bluuebunny/crossref_metadata_2025 huggingface dataset:
Ag-Decorated Fe3O4@SiO2Nanorods: Synthesis, Characterization, and Applications in Degradation of Organic Dyes
Authors: Li Chao , Sun Junjie , Chen Duo , Han Guangbing , Yu Shuyun , Kang Shishou , Mei Liangmo
Published: May 2016

Well-dispersed Ag nanoparticles (NPs) are successfully decorated on Fe3O4@SiO2nanorods (NRs) via a facile step-by-step strategy. This method involves coatingα-Fe2O3NRs with uniform silica layer, reduction in 10% H2/Ar atmosphere at 450°C to obtain Fe3O4@SiO2NRs, and then depositing Ag NPs on the surface of Fe3O4@SiO2NRs through a sonochemical step. It was found that the as-prepared Ag-decorated magnetic Fe3O4@SiO2NRs (Ag-MNRs) exhibited a higher catalytic efficiency than bare Ag NPs in the degradation of organic dye and could be easily recovered by convenient magnetic separation, which show great application potential for environmental protection applications.
lwAKE: A Lightweight Authenticated Key Exchange for Class 0 Devices
Authors: Echevarria Juan Jose , Legarda Jon , Larrañaga Janire , Ruiz-de-Garibay Jonathan
Published: May 2016

Device-to-Device (D2D) communication enables devices in proximity to establish a wireless direct link. However, these devices may be severely constrained in terms of memory, CPU, and processing resources. Hence, a D2D communication with a constrained device implies new challenges as it does not have the resources required to be secured with standard cryptography. We propose lwAKE for class 0 devices (RFC 7228), which uses one-way cryptographic functions and zero-knowledge proofs to provide mutual authentication and a secure key establishment. We specify the protocol using the High Level Protocol Specification Language and then verify the security properties using the model checkers OFMC and CL-AtSe. The significance of the protocol stands in a key reuse for any successive authentication. Experimental results show that this shortened authentication mode reduces the computational load greatly.
Streptococcus milleriand Recurrent Intra-Abdominal Abscesses: A Case Report and Literature Review
Authors: Gana Tabitha M. , Awolaran Olugbenga , Akhtar Sobia
Published: May 2016

We report a case of recurrent intra-abdominal abscesses as a postoperative complication following diverticular perforation in whichStreptococcus milleri(SM) was isolated. SM is evaluated here as a potent pyogenic organism commonly associated with intra-abdominal abscess especially in the postoperative setting. With the commonly adopted conservative management, the challenges of recurrence and prolonged hospital stay experienced in the indexed case as well as many other previous reports are highlighted. We also present a recommendation of the need for a more intensive approach of SM-related abscess drainage along with areas that would benefit further research.
Development of Oral Dissolvable Films of Diclofenac Sodium for Osteoarthritis UsingAlbiziaandKhayaGums as Hydrophilic Film Formers
Authors: Bonsu Martina Aduenimaa , Ofori-Kwakye Kwabena , Kipo Samuel Lugrie , Boakye-Gyasi Mariam El , Fosu Mary-Ann
Published: May 2016

Oral dissolvable films (ODFs) of diclofenac sodium intended for osteoarthritis were prepared usingAlbiziaandKhayagums as hydrophilic film formers. The physicochemical properties of the gums were characterized and the gums were used to prepare diclofenac sodium ODFs (~50 mg/4 cm2film) by solvent casting. The two gums showed satisfactory film forming properties. The physicomechanical properties, drug-excipient compatibility, andin vitrodrug release of the films in phosphate buffer pH 6.8 were studied.Khayagum had higher extraction yield, moisture content, insoluble matter and true density whileAlbiziagum showed greater swelling capacity, solubility, and minerals content. The ODFs were thin, soft, and flexible with smooth glossy surfaces and possessed satisfactory physicomechanical properties. FTIR studies showed that no interaction occurred between the drug and the gums. The ODFs disintegrated in <45 s achieved >75% drug release within 7 min with dissolution efficiencies of ~83–96%. Drug releases from F2, F3, F4, F5, and F6 were similar to F1 (p>0.05;f1<15andf2≥50) while F7 differed markedly from F1 (p<0.001;f1>15andf2<50). Drug release followed the Higuchi kinetic model which is indicative of Fickian drug diffusion.
DrosophilaTorsin Protein Regulates Motor Control and Stress Sensitivity and Forms a Complex with Fragile-X Mental Retardation Protein
Authors: Nguyen Phuong , Seo Jong Bok , Ahn Hyo-Min , Koh Young Ho
Published: May 2016

We investigated unknownin vivofunctions of Torsin by usingDrosophilaas a model. Downregulation ofDrosophilaTorsin (DTor) by DTor-specific inhibitory double-stranded RNA (RNAi) induced abnormal locomotor behavior and increased susceptibility to H2O2. In addition, altered expression of DTor significantly increased the numbers of synaptic boutons. One important biochemical consequence of DTor-RNAi expression in fly brains was upregulation of alcohol dehydrogenase (ADH). Altered expression of ADH has also been reported inDrosophilaFragile-X mental retardation protein (DFMRP) mutant flies. Interestingly, expression of DFMRP was altered in DTor mutant flies, and DTor and DFMRP were present in the same protein complexes. In addition, DTor and DFMRP immunoreactivities were partially colocalized in several cellular organelles in larval muscles. Furthermore, there were no significant differences between synaptic morphologies ofdfmrpnull mutants anddfmrpmutants expressing DTor-RNAi. Taken together, our evidences suggested that DTor and DFMRP might be present in the same signaling pathway regulating synaptic plasticity. In addition, we also found that human Torsin1A and human FMRP were present in the same protein complexes, suggesting that this phenomenon is evolutionarily conserved.
Characteristic Analysis and Simulated Test of Hybrid Bearing with the Introduction of Piezoelectric Controller
Authors: Chen Runlin , Ouyang Wu , Shi Zhaoyang , Wei Yangyang , Yuan Xiaoyang
Published: May 2016

A novel hybrid bearing with the introduction of piezoelectric controller and tilting pads to control vibration actively is proposed in this paper, and the feasibility of this scheme is verified by theoretical calculation and experimental data. This scheme can control the vibration of bearing actively by using the electromechanical characteristics of piezoelectric ceramic transducer (PZT) components. The static internal character of PZT and static external characteristic of piezoelectric control component are analyzed, and the calculation equations of preload coefficient and driving force of the new bearing are given. The simulation setup of the new bearing is designed and developed. The data representing the relationship of displacement of pad pivot, driving force, voltage, and the simulation stiffness of liquid film are obtained in the test, and the feature parameters of piezoelectric control component are amended to analyze the relationship between preload coefficient of the bearing and driving voltage. The proposed new bearing has the function of controlling preload actively. The theoretical and experimental research results provide essential guidance for the detail design of this new bearing and also provide a new idea for the vibration control of high speed rotor systems.
Ewing Sarcoma of the External Ear Canal
Authors: Binnetoglu Adem , Baglam Tekin , Tokuc Gulnur , Kecelioglu Binnetoglu Kiymet , Gerin Fatma , Sari Murat
Published: May 2016

Background.Ewing sarcoma (ES) is a high-grade malignant tumor that has skeletal and extraskeletal forms and consists of small round cells. In the head and neck region, reported localization of extraskeletal ES includes the larynx, thyroid gland, submandibular gland, nasal fossa, pharynx, skin, and parotid gland, but not the external ear canal.Methods.We present the unique case of a 2-year-old boy with extraskeletal ES arising from the external ear canal, mimicking auricular hematoma.Results.Surgery was performed and a VAC/IE (vincristine, adriamycin, cyclophosphamide alternating with ifosfamide, and etoposide) regimen was used for adjuvant chemotherapy for 12 months.Conclusion.The clinician should consider extraskeletal ES when diagnosing tumors localized in the head and neck region because it may be manifested by a nonspecific clinical picture mimicking common otorhinolaryngologic disorders.
Application of Partial Internal Transcribed Spacer Sequences for the Discrimination of Artemisia capillaris from Other Artemisia Species
Authors: Doh Eui Jeong , Paek Seung-Ho , Lee Guemsan , Lee Mi-Young , Oh Seung-Eun
Published: May 2016

Several Artemisia species are used as herbal medicines including the dried aerial parts of Artemisia capillaris, which are used as Artemisiae Capillaris Herba (known as “Injinho” in Korean medicinal terminology and “Yin Chen Hao” in Chinese). In this study, we developed tools for distinguishing between A. capillaris and 11 other Artemisia species that grow and/or are cultured in China, Japan, and Korea. Based on partial nucleotide sequences in the internal transcribed spacer (ITS) that differ between the species, we designed primers to amplify a DNA marker for A. capillaris. In addition, to detect other Artemisia species that are contaminants of A. capillaris, we designed primers to amplify DNA markers of A. japonica, A. annua, A. apiacea, and A. anomala. Moreover, based on random amplified polymorphic DNA analysis, we confirmed that primers developed in a previous study could be used to identify Artemisia species that are sources of Artemisiae Argyi Folium and Artemisiae Iwayomogii Herba. By using these primers, we found that multiplex polymerase chain reaction (PCR) was a reliable tool to distinguish between A. capillaris and other Artemisia species and to identify other Artemisia species as contaminants of A. capillaris in a single PCR.
A Rare Complication of Herpes Zoster: Segmental Zoster Paresis
Authors: Teo Hooi Khee , Chawla Mayank , Kaushik Manish
Published: May 2016

Herpes zoster is a common presentation in both the community and emergency department; however segmental zoster paresis is a rare complication that can lead to misdiagnosis. We present a case of a 74-year-old Indian gentleman with a background of well controlled diabetes mellitus, hypertension, and ischaemic heart disease who presented with sudden right lower limb weakness. This was preceded by a 5-day history of paraesthesia starting in the right foot and ascending up the right lower limb. On examination, there was a characteristic vesicular rash in the L2/3 region with MRC grading 3/5 in the right hip flexors. The rest of the neurological examination was unremarkable. MRI of the spine did not show any evidence of spinal disease. The patient was initiated on IV acyclovir with improvement of the lower limb weakness to MRC grading 5/5 as the vesicles improved. This is an interesting case as it highlights a rare presentation of zoster: segmental motor paresis that recovered fully with resolution of the rash. It shows the importance of recognizing motor neuropathy as a complication of shingles as it has a very good prognosis with most patients regaining full motor function of the affected limb with treatment.
Development of a Lunar-Phase Observation System Based on Augmented Reality and Mobile Learning Technologies
Authors: Tarng Wernhuar , Lin Yu-Sheng , Lin Chiu-Pin , Ou Kuo-Liang
Published: May 2016

Observing the lunar phase requires long-term involvement, and it is often obstructed by bad weather or tall buildings. In this study, a lunar-phase observation system is developed using the augmented reality (AR) technology and the sensor functions of GPS, electronic compass, and 3-axis accelerometer on mobile devices to help students observe and record lunar phases easily. By holding the mobile device towards the moon in the sky, the screen will show the virtual moon at the position of the real moon. The system allows the user to record the lunar phase, including its azimuth/elevation angles and the observation date and time. In addition, the system can shorten the learning process by setting different dates and times for observation, so it can solve the problem of being unable to observe and record lunar phases due to a bad weather or the moon appearing late in the night. Therefore, it is an effective tool for astronomy education in elementary and high schools. A teaching experiment has been conducted to analyze the learning effectiveness of the system and the results show that it is effective in learning the lunar concepts. The questionnaire results reveal that students considered the system easy to operate and it is useful in locating the moon and recording the lunar data.
Frequency ofBCR-ABLTranscript Types in Syrian CML Patients
Authors: Farhat-Maghribi Sulaf , Habbal Wafa , Monem Fawza
Published: May 2016

Background. In Syria, CML patients are started on tyrosine kinase inhibitors (TKIs) and monitored until complete molecular response is achieved.BCR-ABLmRNA transcript type is not routinely identified, contrary to the recommendations. In this study we aimed to identify the frequency of differentBCR-ABLtranscripts in Syrian CML patients and highlight their significance on monitoring and treatment protocols.Methods. CML patients positive forBCR-ABLtranscripts by quantitative RT-PCR were enrolled.BCR-ABLtranscript types were investigated using a home-made PCR method that was adapted from published protocols and optimized. The transcript types were then confirmed using a commercially available research kit.Results. Twenty-four transcripts were found in 21 patients. The most common was b2a2, followed by b3a2, b3a3, and e1a3 present solely in 12 (57.1%), 3 (14.3%), 2 (9.5%), and 1 (4.8%), respectively. Three samples (14.3%) contained dual transcripts. While b3a2 transcript was apparently associated with warning molecular response to imatinib treatment, b2a2, b3a3, and e1a3 transcripts collectively proved otherwise (P=0.047).Conclusion. It might be advisable to identify theBCR-ABLtranscript type in CML patients at diagnosis, using an empirically verified method, in order to link the detected transcript with the clinical findings, possible resistance to treatment, and appropriate monitoring methods.
Effect of Static Magnetic Field on Oxidant/Antioxidant Parameters in Cancerous and Noncancerous Human Gastric Tissues
Authors: Öztürk Bahadır , Durak Zahide Esra , Büber Süleyman , Kocaoğlu Ender Hilmi
Published: May 2016

Aim. To investigate the effects of static magnetic field (SMF) on oxidant and antioxidant parameters of the cancerous and noncancerous human gastric tissues.Materials and Methods. Gastric tissues obtained from patients with gastric cancer were used in the study. SMF was created by using two static magnets. Before and after treatment with SMF, oxidant and antioxidant parameters were measured in the tissue samples.Results. In the cancerous tissue, superoxide dismutase (SOD) activity was found higher and malondialdehyde (MDA) level was found lower as compared with noncancerous tissue. SMF affects oxidant/antioxidant parameters differently in the cancerous and noncancerous tissues. In this regard, SMF causes increase in SOD activity and decrease in MDA level in the noncancerous tissue. However, it decreases SOD and glutathione peroxidase (GSH-Px) activities and increases MDA level and catalase (CAT) activity in the cancerous tissue. There were no differences between nitric oxide (NO) and nitric oxide synthase (NOS) parameters in or among the cancerous and noncancerous tissues.Conclusions. SMF accelerates peroxidation reactions possibly by suppressing SOD and GSH-Px enzymes in the cancerous gastric tissue. This event caused by SMF might play part in the death of cancer cells, which may be a good supportive vehicle for the cancer therapy.
Review of Brain-Machine Interfaces Used in Neural Prosthetics with New Perspective on Somatosensory Feedback through Method of Signal Breakdown
Authors: Vidal Gabriel W. Vattendahl , Rynes Mathew L. , Kelliher Zachary , Goodwin Shikha Jain
Published: May 2016

The brain-machine interface (BMI) used in neural prosthetics involves recording signals from neuron populations, decoding those signals using mathematical modeling algorithms, and translating the intended action into physical limb movement. Recently, somatosensory feedback has become the focus of many research groups given its ability in increased neural control by the patient and to provide a more natural sensation for the prosthetics. This process involves recording data from force sensitive locations on the prosthetics and encoding these signals to be sent to the brain in the form of electrical stimulation. Tactile sensation has been achieved through peripheral nerve stimulation and direct stimulation of the somatosensory cortex using intracortical microstimulation (ICMS). The initial focus of this paper is to review these principles and link them to modern day applications such as restoring limb use to those who lack such control. With regard to how far the research has come, a new perspective for the signal breakdown concludes the paper, offering ideas for more real somatosensory feedback using ICMS to stimulate particular sensations by differentiating touch sensors and filtering data based on unique frequencies.
Thyroid Hormone Profile in Patients Ingesting Soft Gel Capsule or Liquid Levothyroxine Formulations with Breakfast
Authors: Cappelli Carlo , Pirola Ilenia , Gandossi Elena , Cristiano Alessandra , Daffini Linda , Agosti Barbara , Casella Claudio , Castellano Maurizio
Published: May 2016

Background. Recently, it has been shown that liquid L-T4 formulation can be ingested with breakfast. This study looked to extend these findings by investigating whether a soft gel capsule formulation of L-T4 could also be ingested at breakfast time.Methods. 60 patients (18–65 yrs), previously submitted to thyroidectomy for proven benign goitre in stable euthyroidism receiving liquid L-T4 therapy ingested with breakfast, were enrolled. TSH, fT4, and fT3 levels were assessed in all the patients who were switched from liquid L-T4 to a soft gel capsule formulation at the same dosage of L-T4. After 6 months, TSH, fT4, and fT3 levels were determined again.Results. There were no differences in TSH levels, but fT3 and fT4 levels during treatment with the soft gel capsule were significantly lower than those at enrolment with the liquid L-T4 formulation (TSH median (min–max): 1.9 (0.5–4.0) versus 2.2 (0.5–4.5) mIU/L, fT3: 2.5 (2.4–3.1) versus 2.7 (2.4–3.3) pg/mL,p<0.05, and fT4: 9.9 (8.0–13) versus 10.6 (8.6–13.8) pg/mL,p<0.0001).Conclusion. Both liquid and soft gel formulations of L-T4 can be taken with breakfast. However, liquid L-T4 would be the preferred formulation for patients in whom even small changes in fT4 and fT3 levels are to be avoided.
Effects of Addition of Systemic Tramadol or Adjunct Tramadol to Lidocaine Used for Intravenous Regional Anesthesia in Patients Undergoing Hand Surgery
Authors: Yektaş Abdulkadir , Gümüş Funda , Karayel Abdulhalim , Alagöl Ayşin
Published: May 2016

Intravenous regional anesthesia (IVRA) is used in outpatient hand surgery as an easily applicable and cost-effective technique with clinical advantages. The present study aimed to investigate the effects of addition of systemic tramadol or adjunct tramadol to lidocaine for IVRA in patients undergoing hand surgery. American Society of Anesthesiologists (ASA) I-II patients (n=60) who underwent hand surgery were included. For this purpose, only lidocaine (LDC), lidocaine+adjunct tramadol (LDC+TRA group), or lidocaine+systemic tramadol (LDC+SysTRA group) was administered to the patients for IVRA and the groups were compared in terms of onset and recovery time of sensory and motor blocks, quality of anesthesia, and the degree of intraoperative and postoperative pain. The onset time of sensorial block was significantly shorter in the LDC+TRA group than that in the LDC+SysTRA group. The motor block recovery time was significantly shorter in the LDC+SysTRA group than that in the LDC+TRA and LDC groups. Administration of tramadol as an adjunct showed some clinical benefits by providing a shorter onset time of sensory and motor block, decreasing pain and analgesic requirement, and improving intraoperative conditions during IVRA. It was determined that systemic tramadol administration had no superiority.
Integral Transforms on a Function Space with Change of Scales Using Multivariate Normal Distributions
Authors: Cho Dong Hyun
Published: May 2016

Using simple formulas for generalized conditional Wiener integrals on a function space which is an analogue of Wiener space, we evaluate two generalized analytic conditional Wiener integrals of a generalized cylinder function which is useful in Feynman integration theories and quantum mechanics. We then establish various integral transforms over continuous paths with change of scales for the generalized analytic conditional Wiener integrals. In these evaluation formulas and integral transforms we use multivariate normal distributions so that the orthonormalization process of projection vectors which are needed to establish the conditional Wiener integrals can be removed in the existing change of scale transforms. Consequently the transforms in the present paper can be expressed in terms of the generalized cylinder function itself.
Promoting Optimal Physical Exercise for Life: An Exercise and Self-Management Program to Encourage Participation in Physical Activity after Discharge from Stroke Rehabilitation—A Feasibility Study
Authors: Mansfield Avril , Knorr Svetlana , Poon Vivien , Inness Elizabeth L. , Middleton Laura , Biasin Louis , Brunton Karen , Howe Jo-Anne , Brooks Dina
Published: May 2016

People with stroke do not achieve adequate levels of physical exercise following discharge from rehabilitation. We developed a group exercise and self-management program (PROPEL), delivered during stroke rehabilitation, to promote uptake of physical activity after discharge. This study aimed to establish the feasibility of a larger study to evaluate the effect of this program on participation in self-directed physical activity. Participants with subacute stroke were recruited at discharge from one of three rehabilitation hospitals; one hospital offered the PROPEL program whereas the other two did not (comparison group; COMP). A high proportion (11/16) of eligible PROPEL program participants consented to the study. Fifteen COMP participants were also recruited. Compliance with wearing an accelerometer for 6 weeks continuously and completing physical activity questionnaires was high (>80%), whereas only 34% of daily heart rate data were available. Individuals who completed the PROPEL program seemed to have higher outcome expectations for exercise, fewer barriers to physical activity, and higher participation in physical activity than COMP participants (Hedge’sg≥0.5). The PROPEL program delivered during stroke rehabilitation shows promise for reducing barriers to exercise and increasing participation in physical activity after discharge. This study supports feasibility of a larger randomized trial to evaluate this program.
A Wavelet Based Multiscale Weighted Permutation Entropy Method for Sensor Fault Feature Extraction and Identification
Authors: Yang Qiaoning , Wang Jianlin
Published: May 2016

Sensor is the core module in signal perception and measurement applications. Due to the harsh external environment, aging, and so forth, sensor easily causes failure and unreliability. In this paper, three kinds of common faults of single sensor, bias, drift, and stuck-at, are investigated. And a fault diagnosis method based on wavelet permutation entropy is proposed. It takes advantage of the multiresolution ability of wavelet and the internal structure complexity measure of permutation entropy to extract fault feature. Multicluster feature selection (MCFS) is used to reduce the dimension of feature vector, and a three-layer back-propagation neural network classifier is designed for fault recognition. The experimental results show that the proposed method can effectively identify the different sensor faults and has good classification and recognition performance.
Associations of TNFα -308G>A, TNFα -238G>A, IL-1α -889C>T and IL-10 -1082G>A Genetic Polymorphisms with Atopic Diseases: Asthma, Rhinitis and Dermatitis
Authors: Babić Željka , Sabolić Pipinić Ivana , Varnai Veda Marija , Kežić Sanja , Macan Jelena
Published: May 2016

Background: Polymorphisms of cytokine genes are an interesting focus for association studies involving atopic diseases due to their role in immune cell communications during inflammation. The aim of this study was to investigate associations of TNFα -308G>A, TNFα -238G>A, IL-1α -889C>T and IL-10 -1082G>A polymorphisms with atopic diseases with adjustment for confounding lifestyle and environmental factors. Methods: This study was performed on 356 Croatian students. The diagnosis of atopic asthma, atopic rhinitis and atopic dermatitis was based on symptoms reported by the modified International Study of Asthma and Allergies in Childhood questionnaire and a positive skin prick test (SPT) to at least one common inhalatory allergen. Genetic polymorphisms were genotyped using the polymerase chain reaction-based technique. The influence of personal (gender, body mass index, parental history of atopic disease), lifestyle (cigarette smoking, pet ownership) and environmental (urban/rural residency, residency in continental/Mediterranean region) factors reported in the questionnaire was investigated by univariate and multivariate analysis. Results: Compared to the control subjects, univariate analysis showed a significant negative association of the TNFα -308G>A polymorphism with atopic asthma, atopic dermatitis, asthma and skin symptoms and positive SPT. These observations were confirmed in a multivariate model only for atopic dermatitis and skin symptoms (atopic dermatitis: OR = 0.27; 95% CI 0.07-1.00; p = 0.050; skin symptoms: OR = 0.29; 95% CI 0.10-0.83; p = 0.021). Conclusions: The results indicate a protective role of TNFα -308G>A genetic polymorphisms regarding atopic dermatitis and skin symptoms even after controlling for personal, lifestyle and environmental factors. Further studies are needed to elucidate the molecular patterns of this association in atopic dermatitis and other chronic inflammatory skin disorders.
Arterial Spin Labeling and Blood Oxygen Level-Dependent MRI Cerebrovascular Reactivity in Cerebrovascular Disease: A Systematic Review and Meta-Analysis
Authors: Smeeing Diederik P.J. , Hendrikse Jeroen , Petersen Esben T. , Donahue Manus J. , de Vis Jill B.
Published: May 2016

Background: The cerebrovascular reactivity (CVR) results of blood oxygen level-dependent (BOLD) and arterial spin labeling (ASL) MRI studies performed in patients with cerebrovascular disease (steno-occlusive vascular disease or stroke) were systematically reviewed. Summary: Thirty-one articles were included. Twenty-three (74.2%) studies used BOLD MRI to evaluate the CVR, 4 (12.9%) studies used ASL MRI and 4 (12.9%) studies used both BOLD and ASL MRI. Thirteen studies (3 significant) found a lower BOLD CVR, 2 studies found a similar CVR and 3 studies found a higher CVR in the ipsilateral compared to the contralateral hemisphere. Nine (5 significant) out of 10 studies found a lower BOLD CVR in the ipsilateral hemispheres of patients compared to controls. Six studies (2 significant) found a lower ASL CVR in the ipsilateral compared to the contralateral hemispheres. Three out of 5 studies found a significant lower ASL CVR in the ipsilateral hemispheres of patients compared to controls. Key Messages: This review brings support for a reduced BOLD and ASL CVR in the ipsilateral hemisphere of patients with cerebrovascular disease. We suggest that future studies will be performed in a uniform way so reference values can be established and could be used to guide treatment decisions in patients with cerebrovascular disease.
Component-Resolved Diagnosis of Peanut Allergy and Its Possible Origins of Sensitization in China
Authors: Ma Shikun , Nie Li , Li Hong , Wang Ruiqi , Yin Jia
Published: May 2016

Background: Clinical and immunological characteristics of food allergies vary depending on geographic regions. Little is known about peanut allergy in China. The aim of this study was to investigate the peanut sensitization profile in China. Methods: Thirty-eight participants with immunoglobulin E (IgE)-positive responses to peanuts (peanut-sensitized) were included in our study, and clinical characteristics were evaluated. Total and specific IgE reactivity against peanuts, other plant-derived foods, pollens, and related allergen components were determined. Results: Eighteen patients were symptomatic when exposed to peanuts. The majority of them presented with systemic reactions. More than half of the peanut-sensitized subjects also suffered from mugwort pollinosis and peach allergy. In patients with both peanut and peach allergies, reactions to peanuts were the same as or severer than those to peaches. Positivity rates of IgE response to rAra h 1-3, 8, and 9 in the peanut allergy group were 5.6, 11.1, 5.6, 22.2, and 83.3%, respectively. 66.7% (12/18) of the peanut-allergic patients were monosensitized to rAra h 9. Anti-nArt v 3 [mugwort nonspecific lipid transfer protein (nsLTP)] IgE positivity in the peanut allergy group was significantly higher than that in the asymptomatic peanut-sensitized group. In Ara h 9 (peanut nsLTP)-sensitized patients with mugwort pollinosis, anti-nArt v 3 IgE levels were remarkably higher than anti-rAra h 9 (peanut nsLTP) IgE levels as well as anti-Pru p 3 (peach nsLTP) IgE levels. Conclusions: Ara h 9 was the major allergen of peanut, and Ara h 9 monosensitization was the most common peanut sensitization pattern in our population. Furthermore, there was a strong correlation between peanut sensitization and mugwort pollinosis, as well as peach allergy, in our country.
Non-IgE-Dependent Hypersensitivity to Rocuronium Reversed by Sugammadex: Report of Three Cases and Hypothesis on the Underlying Mechanism
Authors: Spoerl David , D''Incau Stéphanie , Roux-Lombard Pascale , Harr Thomas , Czarnetzki Christoph
Published: May 2016

We present 3 cases of pseudoallergic (anaphylactoid) reactions to perioperatively administered rocuronium, which rapidly resolved after sugammadex injection. Allergological workup showed no evidence for immediate-type hypersensitivity to the drugs used for anesthesia, including rocuronium. However, rocuronium induced an irritative reaction in skin tests in all 3 patients and in 3 healthy individuals. This reaction was specifically suppressed by adding sugammadex at a 1:1 molecular proportion to rocuronium before the skin tests. This observation suggests that the patients suffered from a pseudoallergic reaction, and indicates that sugammadex might act via the inhibition of non-IgE mediated MRGPRX2 (Mas-related G-protein-coupled receptor member X2)-triggered mast cell degranulation induced by rocuronium.
Enabling Equal Access to Molecular Diagnostics: What Are the Implications for Policy and Health Technology Assessment?
Authors: Plun-Favreau Juliette , Immonen-Charalambous Kaisa , Steuten Lotte , Strootker Anja , Rouzier Roman , Horgan Denis , Lawler Mark
Published: May 2016

Molecular diagnostics can offer important benefits to patients and are a key enabler of the integration of personalised medicine into health care systems. However, despite their promise, few molecular diagnostics are embedded into clinical practice (especially in Europe) and access to these technologies remains unequal across countries and sometimes even within individual countries. If research translation and the regulatory environments have proven to be more challenging than expected, reimbursement and value assessment remain the main barriers to providing patients with equal access to molecular diagnostics. Unclear or non-existent reimbursement pathways, together with the lack of clear evidence requirements, have led to significant delays in the assessment of molecular diagnostics technologies in certain countries. Additionally, the lack of dedicated diagnostics budgets and the siloed nature of resource allocation within certain health care systems have significantly delayed diagnostics commissioning. This article will consider the perspectives of different stakeholders (patients, health care payers, health care professionals, and manufacturers) on the provision of a research-enabled, patient-focused molecular diagnostics platform that supports optimal patient care. Through the discussion of specific case studies, and building on the experience from countries that have successfully integrated molecular diagnostics into clinical practice, this article will discuss the necessary evolutions in policy and health technology assessment to ensure that patients can have equal access to appropriate molecular diagnostics.
Gene-Tailored Treatments for Brain Disorders: Challenges and Opportunities
Authors: Esposito Giovanni , Burgunder Jean Marc , Dunlop John , Gorwood Philip , Inamdar Amir , Pfister Stefan M. , Pochet Roland , van den Bent Martin J. , Van Hoylandt Nancy , Weller Michael , Westphal Manfred , Wick Wolfgang , Nutt David
Published: May 2016

Brain disorders pose major challenges to medicine and treatment innovation. This is because their spectrum spans inflammatory, degenerative, traumatic/ischaemic, and neoplastic disease processes with a complex and often ill- understood aetiology. An improved genetic and genomic understanding of specific disease pathways offers new approaches to these challenges, but at present it is in its infancy. Here, we review different aspects of the challenges facing neuromedicine, give examples of where there are advances, and highlight challenges to be overcome. We see that some disorders such as Huntington's disease are the product of single gene mutations, whose discovery has been leading to the development of new targeted interventions. In the field of neurosurgery, the identification of a number of mutations allows an elaborated genetic analysis of brain tumours and opens the door to individualised therapies. Psychiatric disorders remain the area where progress is slow. Genetic analyses show that for major common disorders such as schizophrenia and depression there are no single gene alterations which offer options for targeted therapy development. However, new approaches are being developed to leverage genetic information to predict patients' responses to treatment. These recent developments hold promise for early diagnosis, follow-up with personalised treatments with adjusted therapeutic doses, predictable responses, reduced adverse drug reactions, and personal health planning. The scenario is promising but calls for increased support for curiosity-driven research into the mechanisms of normal brain functioning as well as challenging adaptations of health care and research infrastructures, encompassing legal frameworks for analysing large amounts of personal data, a flexible regulatory framework for correlating big data analyses in cooperative networks between academia and the drug development industry, and finally new strategies for brain banking in order to increase access to brain tissue samples. To make personalised medicine for brain disorders a reality, a joint effort between all relevant stakeholders - among which patients and patient organisations should play an important role - is required.
Personalised Medicine and Scarce Resources: A Discussion of Ethical Chances and Challenges from the Perspective of the Capability Approach
Authors: Brall Caroline , Schröder-Bäck Peter
Published: May 2016

In the aftermath of the economic crisis that started in 2008, resources have become scarcer than ever in some countries, also in health care. Priority setting and rationalisation of existing resources also affect pharmaceutical innovations, including those that would contribute to what is called personalised medicine. In this paper, we will highlight the ethical issues surrounding rationalisation and its impact on personalised medicine through the lens of the capability approach. Thereby, challenges to and opportunities for personalised medicine will be examined, assessing how they affect patients' ‘real options' to access innovative therapies. In our focus on the ‘first challenge: citizens and patients' of the so-called Strategic Research and Innovation Agenda, the strength of the capability approach becomes particularly apparent in identifying what different values are at stake in this context.
Serum Bicarbonate and Structural and Functional Cardiac Abnormalities in Chronic Kidney Disease - A Report from the Chronic Renal Insufficiency Cohort Study
Authors: Dobre Mirela , Roy Jason , Tao Kaixiang , Anderson Amanda H. , Bansal Nisha , Chen Jing , Deo Rajat , Drawz Paul , Feldman Harold I. , Hamm L. Lee , Hostetter Thomas , Kusek John W. , Lora Claudia , Ojo Akinlolu O. , Shrama Kumar , Rahman Mahboob ,   the CRIC Study Investigators
Published: May 2016

Background: Heart failure (HF) is a frequent occurrence in chronic kidney disease (CKD) patients and predicts poor survival. Serum bicarbonate is associated with increased rates of HF in CKD; however, the mechanisms leading to this association are incompletely understood. This study aims to assess whether serum bicarbonate is independently associated with structural and functional cardiac abnormalities in CKD. Methods: The association between serum bicarbonate and left ventricular (LV) hypertrophy (LVH), LV mass indexed to height2.7, LV geometry, ejection fraction (EF) and diastolic dysfunction was assessed in 3,483 participants without NYHA class III/IV HF, enrolled in the Chronic Renal Insufficiency Cohort study. Results: The mean estimated glomerular filtration rate was 42.5 ± 17 ml/min/1.73 m2. The overall prevalence of LVH was 51.2%, with 57.8, 50.9 and 47.7% for bicarbonate categories <22, 22-26 and >26 mmol/l, respectively. Participants with low bicarbonate were more likely to have LVH and abnormal LV geometry (OR 1.32; 95% CI 1.07-1.64, and OR 1.57; 95% CI 1.14-2.16, respectively). However, the association was not statistically significant after adjustment for demographics, traditional cardiovascular risk factors, medications and kidney function (OR 1.07; 95% CI 0.66-1.72, and OR 1.27; 95% CI 0.64-2.51, respectively). No association was found between bicarbonate and systolic or diastolic dysfunction. During follow-up, no significant changes in LV mass or EF were observed in any bicarbonate strata. Conclusions: In a large CKD study, serum bicarbonate was associated with LV mass and concentric LVH; however, this association was attenuated after adjustment for clinical factors suggesting that the observed cardiac effects are mediated through yet unknown mechanisms.
ANÁLISE DA INTENSIDADE DE ADOÇÃO DE INDICADORES DE DESEMPENHO: UMA ABORDAGEM CONTEXTUAL A PARTIR DE UMA PERSPECTIVA INSTITUCIONAL
Authors: Callado Antonio André Cunha , Oliveira Rezilda Rodrigues
Published: May 2016

Empresas individuais podem possuir características técnicas e desempenhar diferentes funções operacionais, bem como possuir culturas organizacionais, crenças e valores distintos. O objetivo deste artigo é identificar a presença de especificidades acerca da adoção de indicadores de desempenho a partir de uma abordagem institucional advinda de distintas funções operacionais executadas por empresas individuais no âmbito de uma cadeia agroalimentar. Foi operacionalizado um survey junto a 121 empresas que foram agrupadas de acordo com suas respectivas funções operacionais dentro da cadeia. Os dados relativos à adoção de 32 indicadores de desempenho foram coletados através de um questionário apresentado ao gestor principal de cada uma das empresas investigadas. A análise dos resultados considerou a Prova Exata de Fisher e a Análise de Agrupamentos. Foi revelado que os padrões de adoção para a maioria dos indicadores de desempenho diferem entre os grupos de empresas analisados, bem como características específicas com relação aos elencos de indicadores de desempenho específicos a cada uma das funções operacionais.
O PLANEJAMENTO EM MUNICÍPIOS DE PEQUENO PORTE EM SÃO PAULO
Authors: Azevedo Ricardo Rocha de , Aquino André Carlos Busanelli de
Published: May 2016

O presente artigo discute o planejamento em municípios de pequeno porte em São Paulo. O ciclo de gestão financeira no Brasil vem passando nas últimas duas décadas por reformas no processo de planejamento e orçamento, mas também por alterações propostas nas leis de austeridade fiscal e transparência. Apesar das alterações da legislação, as reformas no setor público enfrentam resistências no processo de difusão e implantação. Nos municípios analisados o orçamento-programa (program-based budget), que seria um avanço à medida que levaria à avaliação de eficiência do gasto, não é efetivo, programas e indicadores parecem ser mera peça formal. A realidade é menos otimista, em geral o orçamento inicial é proposto pelo contador, sem uma participação ampla das secretarias e dos demais órgãos da administração indireta. A participação legislativa também é baixa, e as câmaras não interagem com a proposta feita pelo governo local no sentido de avaliar e propor emendas.
ANÁLISE DO DESEMPENHO DE ALUNOS NA PERSPECTIVA DO CHA EM DISCIPLINA UTILIZANDO PBL: O QUE SIGNIFICA A SÍNTESE?
Authors: Frezatti Fábio , Borinelli Márcio Luiz , Martins Daiana Bragueto , Espejo Márcia Maria Dos Santos Bortolocci
Published: May 2016

Este artigo tem por objetivo atribuir significado ao conceito final obtido pelo aluno em disciplina ministrada sob a ótica do Problem-Based Learning, considerando a complexidade da perspectiva sinérgica do CHA (Conhecimentos, Habilidades e Atitudes). A estratégia metodológica tem por base o action research aplicado em uma turma noturna de alunos de graduação em Ciências Contábeis e Ciências Atuariais. O tratamento dos dados foi realizado por meio da análise de correlação e cluster, resultando na formação de três agrupamentos. Quanto aos achados, percebe-se que a combinação do CHA não pode ser simplesmente uma soma de elementos, mas sim, sinergicamente, um conjunto que proporciona condições de entender se o aluno, ao final do curso, teve o aprendizado planejado. É importante que o aluno entenda o que significa a nota global da disciplina, bem como as notas de cada elemento do CHA, para que perceba quais elementos que devem ser reforçados. Dessa maneira, o feedback contínuo é vital durante todo o desenvolvimento do curso.
Subject-Verb Agreement with Coordinated Subjects in Ancient Greek
Authors: Mambrini Francesco , Passarotti Marco
Published: May 2016

In Ancient Greek, as well as in other languages, whenever agreement is triggered by two or more coordinated phrases, two different constructions are allowed: either the agreement can be controlled by the coordinated phrase as a whole, or it can be triggered by just one of the coordinated words. In spite of the amount of information that can be read on this topic in grammars of Ancient Greek, much is still to be known even at a general descriptive level. More importantly, the data still lack a convincing explanation. In this paper, we focus on a special domain of agreement (subject and verb agreement) and on one morphological feature that is expected to covary (number). We discuss the agreement in number for conjoined phrases, by revising some of the modern hypotheses with the support of the empirical evidence that can be collected from the available syntactically annotated corpora of Ancient Greek (treebanks). Results are interpreted according to syntactic features, cognitive factors and semantic properties of the coordinated phrases.
Human Protection across Regions: Learning from Norm Promotion and Capacity Building in Southeast Asia and Africa
Authors: Hunt Charles T. , Morada Noel M.
Published: May 2016

This article introduces the special issue on ‘Human Protection across Regions: Learning from Norm Promotion and Capacity Building in Southeast Asia and Africa’. It identifies the aims and objectives of the Southeast Asia-Africa dialogue from which the contributions in this special issue emerged and briefly explains the background of the contributors. It then proceeds to lay out the structure and major arguments of each contribution in the context of norm promotion and capacity building in the two regions.
asean Human Rights Regime and Mainstreaming the Responsibility to Protect: Challenges and Prospects
Authors: Petcharamesree Sriprapha
Published: May 2016

This article explores the challenges and prospects of mainstreaming RtoP in the Association of Southeast Asian Nations (asean) through the analysis of the roles and performance of the asean human rights bodies, in particular the asean Intergovernmental Commission on Human Rights (aichr). The author argues that although asean has made some progress in institutionalizing the promotion and protection of human rights and fundamental freedoms, it will take more time for asean to mark substantial shift in intra-asean relations and suggests that, in Southeast Asia where sovereignty is still jealously guarded, norms and ideas such as RtoP cannot yet have a decisive impact in practice. Specifically, mainstreaming RtoP in asean is constrained by the principles of non-interference and consensus decision-making, which unfortunately remains the norm. In order for asean to effectively care for people, a paradigm shift is necessary. Such shift can be anchored in the asean Human Rights Declaration (ahdr) as well as employing the ‘asean minus X’ decision-making formula, activating the Troika, and dispatching of special envoys. These options, which are not new to asean and have historically helped in its engagement with human rights, could also enable asean to prevent and respond to systematic human rights violations and other issues which may amount to war crimes. As well, promoting national and regional dialogues on RtoP could influence asean member states, especially those who are not yet comfortable with the principle. Different workshops and seminars that the aichr has been organizing already provide the body opportunities for sharing and learning from other regions.
Atrocity Prevention: From Promise to Practice in the Asia Pacific
Authors: Bellamy Alex J.
Published: May 2016

Drawing upon talks delivered at the Second Global Action Against Mass Atrocity Crimes conference, held in Manila 2016, this paper examines the extent to which the Asia Pacific region has begun to translate its commitment to the Responsibility to Protect (R2P) into practice. It finds that the so-called “East Asian Peace” has transformed the region from one of the world’s deadliest to one of the world’s most peaceful. But many key challenges remain and there is much to be done to make R2P and atrocity prevention a daily lived reality. This article proceeds in three parts. The first briefly describes the dramatic decline of atrocity crimes in East Asia. The second points to some key challenges on the ideational and institutional fronts. The third section turns specifically to the need to develop national architectures for atrocity prevention.
African Regionalism & Human Protection Norms: An Overview
Authors: Hunt Charles T.
Published: May 2016

Growing international solidarity for protection principles has formed the backdrop for an evolving notion of human protection at the un in the post-Cold War era. The emergence of the ‘Human Rights up Front’ initiative, protection of children and Women, Peace and Security policy agendas, and normative frameworks such as the protection of civilians and the Responsibility to Protect are indicative of a tangible human protection agenda at the un. However, the extent to which human protection norms have diffused in different regions vary in important ways. Africa – one region or many – has been a norm maker, shaper and taker, as well as a major recipient of action in accordance with this nascent normative regime. This article provides an overview of regionalism in Africa and examines how perspectives and institutional expressions at the regional level(s) have been influenced by – and in turn influenced – the uptake and development of norms around human protection.