the selection of new yeast strains, increasing the bread variety on the market. Consequently, aroma production as a yeast quality characteristic should be taken into account for the selection of new strains involved in breadmaking.
Seed Coat Cracking of Soybean (Glycine max [L.] Merr.) After Soaking and Cooking
Authors: Yasui Takeshi , Toda Kyoko , Yamada Tetsuya , Yumoto Setsuzo , Takahashi Koji , Takahashi Motoki , Hajika Makita
Published: April 2017

Seed coat cracking after soaking (SCAS) and after cooking (SCAC) are unfavorable traits associated with soybeans for food uses, such as cooked and seasoned beans (nimame) and fermented steamed beans (natto) because they cause an inferior appearance of the products and clogging of the production lines. The variation and causes of SCAS and SCAC among cultivars have not yet been clarified, but if they are determined genetically, genetic modification could be possible. Cultivars showed considerable variations in SCAS and SCAC. Significantly positive seasonal correlations of SCAS (Spearman's rank correlation coefficient, ρ = 0.518) and of SCAC (ρ = 0.681) were observed among recombinant inbred lines (RILs) derived from the cross between cultivars Nattoshoryu and Hyokeikuro 3. Quantitative trait locus (QTL) analyses and statistical analyses using generalized linear models showed that QTLs for SCAS (qSCAS1, qSCAS2, and qSCAS3) and SCAC (qSCAC1 and qSCAC2) were located on chromosomes 4 (linkage group [LG]: C1), 6 (LG: C2), and 8 (LG: A2) of the RILs. Interactions between QTLs were also observed. SCAS and SCAC are traits controlled by QTLs, which could provide significant insight into their causes and mechanisms. These undesirable characteristics could be improved through breeding.
Cacao Phylloplane: The First Battlefield againstMoniliophthora perniciosa, Which Causes Witches’ Broom Disease
Authors: Almeida D. S. M. , Gramacho K. P. , Cardoso T. H. S. , Micheli F. , Alvim F. C. , Pirovani C. P.
Published: April 2017

The phylloplane is the first contact surface between Theobroma cacao and the fungus Moniliophthora perniciosa, which causes witches’ broom disease (WBD). We evaluated the index of short glandular trichomes (SGT) in the cacao phylloplane and the effect of irrigation on the disease index of cacao genotypes with or without resistance to WBD, and identified proteins present in the phylloplane. The resistant genotype CCN51 and susceptible Catongo presented a mean index of 1,600 and 700 SGT cm−2, respectively. The disease index in plants under drip irrigation was reduced by approximately 30% compared with plants under sprinkler irrigation prior to inoculation. Leaf water wash (LWW) of the cacao inhibited the germination of spores by up to 98%. Proteins from the LWW of CCN51 were analyzed by two-dimensional sodium dodecyl sulfate polyacrylamide gel electrophoresis followed by tandem mass spectrometry. The gel showed 71 spots and identified a total of 42 proteins (28 from the plant and 14 from bacteria). Proteins related to defense and synthesis of defense metabolites and involved in nucleic acid metabolism were identified. The results support the hypothesis that the proteins and water-soluble compounds secreted to the cacao phylloplane participate in the defense against pathogens. They also suggest that SGT can contribute to the resistance of cacao.
Outcomes of Reverse Total Shoulder Arthroplasty for Proximal Humeral Fractures: Primary Arthroplasty Versus Secondary Arthroplasty After Failed Proximal Humeral Locking Plate Fixation
Authors: Sebastia-Forcada Emilio , Lizaur-Utrilla Alejandro , Cebrian-Gomez Román , Miralles-Muñoz Francisco A. , Lopez-Prats Fernando A.
Published: April 2017

Objective:

To compare the outcomes of reverse shoulder arthroplasty (RSA) between patients with failed proximal humeral locking plate (PHLP) fixation and those with acute fractures.

Design:

Matched case–control study.

Setting:

University hospital, Level I trauma center.

Patients:

Thirty consecutive patients with fracture sequelae because of failed PHLP fixation (mean age 73) were age and sex matched to 30 patients with acute fracture (mean age 75).

Intervention:

All patients underwent RSA.

Main Outcome Measurements:

Constant, University of California Los Angeles (UCLA) and Disability of the Arm, Shoulder and Hand (DASH) scores. Radiological assessments were also performed.

Results:

The mean postoperative follow-up was 3.2 (range, 2–5) years. All functional scores significantly improved from preoperative to postoperative (P = 0.001) in the sequelae group. Pain was relieved in all but one patient, and all but 2 patients were satisfied with their RSA. However, the functional outcomes at the last follow-up were significantly worse in the sequelae group compared with acute group in terms of adjusted Constant (P = 0.013), UCLA (P = 0.020) and DASH (P = 0.048) scores, strength (P = 0.01), anterior forward (P = 0.021), and abduction (P = 0.007). Six patients (20%) in the sequelae group had complications including 2 intraoperative (diaphyseal false passages), 2 early dislocations, 1 acromial fracture, and 1 aseptic loosening of glenoid component. Four of these patients were revised resulting all in a successful outcome at the last follow-up. In the acute group there was one intraoperative humeral fracture with no impact on the final outcome.

Conclusions:

Patients with failed PHLP fixation for fracture who were revised to RSA secondarily obtained marginally lower functional scores and higher complication rates compared with patients treated with primary RSA for fracture. However, patients who treated with secondary RSA had significant functional improvement and pain relief compared with their preoperative status, and most complications were manageable without a significant effect on final outcome.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Sequential Analysis of a Panel of Biomarkers and Pathologic Findings in a Resuscitated Rat Model of Sepsis and Recovery
Authors: Arulkumaran Nishkantha , Sixma Marije L. , Jentho Elisa , Ceravola Elias , Bass Paul S. , Kellum John A. , Unwin Robert J. , Tam Fred W. K. , Singer Mervyn
Published: April 2017

Objectives:

To characterize the temporal pattern of a panel of blood and urinary biomarkers in an animal model of fecal peritonitis and recovery.

Design:

Prospective observational animal study.

Setting:

University research laboratory.

Subjects:

Male Wistar rats.

Interventions:

A fluid-resuscitated, long-term (3 d) rat model of sepsis (fecal peritonitis) and recovery was used to understand the temporal association of sepsis biomarkers in relation to systemic hemodynamics, inflammation, and renal function. At predefined time points (3, 6, 12, 24, 48, 72 hr), animals (≥ 6 per group) underwent echocardiography, blood and urine sampling, and had kidneys taken for histological analysis. Comparison was made against sham-operated controls and naïve animals.

Measurements and Main Results:

The systemic proinflammatory response was maximal at 6 hours, corresponding with the nadir of stroke volume. Serum creatinine peaked late (24 hr), when clinical recovery was imminent. Histological evidence of tubular injury and cell death was minimal. After a recovery period, all biomarkers returned to levels approaching those observed in sham animals. Apart from urine clusterin and interleukin-18, all other urinary biomarkers were elevated at earlier time points compared with serum creatinine. Urine neutrophil gelatinase-associated lipocalin was the most sensitive marker among those studied, rising from 3 hours. While serum creatinine fell at 12 hours, serum cystatin C increased, suggestive of decreased creatinine production.

Conclusions:

Novel information is reported on the temporal profile of a panel of renal biomarkers in sepsis in the context of systemic and renal inflammation and recovery. Insight into the pathophysiology of acute kidney injury is gleaned from the temporal change markers of renal injury (urine neutrophil gelatinase-associated lipocalin, kidney injury molecule-1, calbindin), followed by a marker of cell cycle arrest (urine insulin-like growth factor-binding protein 7) and, finally, by functional markers of filtration (serum creatinine and cystatin C). These clinically relevant findings should have significant influence on future clinical testing.
Cerebral Recovery Index: Reliable Help for Prediction of Neurologic Outcome After Cardiac Arrest
Authors: Tjepkema-Cloostermans Marleen C. , Hofmeijer Jeannette , Beishuizen Albertus , Hom Harold W. , Blans Michiel J. , Bosch Frank H. , van Putten Michel J. A. M.
Published: April 2017

Objective:

Early electroencephalography measures contribute to outcome prediction of comatose patients after cardiac arrest. We present predictive values of a new cerebral recovery index, based on a combination of quantitative electroencephalography measures, extracted every hour, and combined by the use of a random forest classifier.

Design:

Prospective observational cohort study.

Setting:

Medical ICU of two large teaching hospitals in the Netherlands.

Patients:

Two hundred eighty-three consecutive comatose patients after cardiac arrest.

Interventions:

None.

Measurements and Main Results:

Continuous electroencephalography was recorded during the first 3 days. Outcome at 6 months was dichotomized as good (Cerebral Performance Category 1–2, no or moderate disability) or poor (Cerebral Performance Category 3–5, severe disability, comatose, or death). Nine quantitative electroencephalography measures were extracted. Patients were randomly divided over a training and validation set. Within the training set, a random forest classifier was fitted for each hour after cardiac arrest. Diagnostic accuracy was evaluated in the validation set. The relative contributions of resuscitation parameters and patient characteristics were evaluated. The cerebral recovery index ranges from 0 (prediction of death) to 1 (prediction of full recovery). Poor outcome could be predicted at a threshold of 0.34 without false positives at a sensitivity of 56% at 12 hours after cardiac arrest. At 24 hours, sensitivity of 65% with a false positive rate of 6% was obtained. Good neurologic outcome could be predicted with sensitivities of 63% and 58% at a false positive rate of 6% and 7% at 12 and 24 hours, respectively. Adding patient characteristics was of limited additional predictive value.

Conclusions:

A cerebral recovery index based on a combination of intermittently extracted, optimally combined quantitative electroencephalography measures provides unequalled prognostic value for comatose patients after cardiac arrest and enables bedside EEG interpretation of unexperienced readers.
The Right Ventricle Is Dilated During Resuscitation From Cardiac Arrest Caused by Hypovolemia: A Porcine Ultrasound Study*
Authors: Aagaard Rasmus , Granfeldt Asger , Bøtker Morten T. , Mygind-Klausen Troels , Kirkegaard Hans , Løfgren Bo
Published: April 2017

Objectives:

Dilation of the right ventricle during cardiac arrest and resuscitation may be inherent to cardiac arrest rather than being associated with certain causes of arrest such as pulmonary embolism. This study aimed to compare right ventricle diameter during resuscitation from cardiac arrest caused by hypovolemia, hyperkalemia, or primary arrhythmia (i.e., ventricular fibrillation).

Design:

Thirty pigs were anesthetized and then randomized to cardiac arrest induced by three diffrent methods. Seven minutes of untreated arrest was followed by resuscitation. Cardiac ultrasonographic images were obtained during induction of cardiac arrest, untreated cardiac arrest, and resuscitation. The right ventricle diameter was measured. Primary endpoint was the right ventricular diameter at the third rhythm analysis.

Setting:

University hospital animal laboratory.

Subjects:

Female crossbred Landrace/Yorkshire/Duroc pigs (27–32 kg).

Interventions:

Pigs were randomly assigned to cardiac arrest caused by either hypovolemia, hyperkalemia, or primary arrhythmia.

Measurements and Main Results:

At the third rhythm analysis during resuscitation, the right ventricle diameter was 32 mm (95% CI, 29–35) in the hypovolemia group, 29 mm (95% CI, 26–32) in the hyperkalemia group, and 25 mm (95% CI, 22–28) in the primary arrhythmia group. This was larger than baseline for all groups (p = 0.03). When comparing groups at the third rhythm analysis, the right ventricle was larger for hypovolemia than for primary arrhythmia (p < 0.001).

Conclusions:

The right ventricle was dilated during resuscitation from cardiac arrest caused by hypovolemia, hyperkalemia, and primary arrhythmia. These findings indicate that right ventricle dilation may be inherent to cardiac arrest, rather than being associated with certain causes of arrest. This contradicts a widespread clinical assumption that in hypovolemic cardiac arrest, the ventricles are collapsed rather than dilated.
Monitoring Protein-Unbound Valproic Acid Serum Concentrations in Clinical Practice
Authors: Wallenburg Eveline , Klok Bas , de Jong Karin , de Maat Monique , van Erp Nielka , Stalpers-Konijnenburg Sonja , Essink Guus , van Luin Matthijs
Published: April 2017

Background:

Valproic acid (VPA) is an effective antiepileptic drug and mood stabilizer. A key characteristic of VPA is its high and saturable protein binding at higher concentrations. Although the unbound concentration of VPA is responsible for its pharmacological activity, total drug concentrations are monitored in routine clinical practice. Therapeutic drug monitoring (TDM) of unbound VPA is recommended for specific clinical situations. The goal of this study was to evaluate TDM requests for unbound VPA in clinical practice.

Methods:

All TDM requests at our laboratory for unbound VPA in 2014 and 2015 were evaluated retrospectively. In patients with potentially toxic unbound VPA concentrations (ie, >12 mg/L), we evaluated whether toxicity was noted and whether the dose adjustment advice was followed. Total and unbound VPA concentrations were measured by means of a validated immunoassay.

Results:

A total of 273 unbound VPA serum concentrations in 132 different patients were analyzed. The main reasons for unbound VPA TDM were decreased renal function (34%) and a low serum albumin (27%). The median (range) unbound VPA concentration was 9.8 (2.5–47.6) mg/L. In 49 patients (37%), the initial unbound VPA concentration was above the threshold of 12 mg/L, potentially resulting in toxicity. Only 6 of these 49 patients had elevated total VPA concentrations. Clinical toxicity was noted in 38 of the 49 patients (77.6%) with elevated unbound VPA concentrations. Toxicities included drowsiness (n = 26), decreased consciousness (n = 4), rigidity (n = 2), and confusion (n = 2). In 36 of the 38 patients with elevated unbound VPA concentrations and clinical toxicity, a dose reduction was applied. In 27 of 36 patients who had their dose reduced, dose reduction was associated with improvement or resolution of VPA toxicity.

Conclusions:

TDM of unbound VPA is an important tool to manage VPA therapy in selected, vulnerable patients.