bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Results of Minimally Invasive Spine Stabilization for the Management of Metastatic Spinal Tumors Based on the Epidural Spinal Cord Compression Scale
Authors: Uei Hiroshi , Tokuhashi Yasuaki , Maseda Masafumi , Nakahashi Masahiro , Sawada Hirokatsu , Matsumoto Koji , Miyakata Hiroyuki , Soma Hirotoki
Published: November 2018

Purpose. Minimally invasive spine stabilization (MISt) using percutaneous pedicle screws plays a significant role in palliative surgery for metastatic spinal tumors. However, few studies have investigated surgical outcomes based on the epidural spinal cord compression scale (ESCCS). The purpose of this study was to examine outcomes of metastatic spinal tumors as evaluated by ESCCS in patients treated by MISt. Methods. The subjects were 56 patients who underwent MISt for metastatic spinal tumors, including 34 patients with ESCCS 2 or milder (group A) and 22 patients with ESCCS 3 (group B). We analyzed baseline characteristics, perioperative factors and clinical results such as postoperative survival time, neurological outcomes, Barthel Index for activities of daily living (ADL), visual analogue scale (VAS), and the rate of discharge to home. Results. The baseline age (P=0.07), tumor diagnosis (P=0.23), spinal level of compression (P=0.35), American Spinal Injury Association classification (P=0.49), revised Tokuhashi score (P=0.92), spinal instability neoplastic score (P=0.28), VAS (P=0.35), Barthel Index (P=0.07), American Society of Anesthesiologists physical status classification (P=0.76), and type of surgery (P=0.40) did not differ significantly between the two groups. The median postoperative survival time did not differ significantly between the groups (12.0 versus 15.0 months, P=0.60). Neurological improvement by at least 1 grade or maintenance of grade E was favorable in group A. Patients in group A had less posterior decompression (P=0.006), a higher rate of chemotherapy (P=0.009), a higher postoperative Barthel Index (P=0.04), and a higher rate of discharge to home (P=0.01) and no patients died in the hospital (P=0.004). Conclusions. No significant difference was noted in the postoperative survival time between the 2 groups. Patients in the ESCCS 2 or milder group had favorable neurological improvement, higher rates of chemotherapy, better postoperative ADL, and the higher rate of discharge to home.
Research on Eddy Current Imaging Detection of Surface Defects of Metal Plates Based on Compressive Sensing
Authors: Deng Weiquan , Ye Bo , Huang Guoyong , Wu Jiande , Fan Mengbao , Bao Jun
Published: November 2018

Accurate detection and quantitative evaluation of defects and damage in metal plates is a crucial task in a range of technological applications, such as maintaining the integrity, enhancing the safety, and assuring the reliability of structures. There is scope for improving eddy current testing methods by incorporating compressive sensing (CS) in the inspection process. The key scientific problems in eddy current imaging of defects of metal plates are sparse representations and transform domain mapping, sparse testing constraints, and sparse image reconstruction. The main research content of this paper is as follows. We first provide basic theory based on research of sparse representations, transform domain mapping, sparse matrices, sparse transform matrices, and signal recovery a priori errors. We then propose information-recovery methods for completing compressive sensing. Third, we establish an experimental system for validating theories and methods. Finally, we establish theories and methods for eddy current imaging of metal plates.
Adaptive Fuzzy Control for Stochastic Pure‐Feedback Nonlinear Systems with Unknown Hysteresis and External Disturbance
Authors: Liu Xikui , Ge Yingying , Li Yan
Published: November 2018

This paper solves the tracking control problem of a class of stochastic pure‐feedback nonlinear systems with external disturbances and unknown hysteresis. By using the mean‐value theorem, the problem of pure‐feedback nonlinear function is solved. The direction‐unknown hysteresis problem is solved with the aid of the Nussbaum function. The external disturbance problems can be solved by defining new Lyapunov functions. Using the backstepping technique, a new adaptive fuzzy control scheme is proposed. The results show that the proposed control scheme ensures that all signals of the closed‐loop system are semiglobally uniformly bounded and the tracking error converges to the small neighborhood of origin in the sense of mean quartic value. Simulation results illustrate the effectiveness of the proposed control scheme.
Physicochemical and Morphological Characterization of Potato Starch Modified by Bacterial Amylases for Food Industry Applications
Authors: Vafina Adel , Proskurina Victoria , Vorobiev Vyacheslav , Evtugin Vladimir G. , Egkova Galina , Nikitina Elena
Published: November 2018

Two multienzyme bacterial preparations of α-amylase of Bacillus licheniformis and Amylosubtilin® were used in order to modify potato starch at various enzyme concentrations. Eight types of starch were obtained, and their morphological, functional, and physical and chemical characteristics were studied. Induction of enzyme preparations allowed obtaining starches characterized by extended solubility and water-sorption ability and also lower gelation temperatures and viscosity. It was found that studied amylolytic preparations do have different effects on starch granules, despite the identical major amylase activities. The combination of the characteristics studied in the enzymatically modified starches makes them promising for the use as a component of food systems requiring the corrections of their textural features.
Contact Response Analysis of Vertical Impact between Elastic Sphere and Elastic Half Space
Authors: Yang Yang , Zeng Qingliang , Wan Lirong
Published: November 2018

At present, the contact problem between the particle and the plane plate is generally equivalent to the rigid sphere impacting the elastic half space or the elastic sphere impacting the rigid surface. However, in the actual contact process, there will be no rigid body, and both contact and contacted object will deform and absorb energy. The research results obtained from the equivalent of the contact material to the rigid body are less accurate. In order to obtain the accurate mechanical relation and contact response, we took the research of impact between particles and the metal plate as a breakthrough in which the particle is equivalent to an elastic sphere and the metal plate is equivalent to an elastic half space and established the theory of vertical impact contact between elastic sphere and elastic half space by the Hertz contact theory. Through the dynamic simulation of an elastic sphere which has similar properties with rock impacting target in elastic half space in LS‐DYNA, the correctness of the established theory and the feasibility of the contact process simulated by LS‐DYNA are verified. Based on the established theory and 3D simulation, we studied the influence law of material parameters on the contact response and analyzed the differences of the collision vibration signals caused by the different contact objects. From the above research results, we obtain that the theoretical model is more accurate to predict the maximum contact force and contact displacement in this paper than traditional Hertz theory. And the sphere radius and both contact objects’ elastic modulus have larger influence on the contact response than sphere density, while the Poisson’s ratio has the smallest influence on the contact response results. Different material properties will cause the different contact response. The conclusions of this paper provide a theoretical calculation method for contact and a 3D simulation method for elastic half space and provide theoretical guidance for the differences analysis of the vibration signal.
Somatosensory Plasticity in Pediatric Cerebral Palsy following Constraint-Induced Movement Therapy
Authors: Matusz Pawel J. , Key Alexandra P. , Gogliotti Shirley , Pearson Jennifer , Auld Megan L. , Murray Micah M. , Maitre Nathalie L.
Published: November 2018

Cerebral palsy (CP) is predominantly a disorder of movement, with evidence of sensory-motor dysfunction. CIMT1 is a widely used treatment for hemiplegic CP. However, effects of CIMT on somatosensory processing remain unclear. To examine potential CIMT-induced changes in cortical tactile processing, we designed a prospective study, during which 10 children with hemiplegic CP (5 to 8 years old) underwent an intensive one-week-long nonremovable hard-constraint CIMT. Before and directly after the treatment, we recorded their cortical event-related potential (ERP) responses to calibrated light touch (versus a control stimulus) at the more and less affected hand. To provide insights into the core neurophysiological deficits in light touch processing in CP as well as into the plasticity of this function following CIMT, we analyzed the ERPs within an electrical neuroimaging framework. After CIMT, brain areas governing the more affected hand responded to touch in configurations similar to those activated by the hemisphere controlling the less affected hand before CIMT. This was in contrast to the affected hand where configurations resembled those of the more affected hand before CIMT. Furthermore, dysfunctional patterns of brain activity, identified using hierarchical ERP cluster analyses, appeared reduced after CIMT in proportion with changes in sensory-motor measures (grip or pinch movements). These novel results suggest recovery of functional sensory activation as one possible mechanism underlying the effectiveness of intensive constraint-based therapy on motor functions in the more affected upper extremity in CP. However, maladaptive effects on the less affected constrained extremity may also have occurred. Our findings also highlight the use of electrical neuroimaging as feasible methodology to measure changes in tactile function after treatment even in young children, as it does not require active participation.
Ultrasound-Guided Vascular Access Is an Important Tool to Prevent Catastrophes: Transinferior Epigastric Artery Cardiac Catheterization
Authors: Amro Ahmed , Mansoor Kanaan , Amro Mohammad , Sobeih Amal , Sayyed Rameez
Published: November 2018

We report a case of cardiac catheterization that was done entirely by accidentally accessing the inferior epigastric artery (IEA) through an unintentional puncture of the U-shaped portion of the inferior epigastric artery. Luckily the patient did not have any trauma to the IEA and was d/c home with no complications. A 48-year-old female with history of hypertension and CAD S/P left circumflex stent many years ago who presented to our facility with persistent crescendo angina for which decision was made to proceed with LHC. The cardiac catheterization showed no significant CAD with patent stent so it was decided that there is no further intervention needed. Femoral angiogram was done and showed that the stick was high and the tip of the sheath was about to come out of the CFA; at the same time, it came into our minds that the sheath could be passing through the IEA by sticking the U portion of the IEA, but due to the high risk, an immediate access was obtained through the contralateral groin then a balloon over the wire was passed beyond the original sheath tip, then the sheath was slowly pulled back while contrast was injected. Angiogram showed that the sheath was inserted through the U-shaped portion of the IEA. Conclusion. Ultrasound guidance should be the first-line standard for arterial access in any cardiac catheterization procedure. US is a proven tool that can increase success and decrease complications in a wide variety of vascular access procedures.
Nonlocal Black Hole Evaporation and Quantum Metric Fluctuations via Inhomogeneous Vacuum Density
Authors: Yosifov Alexander Y. , Filipov Lachezar G.
Published: November 2018

Inhomogeneity of the actual value of the vacuum energy density is considered in a black hole background. We examine the back-reaction of a Schwarzschild black hole to the highly inhomogeneous vacuum density and argue the fluctuations lead to deviations from general relativity in the near-horizon region. In particular, we found that vacuum fluctuations onto the horizon trigger adiabatic release of quantum information, while vacuum fluctuations in the vicinity of the horizon produce potentially observable metric fluctuations of order of the Schwarzschild radius. Consequently, we propose a form of strong nonviolent nonlocality in which we simultaneously get nonlocal release of quantum information and observable metric fluctuations.
Old and New NICE Guidelines for the Evaluation of New Onset Stable Chest Pain: A Real World Perspective
Authors: Carrabba Nazario , Migliorini Angela , Pradella Silvia , Acquafresca Manlio , Guglielmo Marco , Baggiano Andrea , Moscogiuri Giuseppe , Valenti Renato
Published: November 2018

Stable chest pain is a common clinical presentation that often requires further investigation using noninvasive or invasive testing, resulting in a resource-consuming problem worldwide. At onset of 2016, the National Institute for Health and Care Excellence (NICE) published an update on its guideline on chest pain. Three key changes to the 2010 version were provided by the new NICE guideline. First, the new guideline recommends that the previously proposed pretest probability risk score should no longer be used. Second, they also recommend that a calcium score of zero should no longer be used to rule out coronary artery disease (CAD) in patients with low pretest probability. Third, the new guideline recommends that all patients with new onset chest pain should be investigated with a coronary computed tomographic angiography (CTA) as a first-line investigation. However, in real world the impact of implementation of CTA for the evaluation of new onset chest pain remains to be evaluated, especially regarding its cost effectiveness. The aim of the present report was to discuss the results of the studies supporting new NICE guideline and its comparison with European and US guidelines.
Retrieval of Semantic-Based Inspirational Sources for Emotional Design
Authors: Du Jian , Li Yan , Ma Jinlong , Xiong Yan , Li Wenqiang
Published: November 2018

In the conceptual design stage, inspirational sources play an important role in designers’ creative thinking. This paper proposes a retrieval method for semantic-based inspirational sources, which helps designers obtain inspirational images in the conceptual design stage of emotional design. The core principle involves solving the designer’s own deficiencies in associations and limited knowledge, by bridging the “semantic gap” faced by designers when they use Kansei words for inspirational sources. This method can be divided into two aspects: (1) based on the semantic richness of Kansei words, the first part describes how a lexical ontology for Kansei words called KanseiNet is constructed and proposes a spreading activation mechanism based on KanseiNet to complete the semantic expansion of Kansei words; (2) the second part describes how, using existing semantic techniques, relevant design website resources are crawled and analyzed, images’ context descriptions and Kansei evaluations are extracted, and Kansei evaluation index of inspirational images is established. The KanseiNet for Chinese is first constructed, and the Sources of Inspiration Retrieval System for Emotional Design (SIRSED) is developed. An experiment comparing the existing image retrieval systems with SIRSED proved the latter to be a more comprehensive and accurate way for designers to access inspirational sources.
Regulation Effect of a Chinese Herbal Formula on Flora and Mucosal Immune Secretory Immunoglobulin A in Rats
Authors: Liu Tian-hao , Zhang Xiao-mei , Han Ni-ping , Liu Yang , Wu Yue-ying , Li Xiao-ya , Yang Zhong-shan , Yuan Jia-li
Published: November 2018

Flora and mucosal immunity are considered to be the barrier, which is associated with multiple respiratory diseases, including recurrent respiratory tract infection (RRTI). Fei‐Xi‐Tiao‐Zhi‐Fang (FTF) is a traditional Chinese herbal formula used in the treatment of RRTI. However, the mechanism is little known. This study aims to identify the function of FTF in flora and mucosal immune secretory immunoglobulin A (sIgA) in the model of RRTI rats. The samples of intestine and lung were collected to detect sIgA, short chain fatty acids (SCFAS), and flora with enzyme‐linked immunosorbent assay (ELISA), gas chromatography, and 16S rDNA sequencing. The body weight and viscera index were increased dynamically in RRTI rats after the administration of FTF. Furthermore, the types and proportions of aboriginal flora were significantly changed in the model group, whereas the altered flora was rescued in the FTF administration group. Desulfovibrio increased in the intestinal microflora and Ralstonia and Blautia decreased in the pulmonary microflora at the genus level, similar to that in the normal group. In addition, the expressions of sIgA in pulmonary and intestinal tissues were significantly upregulated and the level of SCFAS was increased in FTF group compared to the RRTI model group. Our study suggests that FTF can alleviate the symptoms of RRTI by increasing sIgA and SCFAS, recovering flora, and improving the immunity.
Effect of Bitter Melon Extracts on Lipid Levels in Japanese Subjects: A Randomized Controlled Study
Authors: Kinoshita Hiroki , Ogata Yasuyuki
Published: November 2018

Dyslipidemia is exemplified by high levels of low‐density lipoprotein cholesterol (LDL‐C) and represents a risk factor for cardiovascular diseases and requires therapeutic intervention. Several experimental studies suggest that bitter melon (Momordica charantia) improves lipid metabolism in animal models of dyslipidemia and diabetes. This study evaluated the effects of bitter melon extracts on lipid metabolism following a 30‐day treatment period in Japanese adults. This randomized, double‐blind, placebo‐controlled trial included 43 adult volunteers who received either 100 mg of hot‐water extracts of bitter melon (n = 23) or a placebo (n = 20) three times daily for 30 days. The body weight, blood pressure, and levels of LDL‐C and other blood parameters of each subject were measured before and after the study period. The results showed that the intervention group exhibited significantly lower LDL‐C levels (P = 0.02) as compared with the control group, and there were no significant changes in either group in terms of body weight, body mass index, systolic pressure, diastolic pressure, total cholesterol, high‐density lipoprotein cholesterol, triglycerides, or blood glucose. These results suggested that bitter melon extracts might effectively lower LDL‐C levels in humans and exhibit potential therapeutic value for the management of dyslipidemic conditions.
Nodular Calcification in Saphenous Vein Graft Successfully Treated by Percutaneous Coronary Intervention
Authors: Yamamoto Ko , Natsuaki Masahiro , Serikawa Takeshi , Okabe Masanori , Yamamoto Yusuke
Published: November 2018

Nodular calcification is sometimes detected in the native coronary artery. However, it is very rare to find in a saphenous vein graft (SVG). We herein report a rare case of stable angina pectoris (AP) due to nodular calcification. A 75-year-old man who had previously undergone coronary artery bypass grafting was admitted to our hospital due to stable AP. On angiography, significant stenosis was detected in the proximal SVG. Based on the findings of coronary angiography and optical coherence tomography, a red thrombus was suspected at the culprit lesion. However, nodular calcification was also suspected, as there were calcifications around the lesion. As intravascular ultrasound showed the protruding calcification, which we judged to be a nodular calcification, the calcified SVG lesion was successfully treated by percutaneous coronary intervention without any complications. Nodular calcification should be considered as a potential cause of AP, even when located in a SVG.
Positiveness and Observer‐Based Finite‐Time Control for a Class of Markov Jump Systems with Some Complex Environment Parameters
Authors: Ren Chengcheng , He Shuping
Published: November 2018

An observer‐based finite‐time L2‐L∞ control law is devised for a class of positive Markov jump systems in a complex environment. The complex environment parameters include bounded uncertainties, unknown nonlinearities, and external disturbances. The objective is to devise an appropriate observer‐based control law that makes the corresponding augment error dynamic Markov jump systems be positive and finite‐time stabilizable and satisfy the given L2‐L∞ disturbance attenuation index. A sufficient condition is initially established on the existence of the observer‐based finite‐time controller by using proper stochastic Lyapunov‐Krasovskii functional. The design criteria are presented by means of linear matrix inequalities. Finally, the feasibility and validity of the main results can be illustrated through a numerical example.
Intravitreal Injection of Hydrogen Peroxide Induces Acute Retinal Degeneration, Apoptosis, and Oxidative Stress in Mice
Authors: Huang Bing , Liang Jia-Jian , Zhuang Xi , Chen Shao-Wan , Ng Tsz Kin , Chen Haoyu
Published: November 2018

Purpose. Oxidative stress is a common pathological condition for multiple retinal diseases. Hydrogen peroxide (H2O2) has been applied as an oxidative stress inducer for the in vitro studies. Here, we report the in vivo effect of H2O2 exposure to the mouse retina and its underlying mechanism. Methods. The H2O2 or saline solution was intravitreally injected into the eyes of female C57BL/6J mice for two consecutive days. The retinal structure was evaluated by in vivo imaging using spectral domain optical coherence tomography (OCT) and validated by histological assessment as well as retinal marker expression. In addition, retinal stress, cell apoptosis, and antioxidant enzyme expression were also determined. Results. Retinal and outer nuclear layer thickness thinning was observed at days 7 and 14 by OCT imaging with the treatment of 10 μg H2O2, which was confirmed by the histopathological analysis. The expressions of photoreceptor (Rho, Rora, Rorb, and Rcvrn), bipolar cell (Chat and Calb2), and retinal pigment epithelial (Rpe65) markers were reduced in the H2O2‐treated group, whereas the expression of retinal ganglion cell marker (Tubb3) was increased. TUNEL‐positive cells were obviously found in the outer nuclear layer and inner nuclear layer of H2O2‐treated mice but sparely found in the ganglion cell layer. Coherently, apoptotic gene expressions (Casp3, Casp9, Bax, and Parp8) were significantly increased in the retina with increasing dosages of H2O2, while Bcl2 expression was mildly decreased. In addition, the expressions of Gfap and antioxidant enzyme genes (Txn2, Sod2, and Gpx4) were significantly upregulated in the retina after the H2O2 treatment, compared to the vehicle control group. Conclusions. This study revealed that intravitreal injection of H2O2 induces acute retinal damage by increasing oxidative stress and cell apoptosis in the retina. This acute retinal degeneration mouse model could provide a platform for drug screening against oxidative stress and retinal diseases.
Emerging Evidence concerning the Role of Sirtuins in Sepsis
Authors: Li Lulan , Chen Zhongqing , Fu Weijun , Cai Shumin , Zeng Zhenhua
Published: November 2018

Sepsis, a dysregulated host response to infection, is a major public health concern. Though experimental and clinical studies relating to sepsis are increasing, the mechanism of sepsis is not completely understood. To date, numerous studies have shown that sirtuins (silent mating type information regulation 2 homolog), which belong to the class III histone deacetylases, may have a varied, or even opposite, effect in the pathogenesis of sepsis. Notably, downstream mechanisms of sirtuins are not fully understood. The sirtuin family consists of sirtuins 1–7; among them, sirtuin 1 (SIRT1) is the most studied one, during the development of sepsis. Furthermore, other sirtuin members are also confirmed to be involved in the regulation of inflammatory or metabolic signaling following sepsis. In addition, sirtuins may interact with each other to form a precise regulatory mechanism in different phases of sepsis. Therefore, in this review, by accumulating data from PubMed, we intend to explain the role of sirtuin in sepsis, which we hope will pave the way for further experimental study and the potential future clinical applications of sirtuins.
Computer Aided Diagnosis System for Detection of Cancer Cells on Cytological Pleural Effusion Images
Authors: Win Khin Yadanar , Choomchuay Somsak , Hamamoto Kazuhiko , Raveesunthornkiat Manasanan , Rangsirattanakul Likit , Pongsawat Suriya
Published: November 2018

Cytological screening plays a vital role in the diagnosis of cancer from the microscope slides of pleural effusion specimens. However, this manual screening method is subjective and time-intensive and it suffers from inter- and intra-observer variations. In this study, we propose a novel Computer Aided Diagnosis (CAD) system for the detection of cancer cells in cytological pleural effusion (CPE) images. Firstly, intensity adjustment and median filtering methods were applied to improve image quality. Cell nuclei were extracted through a hybrid segmentation method based on the fusion of Simple Linear Iterative Clustering (SLIC) superpixels and K-Means clustering. A series of morphological operations were utilized to correct segmented nuclei boundaries and eliminate any false findings. A combination of shape analysis and contour concavity analysis was carried out to detect and split any overlapped nuclei into individual ones. After the cell nuclei were accurately delineated, we extracted 14 morphometric features, 6 colorimetric features, and 181 texture features from each nucleus. The texture features were derived from a combination of color components based first order statistics, gray level cooccurrence matrix and gray level run-length matrix. A novel hybrid feature selection method based on simulated annealing combined with an artificial neural network (SA-ANN) was developed to select the most discriminant and biologically interpretable features. An ensemble classifier of bagged decision trees was utilized as the classification model for differentiating cells into either benign or malignant using the selected features. The experiment was carried out on 125 CPE images containing more than 10500 cells. The proposed method achieved sensitivity of 87.97%, specificity of 99.40%, accuracy of 98.70%, and F-score of 87.79%.
Choriocarcinoma Syndrome as an Initial Presentation of Testicular Cancer
Authors: Salazar-Mejía Carlos Eduardo , García-Gutiérrez María Elena , Contreras-Salcido María Inés , Rodríguez-Álvarez Carlos Javier , Wimer-Castillo Blanca Otilia , Lara-Campos Jackeline Grace , Llerena-Hernández Edio , González-Vela José Luis , Hernández-Barajas David
Published: November 2018

Choriocarcinoma syndrome (CS) is a rare clinical entity within the spectrum of nonseminomatous germ-cell tumors (NSGCT). It is characterized by the abrupt establishment of rapidly progressive and hemorrhagic tumors associated with very high levels of the beta fraction of human chorionic gonadotropin (β-hCG) and with a very poor prognosis, particularly in patients with β-hCG values above 50,000 IU/L. We present the case of a 17-year-old man with a sudden onset nonmassive hemoptysis. Physical examination revealed a right testicular mass. Imaging studies showed metastatic lung, bone, and retroperitoneal disease. β-hCG serum levels were 222,493.21 IU/L, AFP 1.56 ng/mL, and DHL 457 IU/L. Histopathological study after right radical orchiectomy showed a mixed germ-cell tumor. Based on poor-risk characteristics, chemotherapy was started with an adequate clinical response. Physicians should be aware of the potential complications of CS in the treatment of testicular cancer with high β-hCG levels since they could be associated with a rapidly progressive and high-volume disease. Patients in this category should be referred to the centers experienced in the treatment of advanced germ-cell tumors. Due to the severity of the presentation, hemodynamic monitoring, ideally in an intensive care unit, is essential as well as timely administration of cytotoxic treatment.
Isolation of Aflatoxin B1 from Moldy Foods by Solid-Phase Extraction Combined with Bifunctional Ionic Liquid-Based Silicas
Authors: Fang Luwei , Tian Minglei , Yan Xuemin , Xiao Wei
Published: November 2018

A solid-phase extraction method was developed by using new bifunctional ionic liquid-based silicas as sorbents to isolate aflatoxin B1 from moldy corn and peanut. Firstly, according to the adsorption efficiency, two sorbents imidazolium chloride-butylimidazolium chloride-based silica (Sil@BIm-Im) and imidazolium chloride-hexylimidazolium chloride-based silica (Sil@HIm-Im) were selected. The RSM was introduced to optimize adsorption conditions such as methanol/water ratio, time, and pH. Sil@HIm-Im, which had the highest adsorption efficiency, was used in SPE as a sorbent. After 2.0 mL of loading samples, washing solvents were optimized as 6.0 mL and 4.0 mL of water for corn and peanut, 2.0 mL of acetonitrile, and 3.0 mL of methanol. 3.0 mL of methanol/acetic acid (2.0% vol.) was investigated as an elution solvent. Finally, 0.009 μg/g and 0.023 μg/g of aflatoxin B1 were obtained in corn and peanut extract with recoveries of 80.0%–103.3% and RSDs of 2.37%–6.58%.
Contrast-Enhanced Mammography (CEM) for Detecting Residual Disease after Neoadjuvant Chemotherapy: A Comparison with Breast Magnetic Resonance Imaging (MRI)
Authors: Barra Filipe Ramos , Sobrinho Alaor Barra , Barra Renato Ramos , Magalhães Mayra Teixeira , Aguiar Laira Rodrigues , Albuquerque Gabriela Feitosa Lins de , Costa Rodrigo Pepe , Farage Luciano , Pratesi Riccardo
Published: November 2018

Objective. To evaluate the performance of contrast-enhanced mammography (CEM) compared to magnetic resonance imaging (MRI) for estimating residual tumor size after neoadjuvant chemotherapy (NAC) in women with newly diagnosed breast cancer. Methods. The institutional review board approved this study. This prospective study included women with newly diagnosed breast cancer who underwent breast CEM and MRI at the end of the last cycle of NAC and before definitive surgery. Size of residual malignancy on post-NAC CEM and MRI was compared with surgical pathology. Agreements and correlations of CEM and MRI measurements with histological size were assessed. Results. Thirty-three patients were included with a mean age of 45 years (range 22–76). The sensitivity, specificity, and positive and negative predictive value for detection of residual disease of CEM were 76%, 87.5%, 95%, and 86.4%, and those of MRI were 92%, 75%, 92%, and 75%. Comparing CEM to MRI, the mean difference was −0.8 cm, concordance coefficient was 0.7, and Pearson correlation was 0.7 (p = 0.0003). The concordance coefficient between measurements of each imaging modality and pathologic tumor size was 0.7 for CEM and 0.4 for MRI. Pearson correlation was 0.8 for CEM and 0.5 for MRI. Mean differences between CEM, MRI, and residual histopathological tumor size were 0.8 cm and 1.8 cm, respectively. Conclusions. CEM has good correlation and agreement with histopathology for measuring residual disease after NAC. CEM was comparable to MRI, showing high positive predictive value and specificity for detecting residual disease.
Upregulation of Heme Oxygenase‐1 by Hemin Alleviates Sepsis‐Induced Muscle Wasting in Mice
Authors: Yu Xiongwei , Han Wenjun , Wang Changli , Sui Daming , Bian Jinjun , Bo Lulong , Deng Xiaoming
Published: November 2018

Hemin, an inducer of heme oxygenase‐1 (HO‐1), can enhance the activation of HO‐1. HO‐1 exhibits a variety of activities, such as anti‐inflammatory, antioxidative, and antiapoptotic functions. The objective of this study was to investigate the effects of hemin on sepsis‐induced skeletal muscle wasting and to explore the mechanisms by which hemin exerts its effects. Cecal ligation and perforation (CLP) was performed to create a sepsis mouse model. Mice were randomly divided into four groups: control, CLP, CLP plus group, and CLP‐hemin‐ZnPP (a HO‐1 inhibitor). The weight of the solei from the mice was measured, and histopathology was examined. Cytokines were measured by enzyme‐linked immunosorbent assay (ELISA). Real‐time quantitative reverse transcription polymerase chain reaction (qRT‐PCR) and Western blotting were used to assess the expression levels of HO‐1 and atrogin‐1. Furthermore, we investigated the antioxidative effects of HO‐1 by detecting malondialdehyde (MDA) levels and superoxide dismutase (SOD) activity. CLP led to dramatic skeletal muscle weakness and atrophy, but pretreatment with hemin protected mice against CLP‐mediated muscle atrophy. Hemin also induced high HO‐1 expression, which resulted in suppressed proinflammatory cytokine and reactive oxygen species (ROS) production. The expression of MuRF1 and atrogin‐1, two ubiquitin ligases of the ubiquitin‐proteasome system‐ (UPS‐) mediated proteolysis, was also inhibited by increased HO‐1 levels. Hemin‐mediated increases in HO‐1 expression exert protective effects on sepsis‐induced skeletal muscle atrophy at least partly by inhibiting the expression of proinflammatory cytokines, UPS‐mediated proteolysis, and ROS activation. Therefore, hemin might be a new treatment target against sepsis‐induced skeletal muscle atrophy.
Pentacam HR Indices Variation in Normal Corneas with Different Corneal Thickness
Authors: Roshdy Maged Maher Salib , Wahba Sherine Shafik , Elkitkat Rania Serag , Madkour Nermine Said , Fikry Ramy Riad
Published: November 2018

Purpose. To evaluate the effect of variable corneal thickness on Pentacam HR diagnostic indices in normal corneas.Methods. Retrospective study was conducted at Al Watany Eye Hospital, Cairo, Egypt. Consecutive 160 eyes of young myopic subjects without KC were evaluated using Pentacam HR (WaveLight Allegro Oculyzer II, Erlangen, Germany). The elevation- and thickness-based indices were recorded. Enrolled corneas were categorized into three groups according to TCT quartiles; group 1 (39 eyes) included corneas with TCT <523 µm, group 2 (81 eyes) with TCT between 523 and 564 µm, while group 3 (40 eyes) enrolled TCT >564 µm. The possible effect of pachymetry on Pentacam HR indices was assessed using partial correlation tests.Results. In normal corneas, back elevation from best fit sphere (BE from BFS) and that from best fit toric ellipsoid (BFTE) were the elevation indices that showed statistically significant differences among groups (P=0.013and0.019, respectively). Regarding pachymetric indices, maximum pachymetry progression index (PPI max) showed statistical significance (P=0.001). Partial correlations, after excluding age and refractive error effects, showed that TCT was correlated with BE from BFS, BE from BFTE, and PPI max (P=0.001,0.001,0.002, respectively).Conclusions. Some Pentacam HR indices varied with different corneal thickness in normal corneas. This necessitates inclusion of pachymetric subgroups in the normative database. The use of the more robust indices (average pachymetry progression index and front elevations) is recommended in relatively thin or thick corneas.
Terminalia bellirica (Gaertn.) Roxb. Extract and Gallic Acid Attenuate LPS‐Induced Inflammation and Oxidative Stress via MAPK/NF‐κB and Akt/AMPK/Nrf2 Pathways
Authors: Tanaka Miori , Kishimoto Yoshimi , Sasaki Mizuho , Sato Akari , Kamiya Tomoyasu , Kondo Kazuo , Iida Kaoruko
Published: November 2018

Excessive oxidative stress plays a critical role in the progression of various diseases. Recently, we showed that Terminalia bellirica (Gaertn.) Roxb. extract (TBE) inhibits inflammatory response and reactive oxygen species (ROS) production in THP‐1 macrophages. However, molecular mechanisms underlying anti‐inflammatory and antioxidant activities of TBE and its major polyphenolic compounds gallic acid (GA) and ellagic acid (EA) remain unclear. We found that TBE and GA attenuated LPS‐induced inflammatory mediator expression, ROS production, and activation of mitogen‐activated protein kinase (MAPK) and nuclear factor‐kappa B (NF‐κB) in RAW 264 macrophages. Furthermore, TBE and GA increased antioxidant enzyme expression along with upstream mediators nuclear factor erythroid‐2‐related factor 2 (Nrf2), Akt, and AMP‐activated protein kinase (AMPK). Importantly, knockdown of Nrf2 by siRNA and specific inhibition of Akt and AMPK significantly reduced antioxidant enzyme expression induced by TBE and GA. Finally, in vivo effects on histopathology and gene expression were assessed in tissues collected after intraperitoneal injection of LPS with or without TBE treatment. TBE enhanced antioxidant enzyme expression and improved acute kidney injury in LPS‐shock model mice. In conclusion, TBE and GA exert protective effects against inflammation and oxidative stress by suppressing MAPK/NF‐κB pathway and by activating Akt/AMPK/Nrf2 pathway. These results suggest that TBE and GA might be effective for the treatment of inflammation‐related diseases.
Comparison of Intrauterine Suitable Balloon and Foley Balloon in the Prevention of Adhesion after Hysteroscopic Adhesiolysis
Authors: Zhu Ru , Duan Hua , Gan Lu , Wang Sha
Published: November 2018

Objective. To compare the effect of intrauterine suitable balloon (ISB) and Foley balloon (FB) in the prevention of adhesion after hysteroscopic adhesiolysis in patients with intrauterine adhesions (IUAs). Methods. A retrospective study was conducted on 150 women with moderate and severe IUAs, who underwent hysteroscopic adhesiolysis. According to the postoperative placement of the ISB or FB, the cohort was divided into the ISB group and the FB group. A second-look hysteroscopy was performed at 3 months postsurgery. The scoring system proposed by the American Fertility Society (AFS) was used to evaluate the adhesion during hysteroscopy. Subgroup analysis was carried out based on the degree of IUAs. Results. (1) In the ISB group, only 25% (19/76) women presented adhesion reformation after surgery, while, in the FB group, the adhesion reformation was observed in 35.1% (26/74) patients; however, the difference was not statistically significant (P>0.05). Subsequently, the adhesion reformation rate (29.5%, 13/44) after surgery with an ISB for severe intrauterine adhesions was significantly lower as compared to that (53.6%, 15/28) with FB (P<0.05). (2) In the ISB group, the reduction in the adhesion score after surgery was 8 points, which was significantly higher than the 7 points in the FB group (P<0.05). Conclusion. The ISB is better than the FB in preventing the adhesion reformation and reducing the AFS score after hysteroscopic adhesiolysis in severe IUAs. Also, it can effectively prevent the adhesion reformation in severe IUAs with a similar effect on moderate IUAs.
Experimental Study on Bioclogging in Porous Media during the Radioactive Effluent Percolation
Authors: Gui Rong , Pan Yu-xiang , Ding De-xin , Liu Yong , Zhang Zhi-jun
Published: November 2018

The sand columns inoculated with the indigenous microorganism (Aspergillus niger) were used to investigate the effect of bioclogging during the radioactive effluent percolation. The hydraulic gradient, volumetric flow rate, and uranyl ions concentration were monitored over time. The sand columns were operated with continuous radioactive effluent of uranium tailings reservoir. After 68 days, the hydraulic conductivity of the sand columns decreased more than 72%, and the adsorption rate of uranyl ions by Aspergillus niger reached more than 90%. Environmental scanning electron microscope imaging confirmed the biofilm covering the surface of sand particles and connecting sand particles together, which resulted in a reduction of hydraulic conductivity. The results indicated that the propagation of Aspergillus niger can clog the seepage channel and effectively adsorb the uranyl ions of radioactive effluent in the porous media, which provides a suitable measure for controlling the migration of radioactive effluent of uranium tailings reservoir into the subsurface environment.
Ein neuer Therapiestandard für die Behandlung des follikulären Lymphoms in frühen Stadien?
Authors: Claus Rainer
Published: November 2018

Das follikuläre Lymphom (FL) im Stadium I und II nach Ann Arbor kann lokal durch Involved-field-Strahlentherapie (IFRT) in kurativer Intention behandelt werden. Eine aktuell in der Fachzeitschrift «Journal of Clinical Oncology» publizierte Arbeit adressiert nun die Frage, ob die Hinzunahme einer systemischen Chemo(immun)- therapie zur IFRT eine Verbesserung der Prognose bewirkt. In der TROG 99.03-Studie wurden insgesamt 150 Patienten mit FL im Stadium I oder II randomisiert und entweder nur mit 30 Gy IFRT oder mit 30 Gy IFRT plus 6 Zyklen Systemtherapie mit Cyclophosphamid, Vincristin und Prednison ohne (CVP) oder mit Rituximab (R-CVP) behandelt. Nach einem medianen Follow-up von knapp 10 Jahren zeigte sich eine signifikante Überlegenheit im progressionsfreien Überleben (PFS) für Patienten unter der kombinierten Radiochemotherapie gegenüber der alleinigen IFRT (Hazard Ratio (HR) = 0,57; 95%-Konfidenzintervall (KI) = 0,34-0,95; p = 0,033). Das 10-Jahres-PFS lag im Kombinationsarm bei 59% gegenüber 41% im IFRT-Arm. Der PFS-Vorteil war noch deutlicher ausgeprägt bei Patienten, die zusätzlich Rituximab im Rahmen der Kombinationstherapie erhielten (HR = 0,26; 95%-KI = 0,07-0,97; p = 0,045). Das Gesamtüberleben (OS) war mit einem 10-Jahres-OS von 95% für Patienten unter kombinierter Therapie gegenüber 86% unter alleiniger IFRT (p = 0,40) nicht signifikant unterschiedlich. Der frühe Einsatz von Systemtherapie im Kombinationsarm führte jedoch zu einer Verminderung des Risikos für eine Transformation in aggressive Lymphome. Unter Bestrahlung zeigte ein Großteil der Patienten in beiden Therapiearmen Grad 1-2 Toxizitäten, höhergradige Nebenwirkungen waren im IFRT-Arm extrem selten (2% der Patienten). Demgegenüber traten Grad 3-4 Toxizitäten wie Neutropenien, Infektionen, Diarrhoe, Fatigue, febrile Neutropenien und Spättoxizitäten wie Polyneuropathie unter Kombinationstherapie deutlich häufiger auf. Die Autoren um Michael MacManus schlussfolgerten, dass die kombinierte Therapie aus IFRT und Chemoimmuntherapie effektiver für die Behandlung von FL im Frühstadium ist und somit einen möglichen neuen Behandlungsstandard darstellen könnte.
Metronomische Chemotherapie - eine gut verträgliche Option für das metastasierte Mammakarzinom
Authors: Banys-Paluchowski Malgorzata , Fehm Tanja
Published: November 2018

Background: Few data are available on the benefit of metronomic cyclophosphamide, capecitabine, and vinorelbine as first-line therapy in patients with metastatic triple-negative breast cancer. Methods: This phase II study assessed the safety and efficacy of metronomic oral chemotherapy with vinorelbine 40 mg orally 3 times a week, cyclophosphamide 50 mg daily, and capecitabine 500 mg 3 times a day (VEX regimen) in untreated metastatic triple-negative breast cancer patients. The biopsy of the metastatic site had to be triple-negative, independent of the hormone receptor expression of the primary tumor. The primary endpoint was time to progression (TTP). Secondary endpoints included assessment of safety and clinical benefit (objective response rate plus stable disease rate at ≥24 weeks). Results: 25 patients were included, and 22 were evaluable for both efficacy and toxicities (median age, 66 years). Median TTP was 6.4 months (95% confidence interval 3.6-12.6). The most common grade 1-2 toxicities were nausea, diarrhea, leuko-/neutropenia, and reversible liver enzyme alteration. Grade 3 events included hand and foot syndrome (9%). Conclusion: The VEX regimen demonstrated activity and was relatively well tolerated when given as first-line therapy in selected metastatic breast cancer patients with triple-negative disease.
Neoadjuvant Treatment for Borderline Resectable Pancreatic Ductal Adenocarcinoma
Authors: Kaufmann Benedikt , Hartmann Daniel , D’Haese Jan G. , Stupakov Pavel , Radenkovic Dejan , Gloor Beat , Friess Helmut
Published: November 2018

One of the main reasons for the dismal prognosis of pancreatic ductal adenocarcinoma (PDAC) is its late diagnosis. At the time of presentation, only approximately 15–20% of all patients with PDAC are considered resectable and around 30% are considered borderline resectable. A surgical approach, which is the only curative option, is limited in borderline resectable patients by local involvement of surrounding structures. In borderline resectable pancreatic cancer (BRPC), neoadjuvant treatment regimens have been introduced with the rationale to downstage and downsize the tumor in order to enable resection and eliminate ­microscopic distant metastases. However, there are no official guidelines for the preoperative treatment of BRPC. In the majority of cases, patients are administered ­Gemcitabine-based or FOLFIRINOX-based chemotherapy regimens with or without radiation. Radiologic restaging after neoadjuvant therapy has to be judged with caution when it comes to predict tumor response and resectability, since inflammation induced by neoadjuvant therapy may mimic solid tumor. Patients who do not show any disease progression during neoadjuvant therapy should be offered surgical exploration, since a high percentage is likely to undergo resection with negative margins (R0) and, thus, achieve improved overall survival although imaging judged it unlikely. Despite the promising new approaches of neoadjuvant treatment regimens during the last 2 decades, surgery remains the first choice if the tumor appears to be primary resectable at the time of diagnosis. At present, there are no international guidelines regarding the preoperative treatment of BRPC. Therefore, in order to standardize and adjust neoadjuvant treatment in the future, new guidelines have to be determined on the basis of upcoming prospective randomized studies.
Implementation of a Carrier Screening Program in a High-Risk Undergraduate Student Population Using Digital Marketing, Online Education, and Telehealth
Authors: Hardy Melanie Walker , Kener Hillary J. , Grinzaid Karen Arnovitz
Published: November 2018

Background/Aims: Access to preconception carrier screening, which provides at-risk couples with more reproductive options, is critically important. To address this need in the Jewish community, genetic counselors at Emory University launched JScreen (www.jscreen.org), a national online genetic disease education and carrier screening program. To reach the preconception demographic, JScreen initiated a study evaluating the impact of marketing and education on knowledge and screening activity on college campuses. Methods: Students at 10 universities were targeted with a marketing campaign designed for this initiative. Those who elected screening were provided pre-test video education designed for the study. Success was assessed through enrollment in testing, comparison of pre- and post-education knowledge quizzes, and patient satisfaction surveys evaluating genetic counseling and the JScreen process. Results: A total of 1,794 participants were enrolled. Over 99% of those screened were not pregnant. Knowledge quiz scores improved significantly post-education, and patient satisfaction was over 98%. Conclusions: Findings suggested that the use of targeted marketing helped promote preconception screening in this population. The study demonstrated that video education was effective in educating participants about benefits and limitations of testing. Also, the use of telehealth technology facilitated access to professional genetic counseling services. This study serves as a model for future public health initiatives.