bluuebunny/crossref_metadata_2025 huggingface dataset:
Ethnicity-specific factors influencing childhood immunisation decisions among Black and Asian Minority Ethnic groups in the UK: a systematic review of qualitative research
Authors: Forster Alice S , Rockliffe Lauren , Chorley Amanda J , Marlow Laura A V , Bedford Helen , Smith Samuel G , Waller Jo
Published: August 2016

Background

Uptake of some childhood immunisations in the UK is lower among those from some Black and Asian Minority Ethnic (BAME) backgrounds. This systematic review of qualitative research sought to understand the factors that are associated with ethnicity that influence the immunisation decisions of parents from BAME backgrounds living in the UK.

Methods

Databases were searched on 2 December 2014 for studies published at any time using the terms ‘UK’ and ‘vaccination’ and ‘qualitative methods’ (and variations of these). Included articles comprised participants who were parents from BAME backgrounds. Thematic synthesis methods were used to develop descriptive and higher order themes. Themes specific to ethnicity and associated factors are reported.

Results

Eight papers were included in the review. Most participants were from Black (n=62) or Asian (n=38) backgrounds. Two ethnicity-related factors affected immunisation decisions. First, factors that are related to ethnicity itself (namely religion, upbringing and migration, and language) affected parents' perceived importance of immunisations, whether immunisations were permitted or culturally acceptable and their understanding of immunisation/the immunisation schedule. Second, perceived biological differences affected decision-making and demand for information.

Conclusions

Factors related to ethnicity must be considered when seeking to understand immunisation decisions among parents from BAME backgrounds. Where appropriate and feasible, vaccination information should be targeted to address beliefs about ethnic differences held by some individuals from some BAME backgrounds.
Increased von Willebrand factor levels in patients with systemic lupus erythematosus reflect inflammation rather than increased propensity for platelet activation
Authors: Nossent Johannes C , Raymond Warren D , Eilertsen Gro Østli
Published: August 2016

Background

von Willebrand factor (VWF) is involved in platelet plug formation and protein transport. Increased VWF levels in systemic lupus erythematous (SLE) are considered risk factors for vascular events. VWF protein levels, however, do not accurately reflect its platelet-aggregating function, which has not been examined in SLE.

Methods

Cross-sectional study with clinical and laboratory data obtained in patients with SLE (n=92) from a regional lupus registry. VWF function was determined by ristocetin-induced platelet aggregation (VWF ristocetin cofactor, VWF:RCo) and VWF levels by turbidimetric assay (VWF antigen, VWF:Ag). The platelet-aggregating activity per VWF unit was estimated by the VWF RCo/Ag ratio. Healthy controls served as comparators and associations were evaluated by non-parametric methods.

Results

VWF:Ag (142% vs 107%, p=0.001) and VWF:RCo levels (123% vs 78%, p<0.041) were increased in patients with SLE, but VWF RCo/Ag ratio was similar as in controls (0.83 vs 0.82, p=0.8). VWF:Ag levels were higher in patients experiencing serositis but unrelated to other manifestations, thrombotic disease, Systemic Lupus Erythematous Disease Activity Index 2000 or Systemic Lupus International Collaborative Clinics-Damage Index. VWF:Ag levels correlated significantly with VWF:RCo levels (Rs 0.8, p<0.001), erythrocyte sedimentation rate (ESR) (Rs 0.32, p<0.01), anti-dsDNA Ab (Rs 0.27, p<0.01), total IgG (Rs 0.33 p<0.01), fibrinogen (Rs 0.28, p<0.01) and ceruloplasmin (Rs 0.367, p<0.01) levels. VWF:RCo levels were not related to clinical findings but were correlated with ESR, anti-dsDNA and transferrin levels. No serological associations existed for VWF RCo/Ag ratio (all p>0.2).

Conclusions

In this SLE cohort, VWF:Ag behaved similarly to acute-phase reactants, but VWF:Ag increases were not matched by increases in functional activity per unit of VWF. Thus, more VWF did not increase the propensity for platelet aggregation in SLE.
Clinical outcomes of transcatheter aortic valve implantation: from learning curve to proficiency
Authors: Lunardi Mattia , Pesarini Gabriele , Zivelonghi Carlo , Piccoli Anna , Geremia Giulia , Ariotti Sara , Rossi Andrea , Gambaro Alessia , Gottin Leonardo , Faggian Giuseppe , Vassanelli Corrado , Ribichini Flavio
Published: August 2016

Objective

The use of transcatheter aortic valve implantation (TAVI) is growing rapidly in countries with a predominantly elderly population, posing a huge challenge to healthcare systems worldwide. The increment of human and economic resource consumption imposes a careful monitoring of clinical outcomes and cost-benefit balance, and this article is aimed at analysing clinical outcomes related to the TAVI learning curve.

Methods

Outcomes of 177 consecutive transfemoral TAVI procedures performed in 5 years by a single team were analysed by the Cumulative Sum of failures method (CUSUM) according to the clinical events comprised in the Valve Academic Research Consortium (VARC-2) safety end point and the VARC-2 definition of device success. Margins for events acceptance were extrapolated from landmark trials that tested both balloon or self-expandable percutaneous valves.

Results

30-day and 1-year survival rates were 97.2% and 89.9%, respectively. Achievement of the primary end point (number of cases needed to provide the acceptable margin of the composite end point of any death, stroke, myocardial infarction, life-threatening bleeding, major vascular complications, stage 2–3 acute kidney injury and valve-related dysfunction requiring a repeat procedure) required the performance of 54 cases, while the learning curve to achieve ‘device success’ identified 32 cases to reach the expected proficiency. In this experience, the baseline clinical risk as assessed by the Society of Thoracic Surgeons (STS) score determined the long-term survival rather than the adverse events related to the learning curve.

Conclusions

A relatively large number of cases are required to achieve clinical outcomes comparable to those reported in high-volume centres and controlled trials. According to our national workload standards, this represents more than 2 years of continuous activity.
Drivers of healthcare costs associated with the episode of care for surgical aortic valve replacement versus transcatheter aortic valve implantation
Authors: Wijeysundera Harindra C , Li Lindsay , Braga Vevien , Pazhaniappan Nandhaa , Pardhan Anar M , Lian Dana , Leeksma Aric , Peterson Ben , Cohen Eric A , Forsey Anne , Kingsbury Kori J
Published: August 2016

Objective

Transcatheter aortic valve implantation (TAVI) is generally more expensive than surgical aortic valve replacement (SAVR) due to the high cost of the device. Our objective was to understand the patient and procedural drivers of cumulative healthcare costs during the index hospitalisation for these procedures.

Design

All patients undergoing TAVI, isolated SAVR or combined SAVR+coronary artery bypass grafting (CABG) at 7 hospitals in Ontario, Canada were identified during the fiscal year 2012–2013. Data were obtained from a prospective registry. Cumulative healthcare costs during the episode of care were determined using microcosting. To identify drivers of healthcare costs, multivariable hierarchical generalised linear models with a logarithmic link and γ distribution were developed for TAVI, SAVR and SAVR+CABG separately.

Results

Our cohort consisted of 1310 patients with aortic stenosis, of whom 585 underwent isolated SAVR, 518 had SAVR+CABG and 207 underwent TAVI. The median costs for the index hospitalisation for isolated SAVR were $21 811 (IQR $18 148–$30 498), while those for SAVR+CABG were $27 256 (IQR $21 741–$39 000), compared with $42 742 (IQR $37 295–$56 196) for TAVI. For SAVR, the major patient-level drivers of costs were age >75 years, renal dysfunction and active endocarditis. For TAVI, chronic lung disease was a major patient-level driver. Procedural drivers of cost for TAVI included a non-transfemoral approach. A prolonged intensive care unit stay was associated with increased costs for all procedures.

Conclusions

We found wide variation in healthcare costs for SAVR compared with TAVI, with different patient-level drivers as well as potentially modifiable procedural factors. These highlight areas of further study to optimise healthcare delivery.
Variation in the use of definitive treatment options in the management of Graves’ disease: a UK clinician survey
Authors: Hookham Jessica , Collins Emma E , Allahabadia Amit , Balasubramanian Sabapathy P
Published: August 2016

Background

Graves’ disease can be treated with antithyroid drugs (ATDs), radioiodine or surgery. Use of definitive treatments (radioiodine or surgery) varies widely across centres. Specific clinical circumstances, local facilities, patient and clinician preferences and perceptions will affect the choice of treatment. Detailed understanding of UK clinicians’ views and their rationale for different treatments is lacking.

Aims

To study the preferences and perceptions of UK clinicians on the role of surgery and radioiodine in the management of Graves’ disease.

Methods

‘British Thyroid Association’ (BTA), ‘Society for Endocrinology’ (SFE) and ‘British Association of Endocrine and Thyroid Surgeons’ (BAETS) members were invited to complete an online survey examining their management decisions in Graves’ disease and factors that influenced their decisions.

Results

158 responses from UK consultants were included. The ratio of physicians to surgeons was 11:5 and males to females was 12:4. Most clinicians would commence ATDs in uncomplicated first presentation of Graves’ disease. A wide range of risk estimates on the effectiveness and risks of treatment was given by clinicians. Radioiodine was used most frequently in relapsed Graves’ disease. However, severe eye disease and pregnancy strongly influenced choice in favour of surgery. Surgeons underestimated the success of radioiodine (p<0.01) and were more likely to recommend thyroidectomy than physicians.

Conclusions

This survey demonstrates significant variation in clinicians’ perceptions of risks of treatment and their choice of management options for relapsed Graves’ disease. The variation appeared to be dependent on patient and disease-specific factors as well as physician experience, gender and specialty.
Curcumin improves the metabolic syndrome in high-fructose-diet-fed rats: role of TNF-α, NF-κB, and oxidative stress
Authors: Kelany Mohamed Elsayed , Hakami Tahir M. , Omar Adel H.
Published: August 2016

This study aimed to investigate effects of curcumin on high fructose diet (HFD)-induced metabolic syndrome (MetS) in rats and the possible mechanisms involved. MetS was induced in male albino rats (n = 20), over 8 weeks, by 65% HFD. For 8-week experiment period, rats were assigned to 2 equal groups: curcumin-treated rats received curcumin (200 mg/kg, p.o, once daily) along with HFD, and untreated rats were fed with HFD only. We evaluated body mass (BM), systolic blood pressure (SBP), homeostasis model assessment of insulin resistance (HOMA-IR), and serum levels of glucose, insulin, leptin, total cholesterol (TC), triglycerides (TGs), uric acid, malondialdehyde (MDA; lipid peroxidation product), and tumor necrosis factor-α (TNF-α; inflammatory cytokine), and serum catalase (endogenous antioxidant) activity and immunohistochemical expression of nuclear factor κB (NF-κB; inflammation-related transcription factor) in hepatocytes. HFD produced increases in BM, SBP, HOMA-IR, and serum levels of glucose, insulin, leptin, TC, TGs, uric acid, MDA, and TNF-α, a decrease in catalase activity, and strong positive expression of NF-κB in hepatocytes. Curcumin, in presence of HFD, produced significant improvements in all glucose and fat metabolism parameters, and in oxidative stress and inflammation biomarkers. Curcumin may potentially be useful in the treatment of MetS through its ability to modulate oxidation stress status and inflammation cascades.
Dorsomedial hypothalamic NPY affects cholecystokinin-induced satiety via modulation of brain stem catecholamine neuronal signaling
Authors: de La Serre Claire B. , Kim Yonwook J. , Moran Timothy H. , Bi Sheng
Published: August 2016

Increased neuropeptide Y (NPY) gene expression in the dorsomedial hypothalamus (DMH) has been shown to cause hyperphagia, but the pathway underlying this effect remains less clear. Hypothalamic neural systems play a key role in the control of food intake, in part, by modulating the effects of meal-related signals, such as cholecystokinin (CCK). An increase in DMH NPY gene expression decreases CCK-induced satiety. Since activation of catecholaminergic neurons within the nucleus of solitary tract (NTS) contributes to the feeding effects of CCK, we hypothesized that DMH NPY modulates NTS neural catecholaminergic signaling to affect food intake. We used an adeno-associated virus system to manipulate DMH NPY gene expression in rats to examine this pathway. Viral-mediated hrGFP anterograde tracing revealed that DMH NPY neurons project to the NTS; the projections were in close proximity to catecholaminergic neurons, and some contained NPY. Viral-mediated DMH NPY overexpression resulted in an increase in NPY content in the NTS, a decrease in NTS tyrosine hydroxylase (TH) expression, and reduced exogenous CCK-induced satiety. Knockdown of DMH NPY produced the opposite effects. Direct NPY administration into the fourth ventricle of intact rats limited CCK-induced satiety and overall TH phosphorylation. Taken together, these results demonstrate that DMH NPY descending signals affect CCK-induced satiety, at least in part, via modulation of NTS catecholaminergic neuronal signaling.
Rapid classification of hippocampal replay content for real-time applications
Authors: Deng Xinyi , Liu Daniel F. , Karlsson Mattias P. , Frank Loren M. , Eden Uri T.
Published: August 2016

Sharp-wave ripple (SWR) events in the hippocampus replay millisecond-timescale patterns of place cell activity related to the past experience of an animal. Interrupting SWR events leads to learning and memory impairments, but how the specific patterns of place cell spiking seen during SWRs contribute to learning and memory remains unclear. A deeper understanding of this issue will require the ability to manipulate SWR events based on their content. Accurate real-time decoding of SWR replay events requires new algorithms that are able to estimate replay content and the associated uncertainty, along with software and hardware that can execute these algorithms for biological interventions on a millisecond timescale. Here we develop an efficient estimation algorithm to categorize the content of replay from multiunit spiking activity. Specifically, we apply real-time decoding methods to each SWR event and then compute the posterior probability of the replay feature. We illustrate this approach by classifying SWR events from data recorded in the hippocampus of a rat performing a spatial memory task into four categories: whether they represent outbound or inbound trajectories and whether the activity is replayed forward or backward in time. We show that our algorithm can classify the majority of SWR events in a recording epoch within 20 ms of the replay onset with high certainty, which makes the algorithm suitable for a real-time implementation with short latencies to incorporate into content-based feedback experiments.
Masking reduces orientation selectivity in rat visual cortex
Authors: Alwis Dasuni S. , Richards Katrina L. , Price Nicholas S. C.
Published: August 2016

In visual masking the perception of a target stimulus is impaired by a preceding (forward) or succeeding (backward) mask stimulus. The illusion is of interest because it allows uncoupling of the physical stimulus, its neuronal representation, and its perception. To understand the neuronal correlates of masking, we examined how masks affected the neuronal responses to oriented target stimuli in the primary visual cortex (V1) of anesthetized rats ( n = 37). Target stimuli were circular gratings with 12 orientations; mask stimuli were plaids created as a binarized sum of all possible target orientations. Spatially, masks were presented either overlapping or surrounding the target. Temporally, targets and masks were presented for 33 ms, but the stimulus onset asynchrony (SOA) of their relative appearance was varied. For the first time, we examine how spatially overlapping and center-surround masking affect orientation discriminability (rather than visibility) in V1. Regardless of the spatial or temporal arrangement of stimuli, the greatest reductions in firing rate and orientation selectivity occurred for the shortest SOAs. Interestingly, analyses conducted separately for transient and sustained target response components showed that changes in orientation selectivity do not always coincide with changes in firing rate. Given the near-instantaneous reductions observed in orientation selectivity even when target and mask do not spatially overlap, we suggest that monotonic visual masking is explained by a combination of neural integration and lateral inhibition.
Novel Form of Curcumin Improves Endothelial Function in Young, Healthy Individuals: A Double-Blind Placebo Controlled Study
Authors: Oliver Jonathan M. , Stoner Lee , Rowlands David S. , Caldwell Aaron R. , Sanders Elizabeth , Kreutzer Andreas , Mitchell Joel B. , Purpura Martin , Jäger Ralf
Published: August 2016

Curcumin, a turmeric extract, may protect against cardiovascular diseases by enhancing endothelial function. In this randomized controlled double-blind parallel prospective study, fifty-nine healthy adults were assigned to placebo, 50 mg (50 mg), or 200 mg (200 mg) curcumin, for 8 weeks. The higher curcumin (200 mg) supplementation produced a dose-mediated improvement in endothelial function measured by flow-mediated dilation (FMD). The outcome was a clinically substantial 3.0% increase (90% CI 0.7 to 5.3%,p=0.032; benefit : harm odds ratio 546 : 1) with the 200 mg dose, relative to placebo. The 50 mg dose also increased FMD relative to placebo by 1.7% (−0.6 to 4.0%,p=0.23; 25 : 1), but the outcome was not clinically decisive. In apparently healthy adults, 8 weeks of 200 mg oral curcumin supplementation resulted in a clinically meaningful improvement in endothelial function as measured by FMD. Oral curcumin supplementation may present a simple lifestyle strategy for decreasing the risk of cardiovascular diseases. This trial was registered at ISRCTN registry (ISRCTN90184217).
A Study on the Reliability of an On-Site Oral Fluid Drug Test in a Recreational Context
Authors: Gentili Stefano , Solimini Renata , Tittarelli Roberta , Mannocchi Giulio , Busardò Francesco Paolo
Published: August 2016

The reliability of DrugWipe 5A on site test for principal drugs of abuse (cannabis, amphetamines, cocaine, and opiates) detection in oral fluid was assessed by comparing the on-site results with headspace solid-phase microextraction (HS-SPME) gas chromatography-mass spectrometry (GC-MS) analysis on samples extracted by the device collection pad. Oral fluid samples were collected at recreational settings (e.g., discos, pubs, and music bars) of Rome metropolitan area. Eighty-three club goers underwent the on-site drug screening test with one device. Independently from the result obtained, a second device was used just to collect another oral fluid sample subsequently extracted and analyzed in the laboratory following HS-SPME procedure, gas chromatographic separation by a capillary column, and MS detection by electron impact ionization. DrugWipe 5A on-site test showed 54 samples (65.1%) positive to one or more drugs of abuse, whereas 75 samples (90.4%) tested positive for one or more substances following GC-MS assay. Comparing the obtained results, the device showed sensitivity, specificity, and accuracy around 80% for amphetamines class. Sensitivity (67 and 50%) was obtained for cocaine and opiates, while both sensitivity and accuracy were unsuccessful (29 and 53%, resp.) for cannabis, underlying the limitation of the device for this latter drug class.
Fully Automated Lipid Pool Detection Using Near Infrared Spectroscopy
Authors: Pociask Elżbieta , Jaworek-Korjakowska Joanna , Malinowski Krzysztof Piotr , Roleder Tomasz , Wojakowski Wojciech
Published: August 2016

Background. Detecting and identifying vulnerable plaque, which is prone to rupture, is still a challenge for cardiologist. Such lipid core-containing plaque is still not identifiable by everyday angiography, thus triggering the need to develop a new tool where NIRS-IVUS can visualize plaque characterization in terms of its chemical and morphologic characteristic. The new tool can lead to the development of new methods of interpreting the newly obtained data. In this study, the algorithm to fully automated lipid pool detection on NIRS images is proposed. Method. Designed algorithm is divided into four stages: preprocessing (image enhancement), segmentation of artifacts, detection of lipid areas, and calculation of Lipid Core Burden Index. Results. A total of 31 NIRS chemograms were analyzed by two methods. The metrics, total LCBI, maximal LCBI in 4 mm blocks, and maximal LCBI in 2 mm blocks, were calculated to compare presented algorithm with commercial available system. Both intraclass correlation (ICC) and Bland-Altman plots showed good agreement and correlation between used methods. Conclusions. Proposed algorithm is fully automated lipid pool detection on near infrared spectroscopy images. It is a tool developed for offline data analysis, which could be easily augmented for newer functions and projects.
Plesiomonas shigelloidesSeptic Shock Leading to Death of Postsplenectomy Patient with Pyruvate Kinase Deficiency and Hemochromatosis
Authors: Samannodi Mohammed , Zhao Andrew , Nemshah Yaser , Shiley Kevin
Published: August 2016

AlthoughPlesiomonas shigelloides, a water-borne bacterium of the Enterobacteriaceae family, usually causes self-limiting gastroenteritis with diarrhea, several cases of sepsis have been reported. We report the case of a 43-year-old male patient with hemochromatosis, pyruvate kinase deficiency, and asplenia via splenectomy who developed septic shock caused byP.shigelloidescomplicated by respiratory failure, renal failure, liver failure, and disseminated intravascular coagulation. Early aggressive antimicrobial therapy and resuscitation measures were unsuccessful and the patient passed away. We kindly suggest clinicians to implement early diagnosis of septic shock, empirical coverage with antibiotics, and prompt volume resuscitation based on the high mortality rate ofP. shigelloidesbacteremia.
Clinical Application of Revised Laboratory Classification Criteria for Antiphospholipid Antibody Syndrome: Is the Follow-Up Interval of 12 Weeks Instead of 6 Weeks Significantly Useful?
Authors: Park Sang Hyuk , Jang Seongsoo , Park Chan-Jeoung , Chi Hyun-Sook
Published: August 2016

Background. According to revised classification criteria of true antiphospholipid antibody syndrome, at least one of three antiphospholipid antibodies should be present on two or more occasions at least 12 weeks apart. However, it can be inconvenient to perform follow-up tests with interval of 12 weeks. We investigated clinical application of follow-up tests with interval of 12 weeks. Method. Totals of 67, 199, and 332 patients tested positive initially for the lupus anticoagulants confirm, the anti-β2 glycoprotein-I antibody, and the anti-cardiolipin antibody test, respectively, from Jan 2007 to Jul 2009. We investigated clinical symptoms of patients, follow-up interval, and results of each test. Results. Among patients with initial test positive, 1.5%–8.5% were subjected to follow-up tests at interval of more than 12 weeks. Among 25 patients with negative conversion in tests, patients with interval of more than 12 weeks showed clinical symptom positivity of 33.3%, which was higher than that of 12.5% with 6–12 weeks. Among 34 patients with persistent test positive, clinical symptoms positivity trended to be more evident in patients at interval of 6–12 weeks (47.4% versus 26.7%, P=0.191) than more than 12 weeks. Conclusion. Less than 10% of patients with initial test positive had follow-up tests at interval of more than 12 weeks and the patients with persistent test positive at interval of more than 12 weeks showed trends toward having lower clinical symptoms than 6–12 weeks. More research is needed focused on the evidence that follow-up test at interval of more than 12 weeks should be performed instead of 6 weeks.
Two-Dimensional DOA Estimation for Monostatic MIMO Radar with Electromagnetic Vector Received Sensors
Authors: Zheng Guimei , Tang Jun
Published: August 2016

We study two-dimensional direction of arrival (2D-DOA) estimation problem of monostatic MIMO radar with the receiving array which consists of electromagnetic vector sensors (EMVSs). The proposed angle estimation algorithm can be applied to the arbitrary and unknown array configuration, which can be summarized as follows. Firstly, EMVSs in the receiver of a monostatic MIMO radar are used to measure all six electromagnetic-field components of an incident wavefield. The vector sensor array with the six unknown electromagnetic-field components is divided into six spatially identical subarrays. Secondly, ESPRIT is utilized to estimate the rotational invariant factors (RIFs). Parts of the RIFs are picked up to restore the source’s electromagnetic-field vector. Last, a vector cross product operation is performed between electric field and magnetic field to obtain the Pointing vector, which can offer the 2D-DOA estimation. Prior knowledge of array elements’ positions and angle searching procedure are not necessary for the proposed 2D-DOA estimation method. Simulation results prove the validity of the proposed method.
A Rare Case of Mixed Neuroendocrine Tumor and Adenocarcinoma of the Pancreas
Authors: Xenaki Sofia , Lasithiotakis Konstantinos , Andreou Alexandros , Aggelaki Sofia , Tzardi Maria , Daskalaki Anna , Chalkiadakis George , Chrysos Emmanuel
Published: August 2016

Introduction.Neuroendocrine carcinoma (NEC) of pancreas is a rare tumor with aggressive progression and poor prognosis. Its coexistence with adenocarcinoma poses significant clinical problems and has not been addressed in the literature.Methods.We describe a case of a 51-year-old male who underwent pancreatoduodenectomy due to pancreatic head tumor1.5×1×1.4 cm. Histological examination of the specimen revealed a mixed neoplasm: (1) a well differentiated adenocarcinoma, neoplastic blasts of which are extended focally to the submucosa without invading the muscular layer, and (2) a low differentiated NEC consisting of solid clusters and pagetoid formations. All 18 lymph nodes of the specimen were free of neoplastic disease and the surgical margins of the specimen were tumor-free. No adjuvant treatment was administered and two months after the operation the patient developed liver metastasis. FNA cytology of the hepatic lesions revealed low grade carcinoma with neuroendocrine characteristics. Five lines of chemotherapy were administered: VP + CDDP, paclitaxel + ifosfamide + Mesna + CDDP, Folfox + Avastin, Folfiri + Avastin, and CAV. During his treatment he revealed PD and succumbed to his disease 13 months after the operation.Conclusion.Coexistence of NEC with adenocarcinoma of the pancreas is a very rare entity presenting significant challenges regarding its adjuvant treatment and the treatment of distant relapse.
Proteases fromCanavalia ensiformis: Active and Thermostable Enzymes with Potential of Application in Biotechnology
Authors: Gonçalves Rayane Natshe , Gozzini Barbosa Suellen Duarte , Silva-López Raquel Elisa da
Published: August 2016

Extracts of leaves, seeds, roots, and stem from a tropical legume,C. ensiformis, were prepared employing buffers and detergent in aqueous solution. Leaf extracts had the highest protein content and the most pronounced peptidase activity with optimal pH in the neutral to alkaline range. All extracts exhibited peaks of activity at various pH values, suggesting the presence of distinctive classes of proteases. N-α-Tosyl-L-arginine methyl ester hydrolysis was maximal at 30°C to 60°C and peptidase activity from all extracts presented very good thermal stability after 24 h incubation at 70°C.C. ensiformisproteases exhibited molecular masses of about 200–57, 40–37, and 20–15 kDa by SDS-PAGE analysis. These enzymes cleaved hemoglobin, bovine serum albumin, casein, and gelatin at different levels. Serine and metalloproteases are the major proteases inC. ensiformisextracts, modulated by divalent cations, stable at 1% of surfactant Triton X-100 and at different concentrations of the reducing agentβ-mercaptoethanol. Thus,C. ensiformisexpresses a particular set of proteases in distinctive organs with high activity and stability, making this legume an important source of proteases with biotechnological potential.
A Cross-Sectional Survey to Estimate the Cat Population and Ownership Profiles in a Semirural Area of Central Italy
Authors: Carvelli Andrea , Iacoponi Francesca , Scaramozzino Paola
Published: August 2016

Understanding animal population size and its demographic features is essential to address Public Health policies as well as to provide valuable information to pet industries and veterinary practitioners. Nevertheless, official data on feline population are not available worldwide. In the present study, the owned cat population size, its demographic attributes, and the ownership profiles have been investigated through a face-to-face questionnaire in a semirural area of Central Italy. The human : cat ratio was equal to 6.8 (95% CI: 5.7–7.5); 29.3% of households own at least one cat. The majority of cats were living in a rural area (67.8%) and outdoors, were neutered (70.5%), and were fed with commercial food (54.8%) and they visited a veterinarian 1-2 times a year (43.3%). The cat ownership was strongly associated with people living in a rural area and owning another pet. As the cat owned population was mainly kept outdoors in rural areas, the possible relation between the owned and the stray animals is worthy to be monitored in future researches. Our study revealed that the feline owned population was larger than expected and that social and economic human factors do not influence the cat ownership. Health Authorities and veterinary practitioners should promote responsible ownership to increase the veterinary care, to intensify the official identification, and to properly manage the outdoor lifestyle.
Risk of Malignant Neoplasm in Patients with Incident Rheumatoid Arthritis 1980–2007 in relation to a Comparator Cohort: A Population-Based Study
Authors: Raheel Shafay , Crowson Cynthia S. , Wright Kerry , Matteson Eric L.
Published: August 2016

Objective.To determine whether the incidence of malignancy is increased in patients with rheumatoid arthritis (RA) compared to a matched comparison cohort and to identify risk for any individual malignancy in RA.Methods.A cohort of 813 Olmsted County, Minnesota, residents who first fulfilled 1987 ACR criteria for RA in 1980–2007 was previously identified by medical record review. Medical records of 813 RA cases and a comparison cohort of age and sex matched Olmsted County residents without RA were evaluated retrospectively for cancer occurrence. Patients in both cohorts were followed until death, migration from Olmsted County, or 12/31/2014.Results.The RA and non-RA cohorts (mean age at incidence/index date: 55.9 [SD: 15.7] years; 68.4% females in both cohorts) were followed on average of 14.1 (SD: 7.7) and 14.9 (SD: 8.1) years, respectively. Prior to RA incidence/index date, 52 RA patients and 66 non-RA subjects had malignancies excluding NMSC (p=0.21). During follow-up, significantly more malignancies occurred in patients with RA (n=143) than in comparator subjects (n=118; hazard ratio: 1.32;p=0.027). Inclusion of NMSC obviated this difference.Conclusion.After excluding NMSC, there was a small to moderately increased risk of malignancies in patients with RA. Cancer surveillance is imperative in all patients with RA.
The Effect of the Rolling Direction, Temperature, and Etching Time on the Photochemical Machining of Monel 400 Microchannels
Authors: Patil Deepakkumar H. , Mudigonda Sadaiah
Published: August 2016

The present paper describes the effect of the rolling direction on the quality of microchannels manufactured using photochemical machining (PCM) of Monel 400. Experiments were carried out to fabricate microchannels along and across the rolling direction to investigate the effect of the grain orientation on microchannel etching. The input parameters considered were channel width and rolling direction, whereas the depth of etch was the response parameters. Different channels of widths of 60, 100, 150, 200, and 250 μm were etched. The effects of the etching time and temperature of the etchant solution on the undercut and depth of the microchannels were studied. For good quality microchannels, the effects of spinning time, spinning speed, exposure time, and photoresist film strength were also taken into consideration. Optimized values of the above were used for the experimentation. The results show that the depth of etch of the microchannel increases more along the rolling direction than across the rolling direction. The channel width and depth are significantly affected by the etching time and temperature. The proposed study reports an improvement in the quality of microchannels produced using PCM.
Vitis vinifera Assisted Silver Nanoparticles with Antibacterial and Antiproliferative Activity against Ehrlich Ascites Carcinoma Cells
Authors: Asaduzzaman A. K. M. , Chun Byung-Soo , Kabir Syed Rashel
Published: August 2016

Vitis vinifera extract assisted silver nanoparticles (AgNPs) were biosynthesized that was confirmed primarily by color change and a sharp plasmon absorption band was found at 449 nm. Biosynthesized AgNPs shape was spherical and the particle size of 17 nm in average was confirmed by transmission electron microscopy (TEM) images. Functional groups of AgNPs were identified by Fourier transform infrared spectroscopy (FTIR). Streptococcus aureus was the most sensitive bacteria towards the assisted V. vinifera AgNPs as their growth was 90% inhibited at 100 μg/mL concentration. That was also confirmed by the zone of inhibition study. Up to 96 h, no biofilm was observed for K. pneumoniae at 40 μg/mL of AgNPs. Although AgNPs showed a mild toxicity against brine shrimp nauplii, it showed a remarkable level of antiproliferative activity against Ehrlich ascites carcinoma (EAC) cells.
Adaptive Access Class Barring Method for Machine Generated Communications
Authors: Park Jaesung , Lim Yujin
Published: August 2016

Cellular network is provisioned to serve traffic demands generated by human being. The random access channel used for nodes to compete for a connection with an eNB is limited. Even though machines generate very small amount of data traffic, the signaling channel of a network becomes overloaded and collisions occur to fail the access if too many MTC (Machine Type Communication) devices attempt to access network. To tackle the issue, 3GPP specifies an access class barring but leaves a specific algorithm as an implementation issue. In this paper, we propose an adaptive access barring method. Generally, an eNB does not know the number of MTC devices in its coverage area. Thus, it is difficult to control the barring factor by predicting the number of MTC devices in a service area of a cell. On the contrary, we control the barring factor based on the prediction of access intensity which can be measured at an eNB. Simulation results show that since the proposed method can manipulate the barring factor autonomously according to the access intensity, it is superior to the original method in terms of the access success probability and the collision probability.
Bacteremia due toLeuconostoc pseudomesenteroidesin a Patient with Acute Lymphoblastic Leukemia: Case Report and Review of the Literature
Authors: Ino Kazuko , Nakase Kazunori , Suzuki Kei , Nakamura Akiko , Fujieda Atsushi , Katayama Naoyuki
Published: August 2016

Leuconostocspecies are vancomycin-resistant Gram-positive cocci. Infections due toLeuconostocspecies have been reported in various immunocompromised patients, but little is known about such infection in patients with hematologic malignancies. We report a case ofLeuconostocinfection in a 44-year-old woman with acute lymphoblastic leukemia. The patient developed a high fever despite antimicrobial therapy with doripenem after induction chemotherapy. After an isolate from blood cultures was identified asL. pseudomesenteroides, we changed the antibiotics to piperacillin-tazobactam and gentamicin, after which the patient recovered from the infection. Physicians should be aware ofLeuconostocspecies as causative pathogen if they encounter Gram-positive cocci bacteremia resistant to standard antibiotics such as vancomycin and teicoplanin, especially in patients with hematologic malignancies.
Experimental Model of Proximal Junctional Fracture after Multilevel Posterior Spinal Instrumentation
Authors: Mac-Thiong Jean-Marc , Levasseur Annie , Parent Stefan , Petit Yvan
Published: August 2016

There is a high risk of proximal junctional fractures (PJF) with multilevel spinal instrumentation, especially in the osteoporotic spine. This problem is associated with significant morbidity and possibly the need for reoperation. Various techniques have been proposed in an attempt to decrease the risk of PJF but there is no experimental model described forin vitroproduction of PJF after multilevel instrumentation. The objective of this study is to develop an experimental model of PJF after multilevel posterior instrumentation. Initially, four porcine specimens including 4 vertebrae and instrumented at the 3 caudal vertebrae using a pedicle screw construct were subjected to different loading conditions. Loading conditions on porcine specimens involving cyclic loading along the axis of the center vertebral body line, with constrained flexion between 0° and 15° proximally, and fully constraining the specimen distally resulted in a fracture pattern most representative of a PJF seen clinically in humans, so to undergo human cadaveric testing with similar loading conditions was decided. Clinically relevant PJF were produced in all 3 human specimens. The experimental model described in this study will allow the evaluation of different parameters influencing the incidence and prevention of PJF after multilevel posterior spinal instrumentation.
Cytotoxic Properties of a DEPTOR-mTOR Inhibitor in Multiple Myeloma Cells
Authors: Shi Yijiang , Daniels-Wells Tracy R. , Frost Patrick , Lee Jihye , Finn Richard S. , Bardeleben Carolyne , Penichet Manuel L. , Jung Michael E. , Gera Joseph , Lichtenstein Alan
Published: August 2016

DEPTOR is a 48 kDa protein that binds to mTOR and inhibits this kinase in TORC1 and TORC2 complexes. Overexpression of DEPTOR specifically occurs in a model of multiple myeloma. Its silencing in multiple myeloma cells is sufficient to induce cytotoxicity, suggesting that DEPTOR is a potential therapeutic target. mTORC1 paralysis protects multiple myeloma cells against DEPTOR silencing, implicating mTORC1 in the critical role of DEPTOR in multiple myeloma cell viability. Building on this foundation, we interrogated a small-molecule library for compounds that prevent DEPTOR binding to mTOR in a yeast-two-hybrid assay. One compound was identified that also prevented DEPTOR–mTOR binding in human myeloma cells, with subsequent activation of mTORC1 and mTORC2. In a surface plasmon resonance (SPR) assay, the compound bound to recombinant DEPTOR but not to mTOR. The drug also prevented binding of recombinant DEPTOR to mTOR in the SPR assay. Remarkably, although activating TORC1 and TORC2, the compound induced apoptosis and cell-cycle arrest in multiple myeloma cell lines and prevented outgrowth of human multiple myeloma cells in immunodeficient mice. In vitro cytotoxicity against multiple myeloma cell lines was directly correlated with DEPTOR protein expression and was mediated, in part, by the activation of TORC1 and induction of p21 expression. Additional cytotoxicity was seen against primary multiple myeloma cells, whereas normal hematopoietic colony formation was unaffected. These results further support DEPTOR as a viable therapeutic target in multiple myeloma and suggest an effective strategy of preventing binding of DEPTOR to mTOR. Cancer Res; 76(19); 5822–31. ©2016 AACR.
Water Concentration Analysis by Raman Spectroscopy to Determine the Location of the Tumor Border in Oral Cancer Surgery
Authors: Barroso Elisa M. , Smits Roeland W.H. , van Lanschot Cornelia G.F. , Caspers Peter J. , ten Hove Ivo , Mast Hetty , Sewnaik Aniel , Hardillo José A. , Meeuwis Cees A. , Verdijk Rob , Noordhoek Hegt Vincent , Baatenburg de Jong Robert J. , Wolvius Eppo B. , Bakker Schut Tom C. , Koljenović Senada , Puppels Gerwin J.
Published: August 2016

Adequate resection of oral cavity squamous cell carcinoma (OCSCC) means complete tumor removal with a clear margin of more than 5 mm. For OCSCC, 85% of the surgical resections appear inadequate. Raman spectroscopy is an objective and fast tool that can provide real-time information about the molecular composition of tissue and has the potential to provide an objective and fast intraoperative assessment of the entire resection surface. A previous study demonstrated that OCSCC can be discriminated from healthy surrounding tissue based on the higher water concentration in tumor. In this study, we investigated how the water concentration changes across the tumor border toward the healthy surrounding tissue on freshly excised specimens from the oral cavity. Experiments were performed on tissue sections from 20 patients undergoing surgery for OCSCC. A transition from a high to a lower water concentration, from tumor (76% ± 8% of water) toward healthy surrounding tissue (54% ± 24% of water), takes place over a distance of about 4 to 6 mm across the tumor border. This was accompanied by an increase of the heterogeneity of the water concentration in the surrounding healthy tissue. The water concentration distributions between the regions were significantly different (P < 0.0001). This new finding highlights the potential of Raman spectroscopy for objective intraoperative assessment of the resection margins. Cancer Res; 76(20); 5945–53. ©2016 AACR.
Pediatric Oral/Maxillofacial Soft Tissue Sarcomas: A Clinicopathologic Report of Four Cases
Authors: Thompson Joel C. , Woods Gary M. , Arnold Michael A. , Elmaraghy Charles , Kahwash Samir B. , Cripe Timothy P. , Setty Bhuvana A.
Published: August 2016

Pediatric soft tissue sarcomas of the oral/maxillofacial region are rare neoplasms that present significant difficulty with respect to treatment and local control measures. We report four cases of pediatric oral/maxillofacial soft tissue sarcomas from our tertiary care pediatric hospital and emphasize the rarity of these malignancies and the challenges encountered in treating these lesions, and suggest areas for further research. We conclude that multimodal therapy and interdisciplinary cooperation are paramount to successful management of these lesions.
Combination Chemotherapy of Mitomycin C and Methotrexate Was Effective on Metastatic Breast Cancer Resistant to Eribulin, Vinorelbine, and Bevacizumab after Anthracycline, Taxane, and Capecitabine
Authors: Tanabe Masahiko
Published: August 2016

Complete cure of metastatic breast cancer (MBC) is still considered difficult even after the development of new drugs. While new drugs have been continuously developed, conventional drugs such as mitomycin C (MMC) and methotrexate (MTX) have become less used. Combination chemotherapy with MMC and MTX (MMC/MTX) was reported to be effective for 9.7–19.4% of 31 patients with human epidermal growth factor receptor type 2 (HER2)-negative MBC who were aggressively treated with anthracycline, taxane, capecitabine, and vinorelbine. However, its efficacy, when it is used after newly developed drugs such as eribulin and bevacizumab, is yet to be evaluated. We here introduce one case in which MMC/MTX was effective for MBC that was resistant to chemotherapy with eribulin, vinorelbine, and bevacizumab with paclitaxel after sequential treatment with anthracycline, taxane, capecitabine, and several hormonal therapies. Lung metastasis was newly observed after sequential treatment of MBC for 6 years. Although the disease was resistant to chemotherapy of eribulin, vinorelbine, and bevacizumab with paclitaxel, it responded well to the treatment of MMC/MTX, which continued for 7 months. This case suggests that MMC/MTX could be an effective treatment for MBC patients when the disease progressively develops even after aggressive treatment with multiple regimens.
Driving and Incidence of Functional Limitation in Older People: A Prospective Population-Based Study
Authors: Shimada Hiroyuki , Makizako Hyuma , Tsutsumimoto Kota , Hotta Ryo , Nakakubo Sho , Doi Takehiko
Published: August 2016

Background: Many studies have examined the negative social and health consequences of driving cessation in later life. However, whether the transition to driving cessation results in the incidence of functional limitation in older people remains unclear. Objective: The aim of this study was to examine whether driving cessation was associated with the incidence of functional limitation in older Japanese individuals. Methods: The study included 3,556 participants (mean age: 71.5 ± 5.3 years, 50.2% women) enrolled in the ‘Obu Study of Health Promotion for the Elderly' cohort study between August 2011 and February 2012. The participants were classified into three groups according to their driving status: driving, driving cessation, and nondriving. We assessed new incidence of functional limitation over a 24- month period and examined several confounding factors. Results: The incidence rates for functional limitation in the driving, driving cessation, and nondriving groups were 0.9, 10.8, and 5.6%, respectively (p < 0.001). The fully adjusted Cox proportional hazard model showed that hazard ratios (HRs) for functional limitation in nondrivers [HR: 2.37, 95% confidence interval (CI): 1.27-4.44] and those who had ceased driving (HR: 7.80, 95% CI: 2.61-23.36) were significantly higher relative to those observed in current drivers. Conclusion: Driving cessation exerted a strong impact on the risk of functional limitation. Further study is required to determine appropriate intervention strategies to help older people to maintain the abilities required for safe driving and delay the functional limitation associated with driving cessation.
Reactive Retinal Astrocytic Tumor (Focal Nodular Gliosis): A Case Report
Authors: Hudson Lauren E. , Mendoza Pia R. , Yan Jiong , Grossniklaus Hans E.
Published: August 2016

Purpose: To report the clinical and histopathological findings of a reactive retinal astrocytic tumor (RRAT) that progressed to massive retinal gliosis. Observations: The patient presented with an elevated, white-yellow retinal mass and extensive retinal exudation in the left eye. Progressive enlargement of the mass and proliferative vitreoretinopathy eventually led to phthisis bulbi and enucleation. Histologically, the mass showed a predominant astrocytic component with intense glial fibrillary acidic protein staining, hyperplasia, fibrous metaplasia, and osseous metaplasia of the retinal pigment epithelium. The Ki-67 proliferative index was <5%, and few scattered vascular channels were observed. Conclusions and Importance: These findings show that this tumor is the result of a reactive glial process rather than of neoplastic vascular proliferation. Massive retinal gliosis probably represents the advanced stage of RRAT.