bluuebunny/crossref_metadata_2025 huggingface dataset:
Sympathoexcitation following intermittent hypoxia in rat is mediated by circulating angiotensin II acting at the carotid body and subfornical organ
Authors: Kim Seung Jae , Fong Angelina Y. , Pilowsky Paul M. , Abbott Stephen B. G.
Published: April 2018

Key points

In anaesthetized rats, acute intermittent hypoxia increases sympathetic nerve activity, sympathetic peripheral chemoreflex sensitivity and central sympathetic–respiratory coupling.

Renin–angiotensin system inhibition prevents the sympathetic effects of intermittent hypoxia, with intermittent injections of angiotensin II into the systemic circulation replicating these effects.

Bilateral carotid body denervation reduces the sympathetic effects of acute intermittent hypoxia and eliminates the increases in chemoreflex sensitivity and sympathetic–respiratory coupling.

Pharmacological inhibition of the subfornical organ also reduces the sympathetic effects of acute intermittent hypoxia, although it has no effect on the increases in chemoreflex sensitivity and central sympathetic–respiratory coupling.

Combining both interventions eliminates the sympathetic effects of both intermittent hypoxia and angiotensin II.

Circulating angiotensin II (Ang II) is vital for arterial pressure elevation following intermittent hypoxia in rats, although its importance in the induction of sympathetic changes is unclear. We tested the contribution of the renin–angiotensin system to the effects of acute intermittent hypoxia (AIH) in anaesthetized and ventilated rats. There was a 33.7 ± 2.9% increase in sympathetic nerve activity (SNA), while sympathetic chemoreflex sensitivity and central sympathetic–respiratory coupling increased by one‐fold following AIH. The sympathetic effects of AIH were prevented by blocking angiotensin type 1 receptors with systemic losartan. Intermittent systemic injections of Ang II (Int.Ang II) elicited similar sympathetic responses to AIH. To identify the neural pathways responsible for the effects of AIH and Int.Ang II, we performed bilateral carotid body denervation, which reduced the increase in SNA by 56% and 45%, respectively. Conversely, pharmacological inhibition of the subfornical organ (SFO), an established target of circulating Ang II, reduced the increase in SNA following AIH and Int.Ang II by 65% and 59%, respectively, although it did not prevent the sensitization of the sympathetic peripheral chemoreflex, nor the increase in central sympathetic–respiratory coupling. Combined carotid body denervation and inhibition of the SFO eliminated the enhancement of SNA following AIH and Int.Ang II. Repeated systemic injections of phenylephrine caused an elevation in SNA similar to AIH, and this effect was prevented by a renin inhibitor, aliskiren. Our findings show that the sympathetic effects of AIH are the result of RAS‐mediated activations of the carotid bodies and the SFO.
REVIEWS OF ACOUSTICAL PATENTS
Authors: Fulop Sean A. , Rice Lloyd
Published: April 2018

The purpose of these acoustical patent reviews is to provide enough information for a Journal reader to decide whether to seek more information from the patent itself. Any opinions expressed here are those of the reviewers as individuals and are not legal opinions. Printed copies of United States Patents may be ordered at $3.00 each from the Commissioner of Patents and Trademarks, Washington, DC 20231. Patents are available via the Internet at http://www.uspto.gov.
Ancient sites savaged in Yemen, Iraq
Authors: Lawler Andrew
Published: April 2018

Firsthand accounts reveal worse damage than expected in war-torn regions.
Bystander risk, social value, and ethics of human research
Authors: Shah S. K. , Kimmelman J. , Lyerly A. D. , Lynch H. F. , Miller F. G. , Palacios R. , Pardo C. A. , Zorrilla C.
Published: April 2018

Contentious risks demand a new approach
mRNA structure determines specificity of a polyQ-driven phase separation
Authors: Langdon Erin M. , Qiu Yupeng , Ghanbari Niaki Amirhossein , McLaughlin Grace A. , Weidmann Chase A. , Gerbich Therese M. , Smith Jean A. , Crutchley John M. , Termini Christina M. , Weeks Kevin M. , Myong Sua , Gladfelter Amy S.
Published: April 2018

RNA and membraneless organelles

Membraneless compartments can form in cells through liquidliquid phase separation (see the Perspective by Polymenidou). But what prevents these cellular condensates from randomly fusing together? Using the RNA-binding protein (RBP) Whi3, Langdon
et al.
demonstrated that the secondary structure of different RNA components determines the distinct biophysical and biological properties of the two types of condensates that Whi3 forms. Several RBPs, such as FUS and TDP43, contain prion-like domains and are linked to neurodegenerative diseases. These RBPs are usually soluble in the nucleus but can form pathological aggregates in the cytoplasm. Maharana
et al.
showed that local RNA concentrations determine distinct phase separation behaviors in different subcellular locations. The higher RNA concentrations in the nucleus act as a buffer to prevent phase separation of RBPs; when mislocalized to the cytoplasm, lower RNA concentrations trigger aggregation.

Science
, this issue p.
922
, p.
918
; see also p.
859
Improved memory devices for synthetic cells
Authors: Ho Joanne M. L. , Bennett Matthew R.
Published: April 2018

CRISPR enables efficient recording of signaling events in cells onto DNA
Donor SIRPα polymorphism modulates the innate immune response to allogeneic grafts
Authors: Dai Hehua , Friday Andrew J. , Abou-Daya Khodor I. , Williams Amanda L. , Mortin-Toth Steven , Nicotra Matthew L. , Rothstein David M. , Shlomchik Warren D. , Matozaki Takashi , Isenberg Jeffrey S. , Oberbarnscheidt Martin H. , Danska Jayne S. , Lakkis Fadi G.
Published: April 2018

Detection of nonself SIRPα by CD47 triggers an innate immune response to allografts in mice that lack T, B, and NK cells.
Structural basis for potent antibody-mediated neutralization of human cytomegalovirus
Authors: Chandramouli Sumana , Malito Enrico , Nguyen TuongVi , Luisi Kate , Donnarumma Danilo , Xing Yi , Norais Nathalie , Yu Dong , Carfi Andrea
Published: April 2018

Structures of HCMV Pentamer in complex with neutralizing antibodies reveal immunogenic surfaces important for viral entry.
Human thymoproteasome variations influence CD8 T cell selection
Authors: Nitta Takeshi , Kochi Yuta , Muro Ryunosuke , Tomofuji Yoshihiko , Okamura Tadashi , Murata Shigeo , Suzuki Harumi , Sumida Takayuki , Yamamoto Kazuhiko , Takayanagi Hiroshi
Published: April 2018

Genetic variations in antigen-peptide processing machinery influence T cell repertoire selection and susceptibility to autoimmune disease.
PD-1 blockade: It’s what’s for dinner
Authors: Griffin Gabriel K.
Published: April 2018

Tumor-associated macrophages limit the efficacy of programmed cell death 1 (PD-1) blockade through an FcγR-dependent clearance mechanism.
Moxifloxacin Replacement in Contemporary Tuberculosis Drug Regimens Is Ineffective against Persistent Mycobacterium tuberculosis in the Cornell Mouse Model
Authors: Liu Yingjun , Pertinez Henry , Davies Geraint R. , Gillespie Stephen H. , Coates Anthony R. , Hu Yanmin
Published: April 2018

Tuberculosis (TB), which is caused by
Mycobacterium tuberculosis
, remains a leading killer worldwide, and disease control is hampered by the ineffective control of persistent infections. Substitution of moxifloxacin for isoniazid or ethambutol in standard anti-TB regimens reduces the treatment duration and relapse rates in animal studies, and 4-month regimens were not noninferior in clinical trials. Resuscitation-promoting factor (RPF)-dependent bacilli have recently been implicated in
M. tuberculosis
persistence. We aimed to investigate the therapeutic effects of the substitution of moxifloxacin for a drug used in the standard drug regimen in eradicating CFU count-positive and RPF-dependent persistent
M. tuberculosis
using the Cornell murine model.
M. tuberculosis
-infected mice were treated with regimens in which either isoniazid or ethambutol was replaced by moxifloxacin in the standard regimen. The efficacy of the regimens for bacterial CFU count elimination and removal of persistent tubercle bacilli, evaluated using culture filtrate (CF) derived from
M. tuberculosis
strain H37Rv, was compared to that of the standard regimen. We also measured disease relapse rates. The regimen in which moxifloxacin replaced isoniazid achieved total organ CFU count clearance at 11 weeks posttreatment, which was faster than that by the standard regimen (14 weeks), and showed a 34% lower relapse rate. The regimen in which moxifloxacin replaced ethambutol was similar to standard regimens in these regards. Importantly, neither the regimen in which moxifloxacin replaced isoniazid or ethambutol nor the standard regimen could remove CF-dependent persistent bacilli. The finding of CF-dependent persistent
M. tuberculosis
in TB treatment requires confirmation in human studies and has implications for future drug design, testing, and clinical applications.
Geology, stratigraphy, and paleontology of the Santa Ana Mountains, California, USA
Authors: Lipps Jere H. , Lozinsky Richard , Pedersen-Guzman Jeannine , Scott Eric , Babilonia Lisa
Published: April 2018

The geology, stratigraphy, and paleontology of the Santa Ana Mountains of Southern California span 150 m.y. of subduction and 30 m.y. of transform faulting, producing complex geologic, stratigraphic, and paleontological settings. The mountains are bounded by the Elsinore fault zone on their east side, uplifting the mountains and tilting them westward, where sediments eroded from them were deposited in a variety of marine to terrestrial environments; most of these formations yield fossils so that a rich history of life can be reconstructed. The most recent geologic history includes the continued transform faulting with displacements of many kilometers northwesterly, juxtaposing separate blocks and biotas. The modern sediments are dominated by the Santa Ana River, which flows westerly at the northern end of the Santa Ana Mountains onto the coastal plain of Orange County. It is the primary aquifer supplying significant amounts of water to the residents. Humans have occupied the region for the last 12,000 yr, developing large, sophisticated populations, which, in the most recent years, have impacted the geology significantly.

This field-trip guide starts north of the mountains in Ontario, California, and describes the Elsinore fault zone, the east side of the Santa Ana Mountains, and the ascent of the steep eastern side of those mountains. Extensive vistas of the geology to the east of the mountains can be seen from stops along the way. In the mountains themselves, the guide describes the granitoids of the Peninsular Ranges batholith, sedimentary rocks of the Jurassic Bedford Canyon Formation, rocks of the Cretaceous Santiago Peak Volcanics, and overlying sedimentary rocks of Mesozoic and Cenozoic age. At Ronald W. Caspers Wilderness Park, stops show the early Tertiary Silverado and Santiago formations preserving terrestrial environments that rest unconformably on the marine Cretaceous Williams Formation. On the west side of the mountains, stops at Cretaceous to Miocene conglomerates through mudstones reveal abundant marine mollusks, foraminifera, and vertebrate faunas among others, and a wide variety of sedimentary structures. Younger sediments, faults, and river courses occur along the final leg of the trip from the northern Santa Ana Mountains back to Ontario. Humans have interacted with the geology and its resources for possibly the last 12,000 yr, in ancient times utilizing rock resources and in modern times dealing with geological hazards in developmental and infrastructural construction.
Neogene sedimentation, volcanism, and faulting in the eastern Coyote Mountains, Salton Trough, southern California
Authors: Ann Bykerk-Kauffman
Published: April 2018

The Coyote Mountains of southern California lie at the interface of the Peninsular Ranges and Colorado Desert geomorphic provinces, along the active right-lateral Elsinore fault, just north of the Mexican border. This field-trip guide explores the southeastern part of the range and examines the field evidence for (1) the early Miocene passing of the edge of the slab window underneath the area as the subduction zone west of the area shut down, (2) the inception of the West Salton detachment fault between 8 and 4.5 Ma, and (3) the uplift and right-lateral distributed shearing of the range since ca. 1.2 Ma.
Cardiovascular disease risk factor clustering in children and adolescents: a prospective cohort study
Authors: Seo Young-Gyun , Choi Min-Kyu , Kang Jae-Heon , Lee Hye-Ja , Jang Han Byul , Park Sang Ick , Ju Young Soo , Park Kyung Hee
Published: April 2018

Objective

The early identification of predictors related to cardiovascular disease risk factor clustering (CVD-RFC) can help prevent chronic disease. We aimed to identify the risk factors for CVD-RFC in adolescents.

Methods

A prospective longitudinal cohort study design was used to obtain data included in these analyses from school-aged children who participated in the Korean Child-Adolescent Study 2008–2014. A total of 1309 children aged 6–15 years were enrolled. We compared the participants based on the presence or absence of CVD-RFC and examined the cumulative incidence of CVD-RFC.

Results

Of the total 1309 children, 410 (31.32%) had CVD-RFC in adolescence. A higher average household income ≥3 million Korean Republic won (KRW)/month (3–5 million KRW/month: HR 0.75 (95% CI 0.58 to 0.97); ≥5 million KRW/month: HR 0.58 (95% CI 0.44 to 0.77)) was associated with a lower CVD-RFC incidence, while the presence of parental CVD history (HR 1.28 (95% CI 1.04 to 1.57)), overweight or obesity (HR 3.83 (95% CI 3.05 to 4.80)) and shorter sleep duration of 8–9 hour/day (HR 1.80 (95% CI 1.05 to 3.07)) and <8 hour/day (HR 1.93 (95% CI 1.11 to 3.34)) had higher CVD-RFC incidences.

Conclusions

Obesity in childhood, short sleep duration and parental factors such as low socioeconomic status and parental history of CVD are significant risk factors for the development of CVD-RFC in adolescents. Efforts to create awareness regarding sufficient sleep duration in children via intervention programmes targeting cardiometabolic health in children and special attention to lifestyle modifications and socioeconomic components of the family should be considered.
Laparoscopic excision of deep rectovaginal endometriosis in BSGE endometriosis centres: a multicentre prospective cohort study
Authors: Byrne Dominic , Curnow Tamara , Smith Paul , Cutner Alfred , Saridogan Ertan , Clark T Justin
Published: April 2018

Objective

To estimate the effectiveness and safety of laparoscopic surgical excision of rectovaginal endometriosis.

Design

A multicentre, prospective cohort study.

Setting

51 hospitals accredited as specialist endometriosis centres.

Participants

5162 women of reproductive age with rectovaginal endometriosis of which 4721 women had planned laparoscopic excision.

Interventions

Laparoscopic surgical excision of rectovaginal endometriosis requiring dissection of the pararectal space.

Main outcome measures

Standardised symptom questionnaires enquiring about chronic pelvic pain, bladder and bowel symptoms, analgesia use and quality of life (EuroQol) completed prior to surgery and at 6, 12 and 24 months postoperatively. Serious perioperative and postoperative complications including major haemorrhage, infection and visceral injury were recorded.

Results

At 6 months postsurgery, there were significant reductions in premenstrual, menstrual and non-cyclical pelvic pain, deep dyspareunia, dyschezia, low back pain and bladder pain. In addition, there were significant reductions in voiding difficulty, bowel frequency, urgency, incomplete emptying, constipation and passing blood. These reductions were maintained at 2 years, with the exception of voiding difficulty. Global quality of life significantly improved from a median pretreatment score of 55/100 to 80/100 at 6 months. There was a significant improvement in quality of life in all measured domains and in quality-adjusted life years. These improvements were sustained at 2 years. All analgesia use was reduced and, in particular, opiate use fell from 28.1% prior to surgery to 16.1% at 6 months. The overall incidence of complications was 6.8% (321/4721). Gastrointestinal complications (enterotomy, anastomotic leak or fistula) occurred in 52 (1.1%) operations and of the urinary tract (ureteric/bladder injury or leak) in 49 (1.0%) procedures.

Conclusion

Laparoscopic surgical excision of rectovaginal endometriosis appears to be effective in treating pelvic pain and bowel symptoms and improving health-related quality of life and has a low rate of major complications when performed in specialist centres.
The Dynamic Brain Networks of Motor Imagery: Time-Varying Causality Analysis of Scalp EEG
Authors: Li Fali , Peng Wenjing , Jiang Yuanling , Song Limeng , Liao Yuanyuan , Yi Chanlin , Zhang Luyan , Si Yajing , Zhang Tao , Wang Fei , Zhang Rui , Tian Yin , Zhang Yangsong , Yao Dezhong , Xu Peng
Published: April 2018

Motor imagery (MI) requires subjects to visualize the requested motor behaviors, which involves a large-scale network that spans multiple brain areas. The corresponding cortical activity reflected on the scalp is characterized by event-related desynchronization (ERD) and then by event-related synchronization (ERS). However, the network mechanisms that account for the dynamic information processing of MI during the ERD and ERS periods remain unknown. Here, we combined ERD/ERS analysis with the dynamic networks in different MI stages (i.e. motor preparation, ERD and ERS) to probe the dynamic processing of MI information. Our results show that specific dynamic network structures correspond to the ERD/ERS evolution patterns. Specifically, ERD mainly shows the contralateral networks, while ERS has the symmetric networks. Moreover, different dynamic network patterns are also revealed between the two types of MIs, in which the left-hand MIs exhibit a relatively less sustained contralateral network, which may be the network mechanism that accounts for the bilateral ERD/ERS observed for the left-hand MIs. Similar to the network topologies, the three MI stages also appear to be characterized by different network properties. The above findings all demonstrate that different MI stages that involve specific brain networks for dynamically processing the MI information.
Investigating the thermal conductivity of concrete/graphene nanocomposite by a multi-scale modeling approach
Authors: Ahmadi M. , Ansari R. , Rouhi S.
Published: April 2018

In this paper, a multi-scale modeling approach is used to study the effect of adding graphene sheets to concrete matrix on the thermal conductivity of the concrete. By computing the thermal conductivity of the graphene along the armchair and zigzag directions using molecular dynamics (MO) simulations, it is shown that the graphene sheets have orthotropic thermal behavior. Therefore, at the upper scale, in which the finite element (FE) method is used to obtain the thermal conductivity of the concrete/graphene nanocomposites, the graphene sheets are considered as orthotropic continuous sheets. It is shown that the improvement of the concrete thermal conductivity by adding the graphene sheets is directly related to the graphene sheet volume percentage and cross-sectional dimensions.
High precision linear frequency modulation ranging system based on semiconductor laser
Authors: Xue Mingyuan , Gao Cunxiao , Niu Linquan , Zhu Shaolan , Guo Na , Feng Li , He Haodong
Published: April 2018

Based on the linear frequency modulation (LFM) of semiconductor laser, a laser ranging system is built. The ranging precision of the system is about micron dimension with the repetition frequency of 100 kHz and a distance of 1–10 m. We analyzed the ranging precision experimentally. As the bandwidth increases, the ranging precision becomes higher and higher. When the bandwidth is fixed, as the distance increases, the signal-to-noise ratio (SNR) will decrease, which reduces the precision.
A Mathematical Model for the Control of Infectious Diseases: Effects of TV and Radio Advertisements
Authors: Misra A. K. , Rai Rajanish Kumar
Published: April 2018

The broadcast of awareness programs through TV and radio advertisements (ads) makes people aware and brings behavioral changes among the individuals regarding the risk of infection and its control mechanisms. In this paper, we propose and analyze a nonlinear mathematical model for the control of infectious diseases due to impact of TV and radio advertisements. It is assumed that susceptible individuals are vulnerable to infection as well as information through TV and radio ads and they contract infection via direct contact with infected individuals. In the model formulation, it is also assumed that the growth rates in cumulative number of TV and radio ads are proportional to the number of infected individuals with decreasing function of aware individuals. Further, it is assumed that awareness among susceptible individuals induces behavioral changes and they form separate aware classes, which are fully protected from infection as they use precautionary measures for their protection during the infection period. The feasibility of equilibria and their stability properties are discussed. It is shown that the augmentation in dissemination rate of awareness among susceptible individuals due to TV and radio ads may cause stability switches through Hopf-bifurcation. The analytical findings are supported through numerical simulations.
Study of antimagnetic rotation in 109,111Cd
Authors: Majumder C. , Sharma H. P. , Chakraborty S. , Tiwary S. S.
Published: April 2018

The reduced electric quadrupole transition rates have been calculated for the states of the negative parity bands in [Formula: see text]Cd nuclei using semiclassical model (SCM). The calculated transition rates are found to be decreasing with increasing spin for the states above [Formula: see text] and the dynamic moment of inertia [Formula: see text] of the higher spin states are found to be almost constant. The calculated B(E2) values show better agreement with the experimental B(E2) values for [Formula: see text]Cd. The results for both [Formula: see text]Cd and [Formula: see text]Cd nuclei show a very rapidly increasing value of the [Formula: see text] ratio with increasing spin, suggesting the antimagnetic rotational character of the states lying above the spins [Formula: see text] and [Formula: see text], respectively.
Enhancement of second harmonic generation using a novel asymmetric metal–graphene–insulator–metal plasmonic waveguide
Authors: Soltani Mohamadreza
Published: April 2018

Here, we propose a novel plasmonic structure, called asymmetric plasmonic nanocavity grating (APNCG), which is shown to dramatically enhance nonlinear optical process of second harmonic generation (SHG). The proposed structure consists of two different metals on both sides of lithium niobate and a thin layer of graphene. By using two different metals the nonlinear susceptibility of the waveguide would be increased noticeably causing to increase SHG. On the other hand, it consists of two identical gratings on one side. By two identical gratings, the pump beam is coupled to two opposing SPP waves, which interfere with each other and result in SPP standing wave in the region between the two gratings. The distance between two gratings will be optimized to reach the highest SHG. It will be shown that by optimizing the geometry of proposed structure and using different metals, field enhancement in APNCG waveguides can result in large enhancement of SHG.
The Effect of Shareholder Rights and Information Asymmetry on Stock-Option-Related Repurchase Activity
Authors: Golden Joanna
Published: April 2018

As stock-option holdings increase, managers alter their firms’ payout composition, choosing stock repurchases rather than dividends to return cash to shareholders. Prior research presents two competing explanations for this behavior: the flexibility hypothesis and the shareholder power hypothesis. In support of the flexibility hypothesis, I document that this executive stock-option incentive to repurchase stock as a substitute for dividends is stronger when firms have weak shareholder rights and when information asymmetry is severe. In addition, I find that option-induced repurchases are associated with lower shareholder wealth when shareholder rights are weak or when information asymmetry is high. These firms also perform worse in the following year but show higher total payouts to shareholders. Overall, this paper provides a comprehensive picture of managers’ option-driven repurchase behavior.
Split Equilibrium Problems for Related Games and Applications to Economic Theory
Authors: Li Jinlu
Published: April 2018

In this paper we introduce the concept of split Nash equilibrium problems associated with two related noncooperative strategic games. Then we apply the Fan–KKM theorem to prove the existence of solutions to split Nash equilibrium problems of related noncooperative strategic games, in which the strategy sets of the players are nonempty closed and convex subsets in Banach spaces. As an application of this existence to economics, an example is provided that studies the existence of split Nash equilibrium of utilities of two related economies. As applications, we study the existence of split Nash equilibrium in the dual (playing twice) extended Bertrand duopoly model of price competition.
Wave Profiles of a Virtual Extreme Tsunami in the Northern Region of South China Sea
Authors: Li Zhi-Song , Zhao Xi , An Chao , Liu Hua
Published: April 2018

Tsunami wave profile is one of the important inputs for evaluating impacts of the tsunami on coastal and offshore structures. To understand the tsunami wave patterns along the northern coastal regions of South China Sea, we simulate the tsunami propagation in the South China Sea generated by a hypothetical earthquake of magnitude [Formula: see text] in Manila trench. The Boussinesq equations are adopted to account for the nonlinear and dispersive effects on the propagation and deformation of tsunami wave propagating over the continental shelf. Focusing on several locations in the northern region of South China Sea, the nested grids with gradually higher spatial resolution are used to ensure computational accuracy. Numerical results reveal that undular bores and several soliton-like waves may develop in shallow water in regions where water depth is less than 100[Formula: see text]m. The shallow continental shelf length and the steepness of wavefront are the two dominant variables that determine the development of undulation.
FinTech in Western Asia: Case of Iran
Authors: Assarzadeh Amir H. , Aberoumand Sadegh
Published: April 2018

Financial Technology (FinTech) is a combination of Internet-based technology and the existing financial services. FinTech is an innovation that aims at competing with traditional financial methods in the delivery of financial services. FinTech is an excellent example of Industrial Integration and Innovation. Currently, FinTech is changing the traditional financial services and will have a significant impact on financial operations on a global scale. Iranian Fintech market, as a part of Western Asian Fintech market, can be considered as a growing new market. This research introduces the Iranian FinTech development trend as well as the existing barriers and challenges.
How does sampling density affect mineralization detection in stream sediment geochemical exploration? A case study from NW of Iran
Authors: Shahrestani Shahed , Mokhtari Ahmad Reza , Hosseini-Dinani Hengameh
Published: April 2018

Sampling density is an important parameter in different stages of exploration programs such as stream sediment-based geochemical exploration. Some researchers have suggested the effects of different sampling densities in regional exploration. However, a few researchers have addressed the effect of stream sediment sampling density on anomaly delineation. This research aims at investigating the effect of sampling density in delineating ore-related geochemical signals in stream sediment exploration through sensitivity analysis. A dataset from northwestern Iran with known copper occurrences was employed, and the available data was systematically resampled into different proportions to simulate different sampling densities and analyzed using the true sample catchment basin approach. The results showed a positive correlation between the number of outlining known deposits and sampling density, implying that a higher sampling density increases the chance of outlining new potential zones. Moreover, when sampling density increases, the total size of the delimited anomalous area decreases. The estimated background values (

M
j

) for upstream lithologic units varies heavily with sampling density. This is critical as separating anomalous basins depends on

M
j

.

M
j

variation has been more emphasized for lithologies with high estimated background content, displaying heteroscedastic behavior.
An
incertae sedis
organic-walled microfossil from the Mississippian (Early Carboniferous): Kirby Misperton-1 borehole, North Yorkshire, UK
Authors: McLean Duncan , Bodman David J. , Lucas Peter , Pendleton Janine L.
Published: April 2018

The organic-walled microfossil
Mispertonia desiccata
gen. et sp. nov. is described from the Arnsbergian (Mississippian, Early Carboniferous) of borehole Kirby Misperton-1, North Yorkshire, UK. This species includes thin-walled, originally spherical or sub-spherical vesicles; with a single polygonal field surrounded by a rim and a thickened collar which is interrupted by grooves radiating out from the angles of the polygonal field. The form is recovered from marine strata of the Silsden Formation equivalent, but is not necessarily of marine origin. Similar specimens, here synonymised with
M. desiccata
, are known from the non-marine Late Permian or Early Triassic of India.
Regulation of Immune Function by Polyphenols
Authors: Ding Sujuan , Jiang Hongmei , Fang Jun
Published: April 2018

Immune dysfunction is caused by various factors, including changes in relevant immune regulators and environmental stress. Immune system imbalance leads to a variety of diseases in humans. Nutrition may play an essential role in immunity by interfering with proinflammatory cytokine synthesis, immune cell regulation, and gene expression. Polyphenols, one of many categories of natural substances, exhibit a range of biological activities. Polyphenols promote immunity to foreign pathogens via various pathways. Different immune cells express multiple types of polyphenol receptors that recognise and allow cellular uptake of polyphenols, which subsequently activate signalling pathways to initiate immune responses. Furthermore, the polyphenols curcumin and epigallocatechin gallate can induce epigenetic changes in cells. In summary, polyphenols can be used to regulate intestinal mucosal immune responses, allergic diseases, and antitumour immunity.
Hepatic Epithelioid Hemangioendothelioma Presenting as an Enlarging Vascular Lesion within the Spleen
Authors: Emamaullee Juliet A. , Nowak Klaudia , Beach Marla , Bacani Julinor , Shapiro A. M. James
Published: April 2018

Epithelioid hemangioendothelioma (EHE) is a rare vascular neoplasm with variable malignant potential that most often presents within the liver. Many patients present with bilobar or extrahepatic disease, and the current treatment paradigm involves liver transplantation, with favorable long term results. Up to 25% of patients are diagnosed incidentally following imaging for other indications, and confirmation of diagnosis requires histologic analysis, as there are no classical imaging features to distinguish hepatic EHE (HEHE) from other solid hepatic lesions. Here we describe a case of microscopic HEHE that was diagnosed following splenectomy for an enlarging vascular tumor within the spleen. Due to the unexpected diagnosis of EHE within the spleen and coexisting but stable appearing liver hemangiomata, a left hepatic lobectomy was performed. Explant histology revealed benign hemangiomata and diffuse, microscopic HEHE. The patient ultimately underwent liver transplantation. HEHE can be a challenging diagnosis, and this case emphasizes that any enlarging vascular lesion, even within the spleen, should prompt a high index of suspicion for HEHE in the setting of known hemangiomata.
Efficacy and Safety of Lumen Apposing Self-Expandable Metal Stents for EUS Guided Cholecystostomy: A Meta-Analysis and Systematic Review
Authors: Kalva Nikhil R. , Vanar Vishwas , Forcione David , Bechtold Matthew L. , Puli Srinivas Reddy
Published: April 2018

Background. Patients with acute cholecystitis are treated with early cholecystectomy. A subset of patients are unfit for surgery due to comorbidities and late presentation. Prompt gall bladder drainage (GBD) with percutaneous or endoscopic approach remains a viable therapeutic option for nonoperative candidates. Endoscopic ultrasound (EUS) guided transluminal gall bladder drainage (EUS-GBD) continues to evolve as an alternative approach to percutaneous drainage. With continued refinement in stent technology, lumen apposing self-expandable metal stent (LAMS) offers several advantages. We performed a pooled analysis on the efficacy and safety of EUS-GBD with LAMS in nonoperative candidates with acute cholecystitis. Methods. Extensive English language literature search was performed in Medline, Embase, Cochrane Central, and Google Scholar using keywords “endoscopic ultrasound”, “stent”, “gallbladder”, “acute cholecystitis”, and “cholecystostomy” from Jan 2000 to Dec 2016. Fixed and random effects models were used to calculate the pooled proportions. Results. Data was extracted from 13 studies that met the inclusion criteria (n=233). Pooled proportion of technical success was 93.86% (95% CI = 90.56 to 96.49) and clinical success was 92.48% (95% CI = 88.9 to 95.42). Overall complication rate was 18.31% (95% CI = 13.49 to 23.68) and stent related complication rate was 8.16% (95% CI = 4.03 to 14.96) in the pooled percentage of patients. Pooled proportion for perforation was 6.71% (95% CI 3.65 to 10.6) and recurrent cholangitis/cholecystitis was noted in 4.05% (95% CI = 1.64 to 7.48). Publication bias calculated using Harbord-Egger bias indicator gave a value of −0.61 (95%  CI = −1.39 to 0.16, p=0.11). The Begg-Mazumdar indicator for bias gave Kendall’s tau b value of −0.42 (p≥0.05). Conclusions. EUS-GBD with LAMS is a safe and alternative treatment modality for patients needing gallbladder drainage, with acceptable intraprocedural and postprocedural complications. However, due to the limited data and lack of direct comparison with other methods, further controlled trials are necessary to estimate the overall efficacy and safety and the role of EUS-GBD with LAMS in management of nonoperative patients with acute cholecystitis.
Das geriatrische Assessement kann mehr als nur Risikostratifizierung
Authors: Kolb Gerald
Published: April 2018

Background: The majority of patients with gastrointestinal (GI) malignancies are older. Recently, it has become evident that elements from a geriatric assessment (GA) are powerful predictors of outcomes such as postoperative morbidity and mortality, length of stay, type of treatment received, and survival across several GI tumor types in older adults. A GA is a systematic evaluation of functional status, comorbidities, polypharmacy, cognition, nutritional status, emotional status, and social support. Methods: A PubMed search was performed in order to identify clinical studies investigating the association between GA and outcomes in patients with GI malignancies. Results: A total of 31 studies were included in this review. For colorectal cancer, the evidence linking GA variables and frailty to negative outcomes is substantial and consistent. The data regarding other GI malignancies is more limited, but generally shows the same findings. Conclusion: Increasing data shows that elements from a GA and frailty are consistently associated with negative short- and long-term treatment outcomes in older patients with GI malignancies. Future studies should investigate the impact of geriatric interventions on outcomes.
Effect of Hybrid Blood Purification Treatment on Secondary Hyperparathyroidism for Maintenance Hemodialysis Patients
Authors: Gao Xiao-Fang , Li Jian-Dong , Guo Li , Guo Shan-Shan , Zhang Ran , Gou Yan-Li , Chen Hang
Published: April 2018

Objective: This study aims to investigate the effects of hybrid blood purification treatment on secondary hyperparathyroidism for maintenance hemodialysis (HD) patients. Methods: A total of 40 patients were randomly divided into 2 groups: HD combined with hemoperfusion (HD + HP) group (n = 20) and HD group (n = 20). Changes in intact parathyroid hormone (iPTH) in these 2 groups were compared before and after treatment, and iPTH levels in the HD + HP group were monitored before and after treatment. Results: iPTH, β2 microglobulin (β2-MG), and cystatin C (CysC) levels were significantly lower in the HD + HP group than in the HD group (p < 0.05), iPTH levels were significantly higher than at the first day after treatment (p < 0.05), and iPTH level was significantly higher (p < 0.05). Conclusion: The clearance effects of HD + HP on iPTH, β2-MG, and CysC are better than HD alone. Treatment with HD + HP every 2 weeks is recommended for maintenance HD patients.
What Is the Impact of High-Resolution Manometry in the Functional Diagnostic Workup of Gastroesophageal Reflux Disease
Authors: Keller Jutta
Published: April 2018

International guidelines agree that high-resolution esophageal manometry (HRM) is an integral part of the diagnostic evaluation of patients with refractory reflux symptoms and should be performed before antireflux surgery. Its most important goal is to explore differential diagnoses, in particular major esophageal motility disturbances, that may be responsible for symptoms. HRM additionally provides insights into all relevant pathomechanisms of gastroesophageal reflux disease (GERD): It can reveal important information on the morphology and function of the esophagogastric junction (EGJ), the presence of a hiatus hernia, transient lower esophageal sphincter relaxations, and dysmotility of the esophageal body. To obtain this information, a 3-step hierarchical system has been proposed for the algorithmic characterization of esophageal motor function. The first step is to investigate the morphology and contractility of the EGJ, the second to monitor esophageal body motor patterns in response to water swallows, and the third to determine the contraction reserve in patients with abnormal esophageal motor function using provocation tests. Observations made with HRM can not only explain the cause of symptoms in GERD patients but may also have the potential to direct specific treatment.
End-Organ Saturation Differences in Early Neonatal Transition for Left- versus Right-Sided Congenital Heart Disease
Authors: Altit Gabriel , Bhombal Shazia , Tacy Theresa A. , Chock Valerie Y.
Published: April 2018

Background: For neonates with congenital heart disease (CHD), left-sided (LL) and right-sided (RL) single ventricular physiologies (LL, hypoplastic left heart syndrome; RL, tricuspid atresia or pulmonary atresia with intact ventricular septum) may demonstrate distinct changes in tissue saturation in the first 72 h of life. Near-infrared spectroscopy (NIRS) can measure regional cerebral saturation (Csat) and renal saturation (Rsat) to clarify differences between LL and RL over time. Objectives: Our primary objective was to measure changes in Csat and Rsat in the first 72 h of life using NIRS between CHD infants with LL compared to RL. The secondary objective was to correlate NIRS values to an echocardiographic marker of perfusion. Method: Newborns with hypoplastic left heart syndrome, tricuspid atresia, and pulmonary atresia with intact ventricular septum from 2013 to 2016 underwent routine NIRS monitoring. Csat, Rsat, and systemic saturations (SpO2) in the first 72 h of life were retrospectively analyzed and the echocardiographic descending aorta velocity time integral (VTI) was measured. Mixed effects models compared differences over time between LL and RL. Results: The final cohort included 13 LL, 12 RL, and 4 controls. Csat decreased for RL compared to LL (p = 0.005), while Rsat decreased for both (p = 0.008). Over time, SpO2 increased for LL but decreased for RL (p = 0.046). Compared to the controls, infants with CHD had lower Csat, lower Rsat, and lower SpO2. The descending aorta VTI was correlated with Rsat (R2 = 0.24, p = 0.02). Conclusion: NIRS Csat measures were better preserved in LL compared to RL. Rsat decreased in both groups through time. The correlation between the descending aorta VTI and Rsat suggests an association between NIRS measures of renal saturation and renal perfusion.
Multimodale komplementärmedizinische Therapiekonzepte: Ein Ansatz mit Potential
Authors: Voiß Petra
Published: April 2018

Objectives: Evidence for complementary therapies as important strategies to relieve cancer treatment-associated symptoms is increasing. Mostly, these complementary therapies start at the end of adjuvant treatments, resulting in a long delay until the well-being of patients is addressed. Further, long distances between the rehabilitation center and the patients' residence hinder patients' compliance. Methods: The multimodal outpatient LOTUS Care Cure Project (LCCP) was tested in a randomized controlled trial including patients of various cancer entities and stages while on adjuvant chemotherapy and/or radiotherapy or outpatient aftercare. The intervention group received the LCCP additionally to the conventional treatment (LCCP group, n = 50). The control group (CG) was split into 2 groups, with (CG1, n = 33) and without (CG2, n = 17) weekly talks. The primary endpoint was quality of life (QoL) after 3 months. Results: In the LCCP group, QoL significantly improved after 3 months compared to CG2 (p = 0.022) but not compared to CG1. Other parameters showing a significant improvement were cognitive (p < 0.05, vs. CG1 and CG2) and social function (p < 0.05, vs. CG2). Conclusions: This pilot study describes a multimodal outpatient complementary therapy program conducted in parallel with conventional therapies and its potential to significantly improve QoL and reduce treatment-associated side effects. To substantiate these data, multicenter trials are needed.
Geriatrische Patienten mit gastrointestinalen Karzinomen: Risikofaktoren für kurative Operationen
Authors: Raab Hans-Rudolf
Published: April 2018

Background: The incidence of gastrointestinal cancer increases with age, with approximately 20% of these cases in people over 80 years of age. Due to pre-existing comorbidities, this onco-geriatric population often presents diagnostic and therapeutic challenges. Methods: A systematic review of articles on PubMed was performed to determine the predictive ability of screening tools and their components regarding the occurrence of adverse outcomes in elderly onco-surgical patients with gastrointestinal malignancies. Results: Surgical procedures in this patient cohort, particularly complex resections, may result in increased morbidity and mortality. The decision to treat an elderly patient with curative intent requires sound clinical judgment based on knowledge, consideration of objective parameters, and experience. These patients could potentially be optimized for surgery with the improvement of nutritional and overall performance status as well as with stabilizing comorbidities. Conclusion: Various geriatric assessment and screening tools have been developed to identify risk factors to assist the surgeon and the interdisciplinary team in treatment planning, including the Frailty Assessment Score, Timed Up and Go test, nutritional status, and Activities of Daily Living test. It is important to emphasize that transparent and open communication between the treating surgeon and the patient is crucial in that the patient fully understands the implications of the treatment plan.
Patent Foramen Ovale and Cryptogenic Stroke or Transient Ischemic Attack: To Close or Not to Close? A Systematic Review and Meta-Analysis
Authors: Lattanzi Simona , Brigo Francesco , Cagnetti Claudia , Di Napoli Mario , Silvestrini Mauro
Published: April 2018

Background: The optimal strategy of secondary stroke prevention in patients with patent foramen ovale (PFO) is controversial. This study was performed to evaluate the efficacy and safety of the device closure (DC) versus the medical therapy (MT) in patients with cryptogenic stroke or transient ischemic attack (TIA) and PFO. Summary: Randomized controlled trials with active and control groups receiving the DC plus MT and MT alone in patients with history of cryptogenic stroke/TIA and diagnosis of PFO were systematically searched. The main efficacy outcome was stroke recurrence. Subgroup-analyses were performed according to age, shunt size, and presence of atrial septal aneurysm (ASA). Safety endpoints included any serious adverse event (SAE), atrial fibrillation (AF), and major bleeding complications. Risk ratios (RRs) and hazard ratios (HRs) with 95% CIs were estimated. Five trials were included, involving 3,440 participants (DC = 1,829, MT = 1,611). There was a protective effect of closure in the risk of recurrent stroke (RR 0.43 [0.21–0.90]; p = 0.024; HR = 0.39 [0.19–0.83]; p = 0.014). The benefit of PFO closure was significant in patients with PFO associated with substantial right-to-left shunt or ASA. There were no differences in the risks of SAEs and major bleedings between the groups. The rate of new-onset AF was higher in the DC than in the MT arm (RR 4.46 [2.35–8.41]; p < 0.001). Successful device implantation and effective PFO closure were achieved in 96 and 91% of the patients respectively. Key Messages: In selected adult patients with PFO and history of cryptogenic stroke, the DC plus MT is more effective to prevent stroke recurrence and is associated with an increased risk of new-onset AF compared to the MT alone.