bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimisation of dark adaptation time required for mesopic microperimetry
Authors: Han Ruofan Connie , Gray Joanna Monika , Han Jennie , Maclaren Robert E , Jolly Jasleen Kaur
Published: September 2018

Background

Macular Integrity Assessment (MAIA) microperimetry is increasingly used in clinical and research settings to assess point retinal sensitivity and fixation stability. Testing occurs under mesopic conditions, commonly after a period of dark adaptation. Our aim was to identify the minimum length of adaptation required to optimise microperimetry performance.

Methods

MAIA microperimetry using the 10-2 grid was performed on 40 right eyes of 40 healthy participants aged 18–73 with no ocular pathology and vision of at least 0.1 logMAR after ambient light exposure, with 0, 5, 10, 15, 20 and 30 min of adaptation in mesopic settings. Ten right eyes of 10 participants with choroideremia were also tested following 0 and 20 min of adaptation. We further tested 10 right eyes of 10 healthy participants after bright light exposure, with 0, 10 and 20 min of adaptation. We compared changes in threshold sensitivity and fixation stability across time points.

Results

Microperimetry performance did not improve with increasing adaptation time in healthy participants or patients with choroideremia after ambient light exposure. After bright light exposure, we found microperimetry thresholds improved after 10 min of adaptation, but did not improve further at 20 min.

Conclusion

Mesopic adaptation is not required before MAIA microperimetry after exposure to ambient light. Ten minutes of adaptation is sufficient after exposure to a bright light stimulus, such as ophthalmoscopy or retinal imaging. The brief time of dark adaptation required corresponds to cone adaptation curves and provides further evidence for cone-mediated central retinal function under mesopic conditions.
Comorbidities in the first 2 years after arthroscopic hip surgery: substantial increases in mental health disorders, chronic pain, substance abuse and cardiometabolic conditions
Authors: Rhon Daniel I , Greenlee Tina A , Marchant Bryant G , Sissel Charles Dennis , Cook Chad E
Published: September 2018

Objectives

We aimed to identify the rate of seven comorbidities (mental health disorders, chronic pain, substance abuse disorders, cardiovascular disorders, metabolic syndrome, systemic arthropathy and sleep disorders) that occurred within 2 years after hip arthroscopy.

Methods

Data from individuals (ages 18–50 years) undergoing arthroscopic hip surgery between 2004 and 2013 were collected from the Military Health System (MHS) Data Repository (MDR). The MDR captures all healthcare encounters in all settings and locations for individuals within the MHS. Person-level data over 36 months were pulled and aggregated. Seven comorbidities related to poor outcomes from musculoskeletal disorders (mental health disorders, chronic pain, substance abuse disorders, cardiovascular disorders, metabolic syndrome, systemic arthropathy and sleep disorders) were examined 12 months prior and 24 months after surgery. Changes in frequencies were calculated as were differences in proportions between presurgery and postsurgery.

Results

1870 subjects were identified (mean age 32.24 years; 55.5% men) and analysed. There were statistically significant increases (p<0.001) proportionally for all comorbidities after surgery. Relative to baseline, cases of mental health disorders rose 84%, chronic pain diagnoses increased 166%, substance abuse disorders rose 57%, cardiovascular disorders rose by 71%, metabolic syndrome cases rose 85.9%, systemic arthropathy rose 132% and sleep disorders rose 111%.

Conclusions

Major (potentially ‘hidden’) clinical comorbidities increased substantially after elective arthroscopic hip surgery when compared with preoperative status. These comorbidities appear to have been overlooked in major studies evaluating the benefits and risks of arthroscopic hip surgery.

Level of evidence

Prognostic, level III.
Liquid biopsies to track trastuzumab resistance in metastatic HER2-positive gastric cancer
Authors: Wang De-Shen , Liu Ze-Xian , Lu Yun-Xin , Bao Hua , Wu Xue , Zeng Zhao-Lei , Liu Zekun , Zhao Qi , He Cai-Yun , Lu Jia-Huan , Wang Zhi-Qiang , Qiu Miao-Zhen , Wang Feng , Wang Feng-Hua , Li Yu-Hong , Wang Xiao-Nan , Xie Dan , Jia Wei-Hua , Shao Yang W , Xu Rui-Hua
Published: September 2018

Objective

To monitor trastuzumab resistance and determine the underlying mechanisms for the limited response rate and rapid emergence of resistance of HER2+ metastatic gastric cancer (mGC).

Design

Targeted sequencing of 416 clinically relevant genes was performed in 78 paired plasma and tissue biopsy samples to determine plasma-tissue concordance. Then, we performed longitudinal analyses of 97 serial plasma samples collected from 24 patients who were HER2+  to track the resistance during trastuzumab treatment and validated the identified candidate resistance genes.

Results

The results from targeted sequencing-based detection of somatic copy number alterations (SCNA) of HER2 gene were highly consistent with fluorescence in situ hybridisation data, and the detected HER2 SCNA was better than plasma carcinoembryonic antigen levels at predicting tumour shrinkage and progression. Furthermore, most patients with innate trastuzumab resistance presented high HER2 SCNA during progression compared with baseline, while HER2 SCNA decreased in patients with acquired resistance. PIK3CA mutations were significantly enriched in patients with innate resistance, and ERBB2/4 genes were the most mutated genes, accounting for trastuzumab resistance in six (35.3%) and five (29.4%) patients in baseline and progression plasma, respectively. Patients with PIK3CA/R1/C3 or ERBB2/4 mutations in the baseline plasma had significantly worse progression-free survival. Additionally, mutations in NF1 contributed to trastuzumab resistance, which was further confirmed through in vitro and in vivo studies, while combined HER2 and MEK/ERK blockade overcame trastuzumab resistance.

Conclusion

Longitudinal circulating tumour DNA sequencing provides novel insights into gene alterations underlying trastuzumab resistance in HER2+mGC.
Anaesthetic management during intracranial mechanical thrombectomy: systematic review and meta-analysis of current data
Authors: Gravel Guillaume , Boulouis Grégoire , Benhassen Wagih , Rodriguez-Regent Christine , Trystram Denis , Edjlali-Goujon Myriam , Meder Jean-François , Oppenheim Catherine , Bracard Serge , Brinjikji Waleed , Naggara Olivier N
Published: September 2018

Objective

Our aim was to compare the clinical outcome of patients with ischaemic stroke with anterior large vessel occlusion treated with stent retrievers and/or contact aspiration mechanical thrombectomy (MT) under general anaesthesia (GA) or conscious sedation non-GA through a systematic review and meta-analysis.

Methods

The literature was searched using PubMed, Embase and Cochrane databases to identify studies reporting on anaesthesia and MT. Using fixed or random weighted effect, we evaluated the following outcomes: 3-month mortality, modified Rankin Score (mRs) 0–2, recanalisation success (thrombolysis in cerebral infarction (TICI) ≥2b) and symptomatic intracerebral haemorrhagic (sICH) transformation.

Results

We identified seven cohorts (including three dedicated randomised controlled trials), totalling 1929 patients (932 with GA). Over the entire sample, mortality, mRs 0–2, TICI≥2b and sICH rates were, respectively 17.5% (99% CI 9.7% to 29.6%; Q-value: 60.1; I2: 93%, 1717 patients), 42.1% (99% CI 33.3% to 51.7%; Q-value: 41.3; I2: 87.9%), 82.9% (99% CI 74.0% to 89.1%; Q-value: 20.7; I2: 80.6%, 1006 patients) and 5.5% (99% CI 2.8% to 10.8%; Q-value: 18.6; I2: 78.5%). MT performed in non-GA patients was associated with better 3-month functional outcome (pooled OR, 1.35; 99% CI 1.04 to 1.76; Q-value: 24.0; I2: 9.2%, 1845 patients) and lower 3-month mortality rate (pooled OR, 0.70; 99% CI 0.49 to 0.98; Q-value: 1.4; I2: 0%, 1717 patients; fixed weighted effect model) compared with GA. MT performed under conscious sedation non-GA had significantly shorter onset-to-recanalisation and onset-to-groin delay compared with GA, and recanalisation success and sICH were similar.

Conclusion

Non-GA during MT for anterior acute ischaemic stroke with current-generation stent retriever/aspiration devices is associated with better 3-month functional outcome and lower mortality rates. These unadjusted estimates are subject to biases and should be interpreted with caution.
Single-center experience with the Tigertriever device for the recanalization of large vessel occlusions in acute ischemic stroke
Authors: Kara Batuhan , Selcuk Hatem Hakan , Erbahceci Salik Aysun , Zalov Hasanagha , Yildiz Omer , Gul Gunay , Balkan Bedih
Published: September 2018

Background

Tigertriever (Rapid Medical, Yoqneam, Israel) is a new design of stent retriever.

Purpose

To evaluate the feasibility, safety, and efficacy of the Tigertriever in patients with acute ischemic stroke who have undergone mechanical thrombectomy.

Materials and methods

Two different techniques—namely, standard unsheathing (SUT) and repetitive inflation-deflation (RID) techniques, were used. Modified Thrombolysis in Cerebral Infarction (mTICI) scores of 2b and 3 were considered as successful recanalization.

Results

A total of 61 thrombectomy procedures with Tigertriever were retrospectively evaluated. The mean age of patients was 60.7 years and their National Institutes of Health Stroke Scale score was 14.7. Overall, the percentage of patients with a mTICI score of 0, 2b, and 3 was 24.6, 26.2, and 49.2, respectively. Successful recanalization and first-pass success rates were 75.4% and 37.7%, respectively. There were no statistical differences between the results of the SUT and RID techniques. No vessel rupture, dissection, or device detachment was observed. The number of patients with a good clinical outcome (modified Rankin Scale score 0–2) was 17 (27.9%).

Conclusion

Our results showed that the Tigertriever device is safe and efficient for mechanical thrombectomy.
Assessment of reclaimed soils by unsupervised clustering of proximal sensor data
Authors: Sorenson P.T. , Small C. , Quideau S.A. , Underwood A. , Janz A.
Published: September 2018

The application of soil proximal sensors on reclaimed sites presents a novel method for assessing the quality of reclaimed landscapes. This method improves assessment reliability, information management, and environmental assurance. One proximal sensing system that could be used to provide high spatial resolution measurements of soil parameters is an on-the-go optical sensor that collects data at two wavelengths: 660 and 940 nm. Proximal soil sensing data were collected at 27 sites, where organic matter, cation exchange capacity (CEC), and soil water content were collected from 221 soil samples from 0 to 15 cm. The proximal soil sensor data were then automatically clustered using a combination of self-organizing maps and random uniform forests. Overall, the proximal sensor data combined with this data analysis approach created maps with either three or four soil zones. On average, soil zones had statistically significant differences in organic matter, CEC, and water content. This system could be used to map out zones with significant soil variation as part of reclamation monitoring and then used to guide laboratory analytical sampling. Future work should focus on development of on-the-go reflectance spectroscopy systems to provide quantitative soil data with high spatial resolution.
Proteomic profiling of tracheal fluid in an ovine model of congenital diaphragmatic hernia and fetal tracheal occlusion
Authors: Peiro Jose Luis , Oria Marc , Aydin Emrah , Joshi Rashika , Cabanas Nichole , Schmidt Ronny , Schroeder Christoph , Marotta Mario , Varisco Brian M.
Published: September 2018

Congenital diaphragmatic hernia (CDH) occurs in ~1:2,000 pregnancies and is associated with substantial morbidity and mortality. Fetal tracheal occlusion (TO) is an emerging therapy that improves lung growth and reduces mortality, although substantial respiratory compromise persists in survivors. In this study, we used tracheal fluid in a fetal sheep model of CDH with TO for proteomic analysis with subsequent validation of findings in sheep lung tissue. We found that the proteomic profiles of CDH tracheal fluid was most similar to control lung and CDH/TO lung most similar to TO lung. Among 118 proteins altered in CDH, only 11 were reciprocally regulated in CDH/TO. The most significantly altered pathways and processes were cell proliferation, phosphatidylinositol 3-kinase/AKT/mammalian target of rapamycin signaling, inflammation, and microtubule dynamics. CDH suppressed and TO promoted cell proliferation and AKT-related signaling cascades. By Western blot analysis and immunohistochemistry, epithelial PCNA and phosphorylated AKT were decreased in CDH and increased in TO and CDH/TO lungs. The Wnt target Axin2 was decreased threefold in CDH lung compared with control without a significant increase in CDH/TO lung. Cilia-related pathways were among the most dysregulated with CDH lung having a nearly twofold increase in acetylated α-tubulin and a relative increase in the number of ciliated cells. While TO improves lung growth and patient survival in CDH, the procedure substantially alters many processes important in lung development and cell differentiation. Further elucidation of these changes will be critical to improving lung health in infants with CDH treated with TO.
Electrochemical Skin Conductance as a Marker of Painful Oxaliplatin-Induced Peripheral Neuropathy
Authors: Delmotte Jean-Baptiste , Tutakhail Abdulkarim , Abdallah Kahina , Reach Pauline , D’Ussel Marguerite , Deplanque Gael , Beaussier Hélène , Coudoré François
Published: September 2018

Purpose. Oxaliplatin is a platinum compound widely used in gastrointestinal cancer treatment but produces dose-limiting peripheral neuropathy. New insights into oxaliplatin-induced peripheral neuropathy (OIPN) assessment are needed to detect more effectively this condition. In this context, we conducted Canaloxa study, a prospective preliminary clinical trial that aimed to investigate how Electrochemical Skin Conductance (ESC), a parameter used in small fiber neuropathy assessment, could be helpful in OIPN diagnosis. Methods. Cancer patients treated for at least three months with oxaliplatin and suffering from clinically OIPN were included. Electrochemical Skin Conductance, thermal thresholds, and neuropathic pain were assessed in all included patients. Results. During one year, 36 patients were included. The main result was the correlation between ESC and Neuropathic Pain Symptom Inventory score for hands (rho value = -0.69, p < 0.0001) and feet (rho value = -0.79, p < 0.0001). ESC values were lower in neuropathic patients with painful symptoms than in ones without painful symptoms (p = 0.0003 and p < 0.0001 for hands and feet, respectively). No correlation was observed between ESC and thermal thresholds. Conclusion. These preliminary data suggest that ESC could be a useful objective marker of painful oxaliplatin-induced neuropathy and could complement the use of subjective clinical scales. This study was prospectively registered on clinicaltrials.gov (NCT02827916) before patient recruitment has begun.
Acute Liver Failure due to Disseminated Varicella Zoster Infection
Authors: Brewer Elizabeth Caitlin , Hunter Leigh
Published: September 2018

Acute liver failure (ALF) can be due to numerous causes and result in fatality or necessitate liver transplantation if left untreated. Possible etiologies of ALF include ischemia, venous obstruction, medications, toxins, autoimmune hepatitis, metabolic and infectious causes including hepatitis A-E, varicella-zoster virus (VZV), cytomegalovirus (CMV), herpes simplex virus (HSV), Epstein-Barr virus (EBV), and adenovirus with VZV being the most rarely reported. Pathognomonic skin lesions facilitate diagnosis of VZV hepatitis, but definitive diagnosis is secured with liver biopsy, tissue histopathology, culture, and specific VZV polymerase chain reaction (PCR). Antiviral treatment with intravenous acyclovir can be effective if initiated in a timely manner; however, comorbidities and complications frequently result in high mortality, especially in immunocompromised hosts as exemplified in this case presentation.
Using Zebrafish for Investigating the Molecular Mechanisms of Drug-Induced Cardiotoxicity
Authors: Zakaria Zain Z. , Benslimane Fatiha M. , Nasrallah Gheyath K. , Shurbaji Samar , Younes Nadin N. , Mraiche Fatima , Da’as Sahar I. , Yalcin Huseyin C.
Published: September 2018

Over the last decade, the zebrafish (Danio rerio) has emerged as a model organism for cardiovascular research. Zebrafish have several advantages over mammalian models. For instance, the experimental cost of using zebrafish is comparatively low; the embryos are transparent, develop externally, and have high fecundity making them suitable for large-scale genetic screening. More recently, zebrafish embryos have been used for the screening of a variety of toxic agents, particularly for cardiotoxicity testing. Zebrafish has been shown to exhibit physiological responses that are similar to mammals after exposure to medicinal drugs including xenobiotics, hormones, cancer drugs, and also environmental pollutants, including pesticides and heavy metals. In this review, we provided a summary for recent studies that have used zebrafish to investigate the molecular mechanisms of drug-induced cardiotoxicity. More specifically, we focused on the techniques that were exploited by us and others for cardiovascular toxicity assessment and described several microscopic imaging and analysis protocols that are being used for the estimation of a variety of cardiac hemodynamic parameters.
Effects of Immediate or Delayed Estradiol on Behavior in Old Menopausal Macaques on Obesogenic Diet
Authors: Coleman Kristine , Robertson Nicola D. , Maier Adriane , Bethea Cynthia L.
Published: September 2018

Macaques have served as effective models of human disease, including pathological processes associated with obesity and the metabolic syndrome. This study approached several questions: (1) does a western-style diet (WSD) contribute to sedentary behavior or is sedentary behavior a consequence of obesity and (2) does estradiol (E) hormone therapy offset WSD or ameliorate sedentary behavior? We further questioned whether the timing of E administration (immediately following hysterectomy, ImE; or after a 2-year delay, DE) would impact behavior. Focal observations were taken on the animals in social housing over a period of 2.5 years before and after initiation of the WSD and hysterectomy. In addition, anxiety was assessed through the Human Intruder and Novel Object Tests. All animals gained weight, but ImE delayed the time to maximum weight achieved at 18 months. Over the course of the study, ImE-treated monkeys spent more time “alone” and less time in “close social” contact than placebo-controls. The DE-treated monkeys were not different from placebo-controls in these 2 outcomes. The placebo-control group exhibited more “self-groom” behavior, an indicator of anxiety, than did the ImE-treated group, and DE-treated animals approached levels observed in the ImE-treated animals. All animals exhibited an increase in “consume” behavior over time with no statistical difference between the groups. By the end of the protocol, the placebo-control group exhibited less activity compared to ImE + DE-treated animals combined. Animals also showed increased anxiety after starting on the WSD in the Human Intruder Test and the Novel Object Test. In summary, the data indicated that WSD per se promoted increased consummatory behavior, sedentary behavior, and anxiety-type behaviors, whereas ImE promoted activity. Thus, WSD may precipitate the behaviors observed in humans who then become obese, sedentary, anxious, and socially isolated. ImE replacement ameliorates some of these behaviors, but not all.
Prevalence and Associated Factors of Mental Distress among Caregivers of Patients with Epilepsy in Ethiopia: A Cross-Sectional Study Design
Authors: Seid Sofia , Demilew Demeke , Yimer Solomon , Mihretu Awoke
Published: September 2018

Background. Caregiving to individuals with mental illness is a broad responsibility, including not only practical help and care but also emotional support. Cross-sectional studies in different localities suggested a significant burden of mental distress among caregivers of patients with epilepsy, but we are not aware about the condition in Ethiopia. Therefore, the aim of the current study is to assess the prevalence and associated factors of mental distress among caregivers of patients with epilepsy in Ethiopia. Methods. An institutional based cross-sectional study was conducted in Neuropsychiatric Department of Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia. Using systematic random sampling technique, 409 caregivers participated in the study. Data was collected by face to face interview using standardized and validated Kessler Psychological Distress Scale (K-10) to assess mental distress. Descriptive, bivariate, and multivariate logistic regression models were used for analysis. Adjusted Odd Ratio (AOR) with 95% Confidence Interval (CI) was used to show the odds, and P-value < 0.05 was considered as statistically significant. Results. The mean age of respondents was 43.3 years with standard deviation of ±11.4 years. Two hundred eighteen (53.3%) of the respondents were male. The prevalence of mental distress was found to be 27.1% with 95% CI [22.6-31.1]. Relationship with patient of being mother [AOR: 5.67, 95% CI: (1.68-13.70)], father [AOR: 4.42, 95% CI: (1.25-12.58)], wife/husband [AOR: 10.59, 95% CI: (2.43-14.19)], and child [AOR: 5.37, 95% CI: (1.27-12.69)]; caring for young person below 20 years of age [AOR: 4.00, 95% CI: (1.43-11.21)]; poor social support [AOR: 7.26, 95% CI: (3.60-14.65)]); and experienced stigma [AOR: 3.03, 95% CI: (1.63-5.66)] were statistically and significantly associated factors of mental distress among caregivers of patients with epilepsy. Conclusion and Recommendation. We found a lower prevalence of mental distress among caregivers of patients with epilepsy compared to other low- and middle-income settings. Being caring for young patients, being parents to the patient, poor social support, and stigma were statistically significant associated factors of mental distress among caregivers. Therefore, appropriate psychosocial interventions are warranted to be designed and implemented emphasizing the aforementioned associated factors.
Software Architecture Solution Based on SDN for an Industrial IoT Scenario
Authors: Romero-Gázquez José L. , Bueno-Delgado M. Victoria
Published: September 2018

The Industry 4.0 (I4.0) adoption comprises the change of traditional factories into smart using the ICTs. The goal is to monitor processes, objects, machinery, and workers in order to have real‐time knowledge about what is going on in the factory and for achieving an efficient data collection, management, and decision‐making that help improve the businesses in terms of product quality, productivity, and efficiency. Internet of Things (IoT) will have an important role in the I4.0 adoption because future smart factories are expected to rely on IoT infrastructures composed of constellations of hundreds or thousands of sensor devices spread all over the industrial facilities. However, some problems could arise in the massive IoT deployment in a medium‐high factory: thousands of IoT devices to cope from different technologies and vendors could mean dozens of vendor tools and user interfaces to manage them. Moreover, the heterogeneity of IoT devices could entail different communication protocols, languages, and data formats, which can result in lack of interoperability. On the other hand, conventional IT networks and industrial machinery are expected to be managed together with the IoT infrastructure, maybe using a tool or a set of tools, for orchestrating the whole smart factory. This work meets these challenges presenting an open‐source software architecture solution based on OpenDaylight (ODL), a Software Defined Network (SDN) controller, for orchestrating an industrial IoT scenario. This work is addressed by shedding light on critical aspects from the SDN controller architectural choices, to specific IoT interfaces and the difficulties for covering the wide range of communication protocols, popular in industrial contexts. Such a global view of the process gives light to practical difficulties appearing in introducing SDN in industrial contexts, providing an open‐source architecture solution that guarantees devices and networks interoperability and scalability, breaking the vendor lock‐in barriers and providing a vendor‐agnostic solution for orchestrating all actor of an I4.0 smart factory.
A Meta-Analysis of GBA-Related Clinical Symptoms in Parkinson’s Disease
Authors: Zhang Yuan , Shu Li , Zhou Xun , Pan Hongxu , Xu Qian , Guo Jifeng , Tang Beisha , Sun Qiying
Published: September 2018

Background. GBA gene had been proved to be a crucial gene to the risk of PD. Numerous studies had discussed about the unique clinical characteristics of PD patients with GBA carriers (GBA + PD). However, there was lack of updated comprehensive analysis on the topic. In order to clarify the association between GBA variants and the clinical phenotypes of PD, we conducted this comprehensive meta-analysis. Method. Medline, Embase, and Cochrane were used to perform the searching. Strict selection criteria were followed in screening for new published articles or data. Revman 5.3 software was applied to perform the total statistical analysis, and funnel plots in the software were used to assess the publication biases. Results. A total of 26 articles including 931 GBA + PD and 14861 GBA noncarriers of PD (GBA − PD) were involved in the final meta-analysis, and 14 of them were either newly added publications or related data newly analyzed compared with the version published in 2015. Then, a series of symptoms containing depression, orthostatic hypotension, motor fluctuation, wearing-off, and freezing were newly analyzed due to more articles eligible. Besides, clinical features like family history, AAO, UPDRS-III, H-Y, and dementia previously analyzed were updated with new data added. Significant statistical differences were found in wearing-off, family history, AAO, UPDRS-III, and dementia (OR: 1.14, 1.65; MD: −3.61, 2.17; OR: 2.44; p: 0.03, <0.00001, <0.00001, 0.003, and <0.00001). Depression was slightly associated with GBA + PD (OR: 1.47; p: 0.04). Clinical symptoms such as H-Y, orthostatic hypotension, motor fluctuation, and freezing did not feature GBA + PD. Conclusion. Our results demonstrated that there were unique clinical features in GBA + PD which can help the management of the whole duration of PD patients.
Late-Onset Pompe Disease with Nemaline Bodies
Authors: Frezza E. , Terracciano C. , Giacanelli M. , Rastelli E. , Greco G. , Massa R.
Published: September 2018

Pompe disease is an autosomal recessive disorder characterized by deficiency of alpha-glucosidase, a lysosomal enzyme, which can lead to glycogen accumulation in skeletal muscle, heart, and nervous system. Clinical presentation is highly variable, with infantile and late-onset (LOPED) forms. Although muscle biopsy findings are rather stereotyped, atypical features have been described. A 52-year-old man without a family history of muscle disorders presented with slowly progressing upper and lower limb girdle weakness and hyperCKemia. At needle EMG, a diffuse neurogenic pattern was detected. Muscle biopsy showed a selective type 1 fiber atrophy with vacuoles of various sizes, filled with PAS and acid phosphatase positive material, confirmed to be glycogen by electron microscopy (EM). Many atrophic fibers contained foci of myofibrillar material recognized as nemaline bodies (NBs) at EM. Low level of alpha-glucosidase activity in blood and molecular genetic testing confirmed the diagnosis of late-onset Pompe disease (LOPED). Major causes of hereditary and acquired NB myopathy were ruled out. In conclusion, NBs represent a novel histological finding in LOPED and characterize the atypical presentation of our case.
Effect of Seed Inoculation with Actinomycetes and Rhizobium Isolated from Indigenous Soybean and Rhizosphere on Nitrogen Fixation, Growth, and Yield of Soybean
Authors: Sahur Asmiaty , Ala Ambo , Patandjengi Baharuddin , Syam’un Elkawakib
Published: September 2018

The present study was initiated to determine whether isolates from soil and roots of soybean plants can express nitrogenase activity when grown in the absence of plant host. The study was conducted to answer the question “can benefit gained by” the interaction between Actinomycetes and Rhizobium symbiosis with legume. Thirty-five isolates identified as Rhizobium and twenty-one Actinomycetes were isolated from the rhizosphere of soybean plants and identified by morphological character, biochemical content identified. Fifty-six isolates were tested for their capabilities of N2fixation and siderophore production. The isolated rhizobacteria were grown in N-free media, and twelve of them showed a good growth on the Burk’s N-free media. Almost all strains produced siderophores; however, the production level was very low, and only the strain AK 10 released considerable amounts of this metabolite. One strain of Actinomycetes was selected to test their interactions with Rhizobium. Coinoculation of Actinomycetes and Rhizobium produced synergic benefits on plant growth and get protection from the production of siderophore.
Crypto-Stego-Real-Time (CSRT) System for Secure Reversible Data Hiding
Authors: Desai Latika , Mali Suresh
Published: September 2018

Due to demand of information transfer through higher speed wireless communication network, it is time to think about security of important information to be transferred. Further, as these communication networks are part of open channel, to preserve the security of any Critical Information (CI) is really a challenging task in any real-time application. Data hiding techniques give more security and robustness of important CI against encryption or cryptographic software solutions. However, hardwired approach exhibits better solution not only in terms of reduction of complexity but also in terms of adaptive real-time output. This paper demonstrates frequency, Discrete Cosine Transform (DCT) domain Steganographic data hiding hardware solution for secret communication called Crypto-Stego-Real-Time (CSRT) System. The challenge is to design a secure algorithm keeping reliability of minimum distortion of original cover signal while embedding considerable amount of CI. Field Programmable Gate Array (FPGA) implementation shown in this paper is more secure, robust, and fast. Pipelining process while embedding enhances the speed of embedding, optimizes the memory utilization, and gives better Peak Signal to Noise Ratio (PSNR) and high robustness. Practically implemented hardware Steganographic solutions shown in this paper also give better performance than that of the current state-of-the-art hardware implementations.
Second-Generation Bioethanol from Coconut Husk
Authors: Bolivar-Telleria Maria , Turbay Cárita , Favarato Luiza , Carneiro Tarcio , de Biasi Ronaldo S. , Fernandes A. Alberto R. , Santos Alexandre M. C. , Fernandes Patricia M. B.
Published: September 2018

Coconut palm (Cocos nucifera) is an important commercial crop in many tropical countries, but its industry generates large amounts of residue. One way to address this problem is to use this residue, coconut husk, to produce second-generation (2G) ethanol. The aim of this review is to describe the methods that have been used to produce bioethanol from coconut husk and to suggest ways to improve different steps of the process. The analysis performed in this review determined that alkaline pretreatment is the best choice for its delignification potential. It was also observed that although most reported studies use enzymes to perform hydrolysis, acid hydrolysis is a good alternative. Finally, ethanol production using different microorganisms and fermentation strategies is discussed and the possibility of obtaining other added-value products from coconut husk components by using a biorefinery scheme is addressed.
Epiphysiolysis Type Salter I of the Medial Clavicle with Posterior Displacement: A Case Series and Review of the Literature
Authors: Siebenmann C. , Ramadani F. , Barbier G. , Gautier E. , Vial P.
Published: September 2018

Physeal fractures of the medial clavicle with posterior displacement of the metaphysis are very rare injuries, but additional injuries can be life-threatening. Due to the specific clavicular ossification process, skeletally immature patients present usually not true sternoclavicular joint (SCJ) dislocations accordingly to adults but rather displaced physeal fractures. There is no consensus in the current literature on the best treatment of this lesion. Conservative treatment is not resulting in good outcome; closed reduction is often not successful, and open reduction with internal fixation is finally required. Several methods are described for stabilizing these physeal fractures. We treated three osseous immature patients with this lesion. Due to the small dimension of the medial clavicular epiphysis, we performed in one case a transosseous figure-of-eight suture of the clavicular metaphysis towards the sternum, and in the two other cases, a transosseous suture from the clavicular metaphysis on the anterior clavicular periosteum. The latter technique avoids harm to the small epiphysis or the SCJ and minimizes the risk of retrosternal complications.
The Experience of Women with Obstetric Fistula following Corrective Surgery: A Qualitative Study in Benadir and Mudug Regions, Somalia
Authors: Mohamed Adam A. , Ilesanmi Abiodun O. , Dairo M. David
Published: September 2018

Obstetric fistula is a severe maternal morbidity which can have devastating consequences for a woman’s life and is generally associated with poor obstetric services leading to prolonged obstructed labour. The predisposing factors and consequences of obstetric fistula differ from country to country and from community to community. The World Health Organization estimated that more than 2 million women in sub-Saharan Africa, Asia, the Arab region, Latin America, and the Caribbean are living with the fistula, and some 50,000 to 100,000 new cases develop annually with 30,000–90,000 new cases developing each year in Africa alone. This study aimed at describing and exploring the experiences of women living with obstetric fistulas following corrective surgery in Benadir and Mudug regions, Somalia. Women living with obstetric fistula who had surgical repairs at Daynile and GMC fistula centers and key informants were identified purposively. Twenty-one individual in-depth interviews among women with obstetric fistula and eight key informant interviews were conducted. Thematic analyses were used. Codes were identified, and those codes with similar connections were organized together as to form themes. Detailed reading and rereading of the transcribed interviews were employed in order to achieve and identify themes and categories. Themes, categories, and subcategories illustrating the experiences of women living with obstetric fistula emerged from the thematic analysis of individual in-depth and key informant interviews. These were challenges of living with OBF which include “wounds around genitalia, bad odour, incontinences of urine and feces, stigma, isolation, divorce, powerlessness, dependency, financial constraints, and loss of healthy years” and coping mechanisms which include “withdrawal from the community and improved personal hygiene.” Women with obstetric fistula experience serious health and social consequences which prevents them fulfill social, family, and personal responsibilities. We recommend expansion of BEmONC services to underserved areas, capacity building for local OBF surgeons, and improved media campaign and birth preparedness at community levels.
Accuracy of Markerless 3D Motion Capture Evaluation to Differentiate between On/Off Status in Parkinson’s Disease after Deep Brain Stimulation
Authors: Martinez Hector R. , Garcia-Sarreon Alexis , Camara-Lemarroy Carlos , Salazar Fortino , Guerrero-González María L.
Published: September 2018

Background. Body motion evaluation (BME) by markerless systems is increasingly being considered as an alternative to traditional marker-based technology because they are faster, simpler, and less expensive. They are increasingly used in clinical settings in patients with movement disorders; however, the wide variety of systems available makes results conflicting. Research Question. The objective of this study was to determine whether a markerless 3D motion capture system is a useful instrument to objectively differentiate between PD patients with DBS in On and Off states and controls and its correlation with the evaluation by means of MDS-UPDRS. Methods. Six PD patients who underwent deep brain stimulation (DBS) bilaterally in the subthalamic nucleus were evaluated using BME and the Unified Parkinson’s Disease Rating Scale (UPDRS-III) with DBS turned On and Off. BME of 16 different movements in six controls paired by age and sex was compared with that in PD patients with DBS in On and Off states. Results. A better performance in the BME was correlated with a lower UPDRS-III score. There was no statistically significant difference between patients in Off and On states of DBS regarding BME. However, some items such as left shoulder flexion (p=0.038), right shoulder rotation (p=0.011), and left trunk rotation (p=0.023) were different between Off patients and healthy controls. Significance. Kinematic data obtained with this markerless system could contribute to discriminate between PD patients and healthy controls. This emerging technology may help to clinically evaluate PD patients more objectively.
Stability of Bacteriocin-Like Inhibitory Substance (BLIS) Produced byPediococcus acidilacticikp10 at Different Extreme Conditions
Authors: Md Sidek Nurul Lyana , Halim Murni , Tan Joo Shun , Abbasiliasi Sahar , Mustafa Shuhaimi , Ariff Arbakariya B.
Published: September 2018

Nowadays, bacteriocin industry has substantially grown replacing the role of chemical preservatives in enhancing shelf-life and safety of food. The progress in bacteriocin study has been supported by the emerging of consumer demand on the applications of natural food preservatives. Since food is a complex ecosystem, the characteristics of bacteriocin determine the effectiveness of their incorporation into the food products. Among four commercial media (M17 broth, MRS broth, tryptic soy broth, and nutrient broth) tested, the highest growth ofPediococcus acidilacticikp10 and bacteriocin-like-inhibitory substance (BLIS) production were obtained in the cultivation with M17. BLIS production was found to be a growth associated process where the production was increased concomitantly with the growth of producing strain,P. acidilacticikp10. The antimicrobial property of BLIS against three indicator microorganisms (Listeria monocytogenes,Escherichia coli,andStaphylococcus aureus) remained stable upon heating at 100°C but not detectable at 121°C. The BLIS activity was also observed to be stable and active at a wide pH range (pH 2 to pH 7). The BLIS activity remained constant at -20°C and -80°C for 1 month of storage. However, the activity dropped after 3 and 6 months of storage at 4°C, -20°C, and -80°C with more than 80% reduction. The ability of bacteriocin fromP. acidilacticikp10 to inhibit food-borne pathogens while remaining stable and active at extreme pH and temperature is of potential interest for future applications in food preservatives.
Examining Relationships between Metabolism and Persistent Inflammation in HIV Patients on Antiretroviral Therapy
Authors: Ahmed Duale , Roy David , Cassol Edana
Published: September 2018

With the advent of antiretroviral therapy (ART), HIV-infected individuals are now living longer and healthier lives. However, ART does not completely restore health and treated individuals are experiencing increased rates of noncommunicable diseases such as dyslipidemia, insulin resistance, type 2 diabetes, cardiovascular disease, and nonalcoholic fatty liver disease. While it is well known that persistent immune activation and inflammation contribute to the development of these comorbid diseases, the mechanisms underlying this chronic activation remain incompletely understood. In this review, we will discuss emerging evidence that suggests that alterations in cellular metabolism may play a central role in driving this immune dysfunction in HIV patients on ART.
Self-Nanoemulsifying Drug Delivery System of Tetrandrine for Improved Bioavailability: Physicochemical Characterization and Pharmacokinetic Study
Authors: Liu Chunxia , Lv Li , Guo Wei , Mo Lan , Huang Yaoxing , Li Guocheng , Huang Xingzhen
Published: September 2018

The main purpose of this study was to investigate the potential of self-nanoemulsified drug delivery system (SNEDDS) to improve the oral bioavailability of tetrandrine (Tet). SNEDDS was developed by using rational blends of excipients with good solubilizing ability for Tet which was selected based on solubility studies. Further ternary phase diagram was constructed to determine the self-emulsifying region. The optimal formulation with the best self-nanoemulsified and solubilization ability consisted of 40% (w/w) oleic acid as oil, 15% (w/w) SPC and 30% (w/w) Cremophor RH-40 as surfactant, and 15% (w/w) PEG400as cosurfactant. The average droplet size and zeta-potential of the optimal Tet SNEDDS were 19.75±0.37 nm and 1.87±0.26 mv, respectively. The dissolute rate of Tet SNEDDS in various dissolution media was remarkably faster than Tet commercial tablet. Moreover, in vivo pharmacokinetic study results show that significant increase (p≤ 0.05) in the peak concentration (Cmax) and the area under the curve (AUC) of Tet was observed after the oral administration of Tet SNEDDS and the absorption of Tet from SNEDDS resulted in approximately 2.33-fold increase in oral bioavailability compared with the commercial tablet. Our research suggests that the prepared Tet SNEDDS could be a good candidate for improved the dissolution and oral bioavailability of Tet.
Malaria and Malnutrition: Kwashiorkor Associated with Low Levels of Parasitaemia
Authors: Fevang Per , Havemann Kirsten , Fevang Børre , Høstmark Arne T.
Published: September 2018

Background. The relationship between protein energy malnutrition (PEM) and malaria is controversial. While most studies demonstrate that PEM is associated with greater malaria morbidity, some indicate that PEM may in fact have a protective effect. PEM is differentiated into three subgroups: kwashiorkor (marked protein deficiency), marasmus (calorie deficiency), and kwashiorkor/marasmus. None of the studies concerning PEM and malaria seem to distinguish between these subgroups, and significant differences in susceptibility to malaria between these subgroups may have been overlooked. Plasmodium parasites and malaria infected erythrocytes are sensitive to oxidative stress. Since kwashiorkor patients seem to display an excess of prooxidants and as serum albumin is an important antioxidant, we hypothesized that patients with different forms of PEM might have different levels of malaria parasitaemia. Methods. 72 PEM children older than 6 months admitted to Kwale Family Life Training Programme (Kenya) were included in the study. Results. Mean parasitaemia was significantly lower in the kwashiorkor group than in the marasmus group (p < 0,001). There was no correlation between serum albumin and parasitaemia. Conclusion. Our study suggests a protective effect of kwashiorkor against malaria, warranting further studies.
Mobile Fog Computing‐Assisted Resource Allocation for Two‐Hop SWIPT OFDM Networks
Authors: Di Xiaofei , Zhang Yu , Liu Tong , Kang Shaoli , Zhao Yue
Published: September 2018

The mobile fog computing‐assisted resource allocation (RA) is studied for simultaneous wireless information and power transfer (SWIPT) two‐hop orthogonal frequency division multiplexing (OFDM) networks, where a decode‐and‐forward (DF) relay first harvests energy from signals emitted by a source and then helps the source to forward information to its destination by using the harvested energy. Power splitting (PS) strategy is adopted at the relay and a different PS (DPS) receiver architecture is proposed, where the PS factors of all subcarriers are different. A RA problem is formulated to maximize the system’s achievable rate by jointly optimizing subcarrier pairing, power allocation, and PS factors. Since the RA problem is a nonconvex problem and is difficult to solve, an efficient RA algorithm is designed. As the wireless channels are fast time‐varying, the computation is performed in mobile fog node close to end nodes, instead of remote clouds. Results demonstrate that the achievable rate is significantly increased by using the proposed RA algorithm. It is also found that the computation complexity of RA algorithm of DPS receiver architecture is much lower than the existing identical PS (IPS) receiver architecture, and thus the proposed DPS architecture is more suitable for computation‐constrained fog system.
Sleep Environment and Insomnia in Elderly Persons Living at Home
Authors: Desaulniers Jonathan , Desjardins Sophie , Lapierre Sylvie , Desgagné Alain
Published: September 2018

The aim of this study was to draw a portrait of the sleep environment of elderly persons living in private households and to determine its relationship with the presence of insomnia. A sample of 599 individuals aged 70 years and older responded to questions about the comfort of their pillow and mattress and the noise level and brightness of their bedroom at night and in the morning. They were also asked whether or not they shared their bed or bedroom with a sleep partner. The Insomnia Severity Index was used to assess insomnia severity. Over 40% of the study participants were using a pillow that was not very comfortable, and almost 30% said that their bedroom was not completely quiet. Binomial logistic regression results revealed that two variables were significantly associated with insomnia symptoms: a pillow rated as moderately comfortable to very uncomfortable and a bedroom that was not completely quiet. No other sleep environment characteristics considered in this study were associated with the risk of insomnia. These results indicate that a nonnegligible proportion of the elderly population endures a suboptimal sleep environment. Although it is difficult to predict the real impact of changes to the sleep environment, this study supports the proposal that simple, minor changes to the bedroom can promote sleep in the elderly.
Chronic Skull Base Erosion from Temporomandibular Joint Disease Causes Generalized Seizure and Profound Lactic Acidosis
Authors: Dobish Mark A. , Wyler David A. , Farrell Christopher J. , Dhami Hermandeep S. , Romo Victor M. , Choi Daniel D. , Reed Travis , Mahla Michael E.
Published: September 2018

This report displays a rare presentation of lactic acidosis in the setting of status epilepticus (SE). The differential diagnosis of lactic acidosis is broad and typically originates from states of shock; however, this report highlights an alternative and rare etiology, SE, due to chronic skull base erosion from temporomandibular joint (TMJ) disease. Lactic acidosis is defined by a pH below 7.35 in the setting of lactate values greater than 5 mmol/L. Two broad classifications of lactic acidosis exist: a type A lactic acidosis which stems from global or localized tissue hypoxia or a type B lactic acidosis which occurs once mitochondrial oxidative capacity is unable to match glucose metabolism. SE is an example of a type A lactic acidosis in which oxygen delivery is unable to meet increased cellular energy requirements. This report is consistent with a prior case series that consists of five patients experiencing generalized tonic-clonic (GTC) seizures and lactic acidosis. These patients presented with a pH range of 6.8-7.41 and lactate range of 3.8-22.4 mmol/L. Although severe lactic acidosis following GTC has been described, this is the first report in the literature of chronic skull base erosion from TMJ disease causing SE.