bluuebunny/crossref_metadata_2025 huggingface dataset:
Cannabis exposure as an interactive cardiovascular risk factor and accelerant of organismal ageing: a longitudinal study
Authors: Reece Albert Stuart , Norman Amanda , Hulse Gary Kenneth
Published: November 2016

Objectives

Many reports exist of the cardiovascular toxicity of smoked cannabis but none of arterial stiffness measures or vascular age (VA). In view of its diverse toxicology, the possibility that cannabis-exposed patients may be ageing more quickly requires investigation.

Design

Cross-sectional and longitudinal, observational. Prospective.

Setting

Single primary care addiction clinic in Brisbane, Australia.

Participants

11 cannabis-only smokers, 504 tobacco-only smokers, 114 tobacco and cannabis smokers and 534 non-smokers. Exclusions: known cardiovascular disease or therapy or acute exposure to alcohol, amphetamine, heroin or methadone.

Intervention

Radial arterial pulse wave tonometry (AtCor, SphygmoCor, Sydney) performed opportunistically and sequentially on patients between 2006 and 2011.

Main outcome measure

Algorithmically calculated VA. Secondary outcomes: other central haemodynamic variables.

Results

Differences between group chronological ages (CA, 30.47±0.48 to 40.36±2.44, mean±SEM) were controlled with linear regression. Between-group sex differences were controlled by single-sex analysis. Mean cannabis exposure among patients was 37.67±7.16 g-years. In regression models controlling for CA, Body Mass Index (BMI), time and inhalant group, the effect of cannabis use on VA was significant in males (p=0.0156) and females (p=0.0084). The effect size in males was 11.84%. A dose–response relationship was demonstrated with lifetime exposure (p<0.002) additional to that of tobacco and opioids. In both sexes, the effect of cannabis was robust to adjustment and was unrelated to its acute effects. Significant power interactions between cannabis exposure and the square and cube of CA were demonstrated (from p<0.002).

Conclusions

Cannabis is an interactive cardiovascular risk factor (additional to tobacco and opioids), shows a prominent dose–response effect and is robust to adjustment. Cannabis use is associated with an acceleration of the cardiovascular age, which is a powerful surrogate for the organismal–biological age. This likely underlies and bi-directionally interacts with its diverse toxicological profile and is of considerable public health and regulatory importance.
Do online communities change power processes in healthcare? Using case studies to examine the use of online health communities by patients with Parkinson's disease
Authors: Visser Laura M , Bleijenbergh Inge L , Benschop Yvonne W M , Van Riel Allard C R , Bloem Bastiaan R
Published: November 2016

Objective

Communication technologies, such as personal online health communities, are increasingly considered as a tool to realise patient empowerment. However, little is known about the actual use of online health communities. Here, we investigated if and how patients' use of online communities supports patient empowerment.

Setting

A network of primary and secondary care providers around individual patients with Parkinson's disease.

Participants

We conducted case studies to examine our research question. We interviewed 18 patients with Parkinson's disease and observed the use of online health communities of 14 of them for an average of 1 year.

Primary outcome measures

We analysed the interviews and the online conversations between patients and healthcare providers, using Foucault's framework for studying power processes.

Results

We observed that patient empowerment is inhibited by implicit norms that exist within these communities around the number and content of postings. First, patients refrained from asking too many questions of their healthcare providers, but felt obliged to offer them regular updates. Second, patients scrutinised the content of their postings, being afraid to come across as complainers. Third, patients were cautious in making knowledge claims about their disease.

Conclusions

Changing implicit norms within online communities and the societal context they exist in seems necessary to achieve greater patient empowerment. Possibilities for changing these norms might lie in open dialogue between patient and healthcare providers about expectations, revising the curriculum of medical education and redesigning personal online health communities to support two-way knowledge exchange.
Charm quark mass determined from a pair of sum rules
Authors: Erler Jens , Masjuan Pere , Spiesberger Hubert
Published: November 2016

In this paper, we present preliminary results of the determination of the charm quark mass [Formula: see text] from QCD sum rules of moments of the vector current correlator calculated in perturbative QCD at [Formula: see text]. Self-consistency between two different sum rules allow to determine the continuum contribution to the moments without requiring experimental input, except for the charm resonances below the continuum threshold. The existing experimental data from the continuum region is used, then, to confront the theoretical determination and reassess the theoretic uncertainty.
Influence of nuclear deformation on level density parameter
Authors: Alavi S. A. , Dehghani V.
Published: November 2016

By using semiclassical method and considering deformed Woods–Saxon mean field potential, single-particle level density g, level density parameter a, and nuclear level density have been calculated for some deformed nuclei with deformation parameters ([Formula: see text], [Formula: see text]). Significant difference between deformed and spherical level density parameter and nuclear level density were observed. The effect of [Formula: see text] on level density parameter was notable. A simple formula for single-particle level density has been introduced.
Damping, field–field correlation and dipole–dipole interaction effects on the entanglement and atomic inversion dynamics
Authors: Rustaee N. , Tavassoly M. K. , Daneshmand R.
Published: November 2016

In this paper we study the interaction between two two-level atoms with a two-mode quantized field in the presence of damping. Dipole–dipole interaction between the two atoms and the correlation between the two modes of field are also taken into account. To solve the model, using appropriate transformations, we reduce the considered model to a well-known Jaynes–Cummings model. After finding the analytical solution for the atom–field system, the effects of damping, field–field correlation and atomic dipole–dipole interaction on the entanglement between atoms and population inversion are investigated, numerically. It is observed that the dynamical behavior of the degree of entanglement for damped systems, in relatively large domains of time, takes a low but constant value adequately far from the beginning of the interaction. In addition, it is found that the value of population inversion after the initial oscillations takes negative values for damped systems and eventually vanishes by increasing time. Also, it is seen that simultaneous presence of both dipole–dipole interaction and field–field correlation provides typical collapse–revival phenomenon in the time-behavior of atomic inversion.
A Case of False-PositiveMycobacterium tuberculosisCaused byMycobacterium celatum
Authors: Gildeh Edward , Abdel-Rahman Zaid , Sengupta Ruchira , Johnson Laura
Published: November 2016

Mycobacterium celatumis a nontuberculous mycobacterium shown to cause symptoms similar to pulmonaryM. tuberculosis. Certain strains have been shown to cross-react with the probes used to detectM. tuberculosis, making this a diagnostic challenge. We present a 56-year-old gentleman who developed signs and symptoms of lung infection with computed tomography scan of the chest showing right lung apex cavitation. Serial sputum samples were positive for acid-fast bacilli and nucleic acid amplification testing identifiedM. tuberculosisribosomal RNA, resulting in treatment initiation. Further testing with high performance liquid chromatography showed a pattern consistent withM. celatum. This case illustrates the potential forM. celatumto mimicM. tuberculosisin both its clinical history and laboratory testing due to the identical oligonucleotide sequence contained in both. An increasing number of case reports suggest that early reliable differentiation could reduce unnecessary treatment and public health intervention associated with misdiagnosed tuberculosis.
Dynamics Analysis of Unbalanced Motorized Spindles Supported on Ball Bearings
Authors: Liu Junfeng , Lai Tao , Chen Xiaoan
Published: November 2016

This paper presents an improved dynamic model for unbalanced high speed motorized spindles. The proposed model includes a Hertz contact force model which takes into the internal clearance and an unbalanced electromagnetic force model based on the energy of the air magnetic field. The nonlinear characteristic of the model is analysed by Lyapunov stability theory and numerical analysis to study the dynamic properties of the spindle system. Finally, a dynamic operating test is carried out on a DX100A-24000/20-type motorized spindle. The good agreement between the numerical solutions and the experimental data indicates that the proposed model is capable of accurately predicting the dynamic properties of motorized spindles. The influence of the unbalanced magnetic force on the system is studied, and the sensitivities of the system parameters to the critical speed of the system are obtained. These conclusions are useful for the dynamic design of high speed motorized spindles.
Persistent Tachypnea and Alveolar Hemorrhage in an Infant: An Unexpected Etiology
Authors: Bishara John , Webb Angela , Valsamis Christina , Halaby Claudia , Pirzada Melodi
Published: November 2016

Persistent tachypnea and failure to thrive during infancy have a broad differential diagnosis which includes pulmonary and cardiovascular disorders. Diffuse alveolar hemorrhage (DAH) is a rare entity in children. DAH requires an extensive work-up as certain conditions may need chronic therapy. Cardiovascular disorders are included in the etiology of DAH. We present a case of an 8-month-old female with a moderate, restrictive patent ductus arteriosus (PDA) admitted to the hospital with respiratory distress and failure to thrive. An extensive work-up into tachypnea including multiple echocardiograms did not find an etiology. Open lung biopsy was performed and consistent with pulmonary hypertension. After closure of the PDA, patient’s tachypnea improved, and she was discharged home with periodic follow-up showing a growing, thriving child. When an infant presents with tachypnea, a respiratory viral illness is often a common cause. The diagnosis of persistent tachypnea requires further investigation. Echocardiography, although readily available, may not always be sensitive in detecting clinically significant pulmonary hypertension. A clinician must have a heightened index of suspicion to proceed in evaluating for causes of tachypnea with a nonrespiratory etiology.
Expression and Clinical Significance of the Novel Long Noncoding RNA ZNF674-AS1 in Human Hepatocellular Carcinoma
Authors: Zhang Lufei , He Tianyu , Yan Yingcai , Zhang Yuan , Zhou Xiaohu , Huang Pengfei , Kong Yang , Xie Minjie , Zhang Linshi , Sun Qiang , Zhou Dongkai , Xie Haiyang , Zhou Lin , Zheng Shusen , Wang Weilin
Published: November 2016

Long noncoding RNAs (lncRNAs) play crucial roles in cancer occurrence and progression. However, the relationship between the expression levels of lncRNAs and the hepatocellular carcinoma (HCC) process is unclear. The goal of this study was to determine the expression level of ZNF674-AS1, a newly found lncRNA, in HCC and its clinical association. The expression of ZNF674-AS1 in 137 pairs of tumorous and adjacent normal tissues from patients with HCC was detected by quantitative real-time reverse transcription polymerase chain reaction. Additionally, the potential associations between its level in HCC tissue and clinicopathological features were analyzed. The expression of ZNF674-AS1 in the HCC cell lines HepG2, HCCLM3, SK-Hep1, HuH7, Hep3B, and MHCC97H was significantly downregulated compared with that in the normal liver cell line QSG-7701. The expression of ZNF674-AS1 was downregulated in 72% (99/137) of HCC tissues compared with that in paired adjacent normal tissues (p<0.01). The results showed that the ZNF674-AS1 expression level was significantly correlated with metastasis (p=0.041), clinical stage (p=0.039), and histopathologic grading (p=0.045). In addition, the Kaplan–Meier survival curves revealed that low ZNF674-AS1 expression was associated with poor prognosis in patients with HCC. Our data suggest that ZNF674-AS1 may play some role during cancer occurrence and progression and may be a new biomarker for HCC.
Midbrain Frequency Representation following Moderately Intense Neonatal Sound Exposure in a Precocious Animal Model (Chinchilla laniger)
Authors: D’Alessandro Lisa M. , Harrison Robert V.
Published: November 2016

Auditory brain areas undergo reorganization resulting from abnormal sensory input during early postnatal development. This is evident from studies at the cortical level but it remains unclear whether there is reorganization in the auditory midbrain in a species similar to the human, that is, with early hearing onset. We have explored midbrain plasticity in the chinchilla, a precocious species that matches the human in terms of hearing development. Neonatal chinchillas were chronically exposed to a 2 kHz narrowband sound at 70 dB SPL for 4 weeks. Tonotopic maps in inferior colliculus (central nucleus) were defined based on single neuron characteristic frequency. We hypothesized an overrepresentation of the 2 kHz region of the maps. However, we observed a significant decrease in the proportion of neurons dedicated to the 2 kHz octave band and also away from the exposure frequency at 8 kHz. In addition, we report a significant increase in low frequency representation (<1 kHz), again a change to tonotopic mapping distant to the 2 kHz region. Thus in a precocious species, tonotopic maps in auditory midbrain are altered following abnormal stimulation during development. However, these changes are more complex than the overrepresentation of exposure related frequency regions that are often reported.
Severe Hiatal Hernia as a Cause of Failure to Thrive Discovered by Transthoracic Echocardiogram
Authors: Moore Clint J. , Conley Devan A. , Berry-Cabán Cristóbal S. , Flanagan Ryan P.
Published: November 2016

A newborn infant with failure to thrive presented for murmur evaluation on day of life three due to a harsh 3/6 murmur. During the evaluation, a retrocardiac fluid filled mass was seen by transthoracic echocardiogram. The infant was also found to have a ventricular septal defect and partial anomalous pulmonary venous return. Eventually, a large hiatal hernia was diagnosed on subsequent imaging. The infant ultimately underwent surgical repair of the hiatal hernia at a tertiary care facility. Hiatal hernias have been noted as incidental extracardiac findings in adults, but no previous literature has documented hiatal hernias as incidental findings in the pediatric population.
Fabrication of Electrospun Chitosan/Nylon 6 Nanofibrous Membrane toward Metal Ions Removal and Antibacterial Effect
Authors: Jabur Akram R. , Abbas Laith K. , Moosa Saja A.
Published: November 2016

Nylon 6/Chitosan membranes were fabricated by electrospinning onto a Millipore glass fiber filter to produce nanofibrous filter. Scanning electron microscopy (SEM) and water contact angle (WCA) were done to characterize the produced filter. Filter removal capability (adsorption) for metal ions was investigated for lead nitrate (Pb(NO3)2) and sodium chloride (NaCl). The antibacterial effect of the Nylon 6/Chitosan was investigated for Escherichia coli. Removal optimum values for Pb(NO3)2 and NaCl reached 87% and 75%, respectively. This research demonstrated that Nylon 6/Chitosan nanofibrous membrane has an enormous applicable potential removal for metal ions from aqueous solutions, antibacterial activity reaching 96%, and reasonable inhibition zone against Escherichia coli (E. coli).
Accuracy of Approximation for Discrete Distributions
Authors: Móri Tamás F.
Published: November 2016

The paper is a contribution to the problem of estimating the deviation of two discrete probability distributions in terms of the supremum distance between their generating functions over the interval [0,1]. Deviation can be measured by the difference of the kth terms or by total variation distance. Our new bounds have better order of magnitude than those proved previously, and they are even sharp in certain cases.
Lack of Association betweenSLC30A8Variants and Type 2 Diabetes in Mexican American Families
Authors: Kulkarni Hemant , Mamtani Manju , Peralta Juan Manuel , Diego Vincent , Dyer Thomas D. , Goring Harald , Almasy Laura , Mahaney Michael C. , Williams-Blangero Sarah , Duggirala Ravindranath , Curran Joanne E. , Blangero John
Published: November 2016

SLC30A8encodes zinc transporter 8 which is involved in packaging and release of insulin. Evidence for the association ofSLC30A8variants with type 2 diabetes (T2D) is inconclusive. We interrogated single nucleotide polymorphisms (SNPs) aroundSLC30A8for association with T2D in high-risk, pedigreed individuals from extended Mexican American families. This study of 118 SNPs within 50 kb of theSLC30A8locus tested the association with eight T2D-related traits at four levels: (i) each SNP using measured genotype approach (MGA); (ii) interaction of SNPs with age and sex; (iii) combinations of SNPs using Bayesian Quantitative Trait Nucleotide (BQTN) analyses; and (iv) entire gene locus using the gene burden test. Only one SNP (rs7817754) was significantly associated with incident T2D but a summary statistic based on all T2D-related traits identified 11 novel SNPs. Three SNPs and one SNP were weakly but interactively associated with age and sex, respectively. BQTN analyses could not demonstrate any informative combination of SNPs over MGA. Lastly, gene burden test results showed that at best theSLC30A8locus could account for only 1-2% of the variability in T2D-related traits. Our results indicate a lack of association of theSLC30A8SNPs with T2D in Mexican American families.
Medical Management of Glaucoma in the 21st Century from a Canadian Perspective
Authors: Harasymowycz Paul , Birt Catherine , Gooi Patrick , Heckler Lisa , Hutnik Cindy , Jinapriya Delan , Shuba Lesya , Yan David , Day Radmila
Published: November 2016

Glaucoma is a medical term describing a group of progressive optic neuropathies characterized by degeneration of retinal ganglion cells and retinal nerve fibre layer and resulting in changes in the optic nerve head. Glaucoma is a leading cause of irreversible vision loss worldwide. With the aging population it is expected that the prevalence of glaucoma will continue to increase. Despite recent advances in imaging and visual field testing techniques that allow establishment of earlier diagnosis and treatment initiation, significant numbers of glaucoma patients are undiagnosed and present late in the course of their disease. This can lead to irreversible vision loss, reduced quality of life, and a higher socioeconomic burden. Selection of therapeutic approaches for glaucoma should be based on careful ocular examination, patient medical history, presence of comorbidities, and awareness of concomitant systemic therapies. Therapy should also be individualized to patients’ needs and preferences. Recent developments in this therapeutic field require revisiting treatment algorithms and integration of traditional and novel approaches in order to ensure optimal visual outcomes. This article provides an overview of recent developments and practice trends in the medical management of glaucoma in Canada. A discussion of the surgical management is beyond the scope of this paper.
Relationships between Muscle Architecture of Rectus Femoris and Functional Parameters of Knee Motion in Adults with Down Syndrome
Authors: Valle Maria Stella , Casabona Antonino , Micale Marco , Cioni Matteo
Published: November 2016

This study was designed to measure in vivo muscle architecture of the rectus femoris in adults with Down syndrome, testing possible relationships with functional parameters of the knee motion. Ten adults with Down syndrome and ten typically developed participated in the study. Pennation angle and thickness of the rectus femoris and subcutaneous layer of the thigh were measured via ultrasound imaging. Knee kinematics and electromyographic activity of the rectus femoris were recorded during free leg dropping. Muscle thickness was reduced and subcutaneous layer was thicker in persons with Down syndrome with respect to typically developed adults, but there were no differences in the pennation angle. The area of the rectus femoris EMG activity during the leg flexion was greater in Down syndrome with respect to typically developed adults. The leg movement velocity was lower in Down people than in controls, but the knee excursion was similar between the groups. Functional parameters correlated with pennation angle in the persons with Down syndrome and with muscle thickness in typically developed persons. The description of muscle architecture and the relationships between morphological and functional parameters may provide insights on the limits and the opportunities to overcome the inherent biomechanical instability in Down syndrome.
Rhabdomyolysis in a Hospitalized 16-Year-Old Boy: A Rarely Reported Underlying Cause
Authors: Singh Rishika , Patel Dilip R. , Pejka Sherry
Published: November 2016

Rhabdomyolysis can occur because of multiple causes and account for 7% of all cases of acute kidney injury annually in the United States. Identification of specific cause can be difficult in many cases where multiple factors could potentially cause rhabdomyolysis. We present a case of 16-year-old male who had seizures and was given levetiracetam that resulted in rhabdomyolysis. This side effect has been rarely reported previously and like in our case diagnosis may be delayed.
Primary Ewing’s Sarcoma of the Spine in a Two-Year-Old Boy
Authors: Electricwala Ali J. , Electricwala Jaffer T.
Published: November 2016

Ewing’s Sarcoma (ES) is a highly malignant bone tumour. It may involve any part of the skeleton but the most frequent parts are the ilium and diaphysis of femur and tibia (Alfeeli et al., 2005; Zhu et al., 2012). Primary ES of the spine is extremely rare (Yan et al., 2011). It accounts for only 3.5 to 14.9 percent of all primary bone sarcomas. The age of presentation ranges from 12 to 24 years (median 21 years) (Ferguson, 1999; Sharafuddin et al., 1992; Klimo Jr. et al., 2009). We report an unusual case of primary ES of the spine in a two-year-old boy, who presented to us with paraparesis and features of cauda equina syndrome. MRI scan showed a tumour mass arising from the pedicle of L4 vertebra invading the spinal canal. Tc-99 bone scan showed increased tracer uptake in L4 vertebra and normal tracer uptake elsewhere in the skeleton. After reaching the diagnosis of a space occupying lesion invading the lumber spinal canal, we performed a decompressive laminectomy and a biopsy was sent which confirmed the diagnosis of ES. Immunohistochemistry showed tumour cells staining positive for CD-99 (specific stain for ES). Gene testing showed an EWS-FLI 1 chimera. Surgery was followed by good improvement in motor signs. The child was then referred to a specialized oncotherapy centre for further treatment, radiation, and chemotherapy. To the best of our knowledge, we are the first to report primary ES of the spine at the age of two years.
Halo Gravity Traction Is Associated with Reduced Bone Mineral Density of Patients with Severe Kyphoscoliosis
Authors: Han Xiao , Sun Weixiang , Qiu Yong , Xu Leilei , Sha Shifu , Shi Benlong , Yan Huang , Liu Zhen , Zhu Zezhang
Published: November 2016

Background. Halo gravity traction (HGT) is one of the most commonly used perioperative techniques for the treatment of severe kyphoscoliosis. This study was to explore the influence of HGT on the BMD of these patients.Methods. Patients with severe kyphoscoliosis treated by preoperative HGT for at least 2 months were included. Patients’ BMD were assessed by dual-energy X-ray absorptiometry at lumbar spine (LS, L2–L4) and femur neck (FN) of the nondominant side. The weight and duration of traction, as well as baseline characteristics, were recorded.Results. Twenty patients were recruited. The average traction duration was77.9±13.0days while the mean traction weight was39.9%±11.1% of total body weight. Remarkable decrease of BMD was observed at LS of 17 (85%) patients and at FN of 18 (90%) patients. After HGT, 75% of patients were found to have osteoporosis, the incidence of which was significantly higher than that before HGT (35%). The correlation analysis revealed BMD reduction was only significantly correlated with the traction duration.Conclusions. The current study showed that preoperative HGT can have obvious impact on the BMD. The BMD reduction is associated with traction duration, suggesting that long traction duration may bring more bone mineral loss.
Rationale for the Successful Management of EDTA Chelation Therapy in Human Burden by Toxic Metals
Authors: Ferrero Maria Elena
Published: November 2016

Exposure to environmental and occupational toxicants is responsible for adverse effects on human health. Chelation therapy is the only procedure able to remove toxic metals from human organs and tissue, aiming to treat damage related to acute and/or chronic intoxication. The present review focuses on the most recent evidence of the successful use of the chelating agent ethylenediaminetetraacetic acid (EDTA). Assessment of toxic-metal presence in humans, as well as the rationale of EDTA therapy in cardiovascular and neurodegenerative diseases, is reported.
Real-Time Reporting of Small Operational Failures in Nursing Care
Authors: Stevens Kathleen R. , Ferrer Robert L.
Published: November 2016

Addressing microsystem problems from the frontline holds promise for quality enhancement. Frontline providers are urged to apply quality improvement; yet no systematic approach to problem detection has been tested. This study investigated a self-report approach to detecting operational failures encountered during patient care.Methods. Data were collected from 5 medical-surgical units over 4 weeks. Unit staff documented operational failures on a small distinctive Pocket Card. Frequency distributions for the operational failures in each category were calculated for each hospital overall and disaggregated by shift. Rate of operational failures on each unit was also calculated.Results. A total of 160 nurses participated in this study reporting a total of 2,391 operational failures over 429 shifts. Mean number of problems per shift varied from 4.0 to 8.5 problems with equipment/supply problems being the most commonly reported category.Conclusions. Operational failures are common on medical-surgical clinical units. It is feasible for unit staff to record these failures in real time. Many types of failures were recognized by frontline staff. This study provides preliminary evidence that the Pocket Card is a feasible approach to detecting operational failures in real time. Continued research on methodologies to investigate the impact of operational failures is warranted.
Numerical Study of Single Well Vapor Extraction Process
Authors: Rahnema Milad , Rahnema Hamed , Mcmillan Marcia D. , Edrisi Ali Reza , Rahnema Hamid
Published: November 2016

Vapor extraction (Vapex) is an emerging technology to produce heavy oil and bitumen from subsurface formations. Single well (SW) Vapex technique uses the same concept of Vapex process but only with one horizontal well. In this process solvent is injected from the toe of the horizontal well with oil production at the heel section. The main advantage of SW-Vapex process lies in the economic saving and applicability in problematic reservoirs, where drilling of two horizontal wells is impractical. The performance of SW-Vapex seems to be comparable with dual horizontal Vapex process using proper optimization schemes. This study is grouped into two sections: (i) a screening study of early time operating performance of SW-Vapex and (ii) a sensitivity analysis of the effect of the reservoir and well completion parameters. Simulation results show that solvent injection rate can be optimized to improve oil production rate. Higher injection rates may not necessarily lead to increase in production. This study confirms that SW-Vapex process is very ineffective in reservoirs with high oil viscosity (more than 1,500 cp) and thin formations (less than 10 m).
Z Number Based Fuzzy Inference System for Dynamic Plant Control
Authors: Abiyev Rahib H.
Published: November 2016

Frequently the reliabilities of the linguistic values of the variables in the rule base are becoming important in the modeling of fuzzy systems. Taking into consideration the reliability degree of the fuzzy values of variables of the rules the design of inference mechanism acquires importance. For this purpose, Z number based fuzzy rules that include constraint and reliability degrees of information are constructed. Fuzzy rule interpolation is presented for designing of an inference engine of fuzzy rule-based system. The mathematical background of the fuzzy inference system based on interpolative mechanism is developed. Based on interpolative inference process Z number based fuzzy controller for control of dynamic plant has been designed. The transient response characteristic of designed controller is compared with the transient response characteristic of the conventional fuzzy controller. The obtained comparative results demonstrate the suitability of designed system in control of dynamic plants.
Myeloproliferative Disease: An Unusual Cause of Raynaud’s Phenomenon and Digital Ischaemia
Authors: Beynon Celia , Huws Gwenan , Lawson Tom
Published: November 2016

We describe a 59-year-old female who presented with ischaemic digits, preceded by a 6-month history of Raynaud’s phenomenon affecting her fingers and toes. There were no clinical or laboratory features of primary vasculitis or connective tissue disease, Doppler imaging was normal, and bloods were unremarkable aside from a platelet count of 786 × 109/L (150–400) and white cells of 16 × 109/L (4–11). In view of the thrombocytosis a JAK2 mutation assay was requested which confirmed a JAK2 V617F mutation, suggesting essential thrombocytosis (ET) as the cause. She received treatment with hydroxycarbamide which normalised her platelet count and led to a complete resolution of her Raynaud’s symptoms. Raynaud’s phenomenon is a rare manifestation of ET. Myeloproliferative disorders such as ET should be considered in the differential diagnosis of Raynaud’s phenomenon and vasculitis.
Prediction of Bacillus Calmette-Guerin Response in Patients with Bladder Cancer after Transurethral Resection of Bladder Tumor by Using Genetic Variation Based on Genomic Studies
Authors: Zhang Ning , Jiang Guangliang , Liu Xu , Na Rong , Wang Xiang , Xu Jianfeng
Published: November 2016

Purpose. We aimed to comprehensively review contemporary literature on genetic and epigenetic biomarkers associated with the prediction of Bacillus Calmette-Guerin (BCG) response after the transurethral resection of a bladder tumor and to discuss the application of these biomarkers in precision cancer care for bladder cancer. Method. We performed a systematic review of published literatures in the databases PubMed and Embase by using the following key words: bladder cancer, BCG, gene, and methylation. Studies associated with cell lines, animal models, and muscle invasive bladder cancer were excluded. Results. The genetic variations associated with BCG response can be classified into three categories: germline variations, somatic variations, and epigenetic alterations. Genes related to BCG response were mainly involved in single-nucleotide polymorphisms, copy number variations, and gene methylations. Conclusions. Although these gene alterations are currently the most promising predictive markers of BCG response, most studies about bladder cancer DNA biomarkers are related to germline variations in candidate genes, and the results are not consistent. Only one study is related to somatic variation, and further evaluation in large-scale validation studies should be conducted to assess the potential clinical application of these findings. In addition, other biomarkers based on different “–omics” technologies should be considered in future studies.
Heterogeneous Stromal Signaling within the Tumor Microenvironment Controls the Metastasis of Pancreatic Cancer
Authors: Rucki Agnieszka A. , Foley Kelly , Zhang Pingbo , Xiao Qian , Kleponis Jennifer , Wu Annie A. , Sharma Rajni , Mo Guanglan , Liu Angen , Van Eyk Jennifer , Jaffee Elizabeth M. , Zheng Lei
Published: November 2016

Understanding how stromal signals regulate the development of pancreatic ductal adenocarcinoma (PDAC) may suggest novel therapeutic interventions in this disease. In this study, we assessed the metastatic role of stromal signals suggested to be important in the PDAC microenvironment. Src and IGF-1R phosphorylated the prometastatic molecule Annexin A2 (AnxA2) at Y23 and Y333 in response to stromal signals HGF and IGF-1, respectively, and IGF-1 expression was regulated by the Sonic Hedgehog (Shh) pathway. Both Shh and HGF were heterogeneously expressed in PDAC stroma, and only dual inhibition of these pathways could significantly suppress AnxA2 phosphorylation, PDAC growth, and metastasis. Taken together, our results illuminate tumor–stromal interactions, which drive metastasis, and provide a mechanism-based rationale for a stroma-directed therapy for PDAC. Cancer Res; 77(1); 41–52. ©2016 AACR.
Muscle Injuries and Repair: What's New on the Horizon!
Authors: Huard Johnny , Lu Aiping , Mu Xiaodong , Guo Ping , Li Yong
Published: November 2016

Although we recognize the many advantages of improved musculoskeletal health, we also note that our ability to sustain this health and to maintain quality of life in an aging population is currently deficient. However, global efforts have produced numerous advances in tissue engineering and regenerative medicine that will collectively serve to fill this deficiency in the near future. The purpose of this review is to highlight our current knowledge, to outline our recent advances, and to discuss the evolving paradigms in skeletal muscle injury and repair.
Guidelines for Models of Skeletal Muscle Injury and Therapeutic Assessment
Authors: Willett Nick J. , Krishnan Laxminarayanan , Li Mon Tzu A. , Guldberg Robert E. , Warren Gordon L.
Published: November 2016

Volumetric muscle loss (VML) injuries present a large clinical challenge with a significant need for new interventions. While there have been numerous reviews on muscle injury models, few have critically evaluated VML models. The objective of this review is to discuss current preclinical models of VML in terms of models, analytical outcomes, and therapeutic interventions, and to provide guidelines for the future use of preclinical VML models. This is a work of the US Government and is not subject to copyright protection in the USA. Foreign copyrights may apply. Published by S. Karger AG, Basel
Factors That Affect Tissue-Engineered Skeletal Muscle Function and Physiology
Authors: Khodabukus Alastair , Baar Keith
Published: November 2016

Tissue-engineered skeletal muscle has the promise to be a tool for studying physiology, screening muscle-active drugs, and clinical replacement of damaged muscle. To maximize the potential benefits of engineered muscle, it is important to understand the factors required for tissue formation and how these affect muscle function. In this review, we evaluate how biomaterials, cell source, media components, and bioreactor interventions impact muscle function and phenotype.
The Potential of Combination Therapeutics for More Complete Repair of Volumetric Muscle Loss Injuries: The Role of Exogenous Growth Factors and/or Progenitor Cells in Implantable Skeletal Muscle Tissue Engineering Technologies
Authors: Passipieri Juliana A. , Christ George J.
Published: November 2016

Despite the robust regenerative capacity of skeletal muscle, there are a variety of congenital and acquired conditions in which the volume of skeletal muscle loss results in major permanent functional and cosmetic deficits. These latter injuries are referred to as volumetric muscle loss (VML) injuries or VML-like conditions, and they are characterized by the simultaneous absence of multiple tissue components (i.e., nerves, vessels, muscles, satellite cells, and matrix). There are currently no effective treatment options. Regenerative medicine/tissue engineering technologies hold great potential for repair of these otherwise irrecoverable VML injuries. In this regard, three-dimensional scaffolds have been used to deliver sustained amounts of growth factors into a variety of injury models, to modulate host cell recruitment and extracellular matrix remodeling. However, this is a nascent field of research, and more complete functional improvements require more precise control of the spatiotemporal distribution of critical growth factors over a physiologically relevant range. This is especially true for VML injuries where incorporation of a cellular component into the scaffolds might provide not only a source of new tissue formation but also additional signals for host cell migration, recruitment, and survival. To this end, we review the major features of muscle repair and regeneration for largely recoverable injuries, and then discuss recent cell- and/or growth factor-based approaches to repair the more profound and irreversible VML and VML-like injuries. The underlying supposition is that more rationale incorporation of exogenous growth factors and/or cellular components will be required to optimize the regenerative capacity of implantable therapeutics for VML repair.
A Porcine Urinary Bladder Matrix Does Not Recapitulate the Spatiotemporal Macrophage Response of Muscle Regeneration after Volumetric Muscle Loss Injury
Authors: Aurora Amit , Corona Benjamin T. , Walters Thomas J.
Published: November 2016

Volumetric muscle loss (VML) results in irrecoverable loss of muscle tissue making its repair challenging. VML repair with acellular extracellular matrix (ECM) scaffolds devoid of exogenous cells has shown improved muscle function, but limited de novo muscle fiber regeneration. On the other hand, studies using minced autologous and free autologous muscle grafts have reported appreciable muscle regeneration. This raises the fundamental question whether an acellular ECM scaffold can orchestrate the spatiotemporal cellular events necessary for appreciable muscle fiber regeneration. This study compares the macrophage and angiogenic responses including the remodeling outcomes of a commercially available porcine urinary bladder matrix, MatriStem™, and autologous muscle grafts. The early heightened and protracted M1 response of the scaffold indicates that the scaffold does not recapitulate the spatiotemporal macrophage response of the autograft tissue. Additionally, the scaffold only supports limited de novo muscle fiber formation and regressing vessel density. Furthermore, scaffold remodeling is accompanied by increased presence of transforming growth factor and α-smooth muscle actin, which is consistent with remodeling of the scaffold into a fibrotic scar-like tissue. The limited muscle formation and scaffold-mediated fibrosis noted in this study corroborates the findings of recent studies that investigated acellular ECM scaffolds (devoid of myogenic cells) for VML repair. Taken together, acellular ECM scaffolds when used for VML repair will likely remodel into a fibrotic scar-like tissue and support limited de novo muscle fiber regeneration primarily in the proximity of the injured musculature. This is a work of the US Government and is not subject to copyright protection in the USA. Foreign copyrights may apply. Published by S. Karger AG, Basel
Cutaneous Metastasis due to Breast Cancer in a Patient with Primary Biliary Cirrhosis: A Case Report
Authors: Kamaraju Sailaja , Depke Jill , Povletich Janice , Currey Adam , Weil Elizabeth
Published: November 2016

Background: Breast cancer is the most common solid tumor to cause cutaneous metastases. These are incurable and the treatment goal is geared toward local control with surgical excision, radiation, and chemotherapy. However, treatment can be challenging in subjects with end-stage liver disease and a multidisciplinary approach is warranted. Case Report: In this case report, we present a 61-year-old female with primary biliary cirrhosis and human epidermal growth factor-2 (HER-2)-positive breast cancer, who subsequently developed cutaneous metastases. We briefly describe the treatment challenges due to underlying end-stage liver disease, and an exceptional response to trastuzumab and nab-paclitaxel. Conclusion: A multidisciplinary approach to local control and attenuated doses of nab-paclitaxel and trastuzumab suggest a durable response to HER-2-positive breast cancer with cutaneous metastasis. Subjects with end-stage liver disease pose unique challenges and toxicities, warranting additional research and drug development for less hepatotoxic antineoplastic agents.
Oxygen Uptake Recovery Kinetics after the 6-Minute Walk Test in Patients with Chronic Obstructive Pulmonary Disease
Authors: Baty Florent , van Gestel Arnoldus J.R. , Kern Lukas , Brutsche Martin H.
Published: November 2016

Background: There is a growing interest in exercise parameters capable of objectively evaluating the functional capacity of patients with chronic obstructive pulmonary disease (COPD). Objectives: The purpose of the present study was to analyze breath-by-breath cardiopulmonary and gas exchange recovery responses of patients with COPD after a 6-minute walk test (6MWT). Methods: Oxygen uptake (VO2) kinetics of patients were obtained using mobile telemetric cardiopulmonary monitoring during and after a 6MWT. Recovery kinetics were modelled using a 4-parameter nonlinear logistic model. Multiple linear regression was performed to assess the association between the half-time of recovery of oxygen consumption (T1/2 VO2) and exercise capacity (6-minute walking distance, 6MWD). Results: Sixty-nine patients with COPD (28 females) with a mean age of 65 ± 10 years took part in the study. After adjustment for covariates (body mass index, forced expiratory volume in 1 s, forced vital capacity, and age), T1/2 VO2 was significantly associated with 6MWD (p = 0.002). Conclusions: T1/2 VO2 can be used to reflect exercise capacity in patients with COPD. As T1/2 VO2 mostly depends on the rate of increase in pulmonary blood flow, the results of the present study underline the importance of cardiocirculatory impairment for exercise intolerance in patients with COPD.
Multiple Pigmented Conjunctival Lesions following Intravitreal Injections in a Patient with Uveal Melanoma
Authors: Brouwer Niels J. , Luyten Gregorius P.M. , van Duinen Sjoerd G. , Jager Martine J. , Marinkovic Marina
Published: November 2016

Purpose: This paper reports a case of pigmented conjunctival lesions after intravitreal injections in a patient who received brachytherapy for uveal melanoma. Methods: Clinical and histopathological examination of the pigmented conjunctival lesions was performed. Results: A 57-year-old male who was treated with brachytherapy for uveal melanoma developed radiation retinopathy. Following intravitreal anti-vascular endothelial growth factor (VEGF) injections, 2 pigmented conjunctival spots appeared at the injection sites. After excision of the lesions, histopathology showed pigment-loaded macrophages, with no signs of active tumour cells. Conclusion: Two conjunctival lesions that appeared following uveal melanoma brachytherapy and anti-VEGF injections were excised under suspicion of tumour seeding. Histopathology, however, showed aggregates of pigment-loaded macrophages.
Shoulder Pain after Fall, Septic Shock, and Pyomyositis Associated with Breast Cancer Chemotherapy and Lymphedema
Authors: Kitayama Hiromitsu , Sugiyama Junko , Hirayama Michiaki , Onada Yosihiro , Tsuji Yasushi
Published: November 2016

Background: As a symptom of pyomyositis, sepsis usually follows local inflammation signs. Here, we report pyomyositis with lymphedema of upper extremity in which septic shock and poor local findings initially presented during chemotherapy for breast cancer. Case Report: An 80-year-old woman presented with chronic right shoulder pain during chemotherapy for the recurrent disease. She had a history of postmastectomy lymphedema, diabetes mellitus, and repeated hyaluronic acid injections to the shoulder joint. The pain suddenly worsened with septic shock and no apparent local signs. Magnetic resonance imaging revealed myonecrosis, and no pus was yielded by ultrasound-guided needle aspiration. After 2 weeks of recovery by conservative medical management, surgical drainage was performed. Late formulated massive intramuscular pus showed severe neutrophil infiltration and myonecrosis. Conclusion: Pyomyositis can develop into septic shock with poor local signs. Myelosuppression after chemotherapy can cause myonecrosis without macroabscess, and magnetic resonance imaging was useful for the diagnosis of this condition. When unspecified local pain appears during cancer chemotherapy we should consider this disease, too.
Значення тимчасового протезування для визначення постійної конструкції протезів у пацієнтів із вродженими незрощеннями верхньої губи та піднебіння після операційних втручань
Authors: Oliynyk M. Yu.
Published: November 2016

Patients with congenital cleft lip and palate (CCLP) require long-term dental care with the involvement of many specialists, and the completion of the treatment can be considering only by their prosthetic rehabilitation. From the previous study, adequate temporary structure depends predictions and making them future prosthesis (protection is vital teeth from chemical and thermal stimuli and the choice of optimal variant incisive overlap). The study involved 21 patients with CCLP (10 men and 11 women) who underwent complex prosthetic treatment. Dissection of the teeth previously performed on the models, then conducted laboratory modeling wax temporary structures and the transfer it in plastic and only after the temporary prosthesis began preparing teeth in the mouth. If an insufficient number of teeth and a considerable disparity between the sizes of the upper and lower jaws used removable dentures with dental double row, modeled considering structural and aesthetic correction and correct occlusal relationships. In a large “false” progeny, orthopedic rehabilitation was making removable dentures with double row and three-dimensional basis modeling. The use of temporary dentures enables the patient to imagine the future prosthesis, as well as from the beginning of treatment receive appropriate orthopedic rehabilitation.
Залежність стану тканин пародонта від поведінкових факторів ризику в дітей шкільного віку м. Полтави, виявлених із застосуванням європейських індикаторів
Authors: Kaskova L. F. , Leus P. A. , Kuzminskaya V. V. , Novikova S. Ch. , Anopriyeva N. M. , Mandzyuk T. B. , Popyk K. M.
Published: November 2016

The aim of the work was the definition of informativeness of European indicators in a comprehensive assessment of the state of periodontal tissues in children of school age and identification possible relationships with behavioral risk factors for periodontal disease. Analytical dental epidemiology was employed, using the EGOHID-2005 system. Oral hygiene and dental caries were assessed in 12- 15-year-old children in Poltava city. The main determinants of periodontal tissue diseases were non-observance of children a recommended regime of brushing teeth and unhealthy habits. Systematic monitoring of major dental diseases allows to determine their tendencies and, using European system of indicators of dental health, allows to identify the risk factors to be eliminated in order to prevent periodontal tissue diseases.