bluuebunny/crossref_metadata_2025 huggingface dataset:
Bismuth-Based Quadruple Therapy with Bismuth Subcitrate, Metronidazole, Tetracycline and Omeprazole in the Eradication ofHelicobacter pylori
Authors: Lahaie Raymond , Farley Alain , Dallaire Chrystian , Archambault André , Fallone Carlo A , Ponich Terry , Hunt Richard , Oravec Michael , Whitsitt Paul , Van Zanten Sander Veldhuyzen , Marcon Norman , Bailey Robert , Dumont André , Nguyen Bich , Desrochers Sylvain , Spénard Jean
Published: March 2016

BACKGROUND: A previous study showed that 14 days of qid bismuth-based triple therapy with tetracycline 500 mg, metronidazole 250 mg and colloidal bismuth subcitrate 120 mg resulted in excellentHelicobacter pylorieradication rates (89.5%). The present study looked at a shorter treatment period by adding omeprazole and by reducing the dose of tetracycline.

METHODS: One hundred sixty-one patients withH pyloriconfirmed by histology and13carbon urea breath test were included in the study. They were treated for seven days with bismuth subcitrate 120 mg plus metronidazole 250 mg plus tetracycline 250 mg qid plus omeprazole 20 mg bid (OBMT). Patients were 18 to 75 years of age and had dyspepsia with or without a history of peptic ulcer. Patients with irritable bowel syndrome, active ulcer or previous attempt at eradication, or those who had used antibiotics or antiulcer drugs in the previous 30 days were excluded. Eradication was determined by two13carbon urea breath tests done one and three months, respectively, after treatment. Strains with minimal inhibitory concentrations of 8 µg/mL or higher were considered to be resistant to metronidazole.

RESULTS: The overall per protocol eradication rate was 84% - 89.5% in metronidazole-sensitive and 70.8% in metronidazole-resistant strains. Modified intent-to-treat analysis resulted in a 80% eradication rate - 82.5% in metronidazole-sensitive and 66.7% in metronidazole-resistant strains. Only one patient discontinued treatment because of adverse events.

CONCLUSIONS: The OBMT regimen used in this study is safe and effective against metronidazole-sensitiveH pyloristrains.
Ulcerative Colitis of the Appendix (‘Ulcerative Appendicitis’) Mimicking Acute Appendicitis
Authors: Barclay LR , Depew WT , Taguchi KK , Hurlbut DJ
Published: March 2016

Appendiceal involvement in ulcerative colitis may occur in the setting of either diffuse or distal disease, and is usually diagnosed incidentally at the time of proctocolectomy. The present patient had a rare case of 'ulcerative appendicitis' occurring on a background of clinically quiescent ulcerative colitis, and presented with the signs and symptoms of acute appendicitis.
The Updated Sydney System: Classification and Grading of Gastritis as the Basis of Diagnosis and Treatment
Authors: Stolte Manfred , Meining Alexander
Published: March 2016

In recent years, the importance of the histological diagnosis of gastritis on the basis of routinely obtained antral and corpus biopsies has increased enormously, which is owed not least of all to the discovery ofHelicobacter pylori. The introduction of the Sydney system made it possible, for the first time, to grade histological parameters, identify topographical distribution and, finally, make a statement about the etiopathogenesis of the gastritis. Of pathogenetic importance is, in the first instance, the differentiation between gastritis with and gastritis withoutH pyloriinfection. The group ofH pylori-associated gastritis can be further subdivided into forms of gastritis whose morphological distribution patterns usually identify them as sequelae ofH pyloriinfection, while the group of gastritis unassociated withH pylori, can be differentiated into autoimmune, chemically induced reactive gastritis, ex-H pylorigastritis,Helicobacter heilmanniigastritis, Crohn's gastritis and a number of special forms of gastritis.
Serological and Molecular Testing in Viral Hepatitis: An Update
Authors: Weston Shiobhan R , Martin Paul
Published: March 2016

The routine serological diagnoses of the three major forms of viral hepatitis - A, B and C - as well as delta hepatitis, are important in the evaluation of acute and chronic viral hepatitis. Increasingly, molecular virology is also being used to evaluate patients with chronic hepatitis C, with genotype and viral load testing to plan therapy.
Oral Pantoprazole for Acid Suppression in the Treatment of Patients with Zollinger-Ellison Syndrome
Authors: Désir Barbara , Poitras Pierre
Published: March 2016

BACKGROUND: The management of patients with gastric acid hypersecretion due to gastrinoma, usually recognized as Zollinger-Ellison syndrome (ZES), was radically changed 10 years ago by the use of proton pump inhibitors. Surgical treatment now concentrates on tumour excision, and in the majority of patients, gastrectomy is no longer required to prevent complications of acid hypersecretion that can be managed pharmacologically.

AIMS: To verify the ability of pantoprazole to control gastric acid hypersecretion and the clinical effects of acid hypersecretion in seven patients with documented ZES.

METHODS: Pantoprazole was administered at an initial dose of 80 mg daily for seven days before basal acid output (BAO) was measured at 08:00, ie, 1 h before the next dose of pantoprazole was normally ingested. A lower (40 mg) or higher (120 mg or more) dose of pantoprazole was then used to keep the BAO in the therapeutic range (between 0.1 and 10 mmol/h) and to control clinical symptoms such as acid-related pain or diarrhea.

RESULTS: BAO and clinical symptoms were controlled with pantoprazole 40 mg daily in one patient, 80 mg daily in two patients, 120 mg daily in three patients and 160 mg daily in one patient.

CONCLUSIONS: Pantoprazole was able to control acid hypersecretion in ZES patients when administered in doses between 40 and 160 mg daily. An initial dose of 120 mg given before further titration of the drug regimen appears to be a reasonable therapeutic strategy.
Bioartificial Liver Support
Authors: Bain Vincent G , Montero Jose Luis , de la Mata Manuel
Published: March 2016

Bioartificial liver support has been increasingly the focus of both basic and clinical research in an attempt to replicate the multiplicity of normal liver function. The concept is attractive because, if it is effective, patients with acute liver failure may be supported until native liver regeneration occurs or, by optimizing their condition, until liver transplantation is possible. Current bioartificial liver support systems utilize primary porcine hepatocytes or transformed human hepatocytes, which are housed within a bioreactor, through which the patient's blood or plasma is pumped in an extracorporeal circuit. The optimal source for the hepatocytes is an area of debate; however, a genetically engineered cell line may provide optimal function. Novel three-dimensional matrices that anchor the hepatocytes are being designed to mimic architectural features of the normal liver. Large multicentre, randomized, controlled trials are ongoing following several pilot studies. Serious side effects such as hemodynamic instability and immune reactions have been infrequent. Much controversy, however, surrounds the issue of possible transmission of pig endogenous retrovirus to humans, and current trials are being carefully monitored. Bioartificial liver support is a promising technology, and the results of current and planned studies are awaited with great interest.
Infliximab for the Treatment of Crohn'S Disease: Review and Indications for Clinical Use in Canada
Authors: Panaccione Remo
Published: March 2016

Crohn's disease is a chronic inflammatory disorder of the gastrointestinal tract. It may affect any portion of the gastrointestinal tract from the mouth to the anus. Symptoms typically include cramping abdominal pain, diarrhea (which may be bloody) and nausea. As the severity of the illness worsens, patients may experience constant abdominal pain, vomiting, weight loss and fever. From the perspective of the patient, disease symptoms significantly impair quality of life, and interfere with their work environment and activities of daily living. Unfortunately, there is no cure for Crohn's disease. Patients experience a chronic, relapsing course characterized by recurrent flares of their disease. Conventional medical treatment of Crohn's disease includes the use of non-specific anti-inflammatory drugs (5-aminosalicylic acid agents, prednisone, budesonide), immunosuppressives (6-mercaptopurine, azathioprine, methotrexate) and antibiotics. A variable onset of action, incomplete response rates and a significant risk of adverse effects characterize current therapies. Although surgery is frequently used to treat complications or medically refractory disease, postoperative recurrence is a common problem. Infliximab, a murine chimeric monoclonal antibody directed toward tumour necrosis factor-alpha, is a highly effective treatment of active Crohn's disease. In randomized, placebo-controlled clinical trials, 33% of patients treated with infliximab 5 mg/kg achieved remission (Crohn's Disease Activity Index score less than 150), compared with only 4% of those receiving placebo (P<0.001). Additionally, infliximab is the only drug therapy shown to be effective for the treatment of fistulizing Crohn's disease. In studies done to date, infliximab appears to be well tolerated and has a favourable side effect profile.
Acute Hepatitis Induced by Alpha-Interferon in a Patient with Chronic Hepatitis C
Authors: Kraus Ivan , Vitezic Dinko
Published: March 2016

Hepatic adverse effects occur very rarely with alpha-interferon therapy. A case of acute hepatitis induced by alpha-interferon in a 33-year-old man with chronic hepatitis C is described. The patient developed acute hepatitis with very high aminotransferase activity and jaundice. After discontinuing alpha-interferon therapy, hepatitis resolved rapidly. The immune-mediated mechanism is the most probable cause of this hepatitis.
Reflux Complaints, Symptom Score and the Use of Medication in Patients with Reflux Esophagitis: Results of a Long‐Term Follow‐Up Study
Authors: Loffeld Ruud JLF
Published: March 2016

Reflux esophagitis requires maintenance treatment. A cross‐sectional descriptive study was done to assess the use of medication and prevalence of complaints in patients with esophagitis more than 4.5 years after diagnosis. All patients diagnosed with reflux esophagitis in 1995 received a questionnaire on reflux complaints and use of medication. A symptom score was assessed. Esophagitis was diagnosed in 173 patients; the questionnaire was sent to 130 patients, of whom 95 (74%) responded. Four groups of responders were identified: patients in clinical remission with (group 1, n=18) or without (group 2, n=20) maintenance therapy, and patients suffering from reflux complaints with (group 3, n=48) or without (group 4, n=9) medication. There was no statistically significant difference with respect to initial severity of esophagitis. Seventeen patients (94%) from group 1 and 32 patients (67%) from group 3 used medication on a daily basis (P=0.04). The mean symptom score ± SD, on a scale ranging from 0 to 80, was 7.8±5.3 in group 3 patients and 8.6±8.6 in group 4 patients (not significant). Patients in group 3 had a higher prevalence of retrosternal pain and nocturnal heartburn. It is concluded that most patients still use acid suppressive therapy more than 4.5 years after diagnosis. Only a small number are in clinical remission, although the symptom score is rather low.
Frequency of Use and Standards of Care for the Use of Azathioprine and 6-Mercaptopurine in Treatment of Inflammatory Bowel Disease: A Systematic Review of the Literature and a Survey of Canadian Gastroenterologists
Authors: Wallace Thomas M , Veldhuyzen van Zanten Sander JO
Published: March 2016

OBJECTIVE: To identify the frequency of use and appropriate monitoring guidelines for the adverse effects of azathioprine and 6-mercaptopurine (6-MP) in the therapy of patients with inflammatory bowel disease (IBD).

METHODS: Surveys were sent to all physician members of the Canadian Association of Gastroenterology. Physicians were asked to describe their monitoring practices for IBD patients receiving azathioprine or 6-MP. A systematic literature search was also performed using MEDLINE for articles published in English between 1966 and 1999 using the MeSH terms 'azathioprine', '6-mercaptopurine', 'inflammatory bowel disease' and 'drug monitoring'.

RESULTS: Azathioprine and 6-MP were used to treat an average of 7% of patients - a surprisingly low number given the proven efficacy of these agents. All respondents reported monitoring complete blood counts (CBC), while liver enzyme and pancreatic enzyme levels were monitored by 62% and 29% of respondents, respectively. The most commonly reported initial CBC testing frequencies were weekly (42%), monthly (26%) and biweekly (23%). From the literature, it was determined that severe leukopenia (less than 2.10 g/L) occurs in less than 2% of cases and is sometimes associated with serious outcomes, including death. Most cases of severe leukopenia occurred abruptly, early in treatment. Other reported adverse effects and incidences were pancreatitis (3% to 5%), hepatotoxicity (less than 1%) and hypersensitivity (2% to 3%). Data concerning an increased risk of non-Hodgkin's lymphoma were equivocal.

CONCLUSIONS: Use of azathioprine or 6-MP is low in pa 6, 8 and 12, with subsequent testing every eight weeks for the duration of azathioprine or 6-MP treatment. The evidence in support of pancreatic and hepatic monitoring is weak. The risk of non-Hodgkin's lymphoma is likely low.
Pnematic Dilation in Achalasia
Authors: Bittinger Maximilian , Wienbeck Martin
Published: March 2016

Pneumatic dilation is the most common first-line therapy for the treatment of achalasia. The aim of dilation is a controlled disruption of circular muscle fibres of the lower esophageal sphincter to reduce the functional obstruction. Several types of dilators and different dilation techniques are used, but the achieved results are similar. The mean success rate is about 80% in the short term, but some patients need redilation in the further course (particularly young patients). Best long term results are obtained if the lower esophageal sphincter pressure can be reduced below 10 mmHg. Major complications are rare after pneumatic dilation; the most serious complication is esophageal perforation, which occurs at a mean rate of about 2.5%. Considering the pros and cons of other effective forms of treatment of achalasia (esophagomyotomy and intrasphincteric injection of botulinum toxin), pneumatic dilation is still the treatment of choice in the majority of patients with achalasia.
The Use of Probiotics in Gastrointestinal Disease
Authors: Madsen Karen L
Published: March 2016

Probiotics are living microorganisms that can affect the host in a beneficial manner. Prebiotics are nondigestible food ingredients that stimulate the growth and activity of probiotic bacteria already established in the colon. Efficacy of probiotic compounds has been shown in a wide range of gastrointestinal diseases.Lactobacillus GGalone, or the combination ofBifidobacterium bifidumandStreptococcus thermophilus,is effective in the treatment ofClostridium difficile,as well as in preventing the frequency and severity of infectious acute diarrhea in children. Prevention of antibiotic-induced diarrhea with the concomitant administration of eitherLactobacillus GGorSaccharomyces boulardiihas been demonstrated. The most successful studies involve the use ofLactobacillus GGat a dose of 1×1010viable organisms per day and the yeastboulardiiat a dose of 1 g/day. A probiotic preparation (VSL#3 - 6 g/day) that uses a combination of three species ofBifidobacterium, four strains ofLactobacillusand one strain ofStreptocccushas shown promise in maintaining remission in ulcerative colitis and pouchitis, as well as in preventing the postoperative recurrence of Crohn's disease. The mechanism of action of probiotics may include receptor competition, effects on mucin secretion or probiotic immunomodulation of gut-associated lymphoid tissue. Oral administration of probiotic compounds has been demonstrated to be well tolerated and safe. However, while probiotics have the potential to improve human health and to prevent and treat some diseases, major improvements are needed in labelling and quality assurance procedures for probiotic compounds. In addition, well planned and controlled clinical studies are necessary to delineate fully the potential for probiotic compounds.
Pouchitis-Associated Iritis (Uveitis) Following Total Proctocolectomy and Ileal Pouch-to-Anal Anastomosis in Ulcerative Colitis
Authors: Freeman Hugh James
Published: March 2016

A 26-year-old woman with ulcerative colitis treated with a proctocolectomy and ileal pouch-to-anal anastomosis developed an erosive and ulcerative pouchitis. Although no ophthalmological manifestations were present before the staged surgical procedures, iritis developed after appearance of the pouchitis. Both conditions subsequently resolved with oral corticosteroids and metronidazole.
Management of Fistulas in Patients with Crohn'S Disease: Antibiotic to Antibody
Authors: Paré Pierre
Published: March 2016

Fistulas are common in patients with Crohn's disease and, when associated with inflammatory disease and established for several weeks, tend to be chronic. Perianal fistulas are the most frequent complication of, and are most often associated with, colonic disease. Perianal fistulas commonly require surgical resection and permanent ileostomy. Antibiotics, cyclosporine, methotrexate and thalidomide have been used in uncontrolled trials; only azathioprine, 6-mercaptopurine and infliximab have been assessed in double-blind, placebo controlled studies. Relapse of the fistula occurs with all drugs, unless treatment is continued long term. Each drug differs in its onset of action and long term tolerability. An approach to fistulizing disease in Crohn's disease is suggested.
Nitric Oxide ‐ Its Importance in Swallowing, Inflammatory Bowel Disease and Cirrhotic Cardiomyopathy
Authors: Thomson ABR
Published: March 2016

Nitric oxide is a neurotransmitter found in the central and peripheral nervous systems. Nitric oxide synthase (NOS) is localized in the central nervous system, including the nucleus of the solitary tract, nucleus ambiguus and dorsal motor nucleus of the vagus. These are regions that are implicated in the central control of swallowing and esophageal motility. In rats and rabbits, NOS has been shown to be present in the nucleus subcentralis of the nucleus of the solitary tract, and is thought to be responsible for the central programming of the striated muscle component of esophageal peristalsis. Beyak and co‐workers from the University of Toronto, Toronto, Ontario provided evidence that the L‐arginine‐nitric oxide pathway is implicated in the central control of swallowing and esophageal motility. They studied oropharyngeal swallowing as well as esophageal peristalsis, and determined the functional role of brain stem nitric oxide by examining the effects of blockade of central nervous system NOS on swallowing, and on primary and secondary peristalsis. Administering NOS inhibitors intravenously or intracerebroventricularly into the fourth ventricle produced a number of oropharyngeal swallows and induced primary peristalsis in the smooth muscle portion of the esophageal body. NOS reduced the number of oropharyngeal swallows and the incidence of primary peristalsis in both smooth and striated muscle, and reduced the amplitude of peristalsis and smooth muscle contraction. This suggests that nitric oxide is a functional neurotransmitter in the central pattern generator responsible for swallowing and the central control of esophageal peristalsis. Peripherally administered NOS inhibitor can access structures within the blood‐brain barrier to affect neuronal activity and physiological function. The central pattern generated for swallowing and esophageal peristalsis is suggested to be a serial network of linked neurons within the nucleus of the solitary tract and neighbouring reticular formation, and there is likely one subnetwork for the oropharyngeal phase and the other for the esophageal phase of swallowing. The neurosubstances mediating striated and smooth muscle peristalsis may be both anatomically and neurochemically distinct. The role of nitric oxide in the pathogenesis of esophageal motility disorders remains to be established.
Acute Lower Gastrointestinal Bleeding: Part II
Authors: Enns Robert
Published: March 2016

Diagnostic strategies for lower gastrointestinal bleeding include nuclear scintigraphy, mesenteric angiography and endoscopic evaluation of the lower gastrointestinal tract. Each method has inherent advantages and disadvantages. Nuclear scintigraphy is simple and noninvasive, but high rates of false localization have led most clinicians to insist on confirmation of the bleeding site by another method before considering surgical intervention. Angiography is very specific, but is invasive and not as sensitive as nuclear scintigraphy. Colonoscopy is sensitive and specific, and can offer therapeutic value but can be technically challenging in the face of acute lower gastrointestinal hemorrhage. These strategies and the evidence behind them are discussed.
Surveillance Colonoscopy following Resection of Colorectal Polyps and Cancer
Authors: Rex Douglas K
Published: March 2016

Patients undergoing clearing colonoscopy with resection of adenomas should generally have their next examination at three years. Exceptions include large sessile adenomas removed piecemeal (re-examine at two to six months until no evidence of recurrent polyp, then at one year), average risk patients with a single tubular adenoma (next examination at five years) and patients with 'numerous' adenomas (next examination at one or two years). Patients with surgically resected colorectal cancer should have a clearing colonoscopy preoperatively or within two to three months of surgery in obstructed patients, even if the preoperative barium enema is negative for proximal lesions. After the clearing colonoscopy, subsequent examinations can be performed based on the associated adenoma findings.
Dieulafoy′s Lesions of the Rectum: A Rare Cause of Lower Gastrointestinal Bleeding
Authors: Enns Robert
Published: March 2016

Dieulafoy′s lesions located outside of the stomach are rare occurrences. Lesions found within the colon typically present with painless, massive hematochezia (ie, greater than 5 U). If they can be accurately located, endoscopic therapy in the form of adrenaline injection, sclerotherapy or cauterization appears to have long term success. The present report details the case of a 72‐year‐old man who presented with massive hematochezia and who was discovered to have a Dieulafoy′s lesion within the rectum. The lesion was located just distal to a previous surgical anastomosis, and was successfully treated with adrenaline and electrocautery. Colonic Dieulafoy′s lesions are rare but should always be considered in the differential diagnosis of massive hematochezia, because endoscopic therapy appears to result in complete cessation of bleeding.
Giant Cell Myocarditis in a Patient With Crohn's Disease, Treated with Etanercept – A Tumour Necrosis Factor-Alpha Antagonist
Authors: Nash C , Panaccione R , Sutherland LR , Meddings JB
Published: March 2016

Cardiac disease in association with inflammatory bowel disease (IBD) is uncommon. Reports include pericarditis, pericardial effusion, myocarditis, myocardial infarction, endocarditis and arrythmias. Myocardial inflammation related to IBD may be due to a drug hypersensitivity reaction or micronutrient deficiency, or may be secondary to the underlying IBD as an extraintestinal manifestation. In this setting, myocarditis usually presents as congestive heart failure and/or refractory arrhythmia. Prognosis varies among reported cases, including complete recovery, remission with recurrence and fatal disease. Treatment of myocarditis has included aminosalicylates and immunosuppressive medications. Recently, newer therapies for IBD have been developed, such as tumour necrosis factor-alpha (TNF- α) antagonists. The present report describes a case of a 46-year-old man with clinical and endoscopic evidence of moderately active colonic Crohn's disease who developed congestive heart failure due to giant cell myocarditis. Little clinical improvement occurred with immunosuppressive therapy. Only after the addition of etanercept, a TNF- α p75 receptor antagonist, did complete clinical resolution occur. These authors conclude that the use of TNF- α antagonists may be considered in the treatment of life-threatening extraintestinal manifestations of inflammatory bowel disease.
Spontaneous, Postpartum Coronary Artery Dissection and Cardiogenic Shock with Extracorporeal Membrane Oxygenation Assisted Recovery in a 30-Year-Old Patient
Authors: Knapp Kathleen E. , Weis Ricardo A. , Cubillo Efrain I. , Chapital Alyssa B. , Ramakrishna Harish
Published: March 2016

Coronary artery dissection is an infrequent cause of acute coronary syndrome in the general population. There is, however, a greater incidence of spontaneous coronary artery dissection (SCAD) in young women, especially in the peripartum period. However, the majority of cases have favorable outcomes with medical management or percutaneous coronary intervention; coronary artery bypass grafting (CABG) and transplantation are utilized in severe cases. This case is a one of a 30-year-old postpartum female with multivessel SCAD requiring CABG with subsequent biventricular failure and inability to wean from bypass. We believe this is the first reported case in which venoarterial extracorporeal membrane oxygenation (VA-ECMO) was used in the management of biventricular heart failure in a postpartum patient with SCAD.
Characteristics and Treatment Outcomes of Retreatment Tuberculosis Patients in Benin
Authors: Ade Serge , Adjibodé Omer , Wachinou Prudence , Toundoh Narcisse , Awanou Bérénice , Agodokpessi Gildas , Affolabi Dissou , Adè Gabriel , Harries Anthony D. , Anagonou Séverin
Published: March 2016

Objective. To determine among retreatment tuberculosis patients in Benin baseline characteristics, culture, and drug sensitivity testing (DST) results and treatment outcomes.Materials and Methods. A retrospective national cohort study of all retreatment tuberculosis patients in Benin in 2013 using registers and treatment cards.Results. Of 3957 patients with tuberculosis, 241 (6%) were retreatment cases. Compared to new pulmonary bacteriologically confirmed tuberculosis (NPBCT) patients, there were significantly higher numbers of males (P=0.04), patients from “Atlantique-Littoral” (P=0.006), patients aged 45–64 years (P=0.007), and HIV-positive patients (P=0.04) among those retreated. Overall, 171 (71%) patients submitted sputum for DST, of whom (163) 95% were positive forMycobacterium tuberculosison Xpert MTB/RIF and/or culture and 17 (10%) were rifampicin resistant (9 with MDR-TB and 8 monoresistant to rifampicin). For those without MDR-TB (n=224), treatment success was 93%. Worse outcomes occurred in those with unknown HIV status (RR: 0.27; 0.05–1.45;P<0.01) while better outcomes occurred in those who relapsed (RR: 1.06, 95 CI: 1.02–1.10,P=0.04).Conclusion. In 2013, a high proportion of retreatment patients received DST. Treatment success was good although more needs to be done to systematically increase the final follow-up smear examination. Reasons of high losses to follow-up from “Oueme-Plateau” should be investigated.
Spatial Estimation of Losses Attributable to Meteorological Disasters in a Specific Area (105.0°E–115.0°E, 25°N–35°N) Using Bayesian Maximum Entropy and Partial Least Squares Regression
Authors: Zhang F. S. , Zhong S. B. , Yang Z. T. , Sun C. , Wang C. L. , Huang Q. Y.
Published: March 2016

The spatial mapping of losses attributable to such disasters is now well established as a means of describing the spatial patterns of disaster risk, and it has been shown to be suitable for many types of major meteorological disasters. However, few studies have been carried out by developing a regression model to estimate the effects of the spatial distribution of meteorological factors on losses associated with meteorological disasters. In this study, the proposed approach is capable of the following: (a) estimating the spatial distributions of seven meteorological factors using Bayesian maximum entropy, (b) identifying the four mapping methods used in this research with the best performance based on the cross validation, and (c) establishing a fitted model between the PLS components and disaster losses information using partial least squares regression within a specific research area. The results showed the following: (a) best mapping results were produced by multivariate Bayesian maximum entropy with probabilistic soft data; (b) the regression model using three PLS components, extracted from seven meteorological factors by PLS method, was the most predictive by means ofPRESS/SStest; (c) northern Hunan Province sustains the most damage, and southeastern Gansu Province and western Guizhou Province sustained the least.
Discrete Sliding Mode Control for Hypersonic Cruise Missile
Authors: Fan Yong Hua , Yan Peng Peng , Wang Fan , Xu Hong Yang
Published: March 2016

A discrete variable structure control (DVSC) with sliding vector is presented to track the velocity and acceleration command for a hypersonic cruise missile. In the design an integrator is augmented to ensure the tracking with zero steady-state errors. Furthermore the sliding surface of acceleration is designed using the error of acceleration and acceleration rate to avoid the singularity of control matrix. A proper power rate reaching law is utilized in this proposal; therefore the state trajectory from any initial point can be driven into the sliding surface. Besides, in order to validate the robustness of controller, the unmolded dynamic and parameter disturbance of the missile are considered. Through simulation the proposed controller demonstrates good performance in tracking velocity and acceleration command.
Dendritic Cells and Their Multiple Roles during Malaria Infection
Authors: Amorim Kelly N. S. , Chagas Daniele C. G. , Sulczewski Fernando B. , Boscardin Silvia B.
Published: March 2016

Dendritic cells (DCs) play a central role in the initiation of adaptive immune responses, efficiently presenting antigens to T cells. This ability relies on the presence of numerous surface and intracellular receptors capable of sensing microbial components as well as inflammation and on a very efficient machinery for antigen presentation. In this way, DCs sense the presence of a myriad of pathogens, includingPlasmodiumspp., the causative agent of malaria. Despite many efforts to control this infection, malaria is still responsible for high rates of morbidity and mortality. Different groups have shown that DCs act duringPlasmodiuminfection, and data suggest that the phenotypically distinct DCs subsets are key factors in the regulation of immunity during infection. In this review, we will discuss the importance of DCs for the induction of immunity against the different stages ofPlasmodium, the outcomes of DCs activation, and also what is currently known aboutPlasmodiumcomponents that trigger such activation.
Proteomic Analysis of Stage-II Breast Cancer from Formalin-Fixed Paraffin-Embedded Tissues
Authors: Abdullah Al-Dhabi Naif , Srigopalram Srisesharam , Ilavenil Soundharrajan , Kim Young Ock , Agastian Paul , Baaru Rajasekhar , Balamurugan Kannan , Choi Ki Choon , Valan Arasu Mariadhas
Published: March 2016

Breast cancer is the most frequently occurring disease among women worldwide. The early stage of breast cancer identification is the key challenge in cancer control and prevention procedures. Although gene expression profiling helps to understand the molecular mechanism of diseases or disorder in the living system, gene expression pattern alone is not sufficient to predict the exact mechanisms. Current proteomics tools hold great application for analysis of cancerous conditions. Hence, the generation of differential protein expression profiles has been optimized for breast cancer and normal tissue samples in our organization. Normal and tumor tissues were collected from 20 people from a local hospital. Proteins from the diseased and normal tissues have been investigated by 2D gel electrophoresis and MALDI-TOF-MS. The peptide mass fingerprint data were fed into various public domains like Mascot, MS-Fit, and Pept-ident against Swiss-Prot protein database and the proteins of interest were identified. Some of the differentially expressed proteins identified were human annexin, glutathione S-transferase, vimentin, enolase-1, dihydrolipoamide dehydrogenase, glutamate dehydrogenase, Cyclin A1, hormone sensitive lipase, beta catenin, and so forth. Many types of proteins were identified as fundamental steps for developing molecular markers for diagnosis of human breast cancer as well as making a new proteomic database for future research.
The Government Incentive Regulation Model and Pricing Mechanism in Power Transmission and Distribution Market
Authors: Zhang Huan , Jiang Jian-li
Published: March 2016

The power transmission and distribution (T&D) market’s natural monopoly and individual information have been the impediment to improving the energy efficiency in the whole T&D market. In order to improve the whole social welfare, T&D market should be controlled by government. An incentive regulation model with the target of maximizing social welfare has been studied. A list of contracts with transferring payment and quantity of T&D are given to motivate the corporation to reveal the true technical parameter and input the optimal investment. The corporate revenue, optimal investment, and effort are proved to depend on its own technical parameter. The part of incentive regulation model ends with the optimal pricing mechanism of T&D market. At the end of this paper, we give a numerical example to explain our research and confirm its function graphically.
Facile Synthesis of Photofunctional Nanolayer Coatings on Titanium Substrates
Authors: Choi Kyong-Hoon , Kim Jung-Gil , Kang Byungman , Kim Ho-Joong , Park Bong Joo
Published: March 2016

We developed a two-step chemical bonding process using photosensitizer molecules to fabricate photofunctional nanolayer coatings on hematoporphyrin- (HP-) coated Ti substrates. In the first step, 3-aminopropyltriethoxysilane was covalently functionalized onto the surface of the Ti substrates to provide heterogeneous sites for immobilizing the HP molecules. Then, HP molecules with carboxyl groups were chemically attached to the amine-terminated nanolayer coatings via a carbodiimide coupling reaction. The microstructure and elemental and phase composition of the HP-coated Ti substrates were investigated using field-emission scanning electron microscopy and energy-dispersive X-ray spectrometry. The photophysical properties of the photofunctional nanolayer coatings were confirmed using reflectance ultraviolet-visible absorption and emission spectrophotometry. The singlet oxygen generation efficiency of the photofunctional nanolayer coatings was determined using the decomposition reaction of 1,3-diphenylisobenzofuran. The HP-coated Ti substrates exhibited good biocompatibility without any cytotoxicity, and these nanolayer coatings generated singlet oxygen, which can kill microorganisms using only visible light.
A Fuzzy Collusive Attack Detection Mechanism for Reputation Aggregation in Mobile Social Networks: A Trust Relationship Based Perspective
Authors: Zhang Bo , Song Qianqian , Yang Tao , Zheng Zhonghua , Zhang Huan
Published: March 2016

While the mechanism of reputation aggregation proves to be an effective scheme for indicating an individual’s trustworthiness and further identifying malicious ones in mobile social networks, it is vulnerable to collusive attacks from malicious nodes of collaborative frauds. To conquer the challenge of detecting collusive attacks and then identifying colluders for the reputation system in mobile social networks, a fuzzy collusive attack detection mechanism (FCADM) is proposed based on nodes’ social relationships, which comprises three parts: trust schedule, malicious node selection, and detection traversing strategy. In the first part, the trust schedule provides the calculation method of interval valued fuzzy social relationships and reputation aggregation for nodes in mobile social networks; further, a set of fuzzy valued factors, that is, item judgment factor, node malicious factor, and node similar factor, is given for evaluating the probability of collusive fraud happening and identifying single malicious nodes in the second part; and moreover, a detection traversing strategy is given based on random walk algorithm under the perspectives of fuzzy valued nodes’ trust schedules and proposed malicious factors. Finally, our empirical results and analysis show that the proposed mechanism in this paper is feasible and effective.
Prenatal Evaluation of MicroRNA Expressions in Pregnancies with Down Syndrome
Authors: Erturk Biray , Karaca Emin , Aykut Ayca , Durmaz Burak , Guler Ahmet , Buke Baris , Yeniel Ahmet Ozgur , Ergenoglu Ahmet Mete , Ozkinay Ferda , Ozeren Mehmet , Kazandi Mert , Akercan Fuat , Sagol Sermet , Gunduz Cumhur , Cogulu Ozgur
Published: March 2016

Background. Currently, the data available on the utility of miRNAs in noninvasive prenatal testing is insufficient in the literature. We evaluated the expression levels of 14 miRNAs located on chromosome 21 in maternal plasma and their utility in noninvasive prenatal testing of Down Syndrome.Method. A total of 56 patients underwent invasive prenatal testing; 23 cases were carrying Down Syndrome affected fetuses, and 33 control cases carrying unaffected, normal karyotype fetuses were included for comparison. Indications for invasive prenatal testing were advanced maternal age, increased risk of Down Syndrome in screening tests, and abnormal finding in the sonographic examination. In both the study and control groups, all the pregnant women were at 17th and 18th week of gestation. miRNA expression levels were measured using real-time RT-PCR.Results. Significantly increased maternal plasma levels of miR-3156 and miR-99a were found in the women carrying a fetus with Down Syndrome.Conclusion. Our results provide a basis for multicenter studies with larger sample groups and microRNA profiles, particularly with the microRNAs which were found to be variably expressed in our study. Through this clinical research, the utility of microRNAs in noninvasive prenatal testing can be better explored in future studies.
“Negotiorum Gestio” in Family Medicine, Informed Consent Obtainment, and Disciplinary Responsibility
Authors: Birkeland Søren
Published: March 2016

Introduction. Negotiorum gestio (NG) denotes an action where a person well intendedly acts on behalf of another without obtaining the latter’s prior consent. In broad terms, NG-like actions have played a considerable role in health care provision. In some settings, health care delivery with only little or presumed patients’ consent has been the rule rather than the exception. However, bioethical principles regarding patient autonomy and obtainment of the patient’s informed consent (IC) before intervention are now increasingly materialized in the law of many countries. Aim. To study legal consequences of NG in family medicine and IC handling options. Methods. Case law examination. Results. A disciplinary board case is described concerning a family doctor conducting unlawful NG by not coming up to legal IC requirements. Discussion and Conclusion. The practical and legal implications of IC and possible role of novel Shared Decision-Making approaches in coming up to regulation and bioethical demands are discussed. It is concluded that a doctor may run an unnecessary legal risk when conducting NG in decision-competent patients and furthermore it is suggested that novel Shared Decision-Making approaches could help in obtaining a rightful and practicable IC.
Temperature Values Variability in Piezoelectric Implant Site Preparation: Differences between Cortical and Corticocancellous Bovine Bone
Authors: Lamazza Luca , Garreffa Girolamo , Laurito Domenica , Lollobrigida Marco , Palmieri Luigi , De Biase Alberto
Published: March 2016

Purpose. Various parameters can influence temperature rise and detection during implant site preparation. The aim of this study is to investigate local temperature values in cortical and corticocancellous bovine bone during early stages of piezoelectric implant site preparation.Materials and Methods. 20 osteotomies were performed using a diamond tip (IM1s, Mectron Medical Technology, Carasco, Italy) on two different types of bovine bone samples, cortical and corticocancellous, respectively. A standardized protocol was designed to provide constant working conditions. Temperatures were measured in real time at a fixed position by a fiber optic thermometer.Results. Significantly higher drilling time (154.90 sec versus 99.00 sec;p<0.0001) and temperatures (39.26°C versus 34.73°C;p=0.043) were observed in the cortical group compared to the corticocancellous group. A remarkable variability of results characterized the corticocancellous blocks as compared to the blocks of pure cortical bone.Conclusion. Bone samples can influence heat generation duringin vitroimplant site preparation. When compared to cortical bone, corticocancellous samples present more variability in temperature values. Even controlling most experimental factors, the impact of bone samples still remains one of the main causes of temperature variability.
Stent-in-Stent Technique for the Treatment of Proximal Bronchial Restenosis after Insertion of Metallic Stents: A Report of Two Cases
Authors: Bondue Benjamin , Schlossmacher Pascal , Knoop Christiane , Etienne Isabelle , Luce Sylvie , Sokolow Youri , Leduc Dimitri
Published: March 2016

Endoscopic treatment of a bronchial restenosis previously treated by insertion of a partially covered self-expandable metallic stent (SEMS) can be difficult. Classically, after recanalization of the bronchus, the stent is removed and replaced by a more adapted one. We report on two cases of proximal bronchial restenosis treated by insertion of an additional stent inside the lumen of the previously inserted stent using the stent-in-stent (SIS) technique. The indications for the initial stent were malignancy in Patient 1 and posttransplant bronchial stenosis in Patient 2. Restenosis occurred at the proximal end of the stent within months in both cases. Stent removal and insertion of a new stent were considered, but this option was discarded because of an excessive risk of bronchial perforation and preference towards an alternative approach. In both cases, a second customized SEMS was placed using the SIS technique after ablation of the proximal end stenosis of the stent by argon plasma coagulation and/or dilation with a balloon. Recanalization of the bronchus was achieved in both cases without complications. The SIS technique is a valuable alternative to removal of SEMS in case of proximal bronchial restenosis.
Free Vibration and Hardening Behavior of Truss Core Sandwich Beam
Authors: Chen J. E. , Zhang W. , Sun M. , Yao M. H.
Published: March 2016

The dynamic characteristics of simply supported pyramidal truss core sandwich beam are investigated. The nonlinear governing equation of motion for the beam is obtained by using a Zig-Zag theory. The averaged equations of the beam with primary, subharmonic, and superharmonic resonances are derived by using the method of multiple scales and then the corresponding frequency response equations are obtained. The influences of strut radius and core height on the linear natural frequencies and hardening behaviors of the beam are studied. It is illustrated that the first-order natural frequency decreases continuously and the second-order and third-order natural frequencies initially increase and then decrease with the increase of strut radius, and the first three natural frequencies all increase with the rise of the core height. Furthermore, the results indicate that the hardening behaviors of the beam become weaker with the increase of the rise of strut radius and core height. The mechanisms of variations in hardening behavior of the sandwich beam with the three types of resonances are detailed and discussed.
Control of Cross Talk between Angiogenesis and Inflammation by Mesenchymal Stem Cells for the Treatment of Ocular Surface Diseases
Authors: Li Fei , Zhao Shao-zhen
Published: March 2016

Angiogenesis is beneficial in the treatment of ischemic heart disease and peripheral artery disease. However, it facilitates inflammatory cell filtration and inflammation cascade that disrupt the immune and angiogenesis privilege of the avascular cornea, resulting in ocular surface diseases and even vision loss. Although great progress has been achieved, healing of severe ocular surface injury and immunosuppression of corneal transplantation are the most difficult and challenging step in the treatment of ocular surface disorders. Mesenchymal stem cells (MSCs), derived from various adult tissues, are able to differentiate into different cell types such as endothelial cells and fat cells. Although it is still under debate whether MSCs could give rise to functional corneal cells, recent results from different study groups showed that MSCs could improve corneal disease recovery through suppression of inflammation and modulation of immune cells. Thus, MSCs could become a promising tool for ocular surface disorders. In this review, we discussed how angiogenesis and inflammation are orchestrated in the pathogenesis of ocular surface disease. We overviewed and updated the knowledge of MSCs and then summarized the therapeutic potential of MSCs via control of angiogenesis, inflammation, and immune response in the treatment of ocular surface disease.
Quality of Service Specifications in Small-Scale Proximity-Aware Mobile Sensor Sharing Frameworks
Authors: Mitra Pramita , Golestanian Mehdi , Poellabauer Christian
Published: March 2016

Proximity-awareness, that is, a mobile device being aware of the presence and capabilities of other devices in its proximity, can be beneficial in many frameworks that support spontaneous sharing of sensors available in advanced personal mobile devices (e.g., smartphones and tablets). Providing Quality of Service (QoS) guarantees in such frameworks is highly challenging because of the dynamic and loosely coupled nature of Mobile Ad Hoc Networks (MANETs). A framework called the SPontaneous Information and Resource sharing InfrasTructure (SPIRIT) has been presented before to address the challenges of proximity-aware mobile sensor sharing. SPIRIT allows mobile applications to share sensors as services in an automatic fashion by enabling the service providers and clients to express a variety of QoS specifications. This paper presents a set of mobility-aware QoS mechanisms for enabling the implementation of QoS specifications along the multihop paths between service providers and clients in highly mobile environments. Simulations in small-scale Mobile Ad Hoc Networks show SPIRIT’s ability to effectively control and manage traffic flows while maintaining desired QoS. The implications of the proposed QoS mechanisms extend beyond the scope of SPIRIT, as QoS provisioning is an important issue in many MANET frameworks and applications including Vehicular Ad Hoc Networks (VANETs).