bluuebunny/crossref_metadata_2025 huggingface dataset:
A rare cause of cardiogenic shock: variant angina
Authors: Akhundova Aysel , Sunbul Murat , Bozbay Mehmet , Paudel Ashok , Yesildag Osman
Published: August 2014

Variant angina (VA) is a clinical syndrome caused by spontaneous vasospasm of the epicardial coronary artery which is characterized by episodes of angina. Endothelial dysfunction and neurohormonal hyperactivity are important factors in pathogenesis of VA. Although patient prognosis is good, VA may be one of the reasons of sudden cardiac death (SCD) in case of persistent ST segment elevation and malignant arrhythmias. Therefore, early treatment of VA is crucial for prevention of malignant arrhythmias and SCD. In this case report we describe a case of VA presented with cardiogenic shock and malignant ventricular arrhythmia.
Fumarate treatment in progressive forms of multiple sclerosis: first results of a single-center observational study
Authors: Strassburger-Krogias Katrin , Ellrichmann Gisa , Krogias Christos , Altmeyer Peter , Chan Andrew , Gold Ralf
Published: August 2014

Objectives:

Therapeutic options in progressive forms of multiple sclerosis (MS) are still limited. Dimethyl fumarate (DMF) has immunomodulatory properties but may also exert antioxidative cytoprotective effects. Hence, it may be a therapeutic option for progressive MS. The aim of this observational study was to evaluate safety, adherence and efficacy of fumarates in patients with primary progressive MS (PPMS) or secondary progressive MS.

Methods:

Patients with progressive MS whose condition had failed to respond to standard therapies and had worsened received the fumarate mixture Fumaderm, licensed for psoriasis therapy in Germany, or DMF by pharmaceutical preparation (Bochum ethics approval no. 4797-13). At regular follow-up visits, tolerability and disease course were assessed.

Results:

Twenty-six patients [age 54 ± 7.8 years; female = 13 (50%); PPMS = 12 (46.2%); Expanded Disability Status Scale (EDSS) = 6.0 ± 0.4 (range 3.5–8.0); disease duration = 14.1 ± 8.7 years] were initiated on treatment with Fumaderm ( n = 18) or pharmacy-prepared DMF (n=8). During a mean follow-up period of 13.2 ± 7.5 months (range 6–30) only five patients (19.2%) reported minor complaints. In 15 patients (57.7%) EDSS remained stable. In five cases (19.2%) there was even a decrease in EDSS while in six patients (23.1%) there was an increase in EDSS of more than 0.5 points, reflecting deterioration. Laboratory values were controlled for lymphopenia, renal and hepatic values, without any safety problems. We observed no significant differences between the two pharmaceutical forms.

Conclusion:

Our pilot data indicate that fumarate therapy appears to be safe and well tolerated by patients with progressive MS. In more than 75% of cases no further disease progression was evident. However, controlled studies are warranted to evaluate the detailed therapeutic potential of fumarates and their long-term effects in progressive MS.
De novo transcriptome sequencing and digital gene expression analysis predict biosynthetic pathway of rhynchophylline and isorhynchophylline from Uncaria rhynchophylla, a non-model plant with potent anti-alzheimer’s properties
Authors: Guo Qianqian , Ma Xiaojun , Wei Shugen , Qiu Deyou , Wilson Iain W , Wu Peng , Tang Qi , Liu Lijun , Dong Shoukun , Zu Wei
Published: August 2014

Background

The major medicinal alkaloids isolated fromUncaria rhynchophylla(gouteng in chinese) capsules are rhynchophylline (RIN) and isorhynchophylline (IRN). Extracts containing these terpene indole alkaloids (TIAs) can inhibit the formation and destabilize preformed fibrils of amyloid β protein (a pathological marker of Alzheimer’s disease), and have been shown to improve the cognitive function of mice with Alzheimer-like symptoms. The biosynthetic pathways of RIN and IRN are largely unknown.

Results

In this study, RNA-sequencing of pooledUncariacapsules RNA samples taken at three developmental stages that accumulate different amount of RIN and IRN was performed. More than 50 million high-quality reads from a cDNA library were generated andde novoassembled. Sequences for all of the known enzymes involved in TIAs synthesis were identified. Additionally, 193 cytochrome P450 (CYP450), 280 methyltransferase and 144 isomerase genes were identified, that are potential candidates for enzymes involved in RIN and IRN synthesis. Digital gene expression profile (DGE) analysis was performed on the three capsule developmental stages, and based on genes possessing expression profiles consistent with RIN and IRN levels; four CYP450s, three methyltransferases and three isomerases were identified as the candidates most likely to be involved in the later steps of RIN and IRN biosynthesis.

Conclusion

A combination ofde novotranscriptome assembly and DGE analysis was shown to be a powerful method for identifying genes encoding enzymes potentially involved in the biosynthesis of important secondary metabolites in a non-model plant. The transcriptome data from this study provides an important resource for understanding the formation of major bioactive constituents in the capsule extract fromUncaria, and provides information that may aid in metabolic engineering to increase yields of these important alkaloids.
A survey of offloading practices for diabetes‐related plantar neuropathic foot ulcers
Authors: Raspovic Anita , Landorf Karl B
Published: August 2014

Background

Offloading is key to preventing or healing plantar neuropathic foot ulcers in diabetes. Total contact casts or walkers rendered irremovable are recommended in guidelines as first‐line options for offloading, however the use of such devices has been found to be low. This study aimed to investigate offloading practices for diabetes‐related plantar neuropathic ulcers.

Methods

An online survey of closed and open‐ended questions was administered via SurveyMonkey®. Forty‐one podiatrists experienced in high‐risk foot practice, from 21 high‐risk foot services around Australia, were approached to participate.

Results

The response rate was 88%. Participants reported using 21 modalities or combinations of modalities, for offloading this ulcer type. The most frequently used modalities under the forefoot and hallux were felt padding, followed by removable casts or walkers, then non‐removable casts or walkers. Participants indicated that many factors were considered when selecting offloading modality, including: compliance, risk of adverse effects, psycho‐social factors, restrictions on activities of daily living, work needs and features of the wound. The majority of participants (83%) considered non‐removable casts or walkers to be the gold‐standard for offloading this ulcer type, however they reported numerous, particularly patient‐related, barriers to their use.

Conclusions

Selecting offloading for the management of foot ulceration is complex. Felt padding, not the gold‐standard non‐removable cast or walker, was reported as the most commonly selected modality for offloading plantar neuropathic ulceration. However, further evaluation of felt padding in high quality clinical trials is required to ascertain its effectiveness for ulcer healing.
Production of therapeutic proteins in the chloroplast of Chlamydomonas reinhardtii
Authors: Almaraz-Delgado Alma Lorena , Flores-Uribe José , Pérez-España Víctor Hugo , Salgado-Manjarrez Edgar , Badillo-Corona Jesús Agustín
Published: August 2014

Chloroplast transformation in the photosynthetic algaChlamydomonas reinhardtiihas been used to explore the potential to use it as an inexpensive and easily scalable system for the production of therapeutic recombinant proteins. Diverse proteins, such as bacterial and viral antigens, antibodies and, immunotoxins have been successfully expressed in the chloroplast using endogenous and chimeric promoter sequences. In some cases, proteins have accumulated to high level, demonstrating that this technology could compete with current production platforms. This review focuses on the works that have engineered the chloroplast ofC. reinhardtiiwith the aim of producing recombinant proteins intended for therapeutical use in humans or animals.
SAR assessment on three layered spherical human head model irradiated by mobile phone antenna
Authors: Rajagopal Balamurugan , Rajasekaran Lalithambika
Published: August 2014

With the increasing application of wireless communication devices, mobile phone handsets are used by peoples of various age groups. This paper make an effort to asses the mobile phone radiation exposure effect on 4 years old, 8 years old children and an adult head model. Here, human head is modeled as a three layered sphere composed of skin, skull and brain. Hand held device model (with and without resistive sheet) having dipole antenna enclosed by plastic cover is used for human interaction. The software simulation performed by General Electro Magnetic Simulator, based on Finite Difference Time Domain technique yields Specific Absorption Rate and 3D-thermal distribution on spherical human head. Comparison of 1 g SAR, 10 g SAR values for adult and children head show that, children head absorbs more power than adult. Further, the application of resistive sheet on handset shows effective decrement in coupled power.
Effects of extremely low frequency electromagnetic fields on paraoxonase serum activity and lipid peroxidation metabolites in rat
Authors: Seifirad Soroush , Farzampour Shahrokh , Nourbakhsh Mitra , Amoli Mahsa Mohammad , Razzaghy-Azar Maryam , Larijani Bagher
Published: August 2014

Background

Atherogenic effects of ELF-MF exposure have not been studied well so far. Therefore we have hypothesized that ELF-MF exposure might have atherogenic effect by impairing antioxidant function and increasing lipid peroxidation. This study was therefore undertaken to examine the effects of ELF-MF on paraoxonase (PON) activity, antioxidant capacity and lipid peroxidation metabolites. Effects of time on remodeling of antioxidant system were also investigated in this study.

Methods

Seventy five Wistar rats were randomly allocated into five groups as follows: 1) Sham exposure, 2) Single exposure to 60 Hz, sacrificed immediately after exposure, 3) Single exposure to 60 Hz, sacrificed 72 hours after exposure, 4) Fourteen days of exposure to 60 Hz, sacrificed immediately after exposure, and 5) Fourteen days of exposure to 60 Hz, sacrificed 72 hours after exposure. Blood samples were collected and analyzed. The results were compared using ANOVA and post hoc Tukey HSD for multiple caparisons.

Results

Single ELF-MF exposure significantly increased lipid peroxidation (CD and MDA) and increased antioxidant serum activity (HDL, paraoxonase activity, and serum total antioxidant capacity). Chronic ELF-MF exposure increased lipid peroxidation and affected antioxidant system. Free fatty acids levels were significantly increased after both single and two weeks exposure. Chronic exposure led to irreversible changes while acute exposure tended to reversible alterations on above mentioned parameters.

Conclusions

According to the results of this study, ELF-MF exposure could impair oxidant-antioxidant function and might increase oxidative stress and lipid peroxidation. Antioxidant capability was dependent on the duration and continuity of ELF-MF exposure.
Signal and traveltime parameter estimation using singular value decomposition
Authors: Ursin Bjørn , Silva Michelângelo G. , Porsani Milton J.
Published: August 2014

Signal detection and traveltime parameter estimation can be performed by computing a coherence function in a data window centered around a traveltime function defined by its parameters. We used singular value decomposition of the data matrix, not eigendecomposition of a covariance matrix, to review the most commonly used coherence measures. This resulted in a new reduced semblance coefficient defined from the first eigenimage, assuming that the signal amplitude was the same on all data channels (as in classical semblance). In a second signal model, the time signal was constant on each channel, but the amplitude changed. Then, the semblance coefficient is the square of the first singular value divided by the energy of the data. Two normalized crosscorrelation coefficients derived from the first eigenimage can also be used as a coherence measure: The normalized crosscorrelation of the spatial singular vector with a vector with all elements equal to one, and the normalized crosscorrelation of the temporal singular vector and the average time signal (the stacked trace). We defined a multiple signal classification (MUSIC) measure as the inverse of one minus any of the normalized coherence measures described above. To reduce the numerical range, we preferred to use [Formula: see text] MUSIC. Numerical examples with different coherence measures applied to seismic velocity analysis of synthetic and real data revealed that the normalized crosscorrelation coefficients performed poorly and that log MUSIC gave no resolution enhancement on real data. The normalized eigenimage-energy coherence measure performed poorly on synthetic data but gave the best result for a simulated reflection with a polarity reversal. It also gave good time resolution on the real data. The classical semblance coefficient and the reduced semblance coefficient gave similar results with the reduced semblance coefficient having better resolution.
Recommendations for Initial Evaluation, Staging, and Response Assessment of Hodgkin and Non-Hodgkin Lymphoma: The Lugano Classification
Authors: Cheson Bruce D. , Fisher Richard I. , Barrington Sally F. , Cavalli Franco , Schwartz Lawrence H. , Zucca Emanuele , Lister T. Andrew
Published: August 2014

The purpose of this work was to modernize recommendations for evaluation, staging, and response assessment of patients with Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). A workshop was held at the 11th International Conference on Malignant Lymphoma in Lugano, Switzerland, in June 2011, that included leading hematologists, oncologists, radiation oncologists, pathologists, radiologists, and nuclear medicine physicians, representing major international lymphoma clinical trials groups and cancer centers. Clinical and imaging subcommittees presented their conclusions at a subsequent workshop at the 12th International Conference on Malignant Lymphoma, leading to revised criteria for staging and of the International Working Group Guidelines of 2007 for response. As a result, fluorodeoxyglucose (FDG) positron emission tomography (PET)–computed tomography (CT) was formally incorporated into standard staging for FDG-avid lymphomas. A modification of the Ann Arbor descriptive terminology will be used for anatomic distribution of disease extent, but the suffixes A or B for symptoms will only be included for HL. A bone marrow biopsy is no longer indicated for the routine staging of HL and most diffuse large B-cell lymphomas. However, regardless of stage, general practice is to treat patients based on limited (stages I and II, nonbulky) or advanced (stage III or IV) disease, with stage II bulky disease considered as limited or advanced disease based on histology and a number of prognostic factors. PET-CT will be used to assess response in FDG-avid histologies using the 5-point scale. The product of the perpendicular diameters of a single node can be used to identify progressive disease. Routine surveillance scans are discouraged. These recommendations should improve evaluation of patients with lymphoma and enhance the ability to compare outcomes of clinical trials.
Patient-Reported Outcomes and Survivorship in Radiation Oncology: Overcoming the Cons
Authors: Siddiqui Farzan , Liu Arthur K. , Watkins-Bruner Deborah , Movsas Benjamin
Published: August 2014

Purpose

Although patient-reported outcomes (PROs) have become a key component of clinical oncology trials, many challenges exist regarding their optimal application. The goal of this article is to methodically review these barriers and suggest strategies to overcome them. This review will primarily focus on radiation oncology examples, will address issues regarding the “why, how, and what” of PROs, and will provide strategies for difficult problems such as methods for reducing missing data. This review will also address cancer survivorship because it closely relates to PROs.

Methods

Key articles focusing on PROs, quality of life, and survivorship issues in oncology trials are highlighted, with an emphasis on radiation oncology clinical trials. Publications and Web sites of various governmental and regulatory agencies are also reviewed.

Results

The study of PROs in clinical oncology trials has become well established. There are guidelines provided by organizations such as the US Food and Drug Administration that clearly indicate the importance of and methodology for studying PROs. Clinical trials in oncology have repeatedly demonstrated the value of studying PROs and suggested ways to overcome some of the key challenges. The Radiation Therapy Oncology Group (RTOG) has led some of these efforts, and their contributions are highlighted. The current state of cancer survivorship guidelines is also discussed.

Conclusion

The study of PROs presents significant benefits in understanding and treating toxicities and enhancing quality of life; however, challenges remain. Strategies are presented to overcome these hurdles, which will ultimately improve cancer survivorship.
Interaction of Radiation Therapy With Molecular Targeted Agents
Authors: Morris Zachary S. , Harari Paul M.
Published: August 2014

The development of molecular targeted therapeutics in oncology builds on many years of scientific investigation into the cellular mechanics of malignant transformation and progression. The past two decades have brought an accelerating pace to the clinical investigation of new molecular targeted agents, particularly in the setting of metastatic disease. The integration of molecular targeted agents into phase III clinical trial design has lagged in the curative treatment setting, particularly in combination with established therapeutic modalities such as radiation. In this review, we discuss the interaction of radiation and molecular targeted therapeutics. The dynamics of cellular and tumor response to radiation offer unique opportunities for beneficial interplay with molecular targeted agents that may go unrecognized with conventional screening and monotherapy clinical testing of novel agents. By using epidermal growth factor receptor (EGFR) as a primary example, we discuss recent clinical studies that illustrate the potential synergy of molecular targeted agents with radiation and highlight the clinical value of such interactions. For various molecular targeted agents, their greatest clinical impact may rest in combination with radiation, and efforts to facilitate systematic investigation of this approach appear highly warranted.
Promise and Pitfalls of Heavy-Particle Therapy
Authors: Mitin Timur , Zietman Anthony L.
Published: August 2014

Proton beam therapy, the most common form of heavy-particle radiation therapy, is not a new invention, but it has gained considerable public attention because of the high cost of installing and operating the rapidly increasing number of treatment centers. This article reviews the physical properties of proton beam therapy and focuses on the up-to-date clinical evidence comparing proton beam therapy with the more standard and widely available radiation therapy treatment alternatives. In a cost-conscious era of health care, the hypothetical benefits of proton beam therapy will have to be supported by demonstrable clinical gains. Proton beam therapy represents, through its scale and its cost, a battleground for the policy debate around managing expensive technology in modern medicine.
Emergence of Stereotactic Body Radiation Therapy and Its Impact on Current and Future Clinical Practice
Authors: Timmerman Robert D. , Herman Joseph , Cho L. Chinsoo
Published: August 2014

Stereotactic body radiation therapy (SBRT) is generally a tumor-ablative radiation modality using essential technologies capable of accurately and precisely damaging the target with a high dose while geometrically sparing innocent normal tissues. The intent, conduct, and tissue biology are all dramatically distinct from conventionally fractionated radiotherapy such that new understanding is required for its optimization. It is most practical, tolerable, and tumoricidal in its most potent form treating tumors in the lung and liver. However, it is increasingly being used for tumors adjacent to bowels and nervous tissue, albeit with somewhat less ablative potency. Its strengths include high rates of tumor eradication via a noninvasive, convenient outpatient treatment. Its weakness relates to the possibility of causing difficult-to-manage toxicity (eg, ulceration, stenosis, fibrosis, and even necrosis) that may occur considerably later after treatment, particularly in the vicinity of the body's many tubular structures (eg, organ hila, bowel). However, clinical trials in a variety of organs and sites have shown SBRT to result in good outcomes in properly selected patients. Given its short course, lack of need for recovery, and favorable overall toxicity profile, there is great hope that SBRT will find a prominent place in the treatment of metastatic cancer as a consolidative partner with systemic therapy. With considerable published experience, available required technologies and training, and many patients in need of local therapy, SBRT has found a place in the routine cancer-fighting arsenal.
Radical Irradiation of Extracranial Oligometastases
Authors: Salama Joseph K. , Milano Michael T.
Published: August 2014

Advances in radiotherapy planning and delivery have been used to treat patients with limited metastatic disease. With these techniques, high rates of treated metastasis control and low toxicity have been reported. Some patients have long disease-free intervals after radiotherapy similar to those seen after surgical resection. Ongoing studies will determine the benefit of these irradiation techniques to treat limited metastases, identify appropriate candidates, and assist in integrating these treatments into management strategies for specific diseases.
Molecular Radiobiology: The State of the Art
Authors: Giaccia Amato J.
Published: August 2014

Traditional cytotoxic agents used in cancer therapy were initially discovered based on their ability to kill rapidly dividing cells. The targets of these early-generation agents were typically one or more aspects of DNA synthesis or mitosis. Thus, dose-limiting toxicities commonly associated with these agents include GI dysfunction, immunosuppression, and other consequences of injury to normal tissues in which cells are replicating under normal physiologic conditions. Although many of these agents still play an important role in cancer therapy when given concurrently with radiation therapy, the major thrust of radiobiology research in the last two decades has focused on discovering tumor-specific traits that might be exploited for more selective targeting that would enhance the efficacy of radiotherapy with less normal tissue toxicity. These newer generation molecular targeted therapies interfere with the growth of tumor cells by inhibiting genes and their protein products that are needed specifically by the tumor for survival and expansion. These agents can be complementary to radiotherapy, a spatially targeted agent. Although there have been extraordinary technical advances in radiotherapy in recent years, we are reaching the limits of improvements that radiotherapy delivery technology can bring and need different approaches. This review will highlight promising new tumor biology–based targets and other novel strategies to reduce normal tissue injury, increase tumor control, and expand the use of radiotherapy to treat widespread metastatic disease.
Improvement of the system of evaluation of human settlements to improve the efficiency of their fire protection
Authors: Сербулов  , Serbulov Yuriy , Бартенев  , Bartenev A.
Published: August 2014

A mathematical Mat hex model for securing the territory of settlements units of the fire service. developed generalized method of calculation justification of the number of firefighting units, necessary for maintenance of settlements.
Constructive foundations of real equations with differential operator
Authors: Котов  , Kotov P.
Published: August 2014

Substantive foundations are offered for solution of differential equations with fixed elements of coefficient system and continuous measurable functions of the right part.
Analysis of the functional possibilities CAD MICROCAP on example of the scheme MOS-transistor
Authors: Лавлинский  , Lavlinskiy V. , Жвад  , Zhvad Akhmed Khashim Khalil
Published: August 2014

In article are compared functional possibilities CAD MICROCAP on base different analysis on example of the equiva-lent scheme MOS-transistor
Analysis of the functional possibilities CAD WORKBENCH on example of the scheme MOS-transistor
Authors: Лавлинский  , Lavlinskiy V. , Жвад  , Zhvad Akhmed Khashim Khalil
Published: August 2014

In article are compared functional possibilities modern CAD on base different analysis principle circuitries on example of the equivalent scheme MOS-transistor.
Methodical features of means of support of decision-making at realization of the strategic choice of the organization
Authors: Феоктистов  , Feoktistov R. , Лапшина  , Lapshina Marina , Разинкин  , Razinkin K.
Published: August 2014

In article possibilities of a kompleksirovaniye of approaches to decision-making support at realization of a strategic choice on the basis of the entered all-economic, investment, innovative and organizational indicators, and also quality standards of values of local criteria in each of alternatives and algorithmization and approaches to fore-casting of risks on set of financial and economic indicators are considered.
12-bit buttongenerator CMOS ADC with SOI-structure and a supply voltage of 1.8 ±5%
Authors: Рембеза  , Rembeza S. , Кононов  , Kononov V.
Published: August 2014

Considered architecture CMOS ADC with digital forecasting input analog signal and converted education error signal sectional ADCS from analog convolution. It is shown that 12-bit CMOS ADC with project standards 0.18 micron provides high accuracy and speed of conversion to 600...1000 million samples/s when operating in hard conditions. Noted that through simple modifications considered architecture can increase the bit CMOS ADC to 14 bits.
New registration process for overseas nurses
Authors: Glasper Alan
Published: August 2014

Professor Alan Glasper discusses the new NMC processes for the registration of nurses who have trained outside the European Economic Area, designed to enhance public protection.
Serial changes in serum procalcitonin, interleukin 6, and C-reactive protein levels according to non-specific surgical stimulation
Authors: Jun Kyung Ran , Lee Jeong Neo , Song Sae Am , Oh Seung Hwan , Lee Ja Young , Shin Jeong Hwan , Kim Hye Ran
Published: August 2014

The aim of this study is to investigate useful perioperative monitoring markers by comparing serial levels of serum procalcitonin (PCT), interleukin 6 (IL-6), and C-reactive protein (CRP) in routine surgical circumstances.

In 285 surgeries of 277 patients, blood samples were obtained serially, at least three times per patient: within 48 h before surgery, 0–6 h after surgery (post-OP1), >6–28 h after surgery (post-OP2), and/or later (post-OP3). PCT, IL-6, and CRP were measured. Their demographic, operative, laboratory, and clinical data were collected retrospectively.

The systemic inflammatory response syndrome (SIRS) (n=39) and sepsis (n=11) groups showed higher post-operative values than the non-SIRS group (n=233). Their maximum significant median levels were 8.96 vs. 0.21 μg/L for post-OP2 PCT, 743.1 vs. 85.8 ng/L for post-OP1 IL-6, and 103.4 vs. 49.0 mg/L for post-OP2 CRP. Among non-SIRS patients, 12 patients developed undesirable post-operative events, including secondary surgery and death. The highest area under receiver operator characteristic curves was 0.92 at post-OP1 PCT (cut-off, 0.1 μg/L; sensitivity, 91.7%; specificity, 78.7%), and the next highest was 0.84 at post-OP1 IL-6 (cut-off, 359 ng/L; sensitivity, 66.7%; specificity, 91.9%). All biomarkers were increased by non-specific surgical stimuli; however, post-OP1/post-OP2 PCT were <1.0 μg/L (90th percentile) except major abdominal surgeries.

Post-OP1 PCT measurement may be useful as a post-operative monitoring marker for the following reasons: pre-operative values less than the cut-off regardless of pre-operative state (age, malignancy, and American Society of Anesthesiologists class); minimal influence from surgical stimulus; and prediction of post-operative undesirable events.
Aberrant hypermethylation of CTNNA1 gene is associated with higher IPSS risk in patients with myelodysplastic syndrome
Authors: Qian Jun , Chen Xing-xing , Qian Wei , Yang Jing , Wen Xiang-mei , Ma Ji-chun , Deng Zhao-qun , Qian Zhen , Zhang Ying-ying , Lin Jiang
Published: August 2014

: We investigated the methylation status of

Aberrant hypermethylation of

Our data confirm that aberrant
Development and validation of a HPLC-UV method for the quantification of antiepileptic drugs in dried plasma spots
Authors: Baldelli Sara , Cattaneo Dario , Giodini Luciana , Baietto Lorena , Di Perri Giovanni , D’Avolio Antonio , Clementi Emilio
Published: August 2014

Therapeutic drug monitoring (TDM) of antiepileptic drugs is widely used in clinical practice to optimise therapy, but it is limited by technical problems and cost considerations. The aim of the present study was: 1) to validate a chromatographic method for the concomitant determination of levetiracetam, lamotrigine, ethosuximide, felbamate, rufinamide, zonisamide and monohydroxycarbamazepine; 2) to develop it for dried plasma spot (DPS) assessing its reliability against the classical determination from plasma; and 3) test its clinical application.

Extraction of plasma samples and DPS was done by simple precipitation. Chromatographic analysis was performed using high performance liquid chromatography with ultraviolet detection. After validation, both methods were applied for the quantification of plasma samples from patients on antiepileptic therapy.

Mean inter- and intra-day accuracy and precision were <15% for all compounds both in plasma and in DPS samples. DPS samples were considered stable under tested conditions. Measurements between plasma and DPS samples appeared related (p<0.0001). Bland-Altman analysis revealed accordance in lamotrigine values with mean overestimation of concentration for DPS sample of 2.8%. Also for monohydroxycarbamazepine data the agreement was acceptable (mean overestimation of 9.2%). For levetiracetam mean difference was 7.6%, while for ethosuximide mean percentage difference was 20.6%.

The developed methods simplify TDM of antiepileptic drugs. This is particularly relevant for the method on dried spot sample devices because it facilitates further sample handling, stability and shipments making the management of therapies in epileptic patients easier also in hospitals devoid of a dedicated laboratory.
Determination of quality control limits for serological infectious disease testing using historical data
Authors: Dimech Wayne , Vincini Giuseppe , Karakaltsas Marina
Published: August 2014

An effective quality control (QC) program requires the establishment of control limits within which the results of the QC sample is expected to fall. Traditionally, the mean plus/minus two standard deviations calculated for a set of QC sample results is used to establish control limits. Allowable total error (TEa) and Westgard rules aid in interpreting QC sample results. Westgard rules assume QC sample results are normally distributed and TEa assumes commutability between the QC sample and patient results. None of these paradigms apply to infectious disease testing.

Results from the NRL’s QC program were extracted and sorted into assay/QC lot number-specific data. Control limits for selected QC samples used to monitor 64 commonly used serological assays were calculated and validated using the within- and between-QC lot variance of data from each of the assay/QC combinations.

No assay/QC combination had more than 10% of results less than the lower control limit or greater than the upper control limit. Of the 423 assay/QC lot combinations, 14 (3.3%) had more than 5% of results less than the lower limit and 48 (11.3%) had more than 5% of results greater than the upper limit calculated for that assay/QC combination.

The control limits, established by this novel method, are based on more than a decade of QC test results from >300 laboratories from 30 countries and provides users of the NRL QC program evidence-based control limits that can be applied in isolation or in conjunction with more traditional methods for establishing control limits.
Could molecular assessment of calcium metabolism be a useful tool to early screen patients at risk for pre-eclampsia complicated pregnancy? Proposal and rationale
Authors: Gizzo Salvatore , Noventa Marco , Di Gangi Stefania , Saccardi Carlo , Cosmi Erich , Nardelli Giovanni Battista , Plebani Mario
Published: August 2014

One of the most frequent causes of maternal and perinatal morbidity is represented by hypertensive disorders during pregnancy. Women at high risk must be subjected to a more intensive antenatal surveillance and prophylactic treatments. Many genetic risk factors, clinical features and biomarkers have been proposed but none of these seems able to prevent pre-eclampsia onset. English literature review of manuscripts focused on calcium intake and hypertensive disorders during pregnancy was performed. We performed a critical analysis of evidences about maternal calcium metabolism pattern in pregnancy analyzing all possible bias affecting studies. Calcium supplementation seems to give beneficial effects on women with low calcium intake. Some evidence reported that calcium supplementation may drastically reduce the percentage of pre-eclampsia onset consequently improving the neonatal outcome. Starting from this evidence, it is intuitive that investigations on maternal calcium metabolism pattern in first trimester of pregnancy could represent a low cost, large scale tool to screen pregnant women and to identify those at increased risk of pre-eclampsia onset. We propose a biochemical screening of maternal calcium metabolism pattern in first trimester of pregnancy to discriminate patients who potentially may benefit from calcium supplementation. In a second step we propose to randomly allocate the sub-cohort of patients with calcium metabolism disorders in a treatment group (calcium supplementation) or in a control group (placebo) to define if calcium supplementation may represent a dietary mean to reduce pre-eclampsia onset and to improve pregnancy outcome.
Perceived social support and parental education as determinants of adolescents’ physical activity and eating behaviour: a cross-sectional survey
Authors: Glozah Franklin N. , Pevalin David J.
Published: August 2014

Purpose: To examine the role of perceived social support and parental education on physical activity and eating behaviour of Ghanaian adolescents.

Methods: Seven hundred and seventy Senior High School students (504 boys and 266 girls) between the ages of 14–21 years participated by completing questionnaires on perceived social support, physical activity and eating behaviour. The highest education attained by either parent or guardian was also obtained. Multivariate analysis of covariance was the main statistical test used to analyse the data.

Results: The results showed significant gender differences in physical activity and eating behaviour combined, with boys more likely to engage in physical activity than girls, and girls also more likely to engage in healthy eating behaviour than boys, albeit the effect was not statistically significant. While perceived social support had a significant positive effect on eating behaviour and physical activity, parental education had a significant effect only on eating behaviour but not physical activity.

Conclusion: Perceived social support from family coupled with parental education provides more opportunities for adolescents to engage in healthy eating behaviour. Also, parents’ educational attainment alone does not necessarily guarantee that adolescents will engage in physical activity; providing the needed social support and conducive home environment is more likely to induce physical activity behaviours. Finally, physical activity and eating behaviour should not be construed as alternative health behaviours as suggested by gender differentials in these health behaviours.
Congruence in reported frequency of parent-adolescent sexual health communication: A study from Mexico
Authors: Atienzo Erika E. , Ortiz-Panozo Eduardo , Campero Lourdes
Published: August 2014

Background: Most studies on parent-adolescent sexual health communication come from developed countries and are based on either parents’ or children’s reports. In developing countries, there is little evidence about the agreement among reports of all parties involved in parent-adolescent sexual health communication.

Objective: The objective of this study is to explore the congruence (agreement) between adolescents and their parents about how frequently they discuss on selected sexual health topics.

Subjects: A total of 1606 parent-adolescent dyads of adolescents attending the first year in public high schools and their parents, in Morelos, Mexico were sampled in this study.

Methods: The participants completed a self-administered questionnaire that included the frequency of parent-adolescent communication about eight sexual health topics. An ordinal logistic threshold model was used to estimate intra-class correlation coefficients within parent-adolescent dyads (as a measure of congruence) and to test if thresholds were equal between parents and adolescents.

Results: Congruence in reported frequency of parent-adolescent sexual health communication ranged from 0.205 (menstruation) to 0.307 (condoms) for mother-adolescent dyads, and from 0.103 (ejaculation) to 0.380 (condoms) for father-adolescent dyads. The thresholds (i.e., the cutoff points that define the categories in the observed ordinal variable) differed between parents and adolescents for each of the sexual health topics explored (p<0.05 for father-adolescent dyads and p<0.001 for mother-adolescent dyads).

Conclusion: Our findings suggest a low congruence between parents’ and adolescents’ reports on parent-adolescent sexual health communication. This might be due to interpretation of frequency and intensity of sexual health communication which differs between parents and adolescents.
Atrial fibrillation in a healthy adolescent after heavy smoking of contraband cigarettes
Authors: Ozyilmaz Isa , Ozyilmaz Sinem , Tosun Oyku , Tola Hasan Tahsin , Saygi Murat , Ergul Yakup
Published: August 2014

The use of contraband cigarettes is a serious public health problem. We present a case of atrial fibrillation in a healthy adolescent suspected to be caused by smoking contraband cigarettes. A 15-year-old man was admitted to our emergency department experiencing syncope and palpitations. He was a cigarette smoker, but he had never smoked any illicit tobacco products before. He had finished a pack of counterfeit cigarettes (20 pieces) in 1.5 h. His electrocardiogram showed atrial fibrillation with a rapid ventricular response and irregular RR intervals. The patient had no history of alcohol use, surgery, palpitations, hypertension, chronic bronchitis, or any infectious diseases. His atrial fibrillation was converted to a normal sinus rhythm after the cardioversion treatment. Our patient was discharged from the pediatric cardiology service and advised to quit smoking cigarettes, strictly warning against illicit tobacco products. In conclusion, intensive smoking of counterfeit cigarettes may lead to occurrences of atrial fibrillation.
Esterification of Free Fatty Acids in Crude Palm Oil Using Sulfated Cobalt–Tin Mixed Oxide Catalysts
Authors: Nuithitikul Kamchai , Hasin Worrapat
Published: August 2014

In this study, sulfated tin oxide was modified with cobalt oxide resulting in sulfated cobalt–tin mixed oxide (SO42–/Co2O3–SnO2). For the first time, the catalytic activity of SO42–/Co2O3–SnO2 for the esterification reaction of free fatty acids (FFA) in crude palm oil to produce methyl esters has been investigated. The effects of amount of Co and calcination temperature were studied. The properties of SO42–/Co2O3–SnO2 were determined with N2 adsorption, X-ray diffraction and X-ray fluorescence analysis, Fourier transform infrared spectroscopy, thermogravimetric analysis and potentiometric titration. The esterification was carried out in a stirred-tank reactor equipped with a reflux condenser. The reaction conditions (methanol/oil ratio, catalyst size, catalyst loading and reaction time) were optimized. The results confirm that SO42–/Co2O3–SnO2 is a promising catalyst in the production of methyl esters from FFA in crude palm oil. The addition of Co improved the reusability of sulfated tin oxide.
A Two-Phase CFD Modeling Approach to Investigate the Flow Characteristics in Radial Flow Moving-Bed Reactors
Authors: Xiao Fang-Zhi , Luo Zheng-Hong
Published: August 2014

Based on a complete CFD Eulerian–Eulerian two-fluid approach, a comprehensive three-dimensional (3D) two-phase reactor model was suggested to describe the flow behavior in radial flow moving-bed reactors (RFMBRs). A porous media model was incorporated into the reactor model in order to describe the flow resistance provided by the porous walls of the center and annular pipes. Compared with these previous reactor models, the reactor model considers the solid-phase movement instead of immobilization, which benefits for predicting the formation of cavity practically. The simulation results are agreement with the published experimental data. By employing the verified model, the flow field parameters in the reactors such as pressure drop and flow velocity were obtained. Besides, the simulations were then carried out to investigate the effect of the bed voidage on the flow behavior and to understand the phenomenon of cavity in the RFMBRs. The simulation results showed that both the centripetal and the centrifugal flow configurations have the inhomogeneous flow distribution and the phenomenon of cavity. Furthermore, the inhomogeneous distribution increases with the increase of the bed voidage, whereas the phenomenon of cavity is more obvious with the increase of gas inlet velocity. As a whole, this work provided a realistic modeling and a useful approach for the understanding of RFMBRs.
Absolute Performance of AUSGeoid09 in Mountainous Regions
Authors: Sussanna Vittorio , Janssen Volker , Gibbings Peter
Published: August 2014

The Australian Height Datum (AHD) is the current national vertical datum for Australia, and AUSGeoid09 is the latest quasigeoid model used to compute (normal-orthometric)AHDheights fromGlobalNavigation Satellite System (GNSS) derived ellipsoidal heights. While previous studies have evaluated the AUSGeoid09 model across Australia, such studies have not focused on mountainous regions in particular. This paper investigates the performance of AUSGeoid09 in an absolute sense in the Mid Hunter and Snowy Mountains regions of New South Wales. Absolute (i.e. single point) comparisons were undertaken between AUSGeoid09-derived heights and published AHD heights. The performance of AUSGeoid09 was evaluated relative to its predecessor AUSGeoid98. In both study areas, an overall improvement is evident when applying AUSGeoid09 to compute AHD heights in an absolute sense. In the MidHunter, AUSGeoid09 provided a substantial improvement over its predecessor, clearly demonstrating the benefits of its new geometric component on GNSS-derived AHD height determination. In the Snowy Mountains, moderate improvement over AUSGeoid98 was evident. However, a slope was detected for AUSGeoid09 residuals, and it appears that the geometric component may have overcompensated for sea surface topography in this area. While this appraisal of AUSGeoid09 performance in mountainous regions is encouraging, it has been shown that some discrepancies still remain between AUSGeoid09-derived heights and AHD. Eventually, a new vertical datum will be necessary to ensure homogeneity across Australia.
Thyrotoxic, hypokalemic periodic paralysis (THPP) in adolescents
Authors: Al-Zubeidi Hiba , Demeterco Carla , Jones Kenneth Lee
Published: August 2014

Periodic paralysis associated with hyperthyroidism and hypokalemia is an uncommon disorder reported primarily in Asian males and rarely in children. We report three Hispanic adolescent males who were seen with Graves’ disease (GD) and THPP.

The method used was chart review.

Two of these boys presented with episodes of paralysis and were diagnosed with GD. The third was initially seen with hyperthyroidism and developed weakness and paralysis when his disease progressed because of therapeutic noncompliance. Hypokalemia was documented in two of the three patients with the third not seen during paralysis. Intravenous K

THPP is considered uncommon except in Asian males and rare in childhood and adolescence. Its occurrence in these three Hispanic boys suggests that it may occur more frequently in the young and in the USA than has been suspected, especially with the changing national demographics. We believe that our experience should raise the awareness of THPP among pediatric care providers.
Skin advanced glycation endproducts are elevated at onset of type 1 diabetes in youth
Authors: Báez Eileen A. , Shah Shreepal , Felipe Dania , Maynard John , Lefevre Suzanne , Chalew Stuart A.
Published: August 2014

To compare skin advanced glycation endproducts (AGEs) in children at onset of type 1 diabetes with children without diabetes.

Skin AGEs (sAGEs) were estimated by measurement of skin intrinsic fluorescence (SIF) at diagnosis of type 1 diabetes (NewD; n=47, F=45%, M=55%, Age=10±3.7) and in youth without diabetes (NoD; n=112, F=53%, M=47%, Age=10.4±4.8). HCO

SIF at 405 nm and 420 nm excitation were higher (p=0.03) in NewD children compared to NoD. HCO

Despite the short duration of untreated diabetes, sAGEs were higher in children with NewD compared to children with NoD. Further study will be needed to determine whether early accumulation of sAGEs is associated with higher risk for development and progression of complications.
Prepregnancy maternal obesity and fetal-perinatal death in a Mediterranean country
Authors: Papachatzi Eleni , Papadopoulos Vassilis , Dimitriou Gabriel , Paparrodopoulos Spyros , Papadimitriou-Olivgeris Mattheos , Vantarakis Apostolos
Published: August 2014

Objective: Pre- or early-pregnancy obesity carries significant health implications. This retrospective cohort study investigates the association between pre- or early-pregnancy body mass index (BMI) and the risk of fetal and neonatal death in pregnancies implicated by obesity in a Mediterranean country.

Study design: Data on pregnancies delivered during 2003–2008 at a University hospital was linked to data from regional registry. Logistic regression models were used to determine the odds ratios of a spontaneous fetal death and perinatal death among overweight, obese, and morbid obese women.

Results: Independent predictors of fetal death were maternal prepregnancy BMI over 25, maternal age, maternal co-morbidities, and maternal residence in an island. Perinatal mortality was independently correlated to neonatal birthweight, maternal age, maternal residence in towns and villages, and maternal BMI over 40. Overall, maternal residence in an island, maternal autoimmune disease, and maternal prepregnancy BMI (over 25) were independent risk factors predicting offspring death (both intrauterine and perinatal).

Conclusions: Maternal obesity is correlated to offspring’s mortality during fetal and/or perinatal period. This is one of the very few studies in a Mediterranean country. This study underlines the need for public health interventions to prevent obesity in young women.