bluuebunny/crossref_metadata_2025 huggingface dataset:
High-intensity interval and endurance training are associated with divergent skeletal muscle adaptations in a rodent model of hypertension
Authors: Holloway Tanya M. , Bloemberg Darin , da Silva Mayne L. , Quadrilatero Joe , Spriet Lawrence L.
Published: April 2015

Skeletal muscle is extremely adaptable to a variety of metabolic challenges, as both traditional moderate-intensity endurance (ET) and high-intensity interval training (HIIT) increases oxidative potential in a coordinated manner. Although these responses have been clearly demonstrated in healthy individuals, it remains to be determined whether both produce similar responses in the context of hypertension, one of the most prevalent and costly diseases worldwide. Therefore, in the current study, we used the Dahl sodium-sensitive rat, a model of hypertension, to determine the molecular responses to 4 wk of either ET or HIIT in the red (RG) and white gastrocnemius (WG) muscles. In the RG, both ET and HIIT increased the content of electron transport chain proteins and increased succinate dehydrogenase (SDH) content in type I fibers. Although both intensities of exercise shifted fiber type in RG (increased IIA, decreased IIX), only HIIT was associated with a reduction in endothelial nitric oxide synthase and an increase in HIF-1α proteins. In the WG, both ET and HIIT increased markers of the electron transport chain; however, HIIT decreased SDH content in a fiber-specific manner. ET increased type IIA, decreased IIB fibers, and increased capillarization, while, in contrast, HIIT increased the percentage of IIB fibers, decreased capillary-to-fiber ratios, decreased endothelial nitric oxide synthase, and increased hypoxia inducible factor-1α (HIF-1α) protein. Altogether, these data show that unlike in healthy animals, ET and HIIT have divergent effects in the skeletal muscle of hypertensive rats. This suggests ET may be optimal at improving the oxidative capacity of skeletal muscle in animals with hypertension.
The Application of GeneXpert MTB/RIF for Smear-Negative TB Diagnosis as a Fee-Paying Service at a South Asian General Hospital
Authors: Shrestha Poojan , Arjyal Amit , Caws Maxine , Prajapati Krishna Govinda , Karkey Abhilasha , Dongol Sabina , Pathak Saruna , Prajapati Shanti , Basnyat Buddha
Published: April 2015

The GeneXpert MTB/RIF assay (Xpert) is a novel automated diagnostic tool for tuberculosis but its optimal placement in the healthcare system has not been determined. The objective of this study was to determine the possibility of additional case detection for pulmonary tuberculosis (PTB) by offering Xpert to smear-negative patients in a low-HIV burden setting with noMycobacterium tuberculosis(M.tb.) culture facilities. Patients routinely presenting with symptoms suggestive of PTB with negative smears were offered single Xpert test on a fee-paying basis. Data were retrospectively reviewed to determine case detection in patients tested from February to December 2013. Symptoms associated with a positive test were analysed to determine if refinement of clinical criteria would reduce unnecessary testing. 258 smear-negative patients were included andM.tb.was detected in 55 (21.32%,n=55/258). Using standard clinical assessment for selection, testing 5 patients detected one case of smear-negative PTB. These results demonstrate that fee-paying Xpert service in low-income setting can increase TB case confirmation substantially and further systematic studies of health economic implications should be conducted to determine optimal implementation models to increase access to Xpert in low- and middle-income countries.
Recovering 3D Shape with Absolute Size from Endoscope Images Using RBF Neural Network
Authors: Tsuda Seiya , Iwahori Yuji , Bhuyan M. K. , Woodham Robert J. , Kasugai Kunio
Published: April 2015

Medical diagnosis judges the status of polyp from the size and the 3D shape of the polyp from its medical endoscope image. However the medical doctor judges the status empirically from the endoscope image and more accurate 3D shape recovery from its 2D image has been demanded to support this judgment. As a method to recover 3D shape with high speed, VBW (Vogel-Breuß-Weickert) model is proposed to recover 3D shape under the condition of point light source illumination and perspective projection. However, VBW model recovers the relative shape but there is a problem that the shape cannot be recovered with the exact size. Here, shape modification is introduced to recover the exact shape with modification from that with VBW model. RBF-NN is introduced for the mapping between input and output. Input is given as the output of gradient parameters of VBW model for the generated sphere. Output is given as the true gradient parameters of true values of the generated sphere. Learning mapping with NN can modify the gradient and the depth can be recovered according to the modified gradient parameters. Performance of the proposed approach is confirmed via computer simulation and real experiment.
Catalytic Reductive Degradation of Methyl Orange Using Air Resilient Copper Nanostructures
Authors: Soomro Razium Ali , Nafady Ayman , Sirajuddin  , Sherazi Syed Tufail Hussain , Kalwar Nazar Hussain , Shah Mohammad Raza , Hallam Keith Richard
Published: April 2015

The study describes the application of oxidation resistant copper nanostructures as an efficient heterogeneous catalyst for the treatment of organic dye containing waste waters. Copper nanostructures were synthesized in an aqueous environment using modified surfactant assisted chemical reduction route. The synthesized nanostructures have been characterized by UV‐Vis, Fourier transform infrared spectroscopy FTIR spectroscopy, Atomic force microscopy (AFM), Scanning Electron Microscopy (SEM), and X‐ray diffractometry (XRD). These surfactant capped Cu nanostructures have been used as a heterogeneous catalyst for the comparative reductive degradation of methyl orange (MO) in the presence of sodium borohydride (NaBH4) used as a potential reductant. Copper nanoparticles (Cu NPs) were found to be more efficient compared to copper nanorods (Cu NRds) with the degradation reaction obeying pseudofirst order reaction kinetics. Shape dependent catalytic efficiency was further evaluated from activation energy (EA) of reductive degradation reaction. The more efficient Cu NPs were further employed for reductive degradation of real waste water samples containing dyes collected from the drain of different local textile industries situated in Hyderabad region, Pakistan.
Transcriptional Regulators of Claudins in Epithelial Tight Junctions
Authors: Khan Niamat , Asif Abdul R.
Published: April 2015

Human gastrointestinal tract is covered by a monolayer of specialized epithelial cells that constitute a protective barrier surface to external toxic and infectious agents along with metabolic and digestive functions. Intercellular junctions, among epithelial cells, such as desmosomes, adherens, gap, and tight junctions (TJs), not only provide mechanical integrity but also limit movement of molecules across the monolayer. TJ is a complex structure composed of approximately 35 different proteins that interact with each other at the apical side of two adjacent epithelial cells. Claudin family proteins are important members of TJ with so far 24 known isoforms in different species. Claudins are structural proteins of TJ that help to control the paracellular movement by forming fence and barrier across the epithelial monolayer. Altered function of claudins is implicated in different form of cancers, inflammatory bowel diseases (IBDs), and leaky diarrhea. Based on their significant role in the molecular architecture of TJ, diversity, and disease association, further understanding about claudin family proteins and their genetic/epigenetic regulators is indispensable.
Top-Down Computerized Cognitive Remediation in Schizophrenia: A Case Study of an Individual with Impairment in Verbal Fluency
Authors: Masson Marjolaine , Wykes Til , Maziade Michel , Reeder Clare , Gariépy Marie-Anne , Roy Marc-André , Ivers Hans , Cellard Caroline
Published: April 2015

The objective of this case study was to assess the specific effect of cognitive remediation for schizophrenia on the pattern of cognitive impairments. Case A is a 33-year-old man with a schizophrenia diagnosis and impairments in visual memory, inhibition, problem solving, and verbal fluency. He was provided with a therapist delivered cognitive remediation program involving practice and strategy which was designed to train attention, memory, executive functioning, visual-perceptual processing, and metacognitive skills. Neuropsychological and clinical assessments were administered at baseline and after three months of treatment. At posttest assessment, Case A had improved significantly on targeted (visual memory and problem solving) and nontargeted (verbal fluency) cognitive processes. The results of the current case study suggest that (1) it is possible to improve specific cognitive processes with targeted exercises, as seen by the improvement in visual memory due to training exercises targeting this cognitive domain; (2) cognitive remediation can produce improvements in cognitive processes not targeted during remediation since verbal fluency was improved while there was no training exercise on this specific cognitive process; and (3) including learning strategies in cognitive remediation increases the value of the approach and enhances participant improvement, possibly because strategies using verbalization can lead to improvement in verbal fluency even if it was not practiced.
Isolated T Wave Inversion in Lead aVL: An ECG Survey and a Case Report
Authors: Hassen Getaw Worku , Costea Ana , Carrazco Claire , Frew Tsion , Swaminathan Anand , Feliberti Jason , Chirurgi Roger , Smith Tennyson , Chen Alice , Thompson Sarah , Gushway-Henry Neola , Simmons Bonnie , Fernaine George , Kalantari Hossein , Talebi Soheila
Published: April 2015

Background.Computerized electrocardiogram (ECG) analysis has been of tremendous help for noncardiologists, but can we rely on it? The importance of ST depression and T wave inversions in lead aVL has not been emphasized and not well recognized across all specialties.Objective.This study’s goal was to analyze if there is a discrepancy of interpretation by physicians from different specialties and a computer-generated ECG reading in regard to a TWI in lead aVL.Methods.In this multidisciplinary prospective study, a single ECG with isolated TWI in lead aVL that was interpreted by the computer as normal was given to all participants to interpret in writing. The readings by all physicians were compared by level of education and by specialty to one another and to the computer interpretation.Results.A total of 191 physicians participated in the study. Of the 191 physicians 48 (25.1%) identified and 143 (74.9%) did not identify the isolated TWI in lead aVL.Conclusion.Our study demonstrated that 74.9% did not recognize the abnormality. New and subtle ECG findings should be emphasized in their training so as not to miss significant findings that could cause morbidity and mortality.
Claudin‐4 Undergoes Age‐Dependent Change in Cellular Localization on Pig Jejunal Villous Epithelial Cells, Independent of Bacterial Colonization
Authors: Pasternak J. Alex , Kent-Dennis Coral , Van Kessel Andrew G. , Wilson Heather L.
Published: April 2015

Newborn piglets are immunologically naïve and must receive passive immunity via colostrum within 24 hours to survive. Mechanisms by which the newborn piglet gut facilitates uptake of colostral cells, antibodies, and proteins may include FcRn and pIgR receptor‐mediated endocytosis and paracellular transport between tight junctions (TJs). In the present study, FcRn gene (FCGRT) was minimally expressed in 6‐week‐old gut and newborn jejunum but it was expressed at significantly higher levels in the ileum of newborn piglets. pIgR was highly expressed in the jejunum and ileum of 6‐week‐old animals but only minimally in neonatal gut. Immunohistochemical analysis showed that Claudin‐5 localized to blood vessel endothelial cells. Claudin‐4 was strongly localized to the apical aspect of jejunal epithelial cells for the first 2 days of life after which it was redistributed to the lateral surface between adjacent enterocytes. Claudin‐4 was localized to ileal lateral surfaces within 24 hours after birth indicating regional and temporal differences. Tissue from gnotobiotic piglets showed that commensal microbiota did not influence Claudin‐4 surface localization on jejunal or ileal enterocytes. Regulation of TJs by Claudin‐4 surface localization requires further investigation. Understanding the factors that regulate gut barrier maturation may yield protective strategies against infectious diseases.
Transgenic Carrot Expressing Fusion Protein ComprisingM. tuberculosisAntigens Induces Immune Response in Mice
Authors: Permyakova Natalia V. , Zagorskaya Alla A. , Belavin Pavel A. , Uvarova Elena A. , Nosareva Olesya V. , Nesterov Andrey E. , Novikovskaya Anna A. , Zav’yalov Evgeniy L. , Moshkin Mikhail P. , Deineko Elena V.
Published: April 2015

Tuberculosis remains one of the major infectious diseases, which continues to pose a major global health problem. Transgenic plants may serve as bioreactors to produce heterologous proteins including antibodies, antigens, and hormones. In the present study, a genetic construct has been designed that comprises theMycobacterium tuberculosisgenescfp10, esat6anddIFNgene, which encode deltaferon, a recombinant analog of the humanγ-interferon designed for expression in plant tissues. This construct was transferred to the carrot (Daucus carotaL.) genome byAgrobacterium-mediated transformation. This study demonstrates that the fusion protein CFP10-ESAT6-dIFN is synthesized in the transgenic carrot storage roots. The protein is able to induce both humoral and cell-mediated immune responses in laboratory animals (mice) when administered either orally or by injection. It should be emphasized thatM. tuberculosisantigens contained in the fusion protein have no cytotoxic effect on peripheral blood mononuclear cells.
Severe Hyperammonemia in Late-Onset Ornithine Transcarbamylase Deficiency Triggered by Steroid Administration
Authors: Gascon-Bayarri Jordi , Campdelacreu Jaume , Estela Jordi , Reñé Ramon
Published: April 2015

Ornithine transcarbamylase deficiency (OTCD) is a rare X-linked disorder of urea synthesis leading to hyperammonemia. Several late-onset cases have been reported. Undiagnosed and untreated patients are at the risk of death or suffering from irreversible sequelae. We describe a 56-year-old patient who presented with acute encephalopathy after steroid treatment. Hyperammonemia due to OTCD was diagnosed and a mutation was found. This allowed us to diagnose two other family members with unexplained encephalopathy who are now asymptomatic on a low-protein diet. OTCD should be considered in any patient with hyperammonemic encephalopathy and immediate treatment should be given to avoid a fatal outcome. We emphasize the need to examine other family members if the diagnosis is confirmed, in order to prevent further life-threatening episodes of encephalopathy or neonatal coma of newborn.
Diagnostic Potential of Multidetector Computed Tomography for Characterizing Small Renal Masses
Authors: Mancini Maria Elisabetta , Albergo Annamaria , Moschetta Marco , Angelelli Mariacristina , Scardapane Arnaldo , Angelelli Giuseppe
Published: April 2015

Objectives. To assess the potential of CT for characterizing small renal tumors. Methods. 76 patients with <4 cm renal tumors underwent CT examination. The following parameters were assessed: presence of calcifications, densitometry on unenhanced and enhanced scans, washout percentage, urinary tract infiltration, star‐shaped scar, and paradoxical effect. Results. Calcifications were found in 7/56 (12.5%) carcinomas. Clear cell carcinomas were as follows: mean density 183.5 HU (arterial phase), 136 HU (portal phase), and 94 HU (delayed phase), washout 34.3%; chromophobe carcinomas were as follows: mean density 135 HU (arterial phase), 161 HU (portal phase), and 148 HU (delayed phase), washout 28%; papillary carcinomas were as follows: mean density 50.3 HU (arterial phase), 60 HU (portal phase), and 58.1 HU (delayed phase), washout 2.7%. In 2/56 (3.6%) cases urinary tract infiltration was found. Oncocytomas were as follows: mean density 126.5 HU (arterial phase), 147.5 HU (portal phase), and 115.5 HU (delayed phase), washout 28.6%. On unenhanced scans, angiomyolipomas were as follows: density values <30 HU in 12/12 (100%) of cases and on enhanced scans: mean density 78 HU (arterial phase), 128 HU (portal phase), and 80 HU (delayed phase), washout 50%. Conclusions. Intralesional calcifications and urinary tract infiltration are suggestive for malignancy, with the evidence of adipose tissue for angiomyolipomas and a modest increase in density with a reduced washout for papillary carcinomas. The intralesional density on enhanced scans, peak enhancement, and washout do not seem significant for differentiating clear cell, chromophobe carcinomas, angiomyolipomas, and oncocytomas.
Investigation ofΔEEffect on Vibrational Behavior of Giant Magnetostrictive Transducers
Authors: Sheykholeslami M. , Hojjat Y. , Ghodsi M. , Kakavand K. , Cinquemani S.
Published: April 2015

Resonant magnetostrictive transducers are used for generating vibrations in the sonic and ultrasonic range of frequency. As the mechanical properties of magnetostrictive materials change according to different operating conditions (i.e., temperature, mechanical prestress, and magnetic bias), the vibrational behavior of the transducer changes too.ΔEeffect is the change in the Young modulus of the ferromagnetic material and it has to be considered as it leads to changes in the dynamics of the transducer. This paper deals with the study of such effect from both theoretical and experimental point of view.ΔEeffect on behavior of the transducer based on Terfenol-D is analytically described as a function of different operating conditions focusing on effects on resonance frequency, mode shape, and moreover experimentally the quality factor. Results of resonance frequency prediction have been validated with experiments and good agreement has been seen.
Extraspinal Type I Dural Arteriovenous Fistula with a Lumbosacral Lipomyelomeningocele: A Case Report and Review of the Literature
Authors: Krisht Khaled M. , Karsy Michael , Ray Wilson Z. , Dailey Andrew T.
Published: April 2015

Seven cases of adult spinal vascular malformations presenting in conjunction with spinal dysraphism have been reported in the literature. Two of these involved male patients with a combined dural arteriovenous fistula (DAVF) and lipomyelomeningocele. The authors present the third case of a patient with an extraspinal DAVF and associated lipomyelomeningocele in a lumbosacral location. A 58-year-old woman with rapid decline in bilateral motor function 10 years after a prior L4-5 laminectomy and cord detethering for diagnosed tethered cord underwent magnetic resonance imaging showing evidence of persistent cord tethering and a lipomyelomeningocele. Diagnostic spinal angiogram showed a DAVF with arterial feeders from bilateral sacral and the right internal iliac arteries. The patient underwent Onyx embolization of both feeding right and left lateral sacral arteries. At 6-month follow-up, MRI revealed decreased flow voids and new collateralized supply to the DAVF. The patient underwent successful lipomyelomeningocele exploration, resection, AV fistula ligation, and cord detethering. This report discusses management of this patient as well as the importance of endovascular embolization followed by microsurgery for the treatment of cases with combined vascular and dysraphic anomalies.
Smart TV‐Smartphone Multiscreen Interactive Middleware for Public Displays
Authors: Martinez-Pabon Francisco , Caicedo-Guerrero Jaime , Ibarra-Samboni Jhon Jairo , Ramirez-Gonzalez Gustavo , Hernández-Leo Davinia
Published: April 2015

A new generation of public displays demands high interactive and multiscreen features to enrich people’s experience in new pervasive environments. Traditionally, research on public display interaction has involved mobile devices as the main characters during the use of personal area network technologies such as Bluetooth or NFC. However, the emergent Smart TV model arises as an interesting alternative for the implementation of a new generation of public displays. This is due to its intrinsic connection capabilities with surrounding devices like smartphones or tablets. Nonetheless, the different approaches proposed by the most important vendors are still underdeveloped to support multiscreen and interaction capabilities for modern public displays, because most of them are intended for domestic environments. This research proposes multiscreen interactive middleware for public displays, which was developed from the principles of a loosely coupled interaction model, simplicity, stability, concurrency, low latency, and the usage of open standards and technologies. Moreover, a validation prototype is proposed in one of the most interesting public display scenarios: the advertising.
The Efficacy of Endoscopic Papillary Balloon Dilation for Patients with Acute Biliary Pancreatitis
Authors: Sun Wei-Chih , Chan Hoi-Hung , Lai Kwok-Hung , Tsai Tzung-Jiun , Lin Huey-Shyan , Lin Kung-Hung , Wang Kai-Ming , Kao Sung-Shuo , Chiang Po-Hung , Cheng Jin-Shiung , Hsu Ping-I , Tsai Wei-Lun , Chen Wen-Chi , Li Yun-Da , Wang E-Ming
Published: April 2015

Background. No study investigated the efficacy and safety of endoscopic papillary balloon dilation (EPBD) for the treatment of acute biliary pancreatitis (ABP).Method. We retrospectively reviewed the effects of EPBD on patients with ABP from February 2003 to December 2012. The general data, findings of image studies, details of the procedure, and outcomes after EPBD were analyzed.Result. Total 183 patients (male/female: 110/73) were enrolled. The mean age was 65.9 years. Among them, 155 patients had mild pancreatitis. The meantime from admission to EPBD was 3.3 days. Cholangiogram revealed filling defects inside the common bile duct (CBD) in 149 patients. The mean dilating balloon size was 10.5 mm and mean duration of the dilating procedure was 4.3 minutes. Overall, 124 patients had gross stones retrieved from CBD. Four (2.2%) adverse events and 2 (1.1%) intraprocedure bleeding incidents but no procedure-related mortality were noted. Bilirubin and amylase levels significantly decreased after EPBD. On average, patients resumed oral intake within 1.4 days. The clinical parameters and outcomes were similar in patients with different severity of pancreatitis.Conclusion. EPBD can be effective and safe for the treatment of ABP, even in patients presenting with severe disease.
A Pervasive Promotion Model for Personalized Promotion Systems on Using WLAN Localization and NFC Techniques
Authors: Lam Kam-Yiu , Ng Joseph Kee Yin , Wang Jiantao , Ho Chuen Kam Calvin , Wai-Hung Tsang Nelson
Published: April 2015

In this paper, we propose a novelpervasive business modelfor sales promotion in retail chain stores utilizing WLAN localization andnear field communication (NFC)technologies. The objectives of the model are to increase the customers’flowof the stores and theirincentivesin purchasing. In the proposed model, the NFC technology is used as the first mean to motivate customers to come to the stores. Then, with the use of WLAN, the movements of the customers, who are carrying smartphones, within the stores are captured and maintained in themovement database. By interpreting the movements of customers as indicators of their interests to the displayed items,personalizedpromotion strategies can be formulated to increase their incentives for purchasing future items. Various issues in the application of the adopted localization scheme for locating customers in a store are discussed. To facilitate the item management and space utilization in displaying the items, we propose anenhanced R-treefor indexing the data items maintained in the movement database. Experimental results have demonstrated the effectiveness of the adopted localization scheme in supporting the proposed model.
Association of Birth Parameters with Refractive Status in a Sample of Caucasian Children Aged 4–17 Years
Authors: Akova-Budak Berna , Kıvanç Sertaç Argun , Olcaysü Osman Okan
Published: April 2015

Purpose. To investigate the association of birth parameters with refractive status in different age groups of Caucasian children.Materials and Methods. This cross-sectional study included 564 eyes of 282 children aged 4 to 17 years. All children underwent complete ophthalmologic examination. The children were divided into three groups according to their refractive status (emmetropia,myopia, and hyperopia), ages (4–7, 8-9, 10–12, and 13–17), and appropriateness for gestational age, respectively.Results. The mean age of the children was9.2±2.8(age range 4–17 years). The mean spheric equivalent was+0.3±1.7(range: (−10.0)–(+10.0) diopters). The mean birth weight and gestational age were2681.1±930.8grams (750–5000 grams) and37.2±3.7weeks (25–42 weeks). According to multinominal logistic regression analysis, children with myopia were more likely to have higher birth weights than emmetropic children (OR: 1.0, 95% CI: 1.000–1.001, andP=0.028). The hypermetropes were found to be significantly small for gestational age between 13 and 17 years of age.Conclusion. Birth weight and appropriateness for gestational age as birth parameters may have an impact on development of all types of refractive errors. The hypermetropic children tended to be small for gestational age.
Influence of Hierarchic Structure on the Moisture Permeability of Biomimic Woven Fabric Using Fractal Derivative Method
Authors: Fan Jie , Zhu Na , Wang Li-li , Liu Zhi , Wang Chang-Yuan , Liu Yong
Published: April 2015

The relationship between the unique internal structure of biomimic woven fabric and its moisture management property is investigated using fractal derivative method. The biomimic fabric exhibits a fractal hierarchic inner structure, and its fractal hierarchy can be further extended by fleece finishing treatment on both surfaces of the fabric. Fractal derivative analysis indicates that the fuzzy biomimic fabric with a higher hierarchic construction after fleece finishing performs better in moisture permeability, and the result was proved by experimental tests.
Matrix Metalloproteinases in Inflammatory Bowel Disease: An Update
Authors: O’Sullivan Shane , Gilmer John F. , Medina Carlos
Published: April 2015

Matrix metalloproteinases (MMPs) are known to be upregulated in inflammatory bowel disease (IBD) and other inflammatory conditions, but while their involvement is clear, their role in many settings has yet to be determined. Studies of the involvement of MMPs in IBD since 2006 have revealed an array of immune and stromal cells which release the proteases in response to inflammatory cytokines and growth factors. Through digestion of the extracellular matrix and cleavage of bioactive proteins, a huge diversity of roles have been revealed for the MMPs in IBD, where they have been shown to regulate epithelial barrier function, immune response, angiogenesis, fibrosis, and wound healing. For this reason, MMPs have been recognised as potential biomarkers for disease activity in IBD and inhibition remains a huge area of interest. This review describes new roles of MMPs in the pathophysiology of IBD and suggests future directions for the development of treatment strategies in this condition.
Adult Body Size and Physical Activity in Relation to Risk of Breast Cancer According to Tumor Androgen Receptor Status
Authors: Zhang Xuehong , Eliassen A. Heather , Tamimi Rulla M. , Hazra Aditi , Beck Andrew H. , Brown Myles , Collins Laura C. , Rosner Bernard , Hankinson Susan E.
Published: April 2015

Background: Obesity and physical activity have been hypothesized to affect breast cancer risk partly via the androgen signaling pathway. We conducted the first study to evaluate these associations by tumor androgen receptor (AR) status.

Methods: Height, weight, and physical activity were assessed using questionnaires in the Nurses' Health Study. AR, estrogen receptor (ER), and progesterone receptor (PR) status were determined using immunohistochemistry on tumor tissue and medical/pathology reports.

Results: A total of 1,701 AR+ and 497 AR− cases were documented during 26 years of follow-up of 103,577 women. After adjusting for ER/PR status and other risk factors, the relative risks (RR) and 95% confidence intervals (95% CI) for every 5 kg/m2 increase in body mass index (BMI) were 1.07 (1.01–1.13) for AR+ and 1.16 (1.05–1.29) for AR− tumors (P-heterogeneity = 0.17). The RRs (95% CIs) per 5 hours of brisk walking/week were 0.87 (0.73–1.04) for AR+ and 0.67 (0.45–0.99) for AR− tumors (P-heterogeneity = 0.22). Further, BMI, but not physical activity, associations differed significantly across ER/PR/AR subtypes (P-heterogeneity = 0.04 and 0.63, respectively). The RRs (95% CIs) for 5 kg/m2 increase in BMI were 1.23 (1.04–1.45) for ER+PR+AR−, 1.19 (1.01–1.39) for ER−PR−AR−, 1.15 (1.08–1.23) for ER+PR+AR+, and 0.88 (0.75–1.03) for ER+PR−AR+ tumors.

Conclusions: Higher BMI was associated with an increased risk of both AR+ and AR− breast tumors in postmenopausal women, whereas physical activity, including brisk walking, was associated with a reduced risk of both subtypes. In addition, a significant positive association was observed between higher BMI and ER−PR−AR− tumors.

Impact: The similar associations observed by AR status suggest that mechanisms other than androgen signaling underlie these two breast cancer risk factors. Cancer Epidemiol Biomarkers Prev; 24(6); 962–8. ©2015 AACR.
Prevention and Conservative Therapy of Diverticular Disease
Authors: Kruse Elena , Leifeld Ludger
Published: April 2015

Background: Diverticular disease is a common problem. Prevention and treatment of complications depend on the stage of the disease. Lifestyle modifications are suitable preventive measures, aiming to reduce obesity and to balance the diet with a high amount of fiber and a low amount of meat. However, evidence to guide the pharmacological treatment of diverticular disease and diverticulitis is limited. Methods: Literature review. Results: Antibiotics are not proven to be effective in patients with uncomplicated diverticulitis and without further risk factors; neither do they improve treatment nor prevent complications. Mesalazine might have an effect on pain relief in diverticular disease even though it has no significant effect on the outcome of diverticulitis. In complicated diverticulitis, inpatient treatment including antibiotics is mandatory. Conclusion: Evidence for the treatment of diverticular disease is limited. Further research is needed.
Surgical Strategies in the Treatment of Gynecomastia Grade I-II: The Combination of Liposuction and Subcutaneous Mastectomy Provides Excellent Patient Outcome and Satisfaction
Authors: Schröder Lars , Rudlowski Christian , Walgenbach-Brünagel Gisela , Leutner Claudia , Kuhn Walther , Walgenbach Klaus-Jürgen
Published: April 2015

Background: Gynecomastia (GM) is a benign condition with glandular tissue enlargement of the male breast. GM is classified into 4 grades of increasing severity. We describe a series of GM grade I-II, diagnosed, treated surgically and analyzed regarding feasibility, complication rate, and satisfaction. Methods: From 2005 to 2012, a chart review was performed for 53 patients. Preoperative examination included endocrine and urological examination and exclusion of other pathological conditions. The surgical technique consisted of liposuction through an inframammarian-fold incision and excision of the glandular tissue by a minimal periareolar approach. Results: A total number of 53 male patients with 104 breasts were available for analysis. By liposuction, a median of 300 ml (range: 10-1000 ml) was aspirated from each breast and 25.1 g (range: 3-233 g) gland tissue was resected. Surgery lasted between 25 and 164 min per patient (median: 72 min). 2 postoperative hemorrhages occurred (n = 2, 3.8%). 2 patients underwent re-operation due to cosmetic reasons (n = 2, 3.8%). Conclusions: This analysis demonstrates that treatment of GM grade I-II can easily be performed by liposuction combined with subcutaneous resection of the glandular tissue as a minimally invasive and low-impact surgical treatment with a low rate of complications and excellent patient satisfaction. Preoperative workup is important to rule out specific diseases or malignancy causing the GM.
Lymphoceles Post-Radical Retropubic Prostatectomy: A Retrospective Evaluation of Epidemiology, Risk Factors and Outcome
Authors: Heers Hendrik , Laumeier Tobias , Olbert Peter J. , Hofmann Rainer , Hegele Axel
Published: April 2015

Introduction: We aimed at evaluating the incidence of lymphoceles, a common complication after radical retropubic prostatectomy (RRP), at a high volume centre, define risk factors and assess the clinical outcome. Materials and Methods: 454 patients receiving RRP and pelvic lymph node dissection were assessed for postoperative lymphoceles using the ultrasound method. Findings were correlated to clinical parameters from a database (age, BMI, initial PSA, number of lymph nodes removed, prostate weight, duration of surgery, hospital stay, duration of catheterisation) and possible unconventional risk factors using meteorological data. Results: Overall, 15.4% developed a lymphocele, 2.6% had a symptomatic lymphocele requiring treatment. The mean size of the lymphoceles requiring treatment was significantly higher (400 vs. 115 ml). Patients with lymphocele stayed longer in hospital. No correlation could be found between the clinical parameters and the risk for lymphoceles. Functional results in terms of urinary continence were similar. The assessment of meteorological risk factors showed a correlation of lymphoceles with air humidity. Conclusion: Lymphoceles are common after RRP, but few cases require intervention. There is no reliable clinical predictor for the risk of lymphocele development. Data sets have been published suggesting several risk factors but may be subject to statistical error like in the case of the meteorological predictors in this study.
Tissue-type plasminogen activator-binding RNA aptamers inhibiting low-density lipoprotein receptor family-mediated internalisation
Authors: Bøtkjær Kenneth A. , Helsen Nicky , Andreasen Peter A. , Dupont Daniel M. , Bjerregaard Nils
Published: April 2015

Recombinant tissue-type plasminogen activator (tPA, trade name Alteplase), currently the only drug approved by the US Food and Drug Administration and the European Medicines Agency for the treatment of cerebral ischaemic stroke, has been implicated in a number of adverse effects reportedly mediated by interactions with the low-density lipo-protein (LDL) family receptors, including neuronal cell death and an increased risk of cerebral haemorrhage. The tissue-type plasminogen activator is the principal initiator of thrombolysis in human physiology, an effect that is mediated directly via localised activation of the plasmin zymogen plasminogen at the surface of fibrin clots in the vascular lumen. Here, we sought to identify a ligand to tPA capable of inhibiting the relevant LDL family receptors without interfering with the fibrinolytic activity of tPA. Systematic evolution of ligands by exponential enrichment (SELEX) was employed to isolate tPA-binding RNA aptamers, which were characterised in biochemical assays of tPA association to low density lipoprotein receptor-related protein-1 (LRP-1, an LDL receptor family member); tPA-mediated in vitro and ex vivo clot lysis; and tPA-mediated plasminogen activation in the absence and presence of a stimulating soluble fibrin fragment. Two aptamers, K18 and K32, had minimal effects on clot lysis, but were able to efficiently inhibit tPA-LRP-1 association and LDL receptor family-mediated endocytosis in human vascular endothelial cells and astrocytes. These observations suggest that coadministration alongside tPA may be a viable strategy to improve the safety of thrombolytic treatment of cerebral ischaemic stroke by restricting tPA activity to the vascular lumen.
Effect of Tricuspid Regurgitation and the Right Heart on Survival After Transcatheter Aortic Valve Replacement
Authors: Lindman Brian R. , Maniar Hersh S. , Jaber Wael A. , Lerakis Stamatios , Mack Michael J. , Suri Rakesh M. , Thourani Vinod H. , Babaliaros Vasilis , Kereiakes Dean J. , Whisenant Brian , Miller D. Craig , Tuzcu E. Murat , Svensson Lars G. , Xu Ke , Doshi Darshan , Leon Martin B. , Zajarias Alan
Published: April 2015

Background—

Tricuspid regurgitation (TR) and right ventricular (RV) dysfunction adversely affect outcomes in patients with heart failure or mitral valve disease, but their impact on outcomes in patients with aortic stenosis treated with transcatheter aortic valve replacement has not been well characterized.

Methods and Results—

Among 542 patients with symptomatic aortic stenosis treated in the Placement of Aortic Transcatheter Valves (PARTNER) II trial (inoperable cohort) with a Sapien or Sapien XT valve via a transfemoral approach, baseline TR severity, right atrial and RV size and RV function were evaluated by echocardiography according to established guidelines. One-year mortality was 16.9%, 17.2%, 32.6%, and 61.1% for patients with no/trace (n=167), mild (n=205), moderate (n=117), and severe (n=18) TR, respectively (
P
<0.001). Increasing severity of RV dysfunction as well as right atrial and RV enlargement were also associated with increased mortality (
P
<0.001). After multivariable adjustment, severe TR (hazard ratio, 3.20; 95% confidence interval, 1.50–6.82;
P
=0.003) and moderate TR (hazard ratio, 1.60; 95% confidence interval, 1.02–2.52;
P
=0.042) remained associated with increased mortality as did right atrial and RV enlargement, but not RV dysfunction. There was an interaction between TR and mitral regurgitation severity (
P
=0.04); the increased hazard of death associated with moderate/severe TR only occurred in those with no/trace/mild mitral regurgitation.

Conclusions—

In inoperable patients treated with transcatheter aortic valve replacement, moderate or severe TR and right heart enlargement are independently associated with increased 1-year mortality; however, the association between moderate or severe TR and an increased hazard of death was only found in those with minimal mitral regurgitation at baseline. These findings may improve our assessment of anticipated benefit from transcatheter aortic valve replacement and support the need for future studies on TR and the right heart, including whether concomitant treatment of TR in operable but high-risk patients with aortic stenosis is warranted.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01314313.
The Hippo Pathway in Heart Development, Regeneration, and Diseases
Authors: Zhou Qi , Li Li , Zhao Bin , Guan Kun-Liang
Published: April 2015

The heart is the first organ formed during mammalian development. A properly sized and functional heart is vital throughout the entire lifespan. Loss of cardiomyocytes because of injury or diseases leads to heart failure, which is a major cause of human morbidity and mortality. Unfortunately, regenerative potential of the adult heart is limited. The Hippo pathway is a recently identified signaling cascade that plays an evolutionarily conserved role in organ size control by inhibiting cell proliferation, promoting apoptosis, regulating fates of stem/progenitor cells, and in some circumstances, limiting cell size. Interestingly, research indicates a key role of this pathway in regulation of cardiomyocyte proliferation and heart size. Inactivation of the Hippo pathway or activation of its downstream effector, the Yes-associated protein transcription coactivator, improves cardiac regeneration. Several known upstream signals of the Hippo pathway such as mechanical stress, G-protein–coupled receptor signaling, and oxidative stress are known to play critical roles in cardiac physiology. In addition, Yes-associated protein has been shown to regulate cardiomyocyte fate through multiple transcriptional mechanisms. In this review, we summarize and discuss current findings on the roles and mechanisms of the Hippo pathway in heart development, injury, and regeneration.
DPP4 in Cardiometabolic Disease
Authors: Zhong Jixin , Maiseyeu Andrei , Davis Stephen N. , Rajagopalan Sanjay
Published: April 2015

The discovery of incretin-based medications represents a major therapeutic advance in the pharmacological management of type 2 diabetes mellitus (T2DM), as these agents avoid hypoglycemia, weight gain, and simplify the management of T2DM. Dipeptidyl peptidase-4 (CD26, DPP4) inhibitors are the most widely used incretin-based therapy for the treatment of T2DM globally. DPP4 inhibitors are modestly effective in reducing HbA1c (glycated hemoglobin) (≈0.5%) and while these agents were synthesized with the understanding of the role that DPP4 plays in prolonging the half-life of incretins such as glucagon-like peptide-1 and gastric inhibitory peptide, it is now recognized that incretins are only one of many targets of DPP4. The widespread expression of DPP4 on blood vessels, myocardium, and myeloid cells and the nonenzymatic function of CD26 as a signaling and binding protein, across a wide range of species, suggest a teleological role in cardiovascular regulation and inflammation. Indeed, DPP4 is upregulated in proinflammatory states including obesity, T2DM, and atherosclerosis. Consistent with this maladaptive role, the effects of DPP4 inhibition seem to exert a protective role in cardiovascular disease at least in preclinical animal models. Although 2 large clinical trials suggest a neutral effect on cardiovascular end points, current limitations of performing trials in T2DM over a limited time horizon on top of maximal medical therapy must be acknowledged before rendering judgment on the cardiovascular efficacy of these agents. This review will critically review the science of DPP4 and the effects of DPP4 inhibitors on the cardiovascular system.
β‐Blocker Use and Mortality in COPD Patients After Myocardial Infarction: A Swedish Nationwide Observational Study
Authors: Andell Pontus , Erlinge David , Smith J. Gustav , Sundström Johan , Lindahl Bertil , James Stefan , Koul Sasha
Published: April 2015

Background

Patients with myocardial infarction (MI) and concomitant chronic obstructive pulmonary disease (COPD) constitute a high‐risk group with increased mortality. β‐Blocker therapy has been shown to reduce mortality, prevent arrhythmias, and delay heart failure development after an MI in broad populations. However, the effect of β‐blockers in COPD patients is less well established and they may also be less treated due to fear of adverse reactions. We investigated β‐blocker prescription at discharge in patients with COPD after MI.

Methods and Results

Patients hospitalized for MI between 2005 and 2010 were identified from the nationwide Swedish SWEDEHEART registry. Patients with COPD who were alive and discharged after an MI were selected as the study population. In this cohort, patients who were discharged with β‐blockers were compared to patients not discharged with β‐blockers. The primary end point was all‐cause mortality. A total of 4858 patients were included, of which 4086 (84.1%) were discharged with a β‐blocker while 772 (15.9%) were not. After adjusting for potential confounders including baseline characteristics, comorbidities, and in‐hospital characteristics, patients discharged with a β‐blocker had lower all‐cause mortality (hazard ratio 0.87, 95% CI 0.78 to 0.98) during the total follow‐up time (maximum 7.2 years). In the subgroup of patients with a history of heart failure, the corresponding hazard ratio was 0.77 (95% CI 0.63 to 0.95).

Conclusions

Patients with COPD discharged with β‐blockers after an MI had a lower all‐cause mortality compared to patients not prescribed β‐blockers. The results indicate that MI patients with COPD may benefit from β‐blockers.
A review of the genus Xiphovelia Lundblad, 1933 (Hemiptera: Heteroptera: Veliidae) from China, with descriptions of three new species
Authors: YE ZHEN , BU WENJUN
Published: April 2015

Four species of genus Xiphovelia Lundblad are now known from China. Of these, X. glauca Esaki & Miyamoto, 1959 is the only member of the genus previously recorded from China. In addition, three species, X. denigrata sp. nov., X. fulva sp. nov. and X. reflexa sp. nov., are described as new to science. Photographs of the male and female dorsal habitus, male fore and middle legs, male abdominal segment VIII and endosoma with pygophore are provided, accompanied by habitat photographs and a distribution map for all Chinese Xiphovelia species. A key to all the four Chinese Xiphovelia species is also provided.
Three new species of Diaphorus Meigen (Diptera: Dolichopodidae) from Tibet
Authors: LIU RUOSI , WANG MENGQING , YANG DING
Published: April 2015

The species of Diaphorus Meigen from Tibet are reviewed. Previously only one species, Diaphorus xizangensis Yang & Grootaert, was known to occur in Tibet. The following three species are described as new to science: Diaphorus baheensis sp. nov., Diaphorus longrenensis sp. nov. and Diaphorus nigripedus sp. nov. Diaphorus anatoli Negrobov is recorded from Tibet for the first time. A key to the species of Diaphorus from Tibet and the Himalayan area is presented.
Two new species of the genus Igerna (Hemiptera: Cicadellidae: Megophthalminae) from India
Authors: MESHRAM NARESH M. , BOSE R. N.S. CHANDRA , PARVEEN SHAMA
Published: April 2015

Two new megophthalmine species of leafhoppers, Igerna kolasibensis sp. nov. and I. shillongensis sp. nov., are described from India, Mizoram and Meghalaya, respectively. Detailed morphological descriptions, illustrations and photographs are provided. An updated key to the species and taxonomic notes on the genus are provided.
Coupled Atmospheric–Ice Load Model for Evaluation of Wind Plant Power Loss
Authors: Yang Jing , Yu Wei , Choisnard Julien , Forcione Alain , Antic Slavica
Published: April 2015

Icing is a weather phenomenon that is typical of cold climates. It impacts human activities through ice accretion on tower structures, transmission lines, and the blades of wind turbines. Icing on turbine blades, in particular, results in wind turbine performance degradation and/or safety shutdowns. The objective of this study is to explore the feasibility of using a coupled atmospheric and ice load model to simulate icing start-up, duration, and amount while also quantitatively evaluating power loss in wind plants related to icing events and mechanisms. Eight of 27 icing episodes identified for a wind plant in the Gaspé region of Québec (Canada) during the period 2008–10 were simulated using a mesoscale model (the Global Environmental Multiscale Limited-Area Model, or GEM-LAM). The simulations were verified using near-surface temperature, relative humidity, and wind speed, all of which compared well to in situ observations. Simulated wind speed, precipitation, cloud liquid water content, and median volume diameter of the droplets were used to drive ice load models to simulate the total ice load on a cylindrical structure. The three ice load models accounted for freezing rain, wet snow, and in-cloud icing, respectively, and in all three cases a sink term was added to account for melting due to radiation. The start-up and duration of ice were well captured by the coupled model, and a positive correlation was found between icing episodes and wind power reduction. This study demonstrates the improvements of the icing forecasts by using three ice load models, and provides a framework for both qualitative and quantitative evaluation of icing impact on wind turbine operations.