bluuebunny/crossref_metadata_2025 huggingface dataset:
Chest pain following the use of fluvoxamine in depression
Authors: Pang Tamara , Gudi Alakananda
Published: October 2018

Selective serotonin reuptake inhibitors are considered to be the drug of choice in patients with major depression and cardiovascular disease. Fluvoxamine in particular has been shown to be safe for use in patients with cardiovascular disease. We report a case of chest pain precipitated by fluvoxamine in an elderly lady with a known history of cardiovascular disease. This highlights the need for psychiatrists to be aware of chest pain as a potential side effect of fluvoxamine in their patients.
Effectiveness of different outreach strategies to identify individuals at high risk of diabetes in a heterogeneous population: a study in the Swedish municipality of Södertälje
Authors: Shahim Bahira , Hasselberg Sofia , Boldt-Christmas Oscar , Gyberg Viveca , Mellbin Linda , Rydén Lars
Published: October 2018

Background

Identifying type 2 diabetes mellitus (T2DM) is a prerequisite for the institution of preventive measures to reduce future micro and macrovascular complications. Approximately 50% of people with T2DM are undiagnosed, challenging the assumption that a traditional primary healthcare setting is the most efficient way to reach people at risk of T2DM. A setting of this kind may be even more suboptimal when it comes to reaching immigrants, who often appear to have inferior access to healthcare and/or are less likely to attend routine health checks at primary healthcare centres.

Objectives

The objective of this study was to identify the best strategy to reach individuals at high risk of T2DM and thereby cardiovascular disease in a heterogeneous population.

Methods

All 18–65-year-old inhabitants in the Swedish municipality of Södertälje ( n∼51,000) without known T2DM and cardiovascular disease were encouraged to complete the Finnish Diabetes Risk Score (FINDRISC: score > 15 indicating a high and > 20 a very high risk of future T2DM and cardiovascular disease) through the following communication channels: primary care centres, workplaces, Syrian orthodox churches, pharmacies, crowded public places, mass media, social media and mail. Data collection lasted for six weeks.

Results

The highest response rate was obtained through workplaces (27%) and the largest proportion of respondents at high/very high risk through the Syrian orthodox churches (18%). The proportion reached through primary care centres was 4%, of whom 5% were at elevated risk. The cost of identifying a person at elevated risk through the Syrian orthodox church was €104 compared with €8 through workplaces and €112 through primary care centres.

Conclusions

The choice of communication channels was important to reach high/very high-risk individuals for T2DM and for screening costs. In this immigrant-dense community, primary care centres were inferior to strategies using workplaces and churches in terms of both the proportion of identified at-risk individuals and costs.
Protective effect of CDDO-imidazolide against intestinal ischemia/reperfusion injury in mice
Authors: Huang Youqun , Ye Mulin , Wang Chunlin , Wang Zhenfen , Zhou Weiping
Published: October 2018

Intestinal ischemia/reperfusion (I/R) is life-threatening and challenging in clinical practice. CDDO-imidazolide (CDDO-Im) is therapeutic in alleviating I/R injury. Nevertheless, there is a lack of investigation on the effects of CDDO-Im on intestinal I/R. Mice were randomly divided into four groups: (a) the sham group, (b) the CDDO-Im group, (c) the I/R group, and (d) the I/R + CDDO-Im group. Intestinal I/R was performed by clamping arteria mesenteric anterior for 45 min, followed by 24 h reperfusion. In addition, Kaplan–Meier method and the log-rank test were used to compare the survival rates among groups by observing for 24 h. Intestinal I/R in model group demonstrated severe injury of the intestinal mucosa, lung, kidney, and liver. The intestinal mucosal damage and intestinal barrier dysfunction were obviously attenuated in CDDO-Im-treated group compared with the model group. Also, preconditioning with CDDO-Im reduced pulmonary, hepatic and renal damage, and decreased oxidative stress (malondialdehyde (MDA), superoxide dismutase (SOD), and NO) and pro-inflammatory responses (tumor necrosis factor (TNF-α), interleukin 1β (IL-1β), and interleukin 6 (IL-6)) following I/R injury. Furthermore, we also observed that these protective properties of CDDO-Im were accomplished by the activation of nuclear factor E2-related factor 2 (Nrf2) signaling pathway and upregulation of its downstream antioxidant genes, including heme oxygenase (HO-1), NQO-1, and glutamate–cysteine ligase regulatory subunit (GCLM). Our data suggest that CDDO-Im exerts a beneficial effect on intestinal I/R-associated mucosal barrier dysfunction and distant organ injuries.
Randomized Trials of Nasal Patency and Dermal Tolerability With External Nasal Dilators in Healthy Volunteers
Authors: Ward John , Ciesla Renee , Becker William , Shanga Gilbert Marava
Published: October 2018

Background

External nasal dilator strips are used as nonpharmacological therapy to reduce snoring and daytime sleepiness. In a product improvement initiative, a marketed strip (BRNS) and 2 prototype nasal strips were evaluated.

Objective

To compare the nasal patency and multiple-use dermal tolerability of the BRNS and prototype nasal strips using both objective and subject-reported outcome measures.

Methods

Two studies were conducted separately in healthy volunteers ≥18 years of age. A single-day nasal patency randomized crossover study assessed minimal cross-sectional area (MCA; second restriction) and nasal volume (using acoustic rhinometry); nasal inspiratory flow and resistance (using posterior rhinomanometry); and subject-reported evaluations of the BRNS compared with the butterfly strip and teardrop strip prototypes. A single-center, randomized, controlled, parallel-group, evaluator-blinded study assessed dermal tolerability of the BRNS and the butterfly strip over 7 consecutive nights of use, using the Dermal Response Scale (DRS) and subject-reported comfort and ease of removal.

Results

In the Patency study (N = 50), all 3 strips demonstrated significant improvement from baseline in MCA, nasal volume, and nasal flow parameters (resistance and peak flow). The prototype strips demonstrated significantly more improvement in nasal volume than the BRNS, and the butterfly strip showed significantly more improvement in MCA than the BRNS; all strips were similar with respect to nasal flow and subject-reported nasal breathing outcomes. In the Dermal Tolerability study (N = 82), all subjects scored 0 (no evidence of irritation) on the DRS at all 7 morning assessments; the BRNS was numerically, but not significantly, superior to the butterfly strip on subject-reported outcomes.

Conclusion

The Patency study demonstrated significant improvement from baseline in nasal dimensions and flow for all 3 evaluated strips; between-strip differences were confined to nasal dimensions. Both the BRNS and butterfly strip were generally well tolerated, with no evidence of dermal response over 7 consecutive nights of use. ClinicalTrials.gov identifiers: NCT01105949 and NCT01495494
Accounting for Growth Effects of Age Structure Transition through Public Education Expenditure: New Macroeconomic Evidence from India
Authors: Narayana M. R.
Published: October 2018

This article quantifies the growth effects of age structure transition through current public education expenditure. Using the National Transfer Accounts’ (NTA) First Demographic Dividend (FDD) model, growth effects are accounted by the impact of current public education expenditure on economic support ratio (ESR) and labour productivity through human capital investments. The results offer new macroeconomic evidence. Age structure transition reduces the education dependency ratio (EDR) by all levels of education but the highest in the elementary education. This impacts on a long-term decline in enrolment in elementary education where the current gross enrolment ratio (GER) is close to 100 per cent and a decline in current public education expenditure. Other things being equal, the resultant potential savings, or the availability of extra budgetary resources, is a new way of financing the investment requirements for secondary and higher education with the aim of increasing national economic growth through human capital investments. In particular, growth effects are shown to be positive, higher and longer up to 2050, if the current public education spending is reallocated more for the secondary and higher education. Surprisingly, growth effects are explained less by the ESR than labour productivity. This justifies a higher human capital investment to enhance labour productivity for attainment of higher economic growth. The afore- mentioned macroeconomic framework, results and implications are of general relevance for other developing countries in South Asia and elsewhere in the world.

JEL Classification: E65, H52, J11
Patient Preferences for the Treatment of Shoulder and Proximal Biceps Disorders Are Associated With Patient Age, Race, Sex, and Activity Level
Authors: Smith Matthew V. , Gosselin Michelle , Steger-May Karen , Matava Matthew J. , Wright Rick W. , Brophy Robert H.
Published: October 2018

Background:

Patient preference information has become increasingly more important in clinical decision making.

Purpose:

To assess patient preferences when making treatment decisions in the shoulder to determine which features are more important according to patient age, race, activity level, and sex.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Study participants aged ≥18 years were surveyed as to their preferences regarding surgical treatment for shoulder and proximal biceps abnormalities. Survey features included time to return to unrestricted activities, time to return to work, size and appearance of scars, the potential for persistent pain in the upper arm or shoulder, fatigue in the biceps with repetitive lifting, potential for muscle cramping, and deformity in the proximal biceps. Participants also completed a validated shoulder activity scale, and demographic data regarding age, race, and sex were collected.

Results:

A total of 349 participants (166 female, 183 male) with a mean age of 45 years (range, 18-81 years) completed the survey. Overall, time to return to unrestricted activities and residual pain were considered very important to the majority of the respondents, while the size and appearance of surgical scars were of little importance. Prior shoulder pain (ρ = –0.17; P = .01) and prior shoulder surgery (ρ = –0.16; P = .03) correlated to concern about time to return to unrestricted activities. Younger age (ρ = –0.11; P = .04) and a higher level of education (ρ = 0.14; P = .03) correlated with greater concern for time to return to work. Women and African Americans were more concerned about the size and appearance of surgical scars (ρ = –0.28; P < .0001 and ρ = –0.20; P = .0002, respectively) and biceps deformity. Respondents with a higher activity level (ρ = 0.20; P = .0002) and men (ρ = 0.11; P = .04) were more concerned about fatigue.

Conclusion:

Concerns about residual pain, time to return to unrestricted activities, and time away from work are important to patients when considering the treatment for shoulder lesions. Patient preferences are associated with age, sex, race, and shoulder activity level. These features should be considered when discussing treatment options for shoulder and proximal biceps tendon disorders.
Ideal Victims and Monstrous Offenders: How the News Media Represent Sexual Predators
Authors: DiBennardo Rebecca A.
Published: October 2018

Drawing on content analysis of 323 Los Angeles Times articles published between 1990 and 2015, this article examines how news reports represent sexual predator victims and offenders in order to examine how such narratives construct images of the sexual predatory. Results demonstrate that representations of the sexually predatory are aged and gendered: stories about child victims encompass more sexual violence, graphic descriptions of that violence, more male victims, and older offenders. Articles use child victims as a rhetorical tool to emphasize the “predatory” nature of offenders and justify retributory violence or harsh legal punishment against sexual predators. Narratives about adult victims focus mainly on women, framing them as responsible for their victimization and minimizing their importance relative to child victims. The cumulative effect of this coverage narrows representations of victims and violence, contributing key dynamics to both the social and legal predator template.
Proteomic profiling identifies outcome-predictive markers in patients with peripheral T-cell lymphoma, not otherwise specified
Authors: Ludvigsen Maja , Bjerregård Pedersen Martin , Lystlund Lauridsen Kristina , Svenstrup Poulsen Tim , Hamilton-Dutoit Stephen Jacques , Besenbacher Søren , Bendix Knud , Møller Michael Boe , Nørgaard Peter , d’Amore Francesco , Honoré Bent
Published: October 2018

Peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS) constitutes a heterogeneous category of lymphomas, which do not fit into any of the specifically defined T-cell lymphoma entities. Both the pathogenesis and tumor biology in PTCL-NOS are poorly understood. Protein expression in pretherapeutic PTCL-NOS tumors was analyzed by proteomics. Differentially expressed proteins were compared in 3 distinct scenarios: (A) PTCL-NOS tumor tissue (n = 18) vs benign lymphoid tissue (n = 8), (B) clusters defined by principal component analysis (PCA), and (C) tumors from patients with chemosensitive vs refractory PTCL-NOS. Selected differentially expressed proteins identified by proteomics were correlated with clinico-pathological features and outcome in a larger cohort of patients with PTCL-NOS (n = 87) by immunohistochemistry (IHC). Most proteins with altered expression were identified comparing PTCL-NOS vs benign lymphoid tissue. PCA of the protein profile defined 3 distinct clusters. All benign samples clustered together, whereas PTCL-NOS tumors separated into 2 clusters with different patient overall survival rates (P = .001). Differentially expressed proteins reflected large biological diversity among PTCL-NOS, particularly associated with alterations of “immunological” pathways. The 2 PTCL-NOS subclusters defined by PCA showed disturbance of “stress-related” and “protein metabolic” pathways. α-Enolase 1 (ENO1) was found differentially expressed in all 3 analyses, and high intratumoral ENO1 expression evaluated by IHC correlated with poor outcome (hazard ratio, 2.09; 95% confidence interval, 1.17-3.73; P = .013). High expression of triosephosphate isomerase (TPI1) also showed a tendency to correlate with poor survival (P = .057). In conclusion, proteomic profiling of PTCL-NOS provided evidence of markedly altered protein expression and identified ENO1 as a novel potential prognostic marker.
Eculizumab in cold agglutinin disease (DECADE): an open-label, prospective, bicentric, nonrandomized phase 2 trial
Authors: Röth Alexander , Bommer Martin , Hüttmann Andreas , Herich-Terhürne Dörte , Kuklik Nils , Rekowski Jan , Lenz Veronika , Schrezenmeier Hubert , Dührsen Ulrich
Published: October 2018

Cold agglutinin disease (CAD) is a complement-dependent disorder, with extravascular and intravascular hemolysis resulting from initial or terminal complement activation, respectively. We tested the efficacy and safety of eculizumab, an inhibitor of the terminal complement pathway. Treatment-requiring patients received 600 mg eculizumab weekly for 4 weeks, followed 1 week later by 900 mg every other week through week 26. The primary end point was the difference in the lactate dehydrogenase level between the first and the last day of therapy. Twelve patients with chronic CAD and 1 patient with an acute cold agglutinin syndrome were included. The median lactate dehydrogenase level decreased from 572 U/L (interquartile range [IQR], 534-685) to 334 U/L (IQR, 243-567; P = .0215), paralleled by an increase in hemoglobin from 9.35 g/dL (IQR, 8.80-10.80) to 10.15 g/dL (IQR, 9.00-11.35; P = .0391; Wilcoxon signed-rank test). Three patients maintained and 8 patients acquired transfusion independence, and 1 patient each showed a reduced or increased transfusion requirement, respectively (P = .0215; exact McNemar’s test). Patients with cold agglutinins with a thermal amplitude of 37°C tended to have less pronounced lactate dehydrogenase responses than patients with cold agglutinins with narrower thermal amplitudes. In the latter, responses were observed at lower serum levels of eculizumab than they were in the former. In contrast to hemolysis, cold-induced circulatory symptoms remained unaffected. In conclusion, eculizumab significantly reduced hemolysis and transfusion requirement in patients with CAD. Suppression of hemolysis caused by cold agglutinins with a wide thermal amplitude may require higher eculizumab doses than used here. The trial is registered with EudraCT (#2009-016966-97) and www.clinicaltrials.gov (#NCT01303952).
Labor market mobility and the early-career outcomes of immigrant men
Authors: Javdani Mohsen , McGee Andrew
Published: October 2018

We examine the role of between- and within-firm mobility in the early-career outcomes of immigrant men. Among Canadian workers with less than 10 years of potential experience, we find that visible minority immigrants were significantly less likely to have been promoted with their initial employers than similar white natives but were just as likely to have moved to new employers over the course of a year between interviews. White immigrants, on the other hand, were just as likely to be promoted as white natives but much more likely to move to new employers—suggesting that they enjoyed more overall mobility than white natives and other immigrants. We present tentative evidence linking these mobility patterns to differences in wage growth and occupational change between immigrants and natives. Overall, our findings suggest that the between- and within-firm mobility of white immigrants may play an important role in their relative economic success in Canada, while adding to growing evidence that visible minority immigrants experience frictions in the labor market that hinder their mobility and thus their economic prospects.

JEL Classification:J61, J71
Nanoengineered, cell-derived extracellular matrix influences ECM-related gene expression of mesenchymal stem cells
Authors: Ozguldez Hatice O. , Cha Junghwa , Hong Yoonmi , Koh Ilkyoo , Kim Pilnam
Published: October 2018

Background

Human mesenchymal stem cells (hMSCs) are, due to their pluripotency, useful sources of cells for stem cell therapy and tissue regeneration. The phenotypes of hMSCs are strongly influenced by their microenvironment, in particular the extracellular matrix (ECM), the composition and structure of which are important in regulating stem cell fate. In reciprocal manner, the properties of ECM are remodeled by the hMSCs, but the mechanism involved in ECM remodeling by hMSCs under topographical stimulus is unclear. In this study, we therefore examined the effect of nanotopography on the expression of ECM proteins by hMSCs by analyzing the quantity and structure of the ECM on a nanogrooved surface.

Methods

To develop the nanoengineered, hMSC-derived ECM, we fabricated the nanogrooves on a coverglass using a UV-curable polyurethane acrylate (PUA). Then, hMSCs were cultivated on the nanogrooves, and the cells at the full confluency were decellularized. To analyze the effect of nanotopography on the hMSCs, the hMSCs were re-seeded on the nanoengineered, hMSC-derived ECM.

Results

hMSCs cultured within the nano-engineered hMSC-derived ECM sheet showed a different pattern of expression of ECM proteins from those cultured on ECM-free, nanogrooved surface. Moreover, hMSCs on the nano-engineered ECM sheet had a shorter vinculin length and were less well-aligned than those on the other surface. In addition, the expression pattern of ECM-related genes by hMSCs on the nanoengineered ECM sheet was altered. Interestingly, the expression of genes for osteogenesis-related ECM proteins was downregulated, while that of genes for chondrogenesis-related ECM proteins was upregulated, on the nanoengineered ECM sheet.

Conclusions

The nanoengineered ECM influenced the phenotypic features of hMSCs, and that hMSCs can remodel their ECM microenvironment in the presence of a nanostructured ECM to guide differentiation into a specific lineage.
Body Image in Anorexia Nervosa
Authors: Slade Peter D.
Published: October 2018

The term ‘body image’ is used to refer to the picture we have in our minds of the size, shape and form of our bodies; and to our feelings concerning the size, shape and form of our bodies, and its constituent parts.
Delusional Infestation
Authors: Reilly T. M.
Published: October 2018

The skin is by far the largest organ of the body and it performs a variety of important functions. In both a concrete and symbolic sense the skin serves as a boundary separating the inner person from the outer world, self from non-self. It is evident therefore that cutaneous awareness is a central part of overall body image. It should be no surprise to learn how frequently real, imaginary or factitious dermal-pathology may occur in association with psychiatric disorder. The false idea that something is alive and moving in the skin has been presented to dermatologists and, to a lesser extent, psychiatrists for many years. It has attracted a ready psychodynamic explanation based on the concept of somatisation of emotional experience, and taking into account the symbolic function of the target organ.
Towards the Unification of Body Image Disorders
Authors: Sims Andrew C. P.
Published: October 2018

The sensations produced were those of exquisite lightness and airiness … I expected to be lifted up and carried away by the first breeze … the walls of my frame were burst outward and tumbled into ruin, and without thinking what form I wore … I felt that I existed throughout a vast extent of space. The blood pulsed from my head, sped through uncounted leagues before it reached my extremities; the air drawn into my lungs expanded into seas of limpid ether, and the arch of my skull was broader than the vault of heaven … I was a mass of transparent jelly, and a confectioner poured me into a twisted mould. (Taylor, 1856)
Adjuvant Gemcitabine Plus Docetaxel Followed by Doxorubicin Versus Observation for High-Grade Uterine Leiomyosarcoma: A Phase III NRG Oncology/Gynecologic Oncology Group Study
Authors: Hensley Martee L. , Enserro Danielle , Hatcher Helen , Ottevanger Petronella B. , Krarup-Hansen Anders , Blay Jean-Yves , Fisher Cyril , Moxley Katherine M. , Lele Shashikant B. , Lea Jayanthi S. , Tewari Krishnansu S. , Thaker Premal H. , Zivanovic Oliver , O’Malley David M. , Robison Katina , Miller David S.
Published: October 2018

Purpose

We conducted a randomized phase III trial to determine whether adjuvant chemotherapy improves survival in women with uterine leiomyosarcoma.

Methods

Women with uterus-confined, high-grade leiomyosarcoma who were confirmed disease free by imaging were randomly assigned to four cycles of gemcitabine plus docetaxel, followed by four cycles of doxorubicin, or to observation. All were followed for evidence of recurrence. The primary end point was overall survival (OS).

Results

With international collaboration, 38 of the targeted accrual of 216 patients were enrolled, after which the study was closed by the National Cancer Institute for accrual futility. Twenty patients were assigned to chemotherapy, 18 to observation. Among the 17 patients treated with at least one cycle of chemotherapy, grade 3 or 4 toxicities were observed in 47%; among the 18 patients assigned to observation, one had grade 3 hypertension. There were six deaths (chemotherapy, n = 5; observation, n = 1), all due to disease. The restricted mean survival time for OS was estimated as 34.3 months (95% CI, 25.3 to 43.3 months) in the chemotherapy arm and as 46.4 months (95% CI, 43.6 to 49.1 months) in the observation arm. There were eight recurrences in each arm. The restricted mean survival time for recurrence-free survival was estimated as 18.1 (95% CI, 14.2 to 22.0) months in the chemotherapy arm and as 14.6 months (95% CI, 10.3 to 19.0 months) in the observation arm. Neither survival outcome comparison was considered statistically robust, due to the small sample size.

Conclusion

Despite international collaboration to test the role of adjuvant chemotherapy in uterine-confined leiomyosarcoma, this study was closed for accrual futility. Although the sample size precludes robust statistical comparison, observed OS and recurrence-free survival data do not show superior outcomes with adjuvant chemotherapy.
Examination of Health System Resources and Costs Associated With Transitioning Cancer Survivors to Primary Care: A Propensity-Score–Matched Cohort Study
Authors: Mittmann Nicole , Beglaryan Hasmik , Liu Ning , Seung Soo Jin , Rahman Farah , Gilbert Julie , De Rossi Stefanie , Earle Craig C. , Grunfeld Eva , Zwicker Victoria , LeBlanc Dominique , Sussman Jonathan
Published: October 2018

Background:

Transitioning low-risk cancer survivors back to their primary care provider (PCP) has been shown to be safe but the effect on health system resources and costs has not been examined.

Methods:

A Well Follow-Up Care Initiative (WFCI) was implemented in the publicly funded health system. Low-risk breast cancer (BC) survivors in the WFCI intervention group were transitioned from oncologist-led cancer clinics to PCPs. We compared health system costs ($2,014 in Canadian dollars) and resource utilization in this intervention group with that in propensity-score–matched nontransitioned BC survivors (ie, controls) diagnosed in the same year, with similar disease profile and patient characteristics using publicly funded administrative databases.

Results:

A total of 2,324 BC survivors from the WFCI intervention group were 1:1 matched to controls and observed for 25 months. Compared with controls, survivors in the intervention group incurred a similar number of PCP visits (6.9 v 7.5) and fewer oncologist visits (0.3 v 1.2) per person-year. Fewer survivors in the intervention group (20.1%) were hospitalized than in the control group (24.4%). There were no differences in emergency visits. More survivors in the intervention group had mammograms (82.6% v 73.1%), but other diagnostic tests were less frequent. There was a 39.3% reduction in overall mean annual costs ($6,575 v $10,832) and a 22.1% reduction in overall median annual costs ($2,261 v $2,903). Overall survival in the intervention group was not worse than controls.

Conclusion:

Transitioning low-risk BC survivors to PCPs was associated with lower health system resource use and a lower annual cost per patient than matched controls. The WFCI model represents a reasonable approach at the population level to delivering quality care for low-risk BC survivors that seems to be cost effective.
Adult-Onset Hepatocyte GH Resistance Promotes NASH in Male Mice, Without Severe Systemic Metabolic Dysfunction
Authors: Cordoba-Chacon Jose , Sarmento-Cabral Andre , del Rio-Moreno Mercedes , Diaz-Ruiz Alberto , Subbaiah Papasani V , Kineman Rhonda D
Published: October 2018

Nonalcoholic fatty liver disease (NAFLD), which includes nonalcoholic steatohepatitis (NASH), is associated with reduced GH input/signaling, and GH therapy is effective in the reduction/resolution of NAFLD/NASH in selected patient populations. Our laboratory has focused on isolating the direct vs indirect effects of GH in preventing NAFLD/NASH. We reported that chow-fed, adult-onset, hepatocyte-specific, GH receptor knockdown (aHepGHRkd) mice rapidly (within 7 days) develop steatosis associated with increased hepatic de novo lipogenesis (DNL), independent of changes in systemic metabolic function. In this study, we report that 6 months after induction of aHepGHRkd early signs of NASH develop, which include hepatocyte ballooning, inflammation, signs of mild fibrosis, and elevated plasma alanine aminotransferase. These changes occur in the presence of enhanced systemic lipid utilization, without evidence of white adipose tissue lipolysis, indicating that the liver injury that develops after aHepGHRkd is due to hepatocyte-specific loss of GH signaling and not due to secondary defects in systemic metabolic function. Specifically, enhanced hepatic DNL is sustained with age in aHepGHRkd mice, associated with increased hepatic markers of lipid uptake/re-esterification. Because hepatic DNL is a hallmark of NAFLD/NASH, these studies suggest that enhancing hepatocyte GH signaling could represent an effective therapeutic target to reduce DNL and treat NASH.
Hypothalamic-Pituitary-Testicular Axis Effects and Urinary Detection Following Clomiphene Administration in Males
Authors: Miller Geoffrey D , Moore Chad , Nair Vinod , Hill Brian , Willick Stuart E , Rogol Alan D , Eichner Daniel
Published: October 2018

Context

Clomiphene is a performance-enhancing drug commonly abused by males in sport, but the extent to which testosterone increases in healthy males following its use is unknown. In addition, evidence suggests that clomiphene, a mixture of cis- and trans-isomers zuclomiphene and enclomiphene, is detectable in urine for months following use; the isomer-specific urinary detection window has yet to be characterized in a controlled study.

Objective

To determine the effect of once-daily, 30-day clomiphene treatment on serum testosterone and gonadotropin levels in the subject population studied and the urinary clearance and detection window of clomiphene isomers following administration for antidoping purposes.

Participants and Design

Twelve healthy males aged 25 to 38 years, representing a recreational athlete population, participated in this open-label, single-arm study.

Intervention

Oral clomiphene citrate (50 mg) was self-administered once daily for 30 days. Serum and urine samples were collected at baseline and at days 7, 14, 21, 28, 30, 32, 35, 37, 44, 51, and 58; urine collections continued periodically up to day 261.

Results

Mean testosterone, LH, and FSH levels increased 146% (SEM, ±23%), 177% (±34%), and 170% (±33%), respectively, during treatment compared with baseline. Serum drug concentrations and urinary excretion were nonuniform among individuals as isomeric concentrations varied. The zuclomiphene urinary detection window ranged from 121 to >261 days.

Conclusions

Clomiphene significantly raised serum testosterone and gonadotropin levels in healthy men and thus can be abused as a performance-enhancing drug. Such abuse is detectable in urine for ≥4 months following short-term use.
A critical period of susceptibility to sound in the sensory cells of cephalopod hatchlings?
Authors: Solé Marta , Lenoir Marc , Fortuño José-Manuel , van der Schaar Mike , André Michel
Published: October 2018

The cephalopod statocyst and lateral line systems are sensory organs involved in orientation and balance. Lateral lines allow cephalopods to detect particle motion, and are used for locating preys or predators in low light conditions. Here, we show the first analysis of damaged sensory epithelia on three species of cephalopod hatchlings (Sepia officinalis, Loligo vulgaris and Illex coindetii) after sound exposure. Our results indicate lesions in the statocyst sensory epithelia, similarly to what was found in adult specimens. The novelty is that the severity of the lesions worsened faster in hatchling than in adult animals: i.e., a degree of lesion seen in hatchling immediately after noise exposure would develop within 48h in adults. This feature suggests a critical period of increased sensitivity to acoustic trauma in those species as it was described in developing mammalian cochlea and avian basilar papilla. The hair cells in lateral lines of S. officinalis followed the same pattern of damage occurrence while those of L. vulgaris and I. coindetii displayed a decreasing severity of the damage after 24H. These differences could be due to dissimilarities in sizes and live stages between the three species.
Distinct temporal requirements for Sonic hedgehog signaling in development of the tuberal hypothalamus
Authors: Corman Tanya S. , Bergendahl Solsire E. , Epstein Douglas J.
Published: October 2018

Sonic hedgehog (Shh) plays well characterized roles in brain and spinal cord development, but its functions in the hypothalamus have been more difficult to elucidate due to the complex neuroanatomy of this brain area. Here, we utilize fate-mapping and conditional deletion models in mice to define requirements for dynamic Shh activity at distinct stages of tuberal hypothalamic development, a brain region with important homeostatic functions. At early time points, Shh signaling regulates dorsoventral patterning, neurogenesis, and the size of the ventral midline. Fate mapping experiments demonstrate that Shh expressing and responsive progenitors contribute to distinct neuronal subtypes, accounting for some of the cellular heterogeneity in tuberal hypothalamic nuclei. Conditional deletion of the Hedgehog transducer Smoothened (Smo), after dorsoventral patterning has been established, reveals that Shh signaling is necessary to maintain proliferation and progenitor identity during peak periods of hypothalamic neurogenesis. We also find that mosaic disruption of Smo causes a non-cell autonomous gain in Shh signaling activity in neighboring wild type cells, suggesting a mechanism for the pathogenesis of hypothalamic hamartomas, a benign tumor that forms during hypothalamic development.
Hydrodynamics of linear acceleration in bluegill sunfishLepomis macrochirus
Authors: Wise Tyler N. , Schwalbe Margot A. B. , Tytell Eric D.
Published: October 2018

In their natural habitat, fish rarely swim steadily. Instead they frequently accelerate and decelerate. Relatively little is known about how fish produce extra force for acceleration in routine swimming behavior. In this study, we examined the flow around bluegill sunfish Lepomis macrochirus during steady swimming and during forward acceleration, starting at a range of initial swimming speeds. We found that bluegill produce vortices with higher circulation during acceleration, indicating a higher force per tail beat, but they do not substantially redirect the force. We quantified the flow patterns using high speed video and particle image velocimetry and measured acceleration with small inertial measurement units attached to each fish. Even in steady tail beats, the fish accelerates slightly during each tail beat, and the magnitude of the acceleration varies. In steady tail beats, however, a high acceleration is followed by a lower acceleration or a deceleration, so that the swimming speed is maintained; in unsteady tail beats, the fish maintains the acceleration over several tailbeats, so that the swimming speed increases. We can thus compare the wake and kinematics during single steady and unsteady tailbeats that have the same peak acceleration. During unsteady tailbeats when the fish accelerates forward for several tailbeats, the wake vortex forces are much higher than those at the same acceleration during single tailbeats in steady swimming. The fish also undulates its body at higher amplitude and frequency during unsteady tailbeats. These kinematic changes likely increase the fluid dynamic added mass of the body, increasing the forces required to sustain acceleration over several tailbeats. The high amplitude and high frequency movements are also likely required to generate the higher forces needed for acceleration. Thus, it appears that bluegill sunfish face a tradeoff during acceleration: the body movements required for acceleration also make it harder to accelerate.
A review of endovascular treatment of thoracic aorta disease
Authors: Tan GJS , Khoo PLZ , Chan KMJ
Published: October 2018

Introduction

The development of thoracic endovascular aortic repair has altered the approach and reduced the risk of treating the majority of descending thoracic aortic conditions. Primarily developed for the exclusion of thoracic aortic aneurysms, it is now used in place of open repair surgery for most descending thoracic aortic diseases, and has also been used to treat aortic arch diseases in selected cases.

Methods

A literature search was conducted of Medline and Embase databases from January 2007 to February 2017, using the key words ‘aortic disease’, ‘thoracic aorta’ and ‘endovascular repair’; 205 articles were identified, of which 25 studies were selected for review based on their relevance.

Findings

The key findings of the indications, techniques, outcomes, complications and comparisons with open surgical repair were extracted from the published studies and are summarised in this review. Thoracic endovascular aortic repair is the preferred choice of intervention for patients with descending thoracic aortic disease. With time, it has improved to be safer and has the potential to expand aortic treatment choices in future.
Surgery for Cushing’s disease in pregnancy: our experience and a literature review
Authors: Jolly K , Darr A , Arlt W , Ahmed S , Karavitaki N
Published: October 2018

Cushing’s syndrome in pregnancy is a rare phenomenon and there is limited literature on its management. Cushing’s disease in pregnancy is even less common and there is little guidance to help in the treatment for this patient group. Diagnosis of Cushing’s syndrome in pregnancy is often delayed due to overlap of symptoms. In addition, there are no validated diagnostic tests or parameters documented.

We present a case of a 30-year-old woman presenting to the antenatal clinic at 13 weeks of pregnancy with high suspicion of Cushing’s disease. Her 21-week fetal scan showed a congenital diaphragmatic hernia and she underwent pituitary magnetic resonance imaging, which confirm Cushing’s disease. She successfully underwent transsphenoidal adenomectomy with histology confirming a corticotroph adenoma. Tests following transsphenoidal surgery confirmed remission of Cushing’s disease and she underwent an emergency caesarean section at 38 weeks. Unfortunately, her baby died from complications associated with the congenital abnormality 36 hours after birth.

The patient remains in remission following delivery. To date, there have been no reported cases of congenital diaphragmatic hernia associated with Cushing’s disease in pregnancy. In addition, we believe that this is only the eighth reported patient to have undergone successful transsphenoidal surgery for Cushing’s disease in pregnancy.
The rare case of an extraperitoneal ureteral herniation into the inguinal canal of a 12-year-old boy
Authors: Cao K , Turner M , Mishrah P , Cuckow P
Published: October 2018

Ureteric herniation into the inguinal canal is a rare condition in adults and even more so in the paediatric population. These hernia types can be categorised as paraperitoneal or extraperitoneal. The former are the only varieties encountered in the paediatric literature, where patients are generally infants, while the latter phenomenon is seen in 20% of ureteric herniations in adults. We present a case of an extraperitoneal ureteric herniation into the inguinal canal in a 12-year-old boy with previous surgery for cloacal exstrophy, analyse the existing literature on the condition and make the speculation that the extraperitoneal variety is an adult variant seen in this child because of weakness in the surrounding structures as a result of previous surgery.
Gaussian heat kernel estimates: From functions to forms
Authors: Coulhon Thierry , Devyver Baptiste , Sikora Adam
Published: October 2018

On a complete non-compact Riemannian manifold satisfying the volume doubling property, we give conditions on the negative part of the Ricci curvature that
ensure that, unless there are harmonic 1-forms, the Gaussian heat kernel upper estimate on functions transfers to one-forms. These conditions do no entail any constraint on the size of the Ricci curvature, only on its decay at infinity.
Left semi-braces and solutions of the Yang–Baxter equation
Authors: Jespers Eric , Van Antwerpen Arne
Published: October 2018

Letr:X2→X2{r\colon X^{2}\rightarrow X^{2}}be a set-theoretic solution of the Yang–Baxter equation on a finite setX. It was proven by Gateva-Ivanova and Van den Bergh that ifris non-degenerate and involutive, then the algebraK⁢〈x∈X∣x⁢y=u⁢v⁢ if ⁢r⁢(x,y)=(u,v)〉{K\langle x\in X\mid xy=uv\text{ if }r(x,y)=(u,v)\rangle}shares many properties with commutative polynomial algebras in finitely many variables; in particular, this algebra is Noetherian, satisfies a polynomial identity and has Gelfand–Kirillov dimension a positive integer. Lebed and Vendramin recently extended this result to arbitrary non-degenerate bijective solutions. Such solutions are naturally associated to finite skew left braces. In this paper we will prove an analogue result for arbitrary solutionsrB{r_{B}}that are associated to a left semi-braceB; such solutions can be degenerate or can even be idempotent. In order to do so, we first describe such semi-braces and then prove some decompositions results extending those of Catino, Colazzo and Stefanelli.
On the spectralization of affine and perfectly normal spaces
Authors: Golasiński Marek , Bilski Paweł
Published: October 2018

We show that for a field K and

n
≥
1

{n\geq 1}

, the soberification

𝒮
⁢

(

𝔸
n

⁢

(
K
)

)

{\mathcal{S}(\mathbb{A}^{n}(K))}

of the affine n-space

𝔸
n

⁢

(
K
)

{\mathbb{A}^{n}(K)}

over K is homeomorphic to its spectralization

ℬ
⁢
𝒮
⁢

(

𝔸
n

⁢

(
K
)

)

{\mathcal{BS}(\mathbb{A}^{n}(K))}

, and it can be embedded into the spectrum

Spec
⁢

(

K
⁢

[

X
1

,
…
,

X
n

]

)

{\mathrm{Spec}(K[X_{1},\dots,X_{n}])}

. Moreover, if the field K is algebraically closed, then there are homeomorphisms

𝒮
⁢

(

𝔸
n

⁢

(
K
)

)

≈

ℬ
⁢
𝒮
⁢

(

𝔸
n

⁢

(
K
)

)

≈

Spec
⁢

(

K
⁢

[

X
1

,
…
,

X
n

]

)

\mathcal{S}(\mathbb{A}^{n}(K))\approx\mathcal{BS}(\mathbb{A}^{n}(K))\approx%
\mathrm{Spec}(K[X_{1},\dots,X_{n}])

.
We also show that for a space X, the subspace

z
⁢
Spec
⁢

(

C
⁢

(
X
)

)

⊆

Spec
⁢

(

C
⁢

(
X
)

)

z\mathrm{Spec}(C(X))\subseteq\mathrm{Spec}(C(X))

of prime z-ideals of the ring

C
⁢

(
X
)

{C(X)}

of real-valued continuous functions on X is homeomorphic to the space

z
⁢
𝒮
⁢
ℛ
⁢

(
X
)

{z\mathcal{SR}(X)}

of prime z-filters with an appropriate topology and there is a homeomorphism

ℬ
⁢
𝒮
⁢

(
X
)

≈

z
⁢
Spec
⁢

(

C
⁢

(
X
)

)

{\mathcal{BS}(X)\approx z\mathrm{Spec}(C(X))}

provided X is perfectly normal.
Generalized Jiang and Gottlieb groups
Authors: Golasiński Marek , de Melo Thiago
Published: October 2018

Given a map

f
:

X
→
Y

{f\colon X\to Y}

, we extend Gottlieb’s result to the generalized Gottlieb group

G
f

⁢

(
Y
,

f
⁢

(

x
0

)

)

{G^{f}(Y,f(x_{0}))}

and show that the canonical isomorphism

π
1

⁢

(
Y
,

f
⁢

(

x
0

)

)

⁢

→
≈

⁢
𝒟
⁢

(
Y
)

{\pi_{1}(Y,f(x_{0}))\overset{\approx}{\to}\mathcal{D}(Y)}

restricts to an isomorphism

G
f

⁢

(
Y
,

f
⁢

(

x
0

)

)

⁢

→
≈

⁢

𝒟

f
~

0

⁢

(
Y
)

{G^{f}(Y,f(x_{0}))\overset{\approx}{\to}\mathcal{D}^{\tilde{f}_{0}}(Y)}

, where

𝒟

f
~

0

⁢

(
Y
)

{\mathcal{D}^{\tilde{f}_{0}}(Y)}

is some subset of the group

𝒟
⁢

(
Y
)

{\mathcal{D}(Y)}

of deck transformations of Y for a fixed lifting

f
~

0

{\tilde{f}_{0}}

of f with respect to universal coverings of X and Y, respectively.
Hydrodynamics and Reaction Performances of Multiphase Reactors for Marine Applications – A Review
Authors: Iliuta Ion , Larachi Faïçal
Published: October 2018

Hydrodynamics and (catalytic & non-catalytic) reaction [high-pressure hydrodesulfurization; Fischer-Tropsch synthesis; CO2-monoethanolamine (MEA) absorption; simultaneous CO2and H2S absorption in MEA; CO2thermal desorption, enzymatic CO2hydration] performances of trickle-bed and packed-bed column reactors subjected to static inclination, rolling (symmetrical/asymmetrical externally-generated reactor oscillations) and heaving motions were analyzed via detailed dynamic 3-D models which couple the macroscopic volume-averaged momentum, mass, energy and species balance equations in the liquid/gas phases with diffusion/chemical reaction inside the catalyst particles, enzyme washcoat or liquid film near the gas-liquid interface. Axial symmetry breakdown once the packed bed systems become inclined inflicts noticeable reductions of the reactor (or scrubber) performances. Only the performance of Fischer-Tropsch synthesis in the presence of water-gas shift reaction increases slightly with the increase of trickle-bed reactor inclination because of facile uptake of reactants in the key reactions from the gas phase while a fraction of valuable CO can be forwarded in water gas-shift reaction. For most of the reactions examined, the reactor performance is negatively impacted in asymmetric oscillating multiphase reactors with Fischer-Tropsch synthesis as an exception owing to the presence of water-gas shift reaction the performance of which is slightly improved. This performance deterioration/enhancement is maximal for the reactor moving between vertical and an inclined position when the time-dependent performance waves develop around the steady-state solution of the mid-inclination angle. The oscillatory reactor performance moves towards the steady-state solution of the vertical state when the asymmetry between the two inclined positions dwindles. Symmetric oscillating and heaving trickle-bed and packed-bed column reactors generate an oscillatory performance around the steady-state solution of vertical state which is affected by the amplitude and period of the angular and heaving motions of the vessel.
Fusions and Clifford extensions
Authors: Coconeţ Tiberiu , Marcus Andrei , Todea Constantin-Cosmin
Published: October 2018

We introduce

G
¯

{\overline{G}}

-fusions of local pointed groups on a block extension

A
=

b
⁢
𝒪
⁢
G

{A\kern-1.0pt=\kern-1.0ptb\mathcal{O}G}

, where H is a normal subgroup of the finite group G,

G
¯

=

G
/
H

{\overline{G}=G/H}

, and b is a G-invariant block of

𝒪
⁢
H

{\mathcal{O}H}

. We show that certain Clifford extensions associated to these pointed groups are invariant under group graded basic Morita equivalences.
A detailed analysis of the hybrid lattice-reduction and meet-in-the-middle attack
Authors: Wunderer Thomas
Published: October 2018

Over the past decade, the hybrid lattice-reduction and meet-in-the middle attack (called hybrid attack) has been used to evaluate the security of many lattice-based cryptographic schemes such as NTRU, NTRU Prime, BLISS and more.
However, unfortunately, none of the previous analyses of the hybrid attack is entirely satisfactory: They are based on simplifying assumptions that may distort the security estimates.
Such simplifying assumptions include setting probabilities equal to 1, which, for the parameter sets we analyze in this work, are in fact as small as

2

-
80

2^{-80}

.
Many of these assumptions lead to underestimating the scheme’s security.
However, some lead to security overestimates, and without further analysis, it is not clear which is the case.
Therefore, the current security estimates against the hybrid attack are not reliable, and the actual security levels of many lattice-based schemes are unclear.
In this work, we present an improved runtime analysis of the hybrid attack that is based on more reasonable assumptions.
In addition, we reevaluate the security against the hybrid attack for the NTRU, NTRU Prime and R-BinLWEEnc encryption schemes as well as for the BLISS and GLP signature schemes.
Our results show that there exist both security over- and underestimates in the literature.