bluuebunny/crossref_metadata_2025 huggingface dataset:
State of Diabetes Self-Management Education in the European Union Member States and Non-EU Countries: The Diabetes Literacy Project
Authors: Riemenschneider Henna , Saha Sarama , van den Broucke Stephan , Maindal Helle Terkildsen , Doyle Gerardine , Levin-Zamir Diane , Muller Ingrid , Ganahl Kristin , Sørensen Kristine , Chang Peter , Schillinger Dean , Schwarz Peter E. H. , Müller Gabriele
Published: April 2018

Background. Diabetes self-management education (DSME) is considered essential for improving the prevention and care of diabetes through empowering patients to increase agency in their own health and care processes. However, existing evidence regarding DSME in the EU Member States (EU MS) is insufficient to develop an EU-wide strategy. Objectives. This study presents the state of DSME in the 28 EU MS and contrasts it with 3 non-EU countries with comparable Human Development Index score: Israel, Taiwan, and the USA (ITU). Because type 2 diabetes mellitus (T2DM) disproportionately affects minority and low-income groups, we paid particular attention to health literacy aspects of DSME for vulnerable populations. Methods. Data from multiple stakeholders involved in diabetes care were collected from Feb 2014 to Jan 2015 using an online Diabetes Literacy Survey (DLS). Of the 379 respondents (249 from EU MS and 130 from ITU), most were people with diabetes (33% in the EU MS, 15% in ITU) and care providers (47% and 72%). These data were supplemented by an expert survey (ES) administered to 30 key informants. Results. Access to DSME varies greatly in the EU MS: an average of 29% (range 21% to 50%) of respondents report DSME programs are tailored for people with limited literacy, educational attainment, and language skills versus 63% in ITU. More than half of adult T2DM patients and children/adolescents participate in DSME in EU MS; in ITU, participation of T1DM patients and older people is lower. Prioritization of DSME (6.1 ± 2.8 out of 10) and the level of satisfaction with the current state of DSME (5.0 ± 2.4 out of 10) in the EU MS were comparable with ITU. Conclusion. Variation in availability and organization of DSME in the EU MS presents a clear rationale for developing an EU-wide diabetes strategy to improve treatment and care for people with diabetes.
Opening Wedge Osteotomy for Valgus Deformity of the Little Finger after Proximal Phalangeal Fracture in Children: Two Case Reports
Authors: Ohta Souichi , Ikeguchi Ryosuke , Oda Hiroki , Yurie Hirofumi , Takeuchi Hisataka , Matsuda Shuichi
Published: April 2018

In the treatment of posttraumatic valgus deformity of the pediatric little finger, it is usually difficult to achieve accurate correction of angular and rotational deformity using closing wedge osteotomy. We report two cases of valgus deformity of the little finger (both 11-year-old female patients) successfully treated using opening wedge osteotomy followed by intramedullary semirigid fixation with a single Kirschner wire. A wire tip inserted from the retrocondylar fossa of the proximal phalangeal head was advanced along the radial side of the intramedullary cortex after gradual opening of the osteotomy site. If needed, further fine adjustment of the rotational alignment can be performed even after K-wire insertion. Postoperatively, the gap between the little and ring fingers in the fully extended and adducted position and the finger overlapping in the fully flexed position were completely resolved. The flexibility of the pediatric bone and sagittal clearance between the wire and the inner wall of the proximal phalangeal medullary cavity allow fine adjustment of the rotational alignment even after wire insertion.
Experimental and Simulation Research of AC Ripple Losses in a High Temperature Superconductor Tape
Authors: Liu Hongwei , Song Guosheng , Zhang Chuanhui , Tan Jinwen , Feng Wengang
Published: April 2018

Current leads in superconducting magnets are widely adopted for heavy current transmission, and HTS DC cables have great advantages when used as current leads for such purposes. However, as an important parameter of HTS DC cables, AC loss has a strong impact on the stability and operation cost of current leads. In this paper, experiments were conducted to measure AC ripple losses of HTS tapes and HTS cables, and simulations of HTS tapes were carried out. The paper has reached conclusions on the relation between AC losses and power frequencies.
Immunotherapy with CAR-Modified T Cells: Toxicities and Overcoming Strategies
Authors: Sun Shangjun , Hao He , Yang Ge , Zhang Yi , Fu Yang
Published: April 2018

T cells modified via chimeric antigen receptors (CARs) have emerged as a promising treatment modality. Unparalleled clinical efficacy recently demonstrated in refractory B-cell malignancy has brought this new form of adoptive immunotherapy to the center stage. Nonetheless, its current success has also highlighted its potential treatment-related toxicities. The adverse events observed in the clinical trials are described in this review, after which, some innovative strategies developed to overcome these unwanted toxicities are outlined, including suicide genes, targeted activation, and other novel strategies.
Sliding Mode Control of Chaos in a Single Machine Connected to an Infinite Bus Power System
Authors: Alrifai Muthana T. , Zribi Mohamed
Published: April 2018

This paper deals with the control of chaos in a power system. A fourth-order model is adopted for the power system. Three controllers are proposed to suppress the chaos and avoid voltage collapse. The controllers are a feedback linearization controller, a conventional sliding mode controller, and a second-order super-twisting sliding mode controller. It is shown that the proposed controllers guarantee the convergence of the states of the system to their desired values. Simulations studies are presented to show the effectiveness of the proposed control schemes.
Shot Peening Effects on Subsurface Layer Properties and Fatigue Performance of Case‐Hardened 18CrNiMo7‐6 Steel
Authors: Ho H. S. , Li D. L. , Zhang E. L. , Niu P. H.
Published: April 2018

The present study is conducted with a dual‐aim: firstly, to examine the effect of several single shot peening conditions on the subsurface layer properties and fatigue performance of the case‐hardened 18CrNiMo7‐6 steel, and secondly, to propose an optimized peening condition for improved fatigue performance. By carrying out the subsurface integrity analysis and fatigue testing, the underlying relationships among the peening process, subsurface layer property and fatigue performance are investigated, the way peening conditions affect the fatigue life and its associated scatter for the case‐hardened 18CrNiMo7‐6 steel is quantitatively assessed. The in‐depth study shows that dual peening can be an optimized solution, for it is able to produce a subsurface layer with enhanced properties and eventually gain a significant improvement in fatigue performance.
Detection and Structural Characterization of Nucleophiles Trapped Reactive Metabolites of Limonin Using Liquid Chromatography-Mass Spectrometry
Authors: Deng Yujie , Fu Yudong , Xu Shumin , Wang Ping , Yang Nailong , Li Chengqian , Yu Qing
Published: April 2018

Limonin (LIM), a furan-containing limonoid, is one of the most abundant components of Dictamnus dasycarpus Turcz. Recent studies demonstrated that LIM has great potential for inhibiting the activity of drug-metabolizing enzymes. However, the mechanisms of LIM-induced enzyme inactivation processes remain unexplored. The main objective of this study was to identify the reactive metabolites of LIM using liquid chromatography-mass spectrometry. Three nucleophiles, glutathione (GSH), N-acetyl cysteine (NAC), and N-acetyl lysine (NAL), were used to trap the reactive metabolites of LIM in in vitro and in vivo models. Two different types of mass spectrometry, a hybrid quadrupole time-of-flight (Q-TOF) mass spectrometry and a LTQ velos Pro ion trap mass spectrometry, were employed to acquire structural information of nucleophile adducts of LIM. In total, six nucleophile adducts of LIM (M1–M6) with their isomers were identified; among them, M1 was a GSH and NAL conjugate of LIM, M2–M4 were glutathione adducts of LIM, M5 was a NAC and NAL conjugate of LIM, and M6 was a NAC adduct of LIM. Additionally, CYP3A4 was found to be the key enzyme responsible for the bioactivation of limonin. This metabolism study largely facilitates the understanding of mechanisms of limonin-induced enzyme inactivation processes.
An Interdisciplinary Pain Rehabilitation Program for Veterans with Chronic Pain: Description and Initial Evaluation of Outcomes
Authors: Anamkath Nidhi S. , Palyo Sarah A. , Jacobs Sara C. , Lartigue Alain , Schopmeyer Kathryn , Strigo Irina A.
Published: April 2018

Objective. Chronic pain conditions are prominent among Veterans. To leverage the biopsychosocial model of pain and comprehensively serve Veterans with chronic pain, the San Francisco Veterans Affairs Healthcare System has implemented the interdisciplinary pain rehabilitation program (IPRP). This study aims to (1) understand initial changes in treatment outcomes following IPRP, (2) investigate relationships between psychological factors and pain outcomes, and (3) explore whether changes in psychological factors predict changes in pain outcomes. Methods. A retrospective study evaluated relationships between clinical pain outcomes (pain intensity, pain disability, and opioid use) and psychological factors (depressive symptoms, catastrophizing, and “acceptable” level of pain) and changes in these outcomes following treatment. Multiple regression analysis explored whether changes in psychological variables significantly predicted changes in pain disability. Results. Catastrophizing and depressive symptoms were positively related to pain disability, while “acceptable” level of pain was idiosyncratically related to pain intensity. Pain disability and psychological variables showed significant changes in their expected directions. Regression analysis indicated that only changes in depressive symptoms significantly predicted changes in pain disability. Conclusion. Our results are consistent with evidence-based clinical practice guidelines for the management of chronic pain in Veterans. Further investigation of interdisciplinary treatment programs in Veterans is warranted.
The Role of Adjuvant Radiotherapy for a Case of Primary Breast Sarcoma: A Plan Comparison between Three Modern Techniques and a Review of the Literature
Authors: Cozzolino Mariella , Oliviero Caterina , D’Andrea Barbara , Guglielmi Giuseppe , Califano Giorgia , Caivano Rocchina , Bianculli Antonella , Fusco Vincenzo
Published: April 2018

A 65-year-old woman, affected by a malignant fibrous histiocytoma (undifferentiated pleomorphic sarcoma) of the left breast, presented to our department to receive the postoperative radiotherapy. In the absence of prospective and randomized trials and investigations on breast sarcoma irradiation in literature, due to the rarity of this pathology, the role of adjuvant radiotherapy remains unclear. To identify the best radiotherapy technique for this patient, three methods were compared: 3D conformal radiotherapy (3D-CRT), intensity-modulated radiation therapy (IMRT), and volumetric arc therapy (VMAT) or RapidArc® (RA). 50 Gy was prescribed to the chest wall and 66 Gy to the tumor bed. Three plans were designed, and target coverage, organs-at-risk sparing, and treatment efficiency were compared. IMRT and RA improved both target coverage and dose uniformity/homogeneity. Planning objective for the lung is always satisfied comparing the different techniques, but the volume receiving 20 Gy drops to 17% by RA compared to 3D-CRT. The heart volume receiving 30 Gy was 10% by IMRT, against 13% and 16% by RA and 3D-CRT. The monitor unit (MU) required by 3D-CRT was 527 MU, followed by RA and IMRT. Treatment time was similar with 3D-CRT and RA but doubled using IMRT. Although all three radiotherapy techniques offered a satisfactory solution, RA and IMRT offer some improvement on target coverage, dose homogeneity, and conformity for this particular case of breast sarcoma.
Evaluation of Regional Variability and Measurement Reproducibility of Intravoxel Incoherent Motion Diffusion Weighted Imaging Using a Cardiac Stationary Phase Based ECG Trigger Method
Authors: Xiang Zhiming , Ai Zhu , Liang Jianke , Li Guijin , Zhu Xiaolei , Yan Xu
Published: April 2018

Purpose. To evaluate the performance of an optimized ECG trigger diffusion weighted imaging (DWI) sequence in liver and its application in liver disease. Materials and Methods. Eighteen healthy volunteers underwent intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) scan of the liver twice in 1.5T MR scanner with signed informed consent approved by local ethic committees. A new method, called cardiac stationary phase based ECG trigger (CaspECG), and FB method were applied. The apparent diffusion coefficient (ADC) and the IVIM parameters, including pure diffusion coefficient (D), perfusion-related diffusion coefficient (D⁎), and perfusion fraction, (PF) were calculated, and then 18 region of interests were drawn on these parameter maps independently by two readers through whole hepatic lobe. The regional variability and reproducibility between two repeated scans were evaluated using interclass correlation coefficients (ICCs) and Bland-Altman plot, respectively, and compared between the CaspECG and FB methods. The signal-to-noise ratio (SNR) of DWI data was also evaluated. Result. Compared to the FB method, the proposed CaspECG method showed significant higher SNRs in DWI data, lower regional variability between left and right hepatic lobes, and higher reproducibility of ADC, PF, D, and D⁎ between repeat scans [left lobe, limit of agreement (LOA) of Bland-Altman plot: 10.1%, 18.3%, 19.8%, and 59.2%; right lobe, LOA: 10.25%, 14.15%, 16.45%, and 39.45%]. D⁎ showed the worst reproducibility in all parameters. Conclusion. The novel CaspECG method outperformed the FB method in compensating the cardiac motion induced artifacts in DWI data and generating more reliable quantitative parameters, with less regional variability and higher repeatability, especially in the left hepatic lobe.
A Comparative Analysis of Information Hiding Techniques for Copyright Protection of Text Documents
Authors: Taleby Ahvanooey Milad , Li Qianmu , Shim Hiuk Jae , Huang Yanyan
Published: April 2018

With the ceaseless usage of web and other online services, it has turned out that copying, sharing, and transmitting digital media over the Internet are amazingly simple. Since the text is one of the main available data sources and most widely used digital media on the Internet, the significant part of websites, books, articles, daily papers, and so on is just the plain text. Therefore, copyrights protection of plain texts is still a remaining issue that must be improved in order to provide proof of ownership and obtain the desired accuracy. During the last decade, digital watermarking and steganography techniques have been used as alternatives to prevent tampering, distortion, and media forgery and also to protect both copyright and authentication. This paper presents a comparative analysis of information hiding techniques, especially on those ones which are focused on modifying the structure and content of digital texts. Herein, various text watermarking and text steganography techniques characteristics are highlighted along with their applications. In addition, various types of attacks are described and their effects are analyzed in order to highlight the advantages and weaknesses of current techniques. Finally, some guidelines and directions are suggested for future works.
Analysis of Household Consumption Behavior and Indebted Self-Selection Effects: Case Study of Thailand
Authors: Liu Jianxu , Sirikanchanarak Duangthip , Sriboonchitta Songsak , Xie Jiachun
Published: April 2018

Copula is deemed to be a good approach for relaxing bivariate or multivariate distributions in econometric models. This paper combines static and dynamic copula functions with endogenous switching to study self-selection effects and interdependence between error terms. This technique, copula-based models, is applied to analyze household consumption behavior and indebted self-selection effects in Thailand. The independent, Gaussian, Frank, Clayton, Gumbel, and Joe copula functions and the relatively rotated copula functions were employed in the empirical work. The best model was selected by the information criterion, AIC. We separated the households into four groups, indebted households, debt-free households, households with housing/land loans, and households without housing/land loans, which favors the examination of the treatment effects of indebted households or households with housing debts. The main results indicate that dynamic copula-based models offer better performance than others, such as classical endogenous switching models or all static copula-based models. Also, the I–I and the G–G models underestimate the treatment effects relative to the best models. Additionally, importantly, the traditional normal bivariate distribution or the static copula function could characterize the relationship as regards errors between household debt choice and household consumption and can lead to very misleading implications about the treatment effects.
Mechanisms of Antiulcer Effect of an Active Ingredient Group of Modified Xiao Chaihu Decoction
Authors: Liu Wei , Yang Mengling , Chen Xuejian , Li Li , Zhou Aijun , Chen Shuhe , You Pengtao , Liu Yanwen
Published: April 2018

The present study aimed to investigate the antiulcer activities and mechanisms of action of an active ingredient group (AIG) of Modified Xiao Chaihu Decoction (MXCD). The gastroprotective action of the AIG was studied in ethanol‐induced, pylorus ligature‐induced, and acetic acid‐induced in vivo gastric ulcer models. The enzyme‐linked immunoadsorbent assay (tumor necrosis factor‐α (TNF‐α), prostaglandin E2(PGE2), and epidermal growth factor (EGF)), nitrate reductase assay (nitric oxide (NO)), western blot analysis (Bax, Bcl‐2, cleaved‐caspase‐3, and cleaved‐PARP (poly (ADP‐Ribose) polymerase)), histological analysis (HE), and immunohistochemical analysis (HSP‐70, p‐AKT, and PCNA) were used to evaluate the anti‐inflammatory, antiapoptotic, and healing properties of AIG. Numerous mechanisms are involved in the antiulcer activity of AIG, including the increase of PGE2, NO, and EGF content and a reduction in TNF‐α levels. The upregulation of HSP‐70, p‐AKT, and PCNA seems to be directly linked to the healing effect of AIG. Bax, Bcl‐2, cleaved‐caspase‐3, and cleaved‐PARP also play a key role in this process. The AIG exerted gastroprotective effects by reducing antisecretory, anti‐inflammatory, and antiapoptotic mechanisms. In addition, it promotes cell proliferation. Therefore, activation of the PI3K/AKT signaling pathway may play an important role in cell proliferation.
Low Magnitude of Compression Enhances Biosynthesis of Mesenchymal Stem Cells towards Nucleus Pulposus Cells via the TRPV4-Dependent Pathway
Authors: Gan Yibo , Tu Bing , Li Pei , Ye Jixing , Zhao Chen , Luo Lei , Zhang Chengmin , Zhang Zetong , Zhu Linyong , Zhou Qiang
Published: April 2018

Mesenchymal stem cell- (MSC-) based therapy is regarded as a promising tissue engineering strategy to achieve nucleus pulposus (NP) regeneration for the treatment of intervertebral disc degeneration (IDD). However, it is still a challenge to promote the biosynthesis of MSC to meet the requirement of NP regeneration. The purpose of this study was to optimize the compressive magnitude to enhance the extracellular matrix (ECM) deposition towards discogenesis of MSCs. Thus, we constructed a 3D culture model for MSCs to bear different magnitudes of compression for 7 days (5%, 10%, and 20% at the frequency of 1.0 Hz for 8 hours/day) using an intelligent and mechanically active bioreactor. Then, the underlying mechanotransduction mechanism of transient receptor potential vanilloid 4 (TRPV4) was further explored. The MSC-encapsulated hybrids were evaluated by Live/Dead staining, biochemical content assay, real-time PCR, Western blot, histological, and immunohistochemical analysis. The results showed that low-magnitude compression promoted anabolic response where high-magnitude compression induced the catabolic response for the 3D-cultured MSCs. The anabolic effect of low-magnitude compression could be inhibited by inhibiting TRPV4. Meanwhile, the activation of TRPV4 enhanced the biosynthesis analogous to low-magnitude compression. These findings demonstrate that low-magnitude compression promoted the anabolic response of ECM deposition towards discogenesis for the 3D-cultured MSCs and the TRPV4 channel plays a key role on mechanical signal transduction for low-magnitude compressive loading. Further understanding of this mechanism may provide insights into the development of new therapies for MSC-based NP regeneration.
Dynamic Analysis of Vehicle Track Coupling Based on Double Beam Track Model
Authors: Qi Yayun , Dai Huanyun , Yang Jianjin , Xu Kun
Published: April 2018

The rail was considered as double Timoshenko beam in this paper, applied to the vehicle track coupling dynamics model; the Hertz nonlinear method is used to calculate the wheel rail contact force. Wheel rail vertical force and response of vehicle are calculated by using the model under random irregularity and single harmonic excitation; at the same time, wheel rail force and vertical acceleration response of 3‐order, 10‐order, and 19‐order wheel polygon were calculated. The results show that, under the excitation of random irregularity, the wheel rail vertical force of two models was very close in the low frequency band, and the response of the double beam model in the high frequency band of 200–1000 Hz is larger than the single beam model, and the acceleration and displacement responses of the double beam model are relatively close. Under a single harmonic excitation, the double beam model has a shorter wheel rail force attenuation time than that of the single beam model. And wheel rail force peak value of double beam model is 9% larger than that of single beam model. Similarly, the vertical displacement of the double beam model increased by 2.6%. Under the 3‐order and 10‐order wheel polygon excitation, vertical wheel rail peak force of double beam is, respectively, 37.5% and 50% larger than single beam model; the vertical frame acceleration amplitude is 1 g and 1.7 g; under the 19‐order polygon wheel excitation, the difference of the wheel rail force between two models is very small, and the amplitude of acceleration of bogie is 2.3 g. And double beam model has more advantage in analyzing high frequency problems such as wheel polygonization.
Microscopic Flow Characteristics of Fluids in Porous Medium and Its Relationship with Remaining Oil Distribution: A Case Study in Saertu Oilfield of Daqing in China
Authors: Li Z. , Sun X. , Wang F. , Liang Y.
Published: April 2018

The Saertu Oilfield of Daqing in northeast China has entered ultrahigh water-cut stage of development. Numerical simulation is applied in this paper to study characteristics of microscopic fluid velocity and flow pressures variation in the core pores in the Beier Area of Saertu Oilfield. The relationship between the remaining oil distribution and microscopic flow characteristics of fluid in the pores has been analyzed. Study results show that, in the reservoir with stronger heterogeneity of grain size and throat (corresponding to high coordinate number), high flow velocities tend to occur in relatively wider pore throats with great differentiation of flow velocities. The dominant passages are developed in high capacity channel, the detour flows are created in large porous channels, and the isolated islands are formed in small porous channels. The flow velocity declines slowly with long duration of high pressure. Few pores are swept by injected fluids with low sweep efficiency. The microscopic remaining oil is mainly distributed in cluster state. The content of remaining oil is higher with lower oil displacement efficiency. By contrast, in the reservoir with weaker heterogeneity of grain size and throat (corresponding to low coordinate number), high flow velocities also develop in relatively narrower pore throats with little differentiation of flow velocities. The development of detour flows is weaker in large porous channels. The flow velocity declines quickly with a short duration of high pressure. More pores are swept by fluids with high sweep efficiency. The remaining oil is mainly distributed in state of thin film on pore surface. The content of remaining oil is lower with higher oil displacement efficiency.
Rapamycin Inhibits the Growth and Collagen Production of Fibroblasts Derived from Human Urethral Scar Tissue
Authors: Fu Delai , Yin Jian , Huang Shanlong , Li Hecheng , Li Zhaolun , Chong Tie
Published: April 2018

Rapamycin can inhibit fibroblast proliferation, collagen accumulation, and urethral stricture in rabbits. Transforming growth factor-beta-1 (TGF-β1) signaling, with downstream recruitment of Smad2, is known to promote fibrosis. This in vitro study examined the effects of rapamycin on fibroblasts derived from human urethral scar tissue (FHUS) and investigated the possible mechanism with respect to regulation of TGF-β1 signaling. FHUS were cultured from urethral scar tissues collected from four patients with urethral stricture. The cells were exposed to different concentrations of rapamycin (0, 10, 20, 40, 80, or 160 ng/ml) for 24 or 48 hours. Cell growth was assessed by the MTT assay. Collagen content was measured based on hydroxyproline levels. The mRNA expressions of Smad2, eIF-4E, and alpha-1 chains of collagen types I and III (Col1α1 and Col3α1) were determined by semiquantitative reverse-transcription PCR. The protein expressions of Smad2, phospho-Smad2, and eIF-4E were evaluated by western blot. Rapamycin caused a concentration-dependent inhibition of FHUS growth at 24 and 48 hours (P<0.01). Rapamycin decreased total collagen content (P<0.01), collagen content per 105 cells (P<0.05), and mRNA expressions of Col1α1 and Col3α1 (P<0.05) in a concentration-dependent manner. Rapamycin elicited concentration-dependent reductions in the mRNA (P<0.05) and protein (P<0.01) expressions of Smad2 and eIF-4E. The two highest concentrations of rapamycin also enhanced phospho-Smad2 levels (P<0.01). In conclusion, the present study confirmed that rapamycin may reduce the growth and collagen production of FHUS, possibly through inhibition of TGF-β1 signaling.
A Scalar Expected Value of Intuitionistic Fuzzy Random Individuals and Its Application to Risk Evaluation in Insurance Companies
Authors: Li Chunquan , Jin Jianhua
Published: April 2018

Randomness and uncertainty always coexist in complex systems such as decision-making and risk evaluation systems in the real world. Intuitionistic fuzzy random variables, as a natural extension of fuzzy and random variables, may be a useful tool to characterize some high-uncertainty phenomena. This paper presents a scalar expected value operator of intuitionistic fuzzy random variables and then discusses some properties concerning the measurability of intuitionistic fuzzy random variables. In addition, a risk model based on intuitionistic fuzzy random individual claim amount in insurance companies is established, in which the claim number process is regarded as a Poisson process. The mean chance of the ultimate ruin is investigated in detail. In particular, the expressions of the mean chance of the ultimate ruin are presented in the cases of zero initial surplus and arbitrary initial surplus, respectively, if individual claim amount is an exponentially distributed intuitionistic fuzzy random variable. Finally, two illustrated examples are provided.
Predictive Value of Procalcitonin for Bacterial Infection after Transarterial Chemoembolization or Radiofrequency Ablation for Hepatocellular Carcinoma
Authors: Kang Seung Ji , Kim Uh Jin , Kim Seong Eun , An Joon Hwan , Jang Mi Ok , Myung Dae-Seong , Park Kyung-Hwa , Jung Sook-In , Cho Sung Bum , Jang Hee-Chang , Joo Young Eun
Published: April 2018

This prospective observational study aimed at investigating the role of procalcitonin (PCT) in diagnosing bacterial infection and guiding antibiotic therapy for hepatocellular carcinoma (HCC) patients with fever after transarterial chemoembolization (TACE) and/or radiofrequency ablation (RFA). Ninety-seven cases (84 patients) were enrolled. Serum PCT, C-reactive protein (CRP), and white blood cell (WBC) counts were measured on the day of fever onset (day 0) and days 1, 3, 5, and 7 of fever. Empirical antibiotics were initiated only if PCT was ≥0.5 ng/mL or specific infection foci were suspected. An infectious cause was found in nine cases. PCT on day 0 of fever was significantly higher in patients with bacterial infection than in those without infection (P=0.035). The area under the receiver operating characteristic curve for PCT was 0.715 (95% confidence interval, 0.538–0.892) and was higher than that for CRP (0.598 (0.368–0.828)) or WBC counts (0.502 (0.307–0.697)). In patients undergoing TACE and/or RFA, a significantly lower number of antibiotics were prescribed during the study period than during the prestudy period (P<0.001). In conclusion, PCT might be a biomarker for diagnosing infection and guiding antibiotic treatment to reduce unnecessary antibiotic use in patients with fever after TACE and/or RFA.
Herbal Compounds Play a Role in Neuroprotection through the Inhibition of Microglial Activation
Authors: Fu Yan , Yang Jianmei , Wang Xingyu , Yang Pin , Zhao Yang , Li Kun , Chen Yongjun , Xu Ying
Published: April 2018

Since microglia possess both neuroprotective and neurotoxic potential, they play a crucial role in the central nervous system (CNS). Excessive microglial activation induces inflammation-mediated neuronal damage and degeneration. At present, numerous herbal compounds are able to suppress neurotoxicity via inhibiting microglial activation. Therefore, many researchers focus on pharmacological inhibitors of microglial activation to ameliorate neurodegenerative disorders. Further work should concentrate on the exploration of new herbal compounds, which characteristically inhibit microglial neurotoxicity, rather than modulating neuroprotection alone. In this review, we summarize these herbal compounds, which in the past several years have been shown to exert potential neuroprotective activity by inhibiting microglial activation. The therapeutic targets and pharmacological mechanisms of these compounds have also been discussed.
Enhanced Photodecomposition of Methylene Blue in Water with Sr1−xKxTiO3−δ@PC-polyHIPEs under UV and Visible Light
Authors: Gao Yonghua , Zhang Tao , Guo Qipeng , Gao Lizhen
Published: April 2018

Photocatalytic method was investigated to remove water pollutant methylene blue (MB) produced in textile, plastic, and dye industries. PC-polyHIPEs were prepared by light-induced polymerization of dopamine in transparent polyHIPEs which were synthesized by polymerization within high internal phase emulsions. Sr1-xKxTiO3-δ (x = 0–0.5) nanoparticles were incorporated and adhered to PC-polyHIPEs to form Sr1-xKxTiO3-δ@PC-polyHIPEs for the first time. The catalysts were characterized by XRD, FTIR, TGA, UV-Vis DRS, and SEM and their photocatalytic properties for MB decomposition were measured over UV-Vis spectrometer. The PC-polyHIPEs were of interconnected porous structure with around 100 μm pores and 30 μm windows. Sr1−xKxTiO3−δ@PC-polyHIPEs showed excellent MB decomposition activity under either UV or visible light although Sr1−xKxTiO3−δ alone worked only under UV light. When x = 0.3, Sr1−xKxTiO3−δ@PC-polyHIPEs showed the highest photocatalytic performance due to the existence of more oxygen vacancies. When the water solution with 50 mg L−1 MB and 1.6 gcat. L−1 Sr0.7K0.3TiO3−δ@PC-polyHIPEs was exposed to visible light for 160 min at room temperature, 88.3% of MB was decomposed. After being used for eight cycles, 87.6% activity of fresh Sr0.7K0.3TiO3−δ@PC-polyHIPEs still remained. The influences of salinity, temperature, and catalyst concentration on the catalytic activity were studied. For MB decomposition under visible light, the activation energy of Sr0.7K0.3TiO3−δ@PC-polyHIPEs was calculated to be 12.3 kJ mol−1 and the kinetics analysis revealed that the photocatalysis followed the second-order reaction. These findings demonstrated that Sr1−xKxTiO3−δ@PC-polyHIPEs were an effective candidate for real application in decomposition of MB in water.
Keeping a Completely Autotrophic Nitrogen Removal over Nitrite System Effective in Treating Low Ammonium Wastewater by Adopting an Alternative Low and High Ammonium Influent Regime
Authors: Chang Qinglong , Wang Weigang , Chen Jie , Wang Yayi
Published: April 2018

An alternative low and high ammonium influent regime was proposed and adopted to keep a completely autotrophic nitrogen removal over nitrite (CANON) effective when treating low ammonium wastewater. Results show that, by cyclic operating at an alternative low and high ammonium concentration for 10 days and 28 days, the CANON system could effectively treat low ammonium wastewater. Excessive proliferation of nitrite oxidizing bacteria (NOB) under low ammonium environment was still the challenge for the stable CANON operation; but with 28 days of a high ammonium treatment combined with a sludge retention time control, the NOB overproliferated in the low ammonium operational period could be under control. Specifically, when the nitrite oxidation rate reached 8 g N/m3/h, the CANON system should enter the high ammonium influent operating mode. 16S rDNA high-throughput sequencing results show that the appropriate sludge discharging provided an environment favoring Candidatus Jettenia.
Deptor Is a Novel Target of Wnt/β-Catenin/c-Myc and Contributes to Colorectal Cancer Cell Growth
Authors: Wang Qingding , Zhou Yuning , Rychahou Piotr , Harris Jennifer W. , Zaytseva Yekaterina Y. , Liu Jinpeng , Wang Chi , Weiss Heidi L. , Liu Chunming , Lee Eun Y. , Evers B. Mark
Published: April 2018

Activation of the Wnt/β-catenin signaling pathway drives colorectal cancer growth by deregulating expression of downstream target genes, including the c-myc proto-oncogene. The critical targets that mediate the functions of oncogenic c-Myc in colorectal cancer have yet to be fully elucidated. Previously, we showed that activation of PI3K/Akt/mTOR contributes to colorectal cancer growth and metastasis. Here, we show that Deptor, a suppressor of mTOR, is a direct target of Wnt/β-catenin/c-Myc signaling in colorectal cancer cells. Inhibition of Wnt/β-catenin or knockdown of c-Myc decreased, while activation of Wnt/β-catenin or overexpression of c-Myc increased the expression of Deptor. c-Myc bound the promoter of Deptor and transcriptionally regulated Deptor expression. Inhibition of Wnt/β-catenin/c-Myc signaling increased mTOR activation, and the combination of Wnt and Akt/mTOR inhibitors enhanced inhibition of colorectal cancer cell growth in vitro and in vivo. Deptor expression was increased in colorectal cancer cells; knockdown of Deptor induced differentiation, decreased expression of B lymphoma Mo-MLV insertion region 1 (Bmi1), and decreased proliferation in colorectal cancer cell lines and primary human colorectal cancer cells. Importantly, our work identifies Deptor as a downstream target of the Wnt/β-catenin/c-Myc signaling pathway, acting as a tumor promoter in colorectal cancer cells. Moreover, we provide a molecular basis for the synergistic combination of Wnt and mTOR inhibitors in treating colorectal cancer with elevated c-Myc.

Significance: The mTOR inhibitor DEPTOR acts as a tumor promoter and could be a potential therapeutic target in colorectal cancer. Cancer Res; 78(12); 3163–75. ©2018 AACR.
Strategic Therapeutic Targeting to Overcome Venetoclax Resistance in Aggressive B-cell Lymphomas
Authors: Pham Lan V. , Huang Shengjian , Zhang Hui , Zhang Jun , Bell Taylor , Zhou Shouhao , Pogue Elizabeth , Ding Zhiyong , Lam Laura , Westin Jason , Davis R. Eric , Young Ken H. , Medeiros L. Jeffrey , Ford Richard J. , Nomie Krystle , Zhang Leo , Wang Michael
Published: April 2018

Purpose: B-cell lymphoma-2 (BCL-2), an antiapoptotic protein often dysregulated in B-cell lymphomas, promotes cell survival and provides protection from stress. A recent phase I first-in-human study of the BCL-2 inhibitor venetoclax in non-Hodgkin lymphoma showed an overall response rate of 44%. These promising clinical results prompted our examination of the biological effects and mechanism of action underlying venetoclax activity in aggressive B-cell lymphoma, including mantle cell lymphoma (MCL) and diffuse large B-cell lymphoma (DLBCL).

Experimental Design: MCL and DLBCL cell lines, primary patient samples, and in vivo patient-derived xenograft (PDX) models were utilized to examine venetoclax efficacy. Furthermore, the mechanisms underlying venetoclax response and the development of venetoclax resistance were evaluated using proteomics analysis and Western blotting.

Results: Potential biomarkers linked to venetoclax activity and targeted combination therapies that can augment venetoclax response were identified. We demonstrate that DLBCL and MCL cell lines, primary patient samples, and PDX mouse models expressing high BCL-2 levels are extremely sensitive to venetoclax treatment. Proteomics studies showed that venetoclax substantially alters the expression levels and phosphorylation status of key proteins involved in cellular processes, including the DNA damage response, cell metabolism, cell growth/survival, and apoptosis. Short- and long-term exposure to venetoclax inhibited PTEN expression, leading to enhanced AKT pathway activation and concomitant susceptibility to PI3K/AKT inhibition. Intrinsic venetoclax-resistant cells possess high AKT activation and are highly sensitive to PI3K/AKT inhibition.

Conclusions: These findings demonstrate the on-target effect of venetoclax and offer potential mechanisms to overcome acquired and intrinsic venetoclax resistance through PI3K/AKT inhibition. Clin Cancer Res; 24(16); 3967–80. ©2018 AACR.
Exploring the Role of Wealth and Religion on the Ownership of Captive Lemurs in Madagascar Using Qualitative and Quantitative Data
Authors: Reuter Kim E. , Clarke Tara A. , LaFleur Marni , Ratsimbazafy Jonah , Kjeldgaard Fabiola Holiniaina , Rodriguez Lucia , Schaeffer Toby , Schaefer Melissa S.
Published: April 2018

Primates are kept as pets for various reasons including as indicators of wealth. Ownership of primates can also be influenced by religion. In Madagascar, thousands of lemurs are kept as pets, but the roles of wealth and religion in the ownership of captive lemurs have not been explored. We use quantitative and qualitative data to examine these aspects of ownership. Quantitative data were collected (July to August 2016) in households (n = 596) of 12 urban and rural towns in Madagascar using semi-structured interviews. International standards for research ethics were followed. Research was approved by an ethics oversight committee. We also opportunistically visited 13 religious facilities. Qualitative data were used to frame the context of the quantitative data. We found that pet lemur owners do not speak about their lemurs as a symbol of wealth, but non-owners associate pet lemurs with wealth. Therefore, status/wealth may be a motivating factor in the ownership of pet lemurs. We also found evidence that Catholic entities in Madagascar sometimes take in captive lemurs when the owner can no longer care for the animal (being viewed as animal-friendly institutions). However, we did not find evidence of religion (institutional or traditional) influencing the ownership of pet lemurs.
Identity Construction and Symbolic Association in Farmer-Vervet Monkey (Chlorocebus aethiops sabaeus) Interconnections in St. Kitts
Authors: Dore Kerry M. , Eller Andrea R. , Eller Jackie L.
Published: April 2018

Primates occupy a liminal space between humans and animals. On the Caribbean island of St. Kitts, translocated vervet monkeys (Chlorocebus aethiops sabaeus) are respected creatures, yet they cause problems. Vervets regularly consume crops on farms and are considered “pests”; still, Kittitians express empathy and understanding for them based largely on the monkeys' display of human-like behaviours. Using data from interviews with 64 Kittitian farmers, we deconstruct the symbolism of the vervet monkey in St. Kitts and analyse how farmers give the monkeys identities that are meaningful only within human social expectations. Our findings reveal that Kittitian farmers consider monkeys to be clever and emotive, displaying complex intentions such as revenge and remorse. Yet, crop-foraging behaviour is a regular and negative experience for the majority of farmers in this study, and the monkeys' presence itself is a constant reminder of the multitude of challenges farmers face in a newly adopted tourism economy that no longer prioritises agriculture. Our results reveal that while vervet crop consumption is a significant problem in St. Kitts, it is the monkeys' boundary-crossing status that drives the growing mentality that “the monkey problem” is completely out of control.
Effectiveness and Safety of Pylera® in Patients Infected by Helicobacter Pylori: A Multicenter, Retrospective, Real Life Study
Authors: Tursi Antonio , Franceschi Marilisa , Allegretta Leonardo , Savarino Edoardo , De Bastiani Rudi , Elisei Walter , Baldassarre Gianluca , Ferronato Antonio , Scida Serena , Miraglia Chiara , Penna Antonio , Licci Claudio , Rizzo Giovanni Luca , Pranzo Giuseppe , Cassieri Claudio , Brandimarte Giovanni , Picchio Marcello , Di Mario Francesco
Published: April 2018

Background: Our aims were to assess the real life effectiveness and safety of the new bismuth-containing quadruple therapy in a large population of patients infected by Helicobacter pylori. Methods: Consecutive dyspeptic H. pylori-positive patients were enrolled, both naïve for treatment and already unsuccessfully treated. Patients were treated with Pylera® 3 capsules 4 times/daily plus omeprazole 20 mg or esomeprazole 40 mg 2 times/daily for 10 days. Eradication was confirmed using a urea-breath test (at least 30 days after the end of the treatment). Efficacy and safety were assessed. Results: A total of 349 patients were treated. H. pylori eradication was achieved in 316 (90.5%, 95% CIs 80.8–1.0) patients in the intention-to-treat population, and in 93.5% (95% CIs 83.5–1.0) in the per-protocol population. No difference in the eradication rate was found between naïve and previously treated patients (91.3 vs. 90.0%, p = 0.901). Adverse events occurred in 55 patients (15.8%, 95% CIs 11.9–20.1). Five patients discontinued treatment: 2 patients suffered from severe abdominal pain, one patient from headache, one patient from diarrhea, and one patient from diffuse urticarial rush. Conclusions: Pylera® achieved a remarkable eradication rate in real life both as first treatment and as a rescue therapy, with a good safety profile.
Dexamethasone Intravitreal Implant for Early Treatment and Retreatment of Macular Edema Related to Branch Retinal Vein Occlusion: The Multicenter COBALT Study
Authors: Yoon Young Hee , Kim Jong Woo , Lee Joo Yong , Kim In Taek , Kang Se Woong , Yu Hyeong Gon , Koh Hyoung Jun , Kim Sung Soo , Chang Dong-Jin , Simonyi Susan
Published: April 2018

Purpose: To evaluate the effect of dexamethasone intravitreal implant for macular edema (ME) following branch retinal vein occlusion (BRVO) in Korean patients. Methods: We performed a prospective, open-label, multicenter study of 71 patients with ME for < 3 months. Retreatment was allowed ≥4 months from the last injection. Results: At 6 and 12 months, mean ± SD best-corrected visual acuity (BCVA) improvement was 18.6 ± 12.9 and 15.3 ± 15.0 letters, respectively. Approximately 70% of maximum treatment response was observed after 1 week. Over the 12-month period, 32 and 49% of patients received 1 and 3 injections, respectively, with a mean ± SD interval of 20.0 ± 5.0 weeks. Patients who required 3 injections had higher central retinal thickness (CRT) and larger macular nonperfusion at baseline compared to those requiring only 1 injection. Adverse events included increased intraocular pressure (35%) and newly diagnosed cataract (16%). Conclusions: Intravitreal dexamethasone treatment with an interval of ≥4 months provides rapid and significantly better improvement in BCVA and CRT in patients with BRVO-associated ME.
Higher Incidence Rates of Hypothyroidism and Late TSH Rise in Preterm Very-Low-Birth-Weight Infants at a Tertiary Care Center
Authors: Tfayli Hala , Charafeddine Lama , Tamim Hani , Saade Joanne , Daher Rose T. , Yunis Khalid
Published: April 2018

Background/Aims: Preterm newborns with a very low birth weight (VLBW) of < 1,500 g have an atypical form of hypothyroidism with a delayed rise in TSH, necessitating a second newborn screening specimen collection. The aims of this study were to survey the compliance with second newborn screening to detect delayed TSH rise in VLBW preterm infants at a tertiary care center, and to determine the rate of atypical hypothyroidism. Methods: Retrospective review of the records of 104 preterm VLBW infants. Late TSH rise was defined as an increase in TSH concentration after 14 days of age in the presence of a normal initial screen. Results: The compliance rate was 92% for the second screening. High rates of hypothyroidism (16.3%) and of late TSH rise (4.8%) were detected. Patients with hypothyroidism had a significantly lower birth weight (p = 0.01) and longer hospital stay (p = 0.004). Patients with late versus those with early TSH rise had a significantly lower mean birth weight (851 ± 302 vs. 1,191 ± 121 g, p = 0.004). Conclusion: The rates of early and late TSH rise in this VLBW population were higher than those in the literature and could be due to the use of povidone-iodine disinfectants. The yield of a second TSH screening in this study was high indicating the need for vigilance in screening VLBW preterm infants.
Experiences Of Individuals Concerning Combined Orthodontic and Orthognathic Surgical Treatment: A Qualitative Twitter Analysis
Authors: Watts Guy D. , Christou Panagiotis  , Antonarakis Gregory S.
Published: April 2018

Objective: The aim of this qualitative study was to analyze the content of posts on Twitter in order to gain an in-depth understanding of patients’ thoughts and experiences surrounding orthognathic surgical treatment. Materials and Methods: Using the Twitter search function, with the keywords “jaw surgery,” the 1,000 most recent posts on Twitter with relevance to a combined orthodontic and orthognathic surgical treatment were extracted. After applying relevant inclusion and exclusion criteria, the selected posts were analyzed using thematic analysis by 2 independent investigators. Distinct themes and subthemes were developed. Results: A total of 689 posts were analyzed; the 3 main themes identified in relation to orthognathic surgery were preoperative engagement, postoperative difficulties, and posttreatment satisfaction. Twelve subthemes were also identified, expressing issues such as anticipation or apprehension of the surgical procedure, postoperative pain and edema, dietary restrictions and weight loss, paresthesia, depression, and satisfaction with improvements in appearance and self-confidence. The 6 terms most frequently used in tweets were “recovery,” “braces,” “swollen,” “eat,” “liquid diet,” and “pain.” Conclusions: The findings from the present study can increase the awareness of clinicians involved in the combined orthodontic and orthognathic surgical treatment of patients with dentofacial deformities, allowing them to better educate and counsel their patients throughout the entire treatment process.