bluuebunny/crossref_metadata_2025 huggingface dataset:
43 Management of acute low back pain in the ED: a systematic review
Authors: Ashbrook Jane , Rodgdakis Nikos , Goodwin Peter , Yeowell Gill , Callaghan Michael
Published: November 2017

Study objective

There is no consensus on the management of low back pain in the ED and evidence suggests that these patients are likely to receive unwarranted imaging and inappropriate opioid prescription.

The purpose of this study is to review the available literature pertaining to the clinical management of acute low back pain in the ED.

Methods

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) guidelines were observed during this review.

Trials were included if the population studied were adults with acute low back pain in an emergency setting. All diagnostic tests and therapeutic interventions were evaluated.

Methodological quality and risk of bias was appraised using the Downs and Black checklist.

Results

19 articles were identified including 1896 patients that were sub-grouped according to management.

In the pharmacological subgroup corticosteroids were effective in patients with radicular pain, NSAIDs were as effective as other medication with less adverse events, Phenyramidol was not superior to placebo, promethazine and morhpine combined was not more effective than morphine alone and ketamine was no more effective than morphine but had a worse adverse effect profile.

In the emergency transport group TENS and active warming both showed effects in reducing pain, anxiety and heart rate.

In the physical therapy management group less pain and greater satisfaction were reported.

In the adjunct interventions group showed a trend towards pain reduction in the use of heat/ice packs and short term pain relief in acupuncture and auricular acupuncture.

Conclusions

More high quality trials are needed to determine an evidence-based management protocol for the treatment of acute low back pain in the ED.
Subcellular localisation of the stem cell markers OCT4, SOX2, NANOG, KLF4 and c-MYC in cancer: a review
Authors: van Schaijik Bede , Davis Paul F , Wickremesekera Agadha C , Tan Swee T , Itinteang Tinte
Published: November 2017

The stem cell markers octamer-binding transcription factor 4, sex-determining region Y-box 2, NANOG, Kruppel-like factor 4 and c-MYC are key factors in inducing pluripotency in somatic cells, and they have been used to detect cancer stem cell subpopulations in a range of cancer types. Recent literature has described the subcellular localisation of these markers and their potential implications on cellular function. This is a relatively complex and unexplored area of research, and the extent of the effect that subcellular localisation has on cancer development and growth is largely unknown. This review analyses this area of research in the context of the biology of stem cells and cancer and explores the potential modulating effect of subcellular localisation of these proteins as supported by the literature.
The analytical one-loop contributions to Higgs boson mass in the Supersymmetric Standard Model with vector-like particles
Authors: Li Tianjun , Wang Wenyu , Wang Xiao-Chuan , Xiong Zhao-Hua
Published: November 2017

In this paper, we extend the Minimal Supersymmetric Standard Model (MSSM) with additional vector-like particles (VLPs) and compared the differences of mass spectrum and Feynman rules between the MSSM and MSSMV. We analytically calculate the one loop contributions to the Higgs boson mass from the fermions and sfermions in the on shell renormalization scheme. After discussing and numerically analyzing cases without bilinear terms and a case with a (partial) decoupling limit, we find: (i) the corrections depend on the mass splittings between quarks and squarks and between vector-like fermions and their sfermions; (ii) there exists the (partial) decoupling limit, where the VLPs decouple from the electroweak (EW) energy scale, even when one of the VLPs is light around the EW scale. The reason is that the contributions to Higgs mass can be suppressed by the (or partial) decoupling effects, which can make the EW phenomenology different from the MSSM. Moreover, we present some numerical analysis to understand these unique features.
The structural, electronic, magnetic, and mechanical properties of perovskite oxides PbM1/2Nb1/2O3(M = Fe, Co and Ni)
Authors: Erkisi A. , Surucu G. , Deligoz E.
Published: November 2017

In this study, the structural, electronic, magnetic, and mechanical properties of perovskite oxides PbM[Formula: see text]Nb[Formula: see text]O3(M = Fe, Co and Ni) are investigated. The systems are treated in ferromagnetic order. The calculations are carried out in the framework of density functional theory (DFT) within the plane-wave pseudopotential method. The exchange-correlation potential is approximated by generalized-gradient spin approach (GGA). The intra-atomic Coulomb repulsion is also taken into account in calculations (GGA + U). We have considered two generalized-gradient spin approximation functionals, which are Perdew–Burke–Ernzerhof (PBE) and PBE for solids (PBEsol) for structural parameter calculations when it included Hubbard potential. Although the spin-polarized electronic band structures of PbCo[Formula: see text]Nb[Formula: see text]O3and PbNi[Formula: see text]Nb[Formula: see text]O3systems exhibit metallic property in ferromagnetic phase, a bandgap is observed in spin-down states of PbFe[Formula: see text]Nb[Formula: see text]O3resulting in half-metallic behavior. The main reason for this behavior is attributed to the hybridization between [Formula: see text]-states of transition metal atoms and [Formula: see text]-states of oxygen atoms. The stability mechanically and the calculated mechanical properties by using elastic constants show that these compounds are mechanically stable in tetragonal phase and have anisotropic character mechanically.
Transport properties of bilayer graphene due to charged impurity scattering: Temperature-dependent screening and substrate effects
Authors: Linh Dang Khanh , Khanh Nguyen Quoc
Published: November 2017

We calculate the zero-temperature conductivity of bilayer graphene (BLG) impacted by Coulomb impurity scattering using four different screening models: unscreened, Thomas–Fermi (TF), overscreened and random phase approximation (RPA). We also calculate the conductivity and thermal conductance of BLG using TF, zero- and finite-temperature RPA screening functions. We find large differences between the results of the models and show that TF and finite-temperature RPA give similar results for diffusion thermopower S[Formula: see text]. Using the finite-temperature RPA, we calculate temperature and density dependence of S[Formula: see text] in BLG on SiO2, HfO2 substrates and suspended BLG for different values of interlayer distance c and distance between the first layer and the substrate d.
A Simple and Efficient Charge Injection Error Compensation Structure for MOS Sampling Switches
Authors: Naghavi Saeed , Nematzade Mojde , Sharifi Niloofar , Khanshan Tohid Moradi , Abrishamifar Adib , Kuzekanani Ziaaddin Daie , Sobhi Jafar
Published: November 2017

This paper introduces a new technique to design an analog MOS switch to be used in sampled-data circuits. In any sampled-data system, the accuracy of the sampling switch is a critical parameter to determine the overall performance of the system. To satisfy accuracy requirements of the switch, a novel technique to reduce channel charge injection error is proposed. The proposed switch has a very simple structure and it uses a small area of the chip. Also, it has a low on-resistance and its variation over the input signal range is acceptable. In order to evaluate the performance of the proposed switch, simulations are done in a 0.18[Formula: see text][Formula: see text]m standard CMOS technology. Simulation results show that the sampling errors produced by the channel charge injection is eliminated through a cancellation technique using an auxiliary transistor. The output error charge due to charge injection over a wide range of the input signal variation is very low (less than 1.45[Formula: see text]fC). Also, simulation results show that the proposed switch achieves signal-to-noise plus distortion ratio (SNDR) of 85.05[Formula: see text]dB, effective number of bits (ENOB) of 13.83, total harmonic distortion (THD) of [Formula: see text]87.23[Formula: see text]dB and spurious-free dynamic range (SFDR) of 88.14[Formula: see text]dB for a 1[Formula: see text]MHz sinusoidal input of 800[Formula: see text]mV peak-to-peak amplitude at 50[Formula: see text]MHz sampling rate with a 1.8[Formula: see text]V supply voltage.
MEASURING AND MONITORING THE EFFICIENCY OF MARKETS
Authors: MADAN DILIP B. , SCHOUTENS WIM , WANG KING
Published: November 2017

Market efficiency is measured by arbitrage proximity. The level of efficiency is calibrated by extent of a distortion of probability required to neutralize the drift. Simulations of bilateral gamma models estimated from past returns deliver for each asset on each day an empirical acceptability index. The assets covered include equities, commodities, currencies, volatility and hedge fund returns. It is observed that efficiency in equity is related to the process for up moves having more frequent and smaller jumps than its down side counterpart. For commodities the situation is reversed. Volatility indices trade more efficiently than equities, commodities, or currencies. Hedge fund returns reflect lower levels of efficiency supportive of hedge funds effectively exploiting market inefficiences. The relative inefficiency of the absence of trading is noted on comparing close to open with open to close returns. Small capitalization stocks trade more efficiently than the large ones. Sector exchange traded funds trade more efficiently than the S&P 500 index. Furthermore, economic activity reflected in greater high low spreads enhance market efficiency.
On the metric dimension and diameter of circulant graphs with three jumps
Authors: Imran Muhammad , Baig A. Q. , Rashid Saima , Semaničová-Feňovčíková Andrea
Published: November 2017

Let [Formula: see text] be a connected graph and [Formula: see text] be the distance between the vertices [Formula: see text] and [Formula: see text] in [Formula: see text]. The diameter of [Formula: see text] is defined as [Formula: see text] and is denoted by [Formula: see text]. A subset of vertices [Formula: see text] is called a resolving set for [Formula: see text] if for every two distinct vertices [Formula: see text], there is a vertex [Formula: see text], [Formula: see text], such that [Formula: see text]. A resolving set containing the minimum number of vertices is called a metric basis for [Formula: see text] and the number of vertices in a metric basis is its metric dimension, denoted by [Formula: see text]. Metric dimension is a generalization of affine dimension to arbitrary metric spaces (provided a resolving set exists).

Let [Formula: see text] be a family of connected graphs [Formula: see text] depending on [Formula: see text] as follows: the order [Formula: see text] and [Formula: see text]. If there exists a constant [Formula: see text] such that [Formula: see text] for every [Formula: see text] then we shall say that [Formula: see text] has bounded metric dimension, otherwise [Formula: see text] has unbounded metric dimension. If all graphs in [Formula: see text] have the same metric dimension, then [Formula: see text] is called a family of graphs with constant metric dimension.

In this paper, we study the metric properties of an infinite class of circulant graphs with three generators denoted by [Formula: see text] for any positive integer [Formula: see text] and when [Formula: see text]. We compute the diameter and determine the exact value of the metric dimension of these circulant graphs.
Mobile augmented reality visualization and collaboration techniques for on-site finite element structural analysis
Authors: Li W. K. , Nee A. Y. C. , Ong S. K.
Published: November 2017

In this paper, a mobile augmented reality (AR) framework for on-site finite element analysis (FEA) is proposed. The proposed framework is achieved using a client–server architecture. The performance of FEA relies on several important components, namely, computational power, visualization technique, and numerical analysis. AR renders intuitive computer-generated contents directly on a user’s surroundings. Integrating FEA with AR helps users through enhancing their perception and interaction with the engineering problems. Correct and effective visualization of these data using an AR platform can reduce the misinterpretation in spatial and logical aspects. Over the past decade, AR has undergone a transition from desktop to phablet computing. Mobile platforms enable user exploration of FEA results in situ. The client side uses a hybrid method to visualize FEA results in the mobile AR environment. In addition, a user can collaborate with other users by using the result sharing function. A prototype with basic functions has been built and a case study has been implemented to demonstrate the visualization method and evaluate the overall performance.
Characterization and Identification of Cryptic Biopeptides inCarya illinoinensis(Wangenh K. Koch) Storage Proteins
Authors: Mares-Mares Everardo , Gutiérrez-Vargas Santiago , Pérez-Moreno Luis , Ordoñez-Acevedo Leandro G. , Barboza-Corona José E. , León-Galván Ma. Fabiola
Published: November 2017

The objective of this research was to identify and characterize the encoded peptides present in nut storage proteins ofCarya illinoinensis. It was found, through in silico prediction, proteomic analysis, and MS spectrometry, that bioactive peptides were mainly found in albumin and glutelin fractions. Glutelin was the major fraction with ~53% of the nut storage proteins containing at least 21 peptides with different putative biological activities, including antihypertensives, antioxidants, immunomodulators, protease inhibitors, and inhibitors of cell cycle progression in cancer cells. Data showed that using 50 μg/mL tryptic digests of enriched peptides obtained from nut glutelins is able to induce up to 19% of apoptosis in both HeLa and CasKi cervical cancer cells. To our knowledge, this is the first report that shows the potential value of the nut-encoded peptides to be considered as adjuvants in cancer therapies.
Iterative Learning Fault Estimation Design for Nonlinear System with Random Trial Length
Authors: Feng Li , Zhang Ke , Chai Yi , Xu Shuiqing , Yang Zhimin
Published: November 2017

An iterative learning scheme-based fault estimation observer is designed for a class of nonlinear systems with randomly changed trial length. This is achieved by presenting a state observer for monitoring the system state and an iterative learning law for fault estimation in the presence of imprecise system model. An average factor is defined to deal with the lack and redundancy in tracking information caused by random trial length. Via the convergence analysis, sufficient design conditions are developed for estimation of fault signal. The observer gains and iterative learning law indexes are computed by solving the proposed conditions under λ-norm constraints. Numerical examples are presented to demonstrate the validity, the effectiveness, and the superiority of this method.
Image Restoration for Fluorescence Planar Imaging with Diffusion Model
Authors: Zhang Xuanxuan , Gong Yuzhu , Li Yang , Cao Xu , Zhu Shouping
Published: November 2017

Fluorescence planar imaging (FPI) is failure to capture high resolution images of deep fluorochromes due to photon diffusion. This paper presents an image restoration method to deal with this kind of blurring. The scheme of this method is conceived based on a reconstruction method in fluorescence molecular tomography (FMT) with diffusion model. A new unknown parameter is defined through introducing the first mean value theorem for definite integrals. System matrix converting this unknown parameter to the blurry image is constructed with the elements of depth conversion matrices related to a chosen plane named focal plane. Results of phantom and mouse experiments show that the proposed method is capable of reducing the blurring of FPI image caused by photon diffusion when the depth of focal plane is chosen within a proper interval around the true depth of fluorochrome. This method will be helpful to the estimation of the size of deep fluorochrome.
Mechanical Attributes of Uniaxial Compression for Calcium Carbonate Whisker Reinforced Oil Well Cement Pastes
Authors: Yang Yuanyi , Fu Shun , Li Xingkui
Published: November 2017

It is crucial for design and safety of the cementing sheath to develop better understanding of the CaCO3 whisker reinforced oil well cement pastes. The uniaxial compression curve, mechanical constitutive relation, and reinforcing mechanism of the CaCO3 whisker reinforced oil well cement pastes are studied in this script. The results indicate that the CaCO3 whisker under the 10% dosage could improve the tensile strength of the cement paste significantly. The peak stress, elasticity modulus, and the energy at different stages of the stress-strain curve of the CaCO3 whisker reinforced cement paste are reinforced with the increasing of CaCO3 whisker. Afterward, the constitutive model of stress-strain curve, the toughness index, and capability coefficients index of the CaCO3 whisker reinforced cement paste are established. A physical model of the interface layer is also established and the micromechanical reinforcement is related to the double film layer between the CaCO3 whisker and cement matrix which could be bonded with much more fastness to the cement surface. The development of this script provides new ways to analyze the toughening mechanism of CaCO3 whisker and establishes a correlation between basic material structure and the physical properties.
Affective Synchrony and Autonomic Coupling during Cooperation: A Hyperscanning Study
Authors: Vanutelli Maria Elide , Gatti Laura , Angioletti Laura , Balconi Michela
Published: November 2017

Previous research highlighted that during social interactions people shape each other’s emotional states by resonance mechanisms and synchronized autonomic patterns. Starting from the idea that joint actions create shared emotional experiences, in the present study a social bond was experimentally induced by making subjects cooperate with each other. Participants’ autonomic system activity (electrodermal: skin conductance level and response: SCL, SCR; cardiovascular indices: heart rate: HR) was continuously monitored during an attentional couple game. The cooperative motivation was induced by presenting feedback which reinforced the positive outcomes of the intersubjective exchange. 24 participants coupled in 12 dyads were recruited. Intrasubject analyses revealed higher HR in the first part of the task, connoted by increased cognitive demand and arousing social dynamic, while intersubject analysis showed increased synchrony in electrodermal activity after the feedback. Such results encourage the use of hyperscanning techniques to assess emotional coupling in ecological and real-time paradigms.
Autoantibodies against CYP-2C19: A Novel Serum Marker in Pediatric De Novo Autoimmune Hepatitis?
Authors: Clemente Maria Grazia , Antonucci Roberto , Mandato Claudia , Cicotto Lucia , Meloni Antonella , Gridelli Bruno , De Virgiliis Stefano , Manns Michael P. , Vajro Pietro
Published: November 2017

Diagnosis of de novo autoimmune hepatitis (AIH) after orthotopic liver transplantation (OLT) is challenging especially in the absence of hyper-γ-globulinemia. Circulating autoantibodies are not sensitive nor specific in de novo AIH but when positive increase the diagnostic probability. We report the discovery of novel liver microsomal (LM) autoantibodies against CYP-2C19 in a 9-year-old boy with “de novo” AIH developed 7 years after OLT. Graft dysfunction presented with hypertransaminasemia (up to 400 IU/L), while serum γ-globulins remained within the normal range for age. Liver histology and response to high dose prednisone (2 mg/kg/day) with the addition of azathioprine therapy further supported the diagnosis of de novo AIH. Autoantibodies investigation by indirect immunofluorescence (IF) on rodent tissues showed a novel staining pattern involving the pericentral liver zone and sparing the renal tissue. Human but not rat liver proteins immunoblotting allowed us to characterize the novel LM antibodies and to identify CYP-2C19 as human antigen. The finding offers insights into the controversial discussion about autoimmunity versus alloreactivity with regard to the pathogenesis of de novo AIH. Correct information on human versus rat tissue antigens tested by methods other than IF for antibodies detection may have significant implications for the correct diagnosis and management of patients followed up after OLT.
A Robust Text Classifier Based on Denoising Deep Neural Network in the Analysis of Big Data
Authors: Aziguli Wulamu , Zhang Yuanyu , Xie Yonghong , Zhang Dezheng , Luo Xiong , Li Chunmiao , Zhang Yao
Published: November 2017

Text classification has always been an interesting issue in the research area of natural language processing (NLP). While entering the era of big data, a good text classifier is critical to achieving NLP for scientific big data analytics. With the ever-increasing size of text data, it has posed important challenges in developing effective algorithm for text classification. Given the success of deep neural network (DNN) in analyzing big data, this article proposes a novel text classifier using DNN, in an effort to improve the computational performance of addressing big text data with hybrid outliers. Specifically, through the use of denoising autoencoder (DAE) and restricted Boltzmann machine (RBM), our proposed method, named denoising deep neural network (DDNN), is able to achieve significant improvement with better performance of antinoise and feature extraction, compared to the traditional text classification algorithms. The simulations on benchmark datasets verify the effectiveness and robustness of our proposed text classifier.
Mesh Migration into the J-Pouch in a Patient with Post-Ulcerative Colitis Colectomy: A Case Report and Literature Review
Authors: Ghanim Asem , Smood Benjamin , Martinez Joseph , Morris Melanie S. , Porterfield John R.
Published: November 2017

Mesh repair offers advantages like lower postsurgical pain and earlier return to work. Thus, it has become a widely used treatment option. Here, we present the first case report of a mesh migration into a J-pouch in a patient with history of ulcerative colitis who underwent total abdominal colectomy with J-pouch and ileoanal anastomosis and a subsequent laparoscopic ventral hernia repair with mesh.
Connexin43 and AMPK Have Essential Role in Resistance to Oxidative Stress Induced Necrosis
Authors: Zhao Chunshan , Fang Jinnv , Li Chunguo , Zhang Min
Published: November 2017

Reactive oxygen species (ROS) induced oxidative stress leads to cell damage and neurological disorders in astrocytes. The gap junction protein connexin43 (Cx43) could form intercellular channels in astrocytes and the expression of Cx43 plays an important role in protecting the cells from damage. In the present study, we investigated the contribution of Cx43 to astrocytic necrosis induced by the ROS hydrogen peroxide (H2O2) and the mechanism by which AMPK was involved in this process. Fluorescence microscopy, flow cytometry, and western blot were used quantitatively and qualitatively to determine the cell apoptosis, necrosis, and protein expression. Lack of Cx43 expression or blockage of Cx43 channels resulted in increased H2O2-induced astrocytic necrosis, supporting a cell protective effect of functional Cx43 channels. Our data suggest that AMPK is important for Cx43-mediated ROS resistance. Inhibition of AMPK activation results in reduction of necrosis and ROS production. Taken together, our findings suggest that the role of Cx43 in response to H2O2stress is dependent on the activation of AMPK signaling pathways and regulates ROS production and cell necrosis.
Meta‐Analysis of Chinese Traditional Medicine Bushen Huoxue Prescription for Endometriosis Treatment
Authors: Shan Jing , Cheng Wen , Zhai Dong-xia , Zhang Dan-ying , Yao Rui-pin , Bai Ling-ling , Cai Zai-long , Liu Yu-huan , Yu Chao-qin
Published: November 2017

Objectives. To evaluate the efficacy and safety of Bushen Huoxue prescription (BSHXP) for endometriosis. Methods. A meta‐analysis was performed, and studies were searched from the seven databases from the date of database establishment to April 30, 2017. Randomized controlled trials (RCTs) that explored the efficacy and safety of BSHXP for patients with endometriosis were included. Two assessors independently reviewed each trial. The Cochrane Risk of Bias assessment tool was used for quality assessment. Results. In the 13 included studies, the total effectiveness rates of BSHXP were higher than those of Western medicine (RR, 1.55; 95% CI, 1.03–2.32; P = 0.04), but the dysmenorrhea alleviation rates of the two treatments did not significantly differ (RR, 1.28; 95% CI, 0.70–2.34; P = 0.42). The pregnancy rates of BSHXP were also higher than those of hormone therapy (RR, 1.99; 95% CI, 1.17–3.39; P = 0.01). However, whether BSHXP is more effective than Western medicine in diminishing endometriotic cyst remains unknown. Conclusions. Our study provides evidence that BSHXP is effective and safe for endometriosis, but this evidence is inconclusive because of the low methodological quality of the included RCTs. Our findings suggest that BSHXP is an alternative drug for endometriosis, but it should be further examined in future clinical research.
A Refined Higher‐Order Hybrid Stress Quadrilateral Element for Free Vibration and Buckling Analyses of Reissner‐Mindlin Plates
Authors: Li Tan , Ma Xu , Chen Wanji , Jing Xili
Published: November 2017

This paper is devoted to develop a new 8‐node higher‐order hybrid stress element (QH8) for free vibration and buckling analysis based on the Mindlin/Reissner plate theory. In particular, a simple explicit expression of a refine method with an adjustable constant is introduced to improve the accuracy of the analysis. A combined mass matrix for natural frequency analysis and a combined geometric stiffness matrix for buckling analysis are obtained using the refined method. It is noted that numerical examples are presented to show the validity and efficiency of the present element for free vibration and buckling analysis of plates. Furthermore, satisfactory accuracy for thin and moderately thick plates is obtained and it is free from shear locking for thin plate analysis and can pass the nonzero shear stress patch test.
Locked Central Fracture Dislocation of the Hip in a Child after Low-Energy Trauma
Authors: Nehme Alexandre H. , Daoud Jack C. , Abdelnour Hicham G. , Bou Mounsef Jad N. , Moucharafieh Ramzi C. , Wehbe Joseph W.
Published: November 2017

We present the case of a 13-year-old boy who sustained a locked central fracture dislocation of the right acetabulum following a bicycle fall. Immediate external reduction maneuvers under general anesthesia were unsuccessful due to intrapelvic entrapment of the femoral head. Open reduction internal fixation was achieved 48 hours later. After an initial satisfactory postoperative course, the patient ended up developing severe hip osteoarthritis 16 months after the procedure. The rarity of this injury in children is discussed, with its possible implications on joint congruity and potential growth injury.
Very High Cycle Fatigue Crack Initiation Mechanism in Nugget Zone of AA 7075 Friction Stir Welded Joint
Authors: He Chao , Kitamura Kazuhiro , Yang Kun , Liu Yong-jie , Wang Qing-yuan , Chen Qiang
Published: November 2017

Very high cycle fatigue behavior of nugget zone in AA 7075 friction stir welded joint was experimentally investigated using ultrasonic fatigue testing system (20 kHz) to clarify the crack initiation mechanism. It was found that the fatigue strength of nugget zone decreased continuously even beyond 107 cycles with no traditional fatigue limits. Fatigue cracks initiated from the welding defects located at the bottom side of the friction stir weld. Moreover, a special semicircular zone could be characterized around the crack initiation site, of which the stress intensity factor approximately equaled the threshold of fatigue crack propagation rate. Finally, a simplified model was proposed to estimate the fatigue life by correlating the welding defect size and applied stress. The predicted results are in good agreement with the experimental results.
Aberrant Long Noncoding RNAs Expression Profiles Affect Cisplatin Resistance in Lung Adenocarcinoma
Authors: Hu Lijuan , Chen Jian , Zhang Fan , Wang Junjun , Pan Jingye , Chen Jie , Wang Yumin
Published: November 2017

Background. Long noncoding RNAs (lncRNAs) have been shown to be involved in the mechanism of cisplatin resistance in lung adenocarcinoma (LAD). However, the roles of lncRNAs in cisplatin resistance in LAD are not well understood. Methods. We used a high-throughput microarray to compare the lncRNA and mRNA expression profiles in cisplatin resistance cell A549/DDP and cisplatin sensitive cell A549. Several candidate cisplatin resistance-associated lncRNAs were verified by real-time quantitative reverse transcription polymerase chain reaction (PCR) analysis. Results. We found that 1,543 lncRNAs and 1,713 mRNAs were differentially expressed in A549/DDP cell and A549 cell, hinting that many lncRNAs were irregular from cisplatin resistance in LAD. We also obtain the fact that 12 lncRNAs were aberrantly expressed in A549/DDP cell compared with A549 cell by quantitative PCR. Among these, UCA1 was the aberrantly expressed lncRNA and can significantly reduce the IC50 of cisplatin in A549/DDP cell after knockdown, while it can increase the IC50 of cisplatin after UCA1 was overexpressed in NCI-H1299. Conclusions. We obtained patterns of irregular lncRNAs and they may play a key role in cisplatin resistance of LAD.
System Dynamic Model for Simulating Demand‐Supply Interaction of Railway Express Freight System
Authors: Wang Lingli , Zhang Xingchen
Published: November 2017

Express freight transportation is a rich seam of profit for China railway, and railway express freight system is a complex system with multiple variables and nonlinear feedback loops. This paper presents a System Dynamic Model for simulating the interaction between demand and supply of railway express freight system in China. The model consists of three submodels including economic environment, demand, supply, and investment, and its validity is verified by running in Vensim DDS software using historical data. In the simulation of period 2000–2025, the three variables are taken as control variables including growth rate of the national economy, railway express freight rate, and investment in fixed railway assets. Three scenarios for each control variable are simulated, and their effects are analyzed to provide beneficial reference for regulating the demand‐supply gap of railway express freight. The simulation demonstrated that raising freight rate, adding investment in fixed railway assets, and decelerating economic growth rate are all effective ways to shrink the demand‐supply gap of railway express freight. The model can be used to forecast the transport demand of railway express freight and test the outcomes of demand‐supply regulating measures.
Ornithine Transcarbamylase Deficiency: If at First You Do Not Diagnose, Try and Try Again
Authors: Santos Christan D. , Ratzlaff Robert A. , Meder Jennifer C. , Atwal Paldeep S. , Joyce Nicole E.
Published: November 2017

Ornithine transcarbamylase (OTC) deficiency is well known for its diagnosis in the neonatal period. Presentation often occurs after protein feeding and manifests as poor oral intake, vomiting, lethargy progressing to seizure, respiratory difficulty, and eventually coma. Presentation at adulthood is rare (and likely underdiagnosed); however, OTC deficiency can be life-threatening and requires prompt investigation and treatment. Reports and guidelines are scarce due to its rarity. Here, we present a 59-year-old woman with a past history of irritable bowel syndrome who underwent a reparative operation for rectal prolapse and enterocele. Her postoperative course was complicated by a bowel perforation (which was repaired), prolonged mechanical ventilation, tracheostomy, critical illness myopathy, protein-caloric malnutrition, and altered mental status. After standard therapy for delirium failed, further investigation showed hyperammonemia and increased urine orotic acid, ultimately leading to the diagnosis of OTC deficiency. This case highlights the importance of considering OTC deficiency in hospitalized adults, especially during the diagnostic evaluation for altered mental status.
Multiple Myeloma-Derived Exosomes Regulate the Functions of Mesenchymal Stem Cells Partially via Modulating miR-21 and miR-146a
Authors: Cheng Qian , Li Xin , Liu Jingru , Ye Qinmao , Chen Yanfang , Tan Sanqin , Liu Jing
Published: November 2017

Exosomes derived from cancer cells can affect various functions of mesenchymal stem cells (MSCs) via conveying microRNAs (miRs). miR-21 and miR-146a have been demonstrated to regulate MSC proliferation and transformation. Interleukin-6 (IL-6) secreted from transformed MSCs in turn favors the survival of multiple myeloma (MM) cells. However, the effects of MM exosomes on MSC functions remain largely unclear. In this study, we investigated the effects of OPM2 (a MM cell line) exosomes (OPM2-exo) on regulating the proliferation, cancer-associated fibroblast (CAF) transformation, and IL-6 secretion of MSCs and determined the role of miR-21 and miR-146a in these effects. We found that OPM2-exo harbored high levels of miR-21 and miR-146a and that OPM2-exo coculture significantly increased MSC proliferation with upregulation of miR-21 and miR-146a. Moreover, OPM2-exo induced CAF transformation of MSCs, which was evidenced by increased fibroblast-activated protein (FAP), α-smooth muscle actin (α-SMA), and stromal-derived factor 1 (SDF-1) expressions and IL-6 secretion. Inhibition of miR-21 or miR-146a reduced these effects of OPM2-exo on MSCs. In conclusion, MM could promote the proliferation, CAF transformation, and IL-6 secretion of MSCs partially through regulating miR21 and miR146a.
Successful Resection of G719X-Positive Pleomorphic Carcinoma after Afatinib Treatment
Authors: Nakamura Daisuke , Miura Kentaro , Kumeda Hirotaka , Agatsuma Hiroyuki , Hyogotani Akira , Hamanaka Kazutoshi , Koizumi Tomonobu , Yamamoto Hiroshi , Tamada Hisashi , Ito Ken-ichi
Published: November 2017

We report a case of pleomorphic carcinoma with exon 18 mutation (G719X) of the epidermal growth factor receptor (EGFR), which showed good response to afatinib and resulted in successful resection. To our knowledge, this is the first report on the use of afatinib for pleomorphic carcinoma followed by the surgical resection. The patient was a 59-year-old woman, who visited our hospital because chest computed tomography showed a 28 × 28-mm nodule in the left upper lobe. Bronchoscopy was performed and the histological findings of transbronchial biopsy revealed adenosquamous carcinoma positive for G719X mutation in exon 18 of the EGFR. Since fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography revealed a positive accumulation in the bilateral hilar and mediastinal lymph nodes, the disease was diagnosed as cT1bN3M0, stage IIIB. After 3 months of afatinib therapy, FDG accumulation in primary tumor was almost gone. However, FDG accumulation in lymph nodes remained unchanged. Video-assisted thoracic surgery was planned for further diagnostic information and left upper lobectomy with mediastinal lymph node dissection was performed. The resected tumor included adenocarcinoma, squamous cell carcinoma, and spindle cell components, without lymph node metastasis. Thus, the disease was diagnosed as pleomorphic carcinoma (pT2aN0M0, stage IB). All components in the resected specimen had the same G719X mutation in exon 18 of the EGFR. The patient has shown no signs of recurrence at 1 year after the operation. The present case indicates the possibility of minor EGFR mutations in pleomorphic carcinoma and successful outcome by the use of afatinib and surgical resection.
Acute Kidney Injury in Elderly Population: A Prospective Observational Study
Authors: Silveira Santos Cássia Gomes da , Romani Rafael Fernandes , Benvenutti Ricardo , Ribas Zahdi João Otávio , Riella Miguel Carlos , Mazza do Nascimento Marcelo
Published: November 2017

Background/Aims: Acute kidney injury (AKI) has been reported as a recognized condition among the elderly population; however, its clinical epidemiology is still poorly evaluated. We propose to evaluate the epidemiological profile of AKI in hospitalized elderly patients and the variables associated with renal replacement therapy (RRT) dependency at discharge after an episode of AKI. Methods: This prospective observational study enrolled 286 elderly patients (aged ≥60 years), who had a diagnosis of AKI and were admitted to a tertiary care hospital. Clinical data were analyzed, which included RRT indication, referral time to nephrologist support, standby period in the emergency care units (ECU) before a transfer to an intensive care unit, staff criteria used to indicate palliative care, and the incidence of patients who stayed on chronic dialysis for at least 6 months after discharge. Results: The overall hospital mortality was 56.3%. Acute Kidney Injury Network (AKIN) 3 at the time of admission was significantly higher in patients who underwent RRT. Intrinsic AKI (p < 0.001), AKIN 3 (p < 0.001), RRT (p < 0.001), and increased length of stay in ECUs (p = 0.01) all had a significantly higher prevalence among non-survivors. On multivariate analysis, however, only renal aetiology (intrinsic AKI) was independently associated with mortality (OR 2.88; 95% CI [1.29–6.13]). Approximately 85% of the discharged patients (n = 125) were dialysis free and 36.4% of them who had a previous diagnosis of chronic kidney disease (CKD) upon admission had a worse renal function. Age, AKIN 3, RRT, prior history of CKD, diabetes mellitus, and the number of hemodialysis sessions showed to have an impact on dialysis dependence. Furthermore, 24 of 161 patients who had a dialysis indication were placed on palliative care. Conclusions: The severity of AKI and the need for RRT were risk factors for mortality and dependence on dialysis. Antecedents of CKD seem to be associated with a poor renal outcome following an AKI episode. Starting RRT had an impact on the clinical decision to enroll these patients into palliative care.
The Use of Peritoneal Dialysis in Phenobarbitone Toxicity in a Critically Unwell Neonate
Authors: Le Page Amelia K. , Stewart Alice E. , Roehr Charles C. , Johnstone Lilian M. , Graudins Andis
Published: November 2017

Background: Phenobarbitone (PB) is the first-line anti-convulsant for neonatal seizures. The use of peritoneal dialysis (PD) to enhance drug elimination in cases of neonatal PB overdose has not been reported. Objective: To report a case of neonatal severe PB toxicity and review the elimination of PB by PD. Methods: Assessment of PD drug clearance. Results: A neonate with prolonged seizures was administered PB. Encephalopathy and myocardial failure developed, which were initially suspected to be secondary to hypoxia. At 42 h of age, the serum PB concentration was in the toxic range at 131 mg/L. Despite supportive care, the infant's condition deteriorated with escalating inotropes and the need for CPR. Enhanced PB elimination via multiple-dose activated charcoal and exchange transfusion were considered too risky. Hourly PD cycles via Tenckhoff catheter were commenced, based on reports suggesting that PD enhances PB clearance. The clinical state of the infant then improved. PD administration was continued for 60 h, recovering 20% of the estimated total PB body load. The infant survived and there were no PD complications. Conclusions: PD increased PB clearance in this neonate, correlating with clinical recovery. Where other techniques are not possible, PD may have a role to play in enhancing PB elimination.
Folliculotropism Does Not Affect Overall Survival in Mycosis Fungoides: Results from a Single-Center Cohort and Meta-Analysis
Authors: Giberson Mariah , Mourad Ahmed , Gniadecki Robert
Published: November 2017

Background: Folliculotropic mycosis fungoides (FMF) is a distinct subtype of mycosis fungoides (MF) with unique clinicopathological features. The medical literature suggests that FMF has a more aggressive course and worse survival than classic MF. Previous studies do not use standardized treatment, and no studies have reported an association between treatment response and overall survival (OS). Objective: To compare OS for MF, FMF, and Sézary syndrome (SS) patients. Methods: Data were collected retrospectively from 218 patients (171 MF, 15 SS, 32 FMF) treated in a single academic center between 1970 and 2016. Results: Negative predictors of OS were age (OR = 1.07), male sex (OR = 1.63), and stage IIB, III, and IV (OR = 4.10, 5.42, and 7.54, respectively, vs. stage IA). Lack of initial PUVA response was strongly associated with negative OS (OR = 3.08). Kaplan-Meier analysis of age-, sex-, and stage-matched MF and FMF patients found similar OS between the 2 groups. The 5-year OS was 91% for FMF and 74% for MF. Meta-analysis of current data and 2 published studies where survival of FMF patients was compared to MF did not reveal statistically significant differences between these 2 diseases. Conclusions: When patients were matched for age, sex, and disease stage, folliculotropism did not affect OS in MF.
Anterior Borderzone Angle for Hemodynamic Collateral Metric in Patients with Symptomatic Middle Cerebral Artery Stenosis
Authors: Li Yongkun , Xiong Yunyun , Cai Qiankun , Liu Dezhi , Dai Qiliang , Liu Wenhua , Huang Zhixin , Sun Wen , Liebeskind David S. , Wang Yinzhou , Liu Xinfeng
Published: November 2017

Background and Aims: We aimed to introduce a parameter of anterior borderzone angle (ABZA) to quantitatively evaluate the ACA-MCA leptomeningeal collaterals for middle cerebral artery stenosis (MCAS). Methods: Two hundred seventy-five patients with 50–100% MCAS and 100 controls were included. The 95% reference range of ABZA was obtained from the controls. ABZAtrans was defined as “ABZA/the 95% upper limit.” Relationships between ABZA and MCAS, ­ABZAtrans and the TICI grade, the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) collateral grade were analyzed. An ABZA grade model for the ACA leptomeningeal collaterals was tentatively developed. Results: The 95% reference range of ABZA was 0.0º–23.0º. ABZA was significantly associated with MCAS by a function of the fourth power (R2 = 0.723, p < 0.001), and could predict hemodynamic MCAS (≥70%) with an AUC of 0.928 (95% CI 0.903–0.953). ABZAtrans was negatively correlated with the TICI grade (rho = –0.752, p < 0.001) and positively with the ASITN/SIR grade (rho = 0.921, p < 0.001). The ABZA grade was created by rounding ­ABZAtrans to a nearest integer, and was closely associated with the ASITN/SIR grade (rho = 0.894, p < 0.001). Conclusions: ABZA can be used as a hemodynamic parameter to quantitatively evaluate ACA leptomeningeal collaterals.
Cystic Lung Disease in Genetic Syndromes with Deficient Tumor Suppressor Gene Function
Authors: Daccord Cécile , Nicod Laurent P. , Lazor Romain
Published: November 2017

Cystic lung diseases constitute a distinct group of rare lung disorders, among which two result from monogenic defects affecting tumor suppressor genes: lymphangioleiomyomatosis, either sporadic or associated with tuberous sclerosis complex, and Birt-Hogg-Dubé syndrome. These disorders have similarities in their clinical expression, including occurrence in young adults, multiple pulmonary cysts, recurrent pneumothorax, skin hamartomas, and renal tumors. However, they markedly differ in their gender distribution, pathogenesis, disease course, and prognosis. Our knowledge on these two rare conditions is rapidly expanding. Management of lymphangioleiomyomatosis has substantially improved in the past decade with the understanding of its pathogenic mechanisms, the discovery of an effective therapy, and development of large cohorts and international guidelines. Birt-Hogg-Dubé syndrome has been described more recently and still awaits deeper understanding of its pathophysiology.
Rho Kinase Regulates Aortic Vascular Smooth Muscle Cell Stiffness Via Actin/SRF/Myocardin in Hypertension
Authors: Zhou Ning , Lee Jia-Jye , Stoll Shaunrick , Ma Ben , Costa Kevin D. , Qiu Hongyu
Published: November 2017

Background/Aims: Our previous studies demonstrated that intrinsic aortic smooth muscle cell (VSMC) stiffening plays a pivotal role in aortic stiffening in aging and hypertension. However, the underlying molecular mechanisms remain largely unknown. We here hypothesized that Rho kinase (ROCK) acts as a novel mediator that regulates intrinsic VSMC mechanical properties through the serum response factor (SRF) /myocardin pathway and consequently regulates aortic stiffness and blood pressure in hypertension. Methods: Four-month old male spontaneously hypertensive rats (SHR) and Wistar-Kyoto (WKY) rats were studied. Aortic stiffness was measured by echography. Intrinsic mechanical properties of VSMCs were measured by atomic force microscopy (AFM) in vitro. Results: Compared to WKY rats, SHR showed a significant increase in aortic stiffness and blood pressure, which is accompanied by a remarkable cell stiffening and ROCK activation in thoracic aortic (TA) VSMCs. Theses alterations in SHR were abolished by Y-27632, a specific inhibitor of ROCK. Additionally, boosted filamentous/globular actin ratio was detected in TA VSMCs from SHR versus WKY rats, resulting in an up-regulation of SRF and myocardin expression and its downstream stiffness-associated genes including α-smooth muscle actin, SM22, smoothelin and myosin heavy chain 11. Reciprocally, these alterations in SHR TA VSMCs were also suppressed by Y-27632. Furthermore, a specific inhibitor of SRF/myocardin, CCG-100602, showed a similar effect to Y-27632 in SHR in both TA VSMCs stiffness in vitro and aorta wall stiffness in vivo. Conclusion: ROCK is a novel mediator modulating aortic VSMC stiffness through SRF/myocardin signaling which offers a therapeutic target to reduce aortic stiffening in hypertension.