bluuebunny/crossref_metadata_2025 huggingface dataset:
Correlation between chronic headaches and the rectus capitis posterior minor muscle: A comparative analysis of cross-sectional trail
Authors: Yuan Xiao-Ying , Yu Sheng-Bo , Liu Cong , Xu Qiang , Zheng Nan , Zhang Jian-Fei , Chi Yan-Yan , Wang Xu-Gang , Lin Xiang-Tao , Sui Hong-Jin
Published: August 2016

Objective

We aimed to investigate the morphological changes and potential correlation between chronic headaches and the rectus capitis posterior minor muscle (RCPmi).

Methods

Comparison of RCPmi between patients with chronic headaches and healthy adult volunteers were collected using magnetic resonance imaging (MRI) and Mimics software.

Results

Among the 235 MRI images analyzed, the data between the two groups were considered statistically significant. The number of males was larger than that of females ( p < 0.001) and the headache group showed greater hypertrophy than the control group in both males ( p < 0.001) and females ( p = 0.001).

Conclusions

Chronic headaches were correlated with the RCPmi. Patients with chronic headaches suffered from more obvious hypertrophy than that of the control group. Additionally, it was supposed that RCPmi hypertrophy may be one pathogenesis of the chronic headaches.
Midbrain raphe hypoechogenicity in migraineurs: An indicator for the use of analgesics but not triptans
Authors: Hamerla Gordian , Kropp Peter , Meyer Bianca , Rocco Alessandro , Jürgens Tim P , Walter Uwe
Published: August 2016

Introduction

The involvement of the serotonergic system of the brainstem raphe in the pathogenesis of migraine is discussed. Here we studied brainstem alterations in migraineurs using transcranial sonography and examined their relation to clinical features and self-medication.

Methods

We investigated 51 migraineurs (11 men, 40 women, mean age 29.7 ± 11.9 years) and 32 healthy individuals without history of headache or depressive disorder (eight men, 24 women, mean age 34.4 ± 13.0 years). Transcranial sonography was performed in an investigator-blinded fashion. Midbrain raphe echogenicity was quantified using digitized analysis. Migraine characteristics and the use of analgesics were evaluated by applying validated questionnaires. Eight migraineurs underwent neurophysiologic evaluation of contingent stimulus-related cortical potentials.

Results

Echo-reduced midbrain raphe was detected in 27 (53%) migraineurs, but only six (19%) control subjects (odds ratio = 4.87, p = 0.002). Lower raphe echogenicity correlated with both higher amplitude of terminal contingent negative variation (Spearman test, r = 0.76, p = 0.028) and higher use of analgesic drugs ( r = −0.45, p = 0.011), but not with use of triptans or with migraine frequency or severity (all p > 0.2). Compared to migraineurs without aura, migraineurs with aura had enlarged third ventricles (t-test, p = 0.014), while the lateral ventricle widths did not differ ( p = 0.62).

Conclusions

Midbrain raphe alteration is frequent in migraineurs and relates to self-medication behavior. This alteration may reflect the dysfunction of serotonergic raphe nuclei.
Use of Nebulized Heparin, Nebulized N-Acetylcysteine, and Nebulized Epoprostenol in a Patient With Smoke Inhalational Injury and Acute Respiratory Distress Syndrome
Authors: Dube Kevin M. , Ditch Kristen L. , Hills Luanne
Published: August 2016

Smoke inhalation injury (SIJ) is associated with an increase in morbidity and mortality in patients with burns. SIJ causes airway damage, inflammation, and bronchial obstruction, resulting in decreased oxygenation and perfusion status in these patients. Retrospective studies have compared the use of nebulized heparin (NH) plus nebulized N-acetylcysteine (NAC) and albuterol in patients with SIJ to those who received standard ventilator support with bronchodilator therapy. These studies are associated with a decrease in mortality when NH and nebulized NAC are administered to patients with SIJ. Approximately 20% of patients who develop SIJ will also develop acute respiratory distress syndrome (ARDS). Epoprostenol, a selective pulmonary vasodilator, has been utilized in the treatment of ARDS with mixed results for improving gas exchange. To our knowledge, this is the first case report of the concomitant administration of NH, nebulized NAC, and nebulized epoprostenol following SIJ in a burn patient with ARDS.
Donovanosis and squamous cell carcinoma: The relationship conundrum!
Authors: Arora Amanjot K , Kumaran Muthu S , Narang Tarun , Saikia Uma N , Handa Sanjeev
Published: August 2016

Donovanosis is a rare, chronic and indolent sexually transmitted infection caused by Klebsiella granulomatis. The ulcers in donovanosis rarely undergo malignant transformation, which is usually seen in longstanding ulcers. We present a case of a 32-year-old male who presented with a two-month history of rapidly progressive, large, foul-smelling ulcers over the groin, distal penile shaft and scrotum. Crushed tissue smears from ulcers revealed basophilic intracellular and extracellular Donovan bodies. Fine needle aspiration cytology from inguinal lymph nodes and biopsy from the ulcers revealed well-differentiated squamous cell carcinoma. The current case aims to alert clinicians that donovanosis is a rare but possible cause of cutaneous malignancy. Nonetheless, the pathogenesis of malignant transformation in donovanosis needs further research.
Urban Health in India
Authors: Kumar Satish , Sharma Aastha , Sood Akanksha , Kumar Sanjiv
Published: August 2016

With rapid pace of urbanization, urban health has emerged as one of the most significant health themes of the decade in India. The increasing proportion of urban poor and vulnerable, with health indicators worse than their rural counterparts, face various social and financial barriers to accessing healthcare. While urban health has been emphasized over the years by various committees and five-year plans (described in detail in the article), there has been little concerted effort at the national level for providing comprehensive healthcare to the urban population, up until the launch of the National Urban Health Mission (NUHM) in 2013. As urban health infrastructure, developed under various schemes and projects in different states, is quite inconsistent across the country, covering the entire urban population with standardized services is a challenge for NUHM. Other challenges include crowding out of the urban poor from available urban facilities, multiple burden of diseases and vulnerability in urban areas and fostering coordination and convergence between various urban stakeholders including the private sector. This article describes the past and current policies on urban health, the current challenges for implementing urban health programmes in India and the way forward.
Association of the Monocyte to HDL Cholesterol Ratio With Thrombus Burden in Patients With ST-Segment Elevation Myocardial Infarction
Authors: Arısoy Arif , Altunkaş Fatih , Karaman Kayıhan , Karayakalı Metin , Çelik Ataç , Ceyhan Köksal , Zorlu Çağrı
Published: August 2016

Intracoronary thrombus burden is associated with some adverse events and poor prognosis in patients with ST-segment elevation myocardial infarction (STEMI). Identifying predictors of the intracoronary thrombus burden may contribute to the management of STEMI. In this study, we evaluated whether monocyte count to high-density lipoprotein cholesterol ratio (MHR) is a predictor of intracoronary thrombus burden in patients with STEMI. The study population consisted of 414 patients with STEMI who underwent primary percutaneous coronary intervention (PCI). Angiographic thrombus burden was classified based on thrombolysis in myocardial infarction (TIMI) thrombus grades. The patients were grouped into 2 categories of low thrombus burden and high thrombus burden. The MHR was significantly higher in the high thrombus burden group compared with the low thrombus group (16.0 [9.2-22.1] vs 25.4 [13.5-44.6]; P < .001). In multivariate logistic regression analysis, MHR was an independent predictor of high thrombus burden (odds ratio: 1.067, 95% CI: 1.031-1.105; P < .001). The area under the receiver–operating characteristic curve of the MHR was 0.688 (0.641-0.733; P < .001) to predict high thrombus burden. In conclusion, MHR was independent predictor of high thrombus burden in patients with STEMI who underwent primary PCI.
Free vibration analysis of magneto-electro-elastic cylindrical composite panel reinforced by various distributions of CNTs with considering open and closed circuits boundary conditions based on FSDT
Authors: Mohammadimehr M , Okhravi SV , Akhavan Alavi SM
Published: August 2016

In this paper, free vibration analysis of magneto-electro-elastic (MEE) cylindrical composite panel reinforced by various distributions of carbon nanotubes (CNTs) considering open and closed circuits boundary conditions based on the first order shear deformation theory (FSDT) is carried out. Carbon nanotubes (CNTs) in Poly-vinylidene fluoride (PVDF) matrix are arranged and different distribution patterns of CNTs including uniform distribution (UD), FG-V, FG-A, FG-X and FG-O are employed. The Young’s and shear moduli are obtained using the extended mixture rule. Also, the material properties of magneto-electric fiber reinforced composite are estimated by mixture rule. By employing energy method and Hamilton’s principle, the equations of motion for cylindrical composite panel reinforced by CNTs are derived. In this paper, the effects of the volume fraction, various distributions of CNTs including uniform and functionally graded (FG) distributions, angle orientation, two elastic foundation parameters, aspect ratio (length-to-thickness ratio), radius-to-thickness ratio, and the multi-physical fields with open and closed circuits boundary conditions on the natural frequency of MEE cylindrical composite panel are considered. These effects play an important role on the natural frequencies. Moreover, the numerical results of this research can be used to manufacturing process design and optimization MEE cylindrical composite panel under multi-physical fields and the previous results can be used in order to prevent the resonance phenomenon.
Protective Strategies of Mothers Abused by Intimate Partners: Rethinking the Deficit Model
Authors: Nixon Kendra L. , Tutty Leslie M. , Radtke H. L. , Ateah Christine A. , Ursel E. Jane
Published: August 2016

Exposure to intimate partner violence is detrimental to children, but can abused mothers protect them, and, if so, what can they do? This study of 350 Canadian abused women represents the first quantitative examination of such protective strategies. The actions that mothers most commonly used and perceived as effective include showing affection and being nurturing to their children. The strategies often suggested by professionals, such as contacting police and obtaining protection orders, were used less and considered less effective than informal strategies. Professionals are urged to ask mothers what strategies they use, especially those who do not involve formal systems.
Assessment of Susceptibility Risk Factors for ADHD in Imaging Genetic Studies
Authors: Vilor-Tejedor N. , Alemany S. , Forns J. , Cáceres A. , Murcia M. , Macià D. , Pujol J. , Sunyer J. , González J. R.
Published: August 2016

Objective: ADHD consists of a count of symptoms that often presents heterogeneity due to overdispersion and excess of zeros. Statistical inference is usually based on a dichotomous outcome that is underpowered. The main goal of this study was to determine a suited probability distribution to analyze ADHD symptoms in Imaging Genetic studies. Method: We used two independent population samples of children to evaluate the consistency of the standard probability distributions based on count data for describing ADHD symptoms. Results: We showed that the zero-inflated negative binomial (ZINB) distribution provided the best power for modeling ADHD symptoms. ZINB reveals a genetic variant, rs273342 (Microtubule-Associated Protein [MAPRE2]), associated with ADHD ( p value = 2.73E-05). This variant was also associated with perivascular volumes (Virchow–Robin spaces; p values < 1E-03). No associations were found when using dichotomous definition. Conclusion: We suggest that an appropriate modeling of ADHD symptoms increases statistical power to establish significant risk factors.
Source and Message Framing Considerations for Recruiting Mature Adults as Organ Donors Through Direct Mail Campaigns
Authors: Quick Brian L. , Reynolds-Tylus Tobias , Fico Ashley E. , Feeley Thomas Hugh
Published: August 2016

Context:

Mature adults represent an important audience segment for organ donation practitioners. Despite their potential impact as organ donors, compared to other age demographics, their registration rates are much lower.

Objective:

The objective of the current campaign was to determine the most effective source and message strategy to promote organ and tissue donation among mature adults.

Methods:

A 2 (states: Illinois and Iowa) by 2 (sources: government agency and organ procurement organization [OPO]) by 3 (taglines: Any age is the right age to share the gift of life, Don’t rule yourself out, and Don’t rule yourself out: Any age is the right age to share the gift of life) between-subjects design was used to test the effectiveness of direct mailings promoting organ donation to mature adults.

Results:

Across both Illinois and Iowa, the results revealed that greater organ donation registration rates emerged following exposure to direct mail authored by a state official such as the Illinois Secretary of State or the Iowa Department of Public Health compared to local OPOs.

Conclusions:

Overall, the findings speak to the effectiveness of direct mail marketing campaign’s ability to register potential organ donors. Moreover, the results reveal that it is more important who sends the message as opposed to what the message states.
Historical operational data analysis for defence preparedness planning
Authors: Shafi Kamran , Debie Essam , Oliver David
Published: August 2016

Preparedness is an important function of defence planning that involves developing defence capabilities to deal with emergent situations relating to national defence and security. Preparedness planning relies on a number of inputs, including requirement analysis, to identify critical capability gaps. Modern data analysis can play an important role in identifying such future requirements. To this end, this paper presents an analytical study, consisting of both descriptive as well as predictive analysis, of historical defence operational data. The descriptive analysis component of the methodology focuses on identifying useful features in the collected data for building a predictive model. The predictive analysis investigates existing patterns in the data, including spatial and temporal trends. An artificial neural network based time series forecasting model is developed to predict future operations based on the identified features. The proposed methodology is applied to a defence operational data set, built from a number of unclassified sources relating to the historical operational deployments of the Australian Defence Force between 1885 and 2012. Implications are also discussed.
A discrete group search optimizer for blocking flow shop multi-objective scheduling
Authors: Guanlong Deng , Shuning Zhang , Mei Zhao
Published: August 2016

This article presents a multi-objective discrete group search optimizer for blocking flow shop multi-objective scheduling problem. The algorithm is designed to search the Pareto-optimal solutions minimizing the makespan and total flow time for the flow shop scheduling with blocking constraint. In the proposed algorithm, a diversified initial population is constructed based on the Nawaz–Enscore–Ham heuristic and its variants. Unlike the original group search optimizer in which continuous solution representation is used, the proposed algorithm employs discrete job permutation representation to adapt to the considered scheduling problem. Accordingly, operations of producer, scrounger, and ranger are newly designed. An insertion-based Pareto local search is put forward in producer procedure, a crossover operation is introduced in scrounger procedure, and a local search based on the insert neighborhood is designed in ranger procedure. A bunch of computational experiments and results show that the proposed algorithm is superior to two existing powerful meta-heuristics in terms of both inverted generational distance and set coverage.
Experimental investigation on frictional property of mechanical seals with varying dimple diameter along the radial face
Authors: Ma Chenbo , Gu Weifeng , Tu Qiaoan , Sun Jianjun , Yu Bo
Published: August 2016

To study frictional property of mechanical seals when distributing dimples with varying parameters along the radial face, friction experiments, including seal faces with varying dimple diameter in various types, invariable dimple diameter, and without dimples, were carried out on end-face tester under different loads and rotation speeds. The results show that the introduction of dimples on seal face does reduce friction coefficient efficiently, but its anti-friction effect is closely related to the arrangement manner of dimple diameter and the operation condition. The type with increasing dimple diameters along the radial face from the inner to the outer diameter should be more suitable for the design of seal faces for its smaller friction coefficient when comparing with the type with optimum invariable dimple diameter. On the other hand, the operation condition, including loads and rotation speeds, must be taken into account to determine how to increase the dimple diameter along the radial face from the inner to the outer diameter. The results could be a good start for further theoretical study to search for the optimum varying dimple parameters of mechanical seals.
Effect of charge shape on blast containment chamber survivability
Authors: Clutter J Keith , King Kim W
Published: August 2016

Computational modeling is routinely used to design protective systems such as blast containment chambers. Hydrocodes are used to define the loads produced if the explosive items were to detonate and finite element analysis codes to calculate the response of the chamber. These efforts typically assume the explosive is a spherical charge. This article investigates the effect this assumption has on the blast loads and the calculated response of the chamber. First, simulations benchmarking a hydrocode with adaptive meshing and Jones–Wilkins–Lee equation of state are performed. How various aspects of the scenario affect the loading on the vessel is discussed. The code is next used to calculate the loading from a spherical charge and one representative of a configuration typically found in actual use of storage vessels. The more realistic charge configuration is found to produce higher loads on the vessel walls. The structural response of the chamber to both charge configurations is calculated using finite element analysis. The non-ideal configuration is found to produce a very different response than the typically assumed ideal spherical charge.
Mesenchymal stem cells from cortical bone demonstrate increased clonal incidence, potency, and developmental capacity compared to their bone marrow–derived counterparts
Authors: Blashki Daniel , Murphy Matthew B , Ferrari Mauro , Simmons Paul J , Tasciotti Ennio
Published: August 2016

In this study, we show that matrix dense cortical bone is the more potent compartment of bone than bone marrow as a stromal source for mesenchymal stem cells as isolated from adult rats. Lineage-depleted cortical bone-mesenchymal stem cells demonstrated >150-fold enrichment of colony forming unit–fibroblasts per cell incidence. compared to lineage-depleted bone marrow-mesenchymal stem cells, corresponding to a 70-fold increase in absolute recovered colony forming unit–fibroblasts. The composite phenotype Lin−/CD45−/CD31−/VLA-1+/Thy-1+ enriched for clonogenic mesenchymal stem cells solely from cortical bone–derived cells from which 70% of clones spontaneously differentiated into all lineages of bone, cartilage, and adipose. Both populations generated vascularized bone tissue within subcutaneous implanted collagen scaffolds; however, cortical bone–derived cells formed significantly more osteoid than bone marrow counterparts, quantified by histology. The data demonstrate that our isolation protocol identifies and validates mesenchymal stem cells with superior clonal, proliferative, and developmental potential from cortical bone compared to the bone marrow niche although marrow persists as the typical source for mesenchymal stem cells both in the literature and current pre-clinical therapies.
Delirium as presenting symptom of neuro-Behcet’s disease
Authors: Alnasser Alsukhni Rana , Ghoubari Mohamed Sourat , Aboras Yasmin , Almohamad Alkhalifa Khadija
Published: August 2016

Objectives:

Behcet’s disease is a multisystemic disorder. Most of its clinical manifestations are due to thrombosis or vasculitis. There is a predominance of mucocutaneous and ocular lesions; neurological manifestations are minority. However, this could be the first problem that leads a patient to seek medical help.

Methods:

We report a 30-year-old female with rapidly progressive headaches and confusion. Brain magnetic resonance imaging showed bilateral thalamic T2 hyperintense lesions and hemorrhage. Directed inquiry revealed recurrent oral ulcers and three miscarriages. During hospitalization, the patient developed a deep venous thrombosis.

Results:

After exclusion of other differential diagnoses, the diagnosis of Behcet’s disease was established.

Conclusion:

Behcet’s disease is a protean disease. Hence it should be in mind in patients with otherwise unexplained signs and symptoms, especially in endemic countries, and treatment decision should not be witheld in critical cases if no alternative diagnosis is plausible.
Talking Politics on Twitter: Gender, Elections, and Social Networks
Authors: McGregor Shannon C. , Mourão Rachel R.
Published: August 2016

As campaign discussions increasingly circulate within social media, it is important to understand the characteristics of these conversations. Specifically, we ask whether well-documented patterns of gendered bias against women candidates persist in socially networked political discussions. Theorizing power dynamics as relational, we use dialectic configurations between actors as independent variables determining network measures as outcomes. Our goal is to assess relational power granted to candidates through Twitter conversations about them and whether they change depending on the gender of their opponent. Based on more than a quarter of a million tweets about 50 candidates for state-wide offices during the 2014 US elections, results suggest that when a woman opposes a man, the conversation revolves around her, but she retains a smaller portion of rhetorical share. We find that gender affects network structure—women candidates are both more central and more replied to when they run against men. Despite the potential for social media to disrupt deeply rooted gender bias, our findings suggest that the structure of networked discussions about male and female candidates still results in a differential distribution of relational power.
Liturgical language and the formation of reflectively embodied imagination as exemplified in the doxological poetry of Ephrem the Syrian
Authors: Edie Fred P
Published: August 2016

Christian Catechumens of antiquity participated bodily in a variety of deeply evocative ritual symbolic practices. At the Syrian church where Ephrem served as a deacon, they would also have spoken or sung poetic verse juxtaposing images from the biblical story to symbols and practices of the baptismal rites of initiation. Although Ephrem's aim was primarily doxological, it also formed in participants a reflective Christian imagination, one that overlaps with but is not identical to contemporary accounts of an embodied imaginative habitus. Christians in the present day who learn to imagine like Ephrem will grow in their capacity to see God's saving work grounded in and through seemingly ordinary experience, they will be challenged to dwell humbly in the mystery of God's revelation, and they will cultivate resources and poetic license for discerning, naming, and participating in God's coming Kingdom.
Biparametric versus multiparametric MRI in the diagnosis of prostate cancer
Authors: Thestrup Karen Cecilie Duus , Logager Vibeke , Baslev Ingerd , Møller Jakob M , Hansen Rasmus Hvass , Thomsen Henrik S
Published: August 2016

Background

Since multiparametric magnetic resonance imaging (mp-MRI) of the prostate exceeds 30 min, minimizing the evaluation time of significant (Gleason scores > 6) prostate cancer (PCa) would be beneficial. A reduced protocol might be sufficient for the diagnosis.

Purpose

To study whether a short unenhanced biparametric MRI (bp-MRI) matches mp-MRI in detecting significant PCa.

Material and Methods

A total of 204 men (median age, 65 years; mean ± SD, 64.1; range 45–75 years; median serum PSA level, 14 ng/mL; range, 2.2–120 ng/mL; median prostate volume, 60 mL; range, 23–263 mL) fulfilled the criteria for being enrolled. They underwent mp-MRI and prostate biopsy from January through June 2014. Of the included patients, 9.3% underwent prostatectomy, 90.7% had TRUS-bx, and 10.8 had MRI-targeted TRUS-bx. Two radiologists separately assessed the mp-MRI examination (T2-weighted [T2W] imaging, diffusion-weighted imaging [DWI], apparent diffusion coefficient map [ADC-map] and dynamic contrast-enhanced imaging [DCE]). Two months later, the bp-MRI version (T2W imaging, DWI, and ADC-map) was evaluated.

Results

Reader 1: Assessing mp-MRI: 0 false negatives, sensitivity of 1, and specificity 0.04. Assessing bp-MRI: four false negatives, sensitivity of 0.94, and specificity 0.15. Reader 2: Assessing mp-MRI: five false negatives, sensitivity of 0.93, and specificity 0.16. Assessing bp-MRI: three false negatives, sensitivity of 0.96, and specificity 0.15. Intra-reader agreement Cohen’s Kappa (κ) was 0.87 for reader 1 (95% confidence interval [CI], 0.83–0.92) and 0.84 for reader 2 (95% CI 0.78–0.89).

Conclusion

Bp-MRI is as good as mp-MRI at detecting PCa. A large prospective study seems to be strongly warranted.
A quantitative metabolomics profiling approach for the noninvasive assessment of liver histology in patients with chronic hepatitis C
Authors: Sarfaraz M. Omair , Myers Robert P. , Coffin Carla S. , Gao Zu‐Hua , Shaheen Abdel Aziz M. , Crotty Pam M. , Zhang Ping , Vogel Hans J. , Weljie Aalim M.
Published: August 2016

Background

High‐throughput technologies have the potential to identify non‐invasive biomarkers of liver pathology and improve our understanding of basic mechanisms of liver injury and repair. A metabolite profiling approach was employed to determine associations between alterations in serum metabolites and liver histology in patients with chronic hepatitis C virus (HCV) infection.

Methods

Sera from 45 non‐diabetic patients with chronic HCV were quantitatively analyzed using 1H‐NMR spectroscopy. A metabolite profile of advanced fibrosis (METAVIR F3‐4) was established using orthogonal partial least squares discriminant analysis modeling and validated using seven‐fold cross‐validation and permutation testing. Bioprofiles of moderate to severe steatosis (≥33 %) and necroinflammation (METAVIR A2‐3) were also derived. The classification accuracy of these profiles was determined using areas under the receiver operator curves (AUROCSs) measuring against liver biopsy as the gold standard.

Results

In total 63 spectral features were profiled, of which a highly significant subset of 21 metabolites were associated with advanced fibrosis (variable importance score >1 in multivariate modeling; R2 = 0.673 and Q2 = 0.285). For the identification of F3–4 fibrosis, the metabolite bioprofile had an AUROC of 0.86 (95 % CI 0.74–0.97). The AUROCs for the bioprofiles for moderate to severe steatosis were 0.87 (95 % CI 0.76–0.97) and for grade A2–3 inflammation were 0.73 (0.57–0.89).

Conclusion

This proof‐of‐principle study demonstrates the utility of a metabolomics profiling approach to non‐invasively identify biomarkers of liver fibrosis, steatosis and inflammation in patients with chronic HCV. Future cohorts are necessary to validate these findings.
Cervical Precancer Treatment in Low- and Middle-Income Countries: A Technology Overview
Authors: Maza Mauricio , Schocken Celina M. , Bergman Katherine L. , Randall Thomas C. , Cremer Miriam L.
Published: August 2016

Cervical cancer is the fourth leading cause of cancer-related death in women worldwide, with 90% of cases occurring in low- and middle-income countries (LMICs). There has been a global effort to increase access to affordable screening in these settings; however, a corresponding increase in availability of effective and inexpensive treatment modalities for ablating or excising precancerous lesions is also needed to decrease mortality. This article reviews the current landscape of available and developing technologies for treatment of cervical precancer in LMICs. At present, the standard treatment of most precancerous lesions in LMICs is gas-based cryotherapy. This low-cost, effective technology is an expedient treatment in many areas; however, obtaining and transporting gas is often difficult, and unwieldy gas tanks are not conducive to mobile health campaigns. There are several promising ablative technologies in development that are gasless or require less gas than conventional cryotherapy. Although further evaluation of the efficacy and cost-effectiveness is needed, several of these technologies are safe and can now be implemented in LMICs. Nonsurgical therapies, such as therapeutic vaccines, antivirals, and topical applications, are also promising, but most remain in early-stage trials. The establishment of evidence-based standardized protocols for available treatments and the development and introduction of novel technologies are necessary steps in overcoming barriers to treatment in LMICs and decreasing the global burden of cervical cancer. Guidance from WHO on emerging treatment technologies is also needed.
Learning in Games via Reinforcement and Regularization
Authors: Mertikopoulos Panayotis , Sandholm William H.
Published: August 2016

We investigate a class of reinforcement learning dynamics where players adjust their strategies based on their actions’ cumulative payoffs over time—specifically, by playing mixed strategies that maximize their expected cumulative payoff minus a regularization term. A widely studied example is exponential reinforcement learning, a process induced by an entropic regularization term which leads mixed strategies to evolve according to the replicator dynamics. However, in contrast to the class of regularization functions used to define smooth best responses in models of stochastic fictitious play, the functions used in this paper need not be infinitely steep at the boundary of the simplex; in fact, dropping this requirement gives rise to an important dichotomy between steep and nonsteep cases. In this general framework, we extend several properties of exponential learning, including the elimination of dominated strategies, the asymptotic stability of strict Nash equilibria, and the convergence of time-averaged trajectories in zero-sum games with an interior Nash equilibrium.
Probiotic Weisella paramesenteroides on enteropathogenic E. coli-induced diarrhea
Authors: Aslinar Aslinar , Jurnalis Yusri Dianne , Purwati Endang , Sayoeti Yorva
Published: August 2016

BackgroundEnteropathogenic Escherichia coli (EPEC) is a causative agent of intestinal inflammation and microfloral imbalance, leading to diarrhea. The presence of tumor necrosis factor-α (TNF-α) in the feces is an indicator of inflammation in the intestinal mucosa. Dadih, (local made of fermented buffalo milk), contains probiotics and is widely consumed by the people in West Sumatera, Indonesia. Weisella paramesenteroides, a probiotic lactic acid bacteria (LAB), has been isolated from dadih and is believed to be useful for improving intestinal microflora balance and inhibiting the activity of harmful microbes.ObjectiveTo determine the efficacy of W. paramesenteroides administration in various doses and durations on bowel frequency, stool’s TNF-α levels, and intestinal microflora balance on mice with EPEC-induced diarrhea.MethodThis randomized experimental animal study examined two factors relating to the effects of W. paramesenteroides on EPEC-induced diarrhea, namely doses of probiotics (factor A), and durations of observation (factor B). The subjects consisted of 100 male white mice (Mus musculus) aged 8 weeks, with weights of 25-30 grams. The outcomes measured were bowel frequency, stool’s TNF-α levels, and the balance of intestinal microflora on mice with EPEC-induced diarrhea.  Subjects were divided into 5 groups: the negative control group (received neither EPEC nor probiotic), positive control group (received only EPEC), and three experimental groups (received EPEC and different doses of W. paramesenteroides ). Probiotics were given twice at the 12-hours and 24-hours for the experimental groups, while the durations of observation conssited of baseline, 12 hours, 24 hours, and 36 hours.ResultsAfter 36 hours, subjects with EPEC-induced diarrhea who received W. Paramesenteroides administration in doses of 2 x 108 (A3), were found to have the largest decline of mean defecation (a 4.4-fold decline) and the largest decline of stool’s mean TNF-α levels (48.3 pg/mL), compared to the positive control group, and other experimental groups who received higher doses of probiotics.
Soil-transmitted helminth infection and skin prick test reactivity in children
Authors: Lubis Schenny Regina , Lrsa Lily , Evalina Rita , Supriatmo Supriatmo , Sjabaroeddin M.
Published: August 2016

Background Allergic diseases cause an increasingly largeburden in developed countries and in urban areas of middleincomecountries . Paras itic infections may induce allergicresponses in humans, particularly soil-transmitted helminth(STH) infections that are prevalent in childhood in developingcountries. Although soil-transmitted helminth infec tions havebeen associated with lower prevalence of allergen skin testreactivity, study outcomes remain inconclusive.Objective To analyze for an association between STH infectionsand skin prick test reactivity in children.Methods We conducted a cross-sectional study in August 2009among primary school students aged 7- 12 years, at SecanggangSubdistrict, Langkat District, North Sumatera Province. Sixtyeight children were recruited in this study consisted of 34 childrenwith STH infections and the other 34 children without any STHinfection. Soil-transmitted helminth infections were determinedby Kato-Katz stool examination s. All subjects underwent skinprick tests for seven allergens. Results were con sidered to bepositive if wheal diameters 2: 3 mm and negative when whealdiameters < 3 mm. Data was an alysed by Chi-square test.Results Stool examinations revealed that the most commoninfec tion was T. trichiura (18/34 subjects), followed by mixedinfections (T. trichiura and A lumbricoides; 12/34 subjects), andA. lumbricoides (4134 subjects). There was a significant associationbetween STH infections and negative skin prick test (P= 0.002).In addition, there were significant associations with negative skinprick tests for each helminth type: A. lumbricoides (P=0.001) ,T. trichiura (P=0.01) and mixed infection (P = 0.006). Severeinfection intensity was also significantly associated with negativeskin prick tests (P=0.031) .Conclusion Children with STH infections tend to have negativeskin prick test results.
Soy-based infant nutrition: a review
Authors: Vandenplas Yvan , Hegar Badriul
Published: August 2016

Dietary consumption of soy varies worldwide.In Asia, people traditionally consume largequantities of soy, while in Europe, soy is notpart of the traditional or daily eating habits.The USA is a major soy producer. The mean intake ofisoflavones by an adult is 8 - 50 mg/day in Asia but only0.5 - 3.5 mg/day in the Western world.1 The soy intakeof a vegetarian is 3 - 12 mg/day and a vegan achievesan intake of 15-60 mg/day.2In the early 1900s, soy-protein preparationswere the only option for the treatment of cow's milkprotein allergy (CMPA) . The first report of the use ofa soybean -based formula for infants dates from 1909.3Most soy drinks are not enriched with zinc, iron,calcium, phosphorous, methionine, or carnitine. Soydrinks also do not contain soy isolate. Soy productsthat do not fulfill the criteria to be an infant formulaare not adapted for infant feeding.
Urinalysis as a diagnostic tool for febrile urinary tract infection in children aged 2 months - 2 years
Authors: Khairina Ayijati , Trihono Partini Pudjiastuti , Munasir Zakiudin
Published: August 2016

Background Children aged 2 months to 2 years with febrileurinary tract infection (UTI) need special attention consideringkidney complications, unspecified symptoms, and difficult urinesample collection. Urinalysis was the main supportive examinationfor UTI because of its immediate result and widespreadavailability.Objective To estimate urine nitrite, leukocyte esterase (LE),leucocyturia, bacteriuria, and their combinations as a diagnostictool for febrile UTI in children aged 2 months to 2 years.Methods This is a diagnostic study held in Cipto MangunkusumoHospital, Tangerang General Hospital, Fatmawati Hospital, andBudhi Asih Hospital, involving 7 5 children aged 2 months to 2years. Urine samples for urinalysis and urine culture were collectedusing urine collector in all subjects. Clinical pathologists whoperformed urine culture, did not know the results of urinalysis.Results By parallel test analyses, we found that the best diagnosticvalue was the combination of 3 tests (LE, leucocyturia, andbacteriuria). This combination test showed sensitivity, specificity,positive predictive value (PPV), negative predictive value (NPV),positive likelihood ratio (LR+), and negative likelihood ratio(LR-) of 69%, 95%, 85%, 88%, 13.1, and 0.3.Conclusion The combination test of LE, leucocyturia, andbacteriuria shows high specificity, NPV, and LR+ . Therefore, thenegative results of these 3 tests in combination can be used to ruleout UTI.
Albendazole alone vs. albendazole and diethylcarbamazine combination therapy for trichuriasis
Authors: Nasution Windya Sari , Ali Muhammad , Pasaribu Ayodhia Pitaloka , Pasaribu Syahril , Lubis Chairuddin P.
Published: August 2016

Background Trichuris trichiura is one of the most commonsoil-transmitted helminths, estimated to infect l billion peopleworldwide. Several studies have compared the efficacies ofalbendazole and diethylcarbamazine, but the efficacy of acombination of these two drugs has been inconclusive.Objective To assess the effectiveness of a single dose ofalbendazole compared to a combination of albendazole anddiethylcarbamazine for trichuriasis treatment.Methods A randomized, clinical open trial was conducted fromJune to September 2009 on elementary school children withtrichuriasis from two villages in the North Sumatera Province.Stool specimens were collected at baseline and at days 7, 14,21, and 28 after treatment, and examined by the Kato Katzmethod. Subjects were randomized into two groups. Group Ireceived a single dose of albendazole (400 mg) and group IIreceived albendazole (400 mg) plus diethylcarbamazine (6 mg!kg). Statistical analyses used were Chi square test for cure ratesand Wilcoxon rank test for egg reduction rates.Results One hundred eight children were enrolled andrandomized into group l (53 children) and group II (55children). The prevalence of T. trichiura infection was 54.7%.There were no significant differences (P=0.52) in the curerate between groups I and II (66% and 60%, respectively) or inegg reduction rates at day 28 (54.5% and 60.07%, respectively,P= 0.10).Conclusion Albendazole alone and abendazole combinedwith diethylcarbamazine have similar efficacies for trichuriasistreatment, in terms of cure rates and egg reduction rates.
Management of childhood Gitelman syndrome: a case study
Authors: Prasetyo Risky Vitria , Saraswati Putu Dian , Soemyarso Ninik Asmaningsih , Noer Mohammad Sjaifullah
Published: August 2016

Gitelman syndrome is a rare, autosomal recessive, renal tubular salt wasting disorder characterized by hypokalemia, and metabolic alkalosis in combination with significant hypomagnesemia and hypocalciuria.1,2 The prevalence is estimated to be 1 in 40,000 individuals. The condition affects both males and females of all ethnic backgrounds. The prevalence of heterozygotes is approximately 1% in Caucasian populations.2,3In the majority of cases, symptoms do not appear before the age of six years and the disease is usually diagnosed during adolescence or adulthood. Symptoms, such as transient episodes of muscle weakness and tetany, sometimes accompanied by abdominal pain, vomiting and fever, are often seen in Gitelman syndrome patients. Paresthesias, especially in the face, frequently occur. Remarkably, some patients are completely asymptomatic except for the appearance of chondrocalcinosis at adult age that causes swelling, local heat, and tenderness over the affected joints. Blood pressure is lower than that in the general population. Sudden cardiac arrest has been reported occasionally. In general, growth is normal but can be delayed in those Gitelman syndrome patients with severe hypokalemia and hypomagnesemia.2,4
Flower opening and vase life of gladiolus cultivars: the sensitivity to ethylene and the carbohydrate content
Authors: Da Costa Lucas Cavalcante , Finger Fernando Luiz
Published: August 2016

Vase life is one of the most important characteristics in the quality of cut flowers. The carbohydrate content of petals from each cultivar can be a decisive factor to vase life of gladiolus flowers. Despite exposure to ethylene does not affect the life of open florets of gladiolus flowers, it may reduce the flower’s commercial life due the occurrence of flower buds abortion. This study thus aimed to evaluate the flower opening and the vase life of gladiolus flowers according to ethylene sensitivity and carbohydrate content of each cultivar. The gladiolus cultivars used in Experiment I were  ‘Amsterdam’, ‘Blue Frost’, ‘Gold Field’, ‘Green Star’, ‘Jester’, ‘Lavender’, ‘Red Beauty’, ‘Rose Supreme’, ‘Traderhorn’, and ‘Verônica’. Stems were stored in airtight chambers and exposed to the ethylene concentrations of 0, 0.1, 1.0, 10, 100, and 1000 μL L−1 for 24 h. Subsequently, flower stem were placed in a test tube with distilled water when were evaluated for percentage of flower opening and vase life. In Experiment II, three cultivars (‘Amsterdam’, ‘Red Beauty’, and ‘Verônica’) were chosen based on the lowest, medium, and highest vase life in Experiment I, respectively. Total soluble sugars, reducing sugars, and starch contents were evaluated in five flower developmental stages. No effect of ethylene on the flower opening or alterations in flower opening between cultivars. The vase life of gladiolus flowers differed between cultivars regardless of ethylene action. ‘Verônica’ and ‘Amsterdam’, which had the highest and lowest vase life, respectively, differed as to the total soluble sugar content. Ethylene does not influence the flower opening or vase life of the gladiolus cultivars studied. In these cultivars, the maintenance of flower opening is attributed to total soluble sugars content, which, in turn, is a major determinant of the vase life.
Methylation of IGF2 regulatory regions to diagnose adrenocortical carcinomas
Authors: Creemers S G , van Koetsveld P M , van Kemenade F J , Papathomas T G , Franssen G J H , Dogan F , Eekhoff E M W , van der Valk P , de Herder W W , Janssen J A M J L , Feelders R A , Hofland L J
Published: August 2016

Adrenocortical carcinoma (ACC) is a rare malignancy with a poor prognosis. Discrimination of ACCs from adrenocortical adenomas (ACAs) is challenging on both imaging and histopathological grounds. HighIGF2expression is associated with malignancy, but shows large variability. In this study, we investigate whether specific methylation patterns ofIGF2regulatory regions could serve as a valuable biomarker in distinguishing ACCs from ACAs. Pyrosequencing was used to analyse methylation percentages in DMR0, DMR2, imprinting control region (ICR) (consisting of CTCF3 and CTCF6) and theH19promoter. Expression ofIGF2andH19mRNA was assessed by real-time quantitative PCR. Analyses were performed in 24 ACCs, 14 ACAs and 11 normal adrenals. Using receiver operating characteristic (ROC) analysis, we evaluated which regions showed the best predictive value for diagnosis of ACC and determined the diagnostic accuracy of these regions. In ACCs, the DMR0, CTCF3, CTCF6 and theH19promoter were positively correlated withIGF2mRNA expression (P<0.05). Methylation in the most discriminating regions distinguished ACCs from ACAs with a sensitivity of 96%, specificity of 100% and an area under the curve (AUC) of 0.997±0.005. Our findings were validated in an independent cohort of 9 ACCs and 13 ACAs, resulting in a sensitivity of 89% and a specificity of 92%. Thus, methylation patterns ofIGF2regulatory regions can discriminate ACCs from ACAs with high diagnostic accuracy. This proposed test may become the first objective diagnostic tool to assess malignancy in adrenal tumours and facilitate the choice of therapeutic strategies in this group of patients.
A Comparison of One-Rate and Two-Rate Inference Frameworks for Site-Specific dN/
dS Estimation
Authors: Spielman Stephanie J , Wan Suyang , Wilke Claus O
Published: August 2016

Two broad paradigms exist for inferring dN/dS, the ratio of nonsynonymous to synonymous substitution rates, from coding sequences: (i) a one-rate approach, where dN/dS is represented with a single parameter, or (ii) a two-rate approach, where dN and dS are estimated separately. The performances of these two approaches have been well studied in the specific context of proper model specification, i.e., when the inference model matches the simulation model. By contrast, the relative performances of one-rate vs. two-rate parameterizations when applied to data generated according to a different mechanism remain unclear. Here, we compare the relative merits of one-rate and two-rate approaches in the specific context of model misspecification by simulating alignments with mutation–selection models rather than with dN/dS-based models. We find that one-rate frameworks generally infer more accurate dN/dS point estimates, even when dS varies among sites. In other words, modeling dS variation may substantially reduce accuracy of dN/dS point estimates. These results appear to depend on the selective constraint operating at a given site. For sites under strong purifying selection (dN/dS ≲ 0.3), one-rate and two-rate models show comparable performances. However, one-rate models significantly outperform two-rate models for sites under moderate-to-weak purifying selection. We attribute this distinction to the fact that, for these more quickly evolving sites, a given substitution is more likely to be nonsynonymous than synonymous. The data will therefore be relatively enriched for nonsynonymous changes, and modeling dS contributes excessive noise to dN/dS estimates. We additionally find that high levels of divergence among sequences, rather than the number of sequences in the alignment, are more critical for obtaining precise point estimates.
Dental Trauma: An inside to Avulsion Teeth
Authors: Mendes DDS Beatriz
Published: August 2016

Several studies shows that a wide range from 3-16% of dentoalveolar traumatic injuries result in avulsion. The ideal treatment for avulsion would be the reimplantation of the tooth. Thus, it is recommended to replant the tooth as quickly as possible. However, immediate repositioning of teeth is not always possible, so the choice of a suitable storage medium for maintenance of Periodontal Ligament cell viability is of extreme importance for the success of replantation. At the present article are discussed some storage medium and the results published in the international literature.