bluuebunny/crossref_metadata_2025 huggingface dataset:
Concomitant Annular Enlargement in Minimally Invasive Aortic Valve Replacement
Authors: Robinson Davida A. , Johnson Carl A. , Goodman Ariana M. , Knight Peter A.
Published: May 2019

Objective

Aortic root enlargement may be necessary to implant adequately sized valves to avoid patient–prosthetic mismatch. Our objective was to assess the feasibility of annular enlargement during aortic valve replacement via a right anterior minithoracotomy.

Methods

Twelve consecutive patients undergoing elective minimally invasive aortic valve replacement requiring annular enlargement over a 2-year period were retrospectively reviewed. A right anterior minithoracotomy was performed in all patients. Cardiopulmonary bypass and aortic crossclamp times, hospital length of stay, postoperative complications, rate of reoperation, echocardiographic data, and mortality were analyzed.

Results

Mean age was 66 years ± 14. Mean body mass index was 34 ± 7.8 kg/m2. All patients had normal preoperative ejection fractions. Indications for aortic valve replacement were severe (3/12, 25%) or critical (9/12, 75%) aortic stenosis due to degenerative aortic valve disease (10/12, 83%) and congenitally bicuspid aortic valve (2/12, 17%). Cardiopulmonary bypass and aortic crossclamp times were 144.7 ± 14.7 minutes and 111.7 ± 10.6 minutes, respectively. The median postoperative length of stay was 4 days. Peak and mean aortic valve gradients on postreplacement intraoperative transesophageal echocardiography were 14.5 ± 9.4 mmHg and 7.2 ± 4.2 mmHg, respectively, with no perivalvular leak on intraoperative or follow-up transthoracic echocardiogram. Postoperative transthoracic echocardiography had peak and mean aortic valve gradients of 12.1 ± 6.9 mmHg and 6.3 ± 3.7 mmHg, respectively. There were no postoperative mortalities. Freedom from reoperation was 100%.

Conclusions

Annular enlargement performed during minimally invasive aortic valve replacement is feasible. Basic minimally invasive skills are recommended prior to instituting these more advanced techniques.
Enabling platform technology for smart fabric design and printing
Authors: Torah Russel , Wei Yang , Grabham Neil , Li Yi , de Vos Marc , Todorov Todor , Popov Boris , Marinov Vlad , Stoyanov Svetlozar , Todorov Vlad , Tudor John
Published: May 2019

A hardware and software platform is presented enabling the design, and realisation via printing, of smart fabrics. The cultural and creative industries are an important economic area within which designers frequently utilise fabrics. Smart fabrics offer further creative opportunities to the cultural and creative industries, but designers often lack the required specialist knowledge, in electronics, software and materials, to produce smart fabrics. The software platform offers the ability to perform design, layout and visualisation of a smart fabric using a library of standard smart fabric functions (e.g. electroluminescence) so specialist expertise is not needed. Operation of the smart fabric can be simulated, and parameters can be set for smart fabric control electronics, which consists of standard circuit board modules. The software also provides driver code for the hardware platform to print the smart fabric. The hardware platform consists of a bespoke dispenser printer; functional inks are deposited via a pneumatic syringe controlled by the driver software, allowing bespoke rapid prototyped smart fabrics to be printed. Operation of the software and hardware system is demonstrated by the realisation of an interactive smart fabric consisting of electroluminescent lamps controlled by a proximity sensor. The modular electronics are used to control the smart fabric operation using embedded code generated by the software platform. For example, the blink rate of the electroluminescent lamp can be adjusted by the proximity of a hand. This control is achieved by the use of intuitive drop-down menus and input/output selections by the creative user. At present, the platform allows the design, print and implementation of smart fabrics incorporating the functions of colour change, electroluminescence, sound emission and proximity sensing. The platform can be expanded to add additional functions in the future and the printer will be compatible with new inks developed for screen and inkjet printing.
A gain-of-function sodium channel β2-subunit mutation in painful diabetic neuropathy
Authors: Alsaloum Matthew , Estacion Mark , Almomani Rowida , Gerrits Monique M , Bönhof Gidon J , Ziegler Dan , Malik Rayaz , Ferdousi Maryam , Lauria Giuseppe , Merkies Ingemar SJ , Faber Catharina G , Dib-Hajj Sulayman , Waxman Stephen G ,   on behalf of the Propane Study Group
Published: May 2019

Diabetes mellitus is a global challenge with many diverse health sequelae, of which diabetic peripheral neuropathy is one of the most common. A substantial number of patients with diabetic peripheral neuropathy develop chronic pain, but the genetic and epigenetic factors that predispose diabetic peripheral neuropathy patients to develop neuropathic pain are poorly understood. Recent targeted genetic studies have identified mutations in α-subunits of voltage-gated sodium channels (Navs) in patients with painful diabetic peripheral neuropathy. Mutations in proteins that regulate trafficking or functional properties of Navs could expand the spectrum of patients with Nav-related peripheral neuropathies. The auxiliary sodium channel β-subunits (β1–4) have been reported to increase current density, alter inactivation kinetics, and modulate subcellular localization of Nav. Mutations in β-subunits have been associated with several diseases, including epilepsy, cancer, and diseases of the cardiac conducting system. However, mutations in β-subunits have never been shown previously to contribute to neuropathic pain. We report here a patient with painful diabetic peripheral neuropathy and negative genetic screening for mutations in SCN9A, SCN10A, and SCN11A—genes encoding sodium channel α-subunit that have been previously linked to the development of neuropathic pain. Genetic analysis revealed an aspartic acid to asparagine mutation, D109N, in the β2-subunit. Functional analysis using current-clamp revealed that the β2-D109N rendered dorsal root ganglion neurons hyperexcitable, especially in response to repetitive stimulation. Underlying the hyperexcitability induced by the β2-subunit mutation, as evidenced by voltage-clamp analysis, we found a depolarizing shift in the voltage dependence of Nav1.7 fast inactivation and reduced use-dependent inhibition of the Nav1.7 channel.
Preoperative anxiety-induced glucocorticoid signaling reduces GABAergic markers in spinal cord and promotes postoperative hyperalgesia by affecting neuronal PAS domain protein 4
Authors: Wu Hao , Huang Yulin , Tian Xinyu , Zhang Zuoxia , Zhang Ying , Mao Yanting , Wang Chenchen , Yang Shuai , Liu Yue , Zhang Wei , Ma Zhengliang
Published: May 2019

Preoperative anxiety is common in patients undergoing elective surgery and is closely related to postoperative hyperalgesia. In this study, a single prolonged stress model was used to induce preoperative anxiety-like behavior in rats 24 h before the surgery. We found that single prolonged stress exacerbated the postoperative pain and elevated the level of serum corticosterone. Previous studies have shown that glucocorticoid is associated with synaptic plasticity, and decreased spinal GABAergic activity can cause hyperalgesia in rodents. Here, single prolonged stress rats’ lumbar spinal cord showed reduced glutamic acid decarboxylase-65, glutamic acid decarboxylase-67, GABA type A receptor alpha 1 subunit, and GABA type A receptor gamma 2 subunit, indicating an impairment of GABAergic system. Furthermore, neuronal PAS domain protein 4 was also reduced in rats after single prolonged stress stimulation, which has been reported to promote GABAergic synapse development. Then, intraperitoneal injection of RU486 (a glucocorticoid receptor antagonist) rather than spironolactone (a mineralocorticoid receptor antagonist) was found to relieve single prolonged stress-induced hyperalgesia and reverse neuronal PAS domain protein 4 reduction and the impairment of GABAergic system. Furthermore, overexpressing neuronal PAS domain protein 4 could also restore the damage of GABAergic system caused by single prolonged stress while interfering with neuronal PAS domain protein 4 caused an opposite effect. Finally, after stimulation of rat primary spinal cord neurons with exogenous corticosterone in vitro, neuronal PAS domain protein 4 and GABAergic markers were also downregulated, and RU486 reversed that. Together, our results demonstrated that preoperative anxiety led to GABAergic system impairment in spinal cord and thus caused hyperalgesia due to glucocorticoid-induced downregulation of neuronal PAS domain protein 4.
Verrucous venous malformations of the hand
Authors: Beijnen Usha E.A. , Saldanha Francesca , Ganske Ingrid , Upton Joseph , Taghinia Amir H.
Published: May 2019

Verrucous venous malformation is a rare vascular anomaly that presents as a deep purple skin stain and evolves into a larger scaly, keratotic lesion that can bleed and cause pain. Because of its similarity to other vascular lesions, it is often misdiagnosed and treated incorrectly. Ten patients with hand verrucous venous malformations evaluated between 1990 and 2017 were reviewed. Diagnosis was confirmed with histopathology. Six patients were initially misdiagnosed and two patients were incorrectly treated. Eight patients had excision procedures. Immunostaining for glucose transporter 1 protein was positive in all specimens that underwent staining. Most (three of four) of the patients with isolated small lesions remained disease free postoperatively, but those with larger lesions experienced recurrence or continued growth. Early recognition of verrucous venous malformation is important because nonsurgical ablative techniques are ineffective; the optimal treatment is surgery.

Level of evidence: IV
Characteristics of Chronic Maxillary Sinusitis in Patients With a History of Long-term Bisphosphonate Use
Authors: Hwang Chi Sang , Lee Chunui , Chae Hee Sung , Han Chun , Yang Hyun Woo , Lee Young Sub , Park Dong-Joon
Published: May 2019

Background

Bisphosphonates are widely used as bone stabilizers, which can cause major side effects including bisphosphonate-related osteonecrosis of the jaw (BRONJ) that occurs more frequently in the mandible. Consequently, there is a need for a detailed investigation of BRONJ of the maxilla and, in particular, of involvement of the maxillary sinus.

Objective

Our aim was to evaluate the characteristic radiologic and clinical manifestations in patients with maxillary sinusitis and a history of long-term bisphosphonate use.

Methods

Between January 2015 and July 2018, 55 patients with symptoms consistent with chronic rhinosinusitis who underwent a paranasal sinus computed tomography (CT) and had a history of >12 months of bisphosphonate therapy were included in the analysis.

Results

Radiologically and clinically evident chronic rhinosinusitis was noted in 24 of the 55 patients, of whom more than half (14/24, 58.3%) had BRONJ. The CT studies demonstrated that the maxillary sinus was involved in all 24 patients, characterized by unilateral involvement (70.8%) and bony remodeling in the posterior maxillary region (90.5%). The evidence of osteitis on CT and/or single-photon emission CT was observed in the majority of cases (19/21, 90.5%) and 12 patients (50.0%) had oroantral fistula. However, there were no differences in the clinical appearance of the diseases with respect to the radiologic aspects.

Conclusions

Besides its well-known effects on the mandible, long-term bisphosphonate use can also affect the maxillary sinus, with typical clinical and radiological manifestations.
Multicentre assessment of motor and sensory evoked potentials in multiple sclerosis: reliability and implications for clinical trials
Authors: Hardmeier Martin , Jacques François , Albrecht Philipp , Bousleiman Habib , Schindler Christian , Leocani Letizia , Fuhr Peter
Published: May 2019

Background

Motor and sensory evoked potentials (EP) are potential candidate biomarkers for clinical trials in multiple sclerosis.

Objective

To determine test -retest reliability of motor EP (MEP) and sensory EP (SEP) and associated EP-scores in patients with multiple sclerosis.

Methods

In three centres, 16 relapsing and five progressive multiple sclerosis patients had MEPs and SEPs 1–29 days apart. Five neurophysiologists independently marked latencies by central reading. By variance component analysis, we estimated the critical difference (absolute reliability) for cross-sectional group comparison, comparison of longitudinal group changes, within-subject minimal detectable change and defined within-subject improvement.

Results

Cortical SEP responses and cortico-muscular MEP latencies were more reliable than central conduction times. For comparison of 20 subjects per arm, cross-sectional group difference ranged from 0.7 to 3.9 ms and 1.1 to 1.7, group difference in longitudinal changes from 0.4 to 1.8 ms and 0.36 to 0.62, within-subject minimal detectable change from 1.2 to 5.8 ms and 1.2 to 2.0, within-subject improvement from 0.8 to 3.8ms and 0.8 to 1.3, for single EP modalities and EP scores, respectively.

Conclusions

Multicentre EP assessment with central EP reading is feasible and reliable. The critical difference is reasonably low to detect significant group changes and to define responders. The results support the concept of using EP and EP-scores as candidate response biomarkers for quantification of disease progression and for studying remyelination in multiple sclerosis.
Randomized Pilot Trial for a Community-Based Group Stretching Exercise Program for Chronic Low Back Pain
Authors: Brodsky Marc , Hansen Ann , Bjerke Wendy
Published: May 2019

Background

Authors of meta-analyses concluded that exercise therapy appears to be slightly effective at decreasing pain and improving function in adults with chronic low back pain (CLBP), particularly in health-care populations. Similar to health-care settings, community organizations provide wellness and lifestyle modification programs. Different versions of the Young Men’s Christian Association (YMCA) Y’s Way to a Healthy Back program were offered from 1974 to 2004. Champions of the YMCA program and authors of the pilot study designed a Healthy Back Curriculum to update and reintroduce the program. Objective: The research aim of this randomized pilot trial was to investigate the feasibility of a follow-up larger randomized controlled trial on the program’s effectiveness for CLBP. The randomized pilot trial addressed subject recruitment, retention, and subject compliance with protocol. Methods: The pilot trial employed a 2-arm parallel group randomized design. Seventy-eight subjects aged 18 to 64 years with low back pain on at least half the days over the previous 6 months were assigned to either (1) a group stretching exercise arm with 12 weekly classes or (2) a self-care book arm. Results: Sixty participants, 30 in each group, completed the study. Out of the 130 members who accepted invitation, 60% were eligible. Retention rate over the 24-week study in the group stretching exercise arm was 30 out of 43 participants (70%). Participants in the group stretching exercise program attended an average of 5 of the 12 classes (42%). Participants completed baseline and follow-up self-report items with no missing data. Conclusion: The pilot study did not prove to be feasible based on the prespecified benchmarks. We suggest that a larger trial should include changes gleaned from the pilot study.
The Integrative Psychiatry Curriculum: Development of an Innovative Model
Authors: Ranjbar Noshene , Ricker Mari , Villagomez Amelia
Published: May 2019

The Integrative Psychiatry Curriculum (IPC) was developed to train psychiatry residents and fellows to apply an Integrative Medicine (IM) approach for patients presenting with psychiatric disorders. Launched in 2015, IPC includes interactive online courses, in-person experiential sessions, and a clinical component with supervision. Twenty-one residents and fellows have completed the curriculum. The purpose of the IPC is 2-fold: to enhance patient wellness through training residents and fellows in evidence-based whole-person care and to improve physician well-being through enhanced stress management and self-awareness utilizing the practice of mind–body skills within a supportive small group setting. Course participants are trained in a broad range of prevention and treatment options and learn about their evidence base; they then practice incorporating IM into diagnosis and treatment plans through supervised clinical experience. This article describes the development of IPC and its elements. Efforts are underway to further develop and standardize the offerings and increase the portability of the course, making it easier for Psychiatry training programs with limited faculty expertise in IM to provide the curriculum for residents and fellows. To reach the goal of disseminating such a curriculum for integrative psychiatry, further funding and collaboration with multiple residency training programs is needed.
Antirelapse effect of pretransplant exposure to rabbit antithymocyte globulin
Authors: Dabas Rosy , Jamani Kareem , Kangarloo Shahbal B. , Dharmani-Khan Poonam , Williamson Tyler S. , Ousia Samar , Durand Caylib , Morris Don , Mahoney Douglas , Savoie Lynn , Chaudhry Ahsan , Jimenez-Zepeda Victor H. , Khan Faisal M. , Daly Andrew , Storek Jan
Published: May 2019

It remains unknown why rabbit antithymocyte globulin (ATG; Thymoglobulin) has not affected relapse after hematopoietic cell transplantation (HCT) in randomized studies. We hypothesized that high pre-HCT ATG area under the curve (AUC) would be associated with a low incidence of relapse, whereas high post-HCT AUC would be associated with a high incidence of relapse. We measured serum levels of ATG capable of binding to mononuclear cells (MNCs), lymphocytes, T cells, CD4 T cells, or CD33 cells. We estimated pre- and post-HCT AUCs in 152 adult recipients of myeloablative conditioning and blood stem cells. High pre-HCT AUCs of MNC- and CD33 cell–binding ATG were associated with a low incidence of relapse and high relapse-free survival (RFS). There was a trend toward an association of high post-HCT AUC of lymphocyte-binding ATG with a high incidence of relapse and low RFS. High pre-HCT AUCs were also associated with faster engraftment and had no impact on graft-versus-host disease (GVHD) or fatal infections. High post-HCT AUCs were associated with a low risk of GVHD, seemed associated with an increased risk of fatal infections, and had no impact on engraftment. In conclusion, pre-HCT AUC seems to have a positive, whereas post-HCT AUC seems to have a negative, impact on relapse.
Prediction of unsuccessful endometrial ablation: a retrospective study
Authors: Stevens K. Y. R. , Meulenbroeks D. , Houterman S. , Gijsen T. , Weyers S. , Schoot B. C.
Published: May 2019

Background

Endometrial ablation (EA) is a frequently used treatment for abnormal uterine bleeding, mainly due to the low risks, low costs and short recovery time associated with the procedure. On the short term, it seems successful, long-term follow-up however, shows decreasing patient satisfaction as well as treament efficacy. There even is a post-ablation hysterectomy rate up to 21%. Multiple factors seem to` influence the outcome of EA. Due to dissimilarities in and variety of these factors, it has not been possible so far to predict the success rate of EA based on pre-operative factors.

Therefore, the aim of this study is to develop two prediction models to help counsel patients for failure of EA or necessity of surgical re-intervention within 2 years after EA.

Methods

We designed a retrospective two-centred cohort study in Catharina Hospital, Eindhoven and Elkerliek Hospital, Helmond, both non-university teaching hospitals in the Netherlands. The study population consisted of 446 pre-menopausal women who underwent EA for abnormal uterine bleeding, with a minimum follow-up time of 2 years. Multivariate logistic regression analysis was used to create the prediction models.

Results

The mean age of the patients was 43.8 years (range 20–55), 97.3% had complaints of menorrhagia, 57.4% of dysmenorrhoea and 61.0% had complaints of intermittent or irregular bleeding. 18.8% of patients still needed a hysterectomy after EA. The risk of re-intervention was significantly greater in women with menstrual duration > 7 days or a previous caesarean section, while pre-operative menorrhagia was significantly associated with success of EA. Younger age, parity ≥ 5 and dysmenorrhea were significant multivariate predictors in both models. These predictors were used to develop prediction models, which had a C-index of 0.71 and 0.68 respectively.

Conclusion

We propose two multivariate models to predict the chance of failure and surgical re-intervention within 2 years after EA. Due to the permanent character of EA, the increasing number of post-operative failure and re-interventions, these prediction models could be useful for both the doctor and patient and may contribute to the shared decision-making.
A combination of omega-3 and plant sterols regulate glucose and lipid metabolism in individuals with impaired glucose regulation: a randomized and controlled clinical trial
Authors: Wang Ji-fang , Zhang Hai-ming , Li Yan-yan , Xia Song , Wei Yin , Yang Ling , Wang Dong , Ye Jing-jing , Li Hao-xiang , Yuan Jing , Pan Rui-rong
Published: May 2019

Background

Lipid metabolism imbalance has been recognized as one of the major drivers of impaired glucose metabolism in the context of type 2 diabetes mellitus (T2DM), the rates of which are steadily increasing worldwide. Impaired glucose regulation (IGR) plays a vital role in the prevention and treatment of T2DM. The goal of this study was to further clarify whether the combination of plant sterols (PS) and omega-3 fatty acids yields any synergistic effect that enhances the prevention and treatment of IGR.

Methods

A total of 200 participants were randomized to receive PS and omega-3 fatty acids (n = 50), PS alone (n = 50), omega-3 fatty acids alone (n = 50), or placebo soy bean powder plus placebo capsules (n = 50) for 12 weeks. Patient characteristics including body composition, blood pressure, glucose metabolism (Fasting plasma glucose (FPG), fasting insulin (FINS), glycosylated hemoglobin (HbA1c), Homeostasis Model Assessment of Insulin Resistance (HOMA-IR)), lipid metabolism (TG, TC, HDL-C, LDL-C) and inflammatory factors (Hs-CRP, IL-6) were all monitored in these IGR individuals.

Results

Compared to the placebo group, the group receiving the combined intervention exhibited significantly decreased TG, HDL-C, FBG, HOMA-IR and HbA1c. Omega-3 fatty acids alone were associated with significant reductions in waistline, TG, FBG, HOMA-IR and Hs-CRP. PS alone was only associated with decreased TG and Hs-CRP. No interventions produced significant changes in body weight, BMI, blood pressure, FINS, body fat percentage, visceral fat rating, TC, LDL-C or IL-6.

Conclusions

In summary, this study has demonstrated for the first time that PS, omega-3 fatty acids or the combination thereof significantly improved inflammation, insulin resistance, as well as glucose and lipid metabolism in IGR individuals. These findings may provide a scientific basis for the development of nutritional products incorporating PS and omega-3 fatty acids, and also for the development of nutritional supplement strategies aimed at preventing the development of disease in the IGR population.
Reducing the effects of DoS attacks in software defined networks using parallel flow installation
Authors: Imran Muhammad , Durad Muhammad Hanif , Khan Farrukh Aslam , Derhab Abdelouahid
Published: May 2019

Software defined networking (SDN) is becoming more and more popular due to its key features, such as monitoring, fine-grained control, flexibility and scalability. The centralized control of SDN makes it vulnerable to various types of attacks, e.g., flooding, spoofing, and denial of service (DoS). Among these attacks, DoS attack has the most severe impact because it degrades the performance of the SDN by overloading its different components, i.e., controller, switch, and control channel. This impact becomes more prominent in SDNs having fine-grained control over traffic for monitoring and management purposes, where large numbers of flow rules are installed. Existing approaches handle DoS attacks in SDN either by dropping malicious packets or by aggregating flow rules, resulting in a legitimate packet drop or loss of fine-grained control over network traffic. In this paper, a parallel flow installation approach is proposed to reduce the effects of DoS attacks, without losing the monitoring capability and fine-grained control over network traffic. The proposed approach installs flow rules in all switches along the path from the source to the destination on a single request from the source; resulting in a considerable reduction of control channel traffic and controller’s utilization. The proposed approach is evaluated by comparing it with the basic SDN controller. The simulation results show that the proposed approach increases the SDN performance in terms of CPU utilization, response time, flow requests, and control channel bandwidth.
Genetics in primary care: validating a tool to pre‐symptomatically assess common disease risk using an Australian questionnaire on family history
Authors: Houwink Elisa J. F. , Hortensius Olga R. , van Boven Kees , Sollie Annet , Numans Mattijs E.
Published: May 2019

Background

A positive family history for diabetes, cardiovascular diseases or various types of cancer increases the relative risk for these diseases by 2 to 5 times compared to people without a positive family history. Taking a family history in daily general practice is useful for early, pre‐symptomatic risk assessment, but at the moment no standardized family history questionnaire is available in the Dutch language. In this study we used a 9‐item questionnaire, previously developed and applied in an Australian study, to probe family history for 7 specific conditions. The aim of the present qualitative study was to test face and content validity of the Australian family history questionnaire in Dutch general practice and to advance the standardization of intake information at an international level. We conducted 10 cognitive interviews with patients over 4 rounds, using the verbal probing technique. This approach allows the collection of data through a series of probe questions, with the aim of obtaining detailed information. After each interview round we modified the questionnaire based on the answers of the interviewees. We also performed 10 semi‐structured interviews with general practitioners (GPs) to get their opinion on the content and usability of the questionnaire in practice.

Results

Patients varied in age and gender, and 4 patients were known to have a genetic disorder. The GPs varied in age, gender, clinical experience, type of practice and location. In the first round, seven problems were identified in the questionnaire in the categories Comprehension (1), Recall (2), Judgement (0), Response process (2) and Completeness, (2); by the fourth and final round no problems remained. The content and usability of the questionnaire were assessed positively.

Conclusions

When translated for everyday use in Dutch general practice, the Australian family history questionnaire showed a strong face and content validity, and GPs were positive regarding feasibility. Validation of this family history questionnaire could aid in the standardized integration of genetically relevant information in the electronic health record and clinical research. Conspicuous questionnaire information might alert the GP regarding specific conditions and enable detection of disease at an earlier stage. Additional questionnaire requirements needed however are accurate patient information and consistent, accessible locations in the electronic health record with a possibility to be automatically registered. By deriving a Dutch family history questionnaire convenient for GPs, we adapted a template that might also prove useful for other countries and other medical professionals. This development could make the rapid operationalization of readily available genetic knowledge feasible in daily practice and clinical research, leading to improved medical care.
Clinical applications of fucoidan in translational medicine for adjuvant cancer therapy
Authors: Hsu Hsien‐Yeh , Hwang Pai‐An
Published: May 2019

The chemical composition of fucoidan, a kind of sulfated polysaccharide mainly derived from brown seaweed, includes a substantial percentage of l‐fucose. Fucoidan has various biological and pharmacological activities, such as anti‐cancer/anti‐tumor, anti‐proliferation, anti‐inflammatory and immune‐modulatory functions, and fucoidan‐related dietary supplements and nutraceuticals have recently drawn considerable attention. In this review, we aim to provide a current view of different aspects of fucoidan biological activity, with a focus on the anti‐cancer regulatory effects of fucoidan on growth signaling mechanisms. First, we discuss historical aspects of fucoidan and fucoidan products, as well as the anti‐cancer effects of fucoidan on various cancer cells. Second, we discuss fucoidan's biological activities and induction of cell death in cancer cells, including multiple mechanisms and signal transduction pathways related to its anti‐cancer effects. Next, we focus on fucoidan and fucoidan‐derived products that have been marketed as dietary supplements or nutraceuticals for cancer, including anti‐cancer effects of fucoidan when combined as an adjuvant with clinical drugs. Finally, case studies of fucoidan in complementary therapy and as an alternative medicine in animal and mouse models and human clinical trials to alleviate side effects of anti‐cancer chemotherapy are discussed. Combining fucoidan with clinical therapeutic agents in the treatment of cancer patients, dissecting the related signal transduction pathways and investigating their dynamic interactions may reveal potential molecular targets in cancer prevention, therapies and key obstacles in the current development of anti‐cancer strategies.
Differential Levels of Regulatory T Cells and T-Helper-17 Cells in Women With Early and Advanced Endometriosis
Authors: Khan Khaleque N , Yamamoto Kazuo , Fujishita Akira , Muto Hideki , Koshiba Akemi , Kuroboshi Haruo , Saito Shigeru , Teramukai Satoshi , Nakashima Masahiro , Kitawaki Jo
Published: May 2019

Context

Regulatory T (Treg) cells and T-helper-17 (Th17) cells may be involved in endometriosis. Information on the pattern of change in the percentages of Treg and Th17 cells in the peripheral blood (PB) and peritoneal fluid (PF) of women with early and advanced endometriosis is unclear.

Objective

To investigate the pattern of change in the percentages of Treg and Th17 cells in the PB and PF of women with early and advanced endometriosis.

Methods

We recruited 31 women with laparoscopically and histologically confirmed, revised American Society of Reproductive Medicine stage I-II endometriosis, 39 women with stage III-IV endometriosis, and 36 control subjects without visible endometriosis. PB and PF samples were collected and T-cell subpopulations analyzed by flow cytometry using specific monoclonal antibodies recognizing CD4+, CD25+, FOXP3+, and IL-17A+ markers. PF concentrations of TGF-β and IL-17 were measured by ELISA.

Results

The percentages of CD25+FOXP3+ Treg cells within the CD4+ T-cell population were significantly higher in the PF of women with advanced endometriosis than in either early endometriosis or in control subjects (P < 0.05 for both). A persistently lower percentage of CD4+IL-17A+ Th17 cells was found in both PB and PF of women with early and advanced endometriosis. Compared with IL-17 levels, PF levels of TGF-β were significantly higher in women with endometriosis (P = 0.01).

Conclusion

Our findings reconfirmed the current speculation that endometriosis is related to alteration of Treg and Th17 cells in the pelvis causing survival and implantation of ectopic endometrial lesions.
What Is an Author? Old Answers to a New Question
Authors: Helle Sophus
Published: May 2019

Premodern sources mainly depict authors as textual transmitters rather than original creators. To treat these figurations of authorship as meaningful in their own right, one has to overcome a series of methodological hurdles. The polarized image of the author as either creative God or passive scribe must be replaced by a focus on the middle ranges of literary agency, which in turn requires theoretical elaboration. Premodern tropes of authorial activity, such as the metaphor of authorship as textile labor, gain a much fuller range of complexity and nuance when they are read with an eye to authorial mediation. Further, conceptualizing authors as mediators proves a better framework for writing the history of authorship, as it clarifies synchronic tensions and diachronic developments that unfolded within this frame. It also reveals that the modern ideal of authorial originality came about not as a radical break with the older ideal of authorial mediation but as a modification and rearrangement of its constitutive terms.
Modern Time: Temporality and the Realism of Romantic History
Authors: Carr Nicholas
Published: May 2019

This article places the works of American Romantic history in the tradition of the nineteenth-century novel. The result is a reframing of a strand of historiography that, for all its great men and its laws of progress, has at its core a realist negation of the freedoms and imaginative possibilities associated with the Romantic. However, this apparent tension between romance and the real ought to be seen as the dialectical face of a historicism that sought to master temporality by ending it with the arrival of the modern. The shifting narrative tenses of both realism and Romantic history stage a debate between epistemological and aesthetic impulses that the affirmation of the existent resolves.
The Birth of Creativity: Emerson’s Creative Impulse
Authors: de Stefano Jason
Published: May 2019

This essay shows how Ralph Waldo Emerson’s ideas of mental and artistic creativity emerged from debates about the creation of living form. Emerson came to believe that “creating nature” and “creative intellect” manifested the same “creative force,” a belief instilled in him by German Romantic Naturphilosophie and its principal Anglophone explicators, the German American philosopher Johann Bernhard Stallo and the English anatomist Richard Owen. They taught Emerson that the intellect does not transcend or otherwise stand outside the natural world; it evolves immanently through reciprocal activity with the material environment. The impulse to create is thus as natural as evolution, but this means that creativity has to be traced beyond the brain and away from autonomous models of mind. In particular, Emerson’s idea of “creative impulse” relied on epigenetic conceptions of generation and birth. He defined life in terms of creative capacity and helped redefine creativity as an innate, impulsive, and ubiquitous quality, definitions that influenced such thinkers as Friedrich Nietzsche, Henri Bergson, and the psychologist James Mark Baldwin and that have stakes for contemporary discussions of creativity, evolution, and mind.
The Politics of Address in George Eliot's Fiction
Authors: Williams Alicia
Published: May 2019

Whence the “dear reader”—and to where? This essay proposes that George Eliot's reformulation of nineteenth-century conventions for addressing reading audiences documents a response to the emergence of Britain's first mass reading public. Eliot inherits a propensity for spontaneous direct address that figuratively emplaces singularized readers in precisely delimited narrative scenes. In her later work she gives up on even this pretense of a shared common ground for readers from a vast and diverse public, instead using more oblique forms of address, like writerly commentary and erudite paratext, to acknowledge readers without delimiting their scale. Drawing on reading history and political literary theory, in particular the work of Jacques Rancière, the essay argues that this shift democratizes address. Democratic address capitalizes on the indiscriminate relationship between text and audience that characterizes a mass reading public. Yet in Eliot this turn toward an expansive, inclusive form of address is also linked to an increasingly rarefied style. The essay concludes by examining how the aesthetically rarefied Henry James and the populist best seller Marie Corelli chart two divergent routes out of Eliot's reformulation of address. Together they reflect the tension in her work between theoretical inclusivity and high literary style—and between democratic principles of universal access and the stratification that in practice organizes a mass reading public.
Vascular defects of DYRK1A knockouts are ameliorated by modulating calcium signaling in zebrafish
Authors: Cho Hyun-Ju , Lee Jae-Geun , Kim Jong-Hwan , Kim Seon-Young , Huh Yang Hoon , Kim Hyo-Jeong , Lee Kyu-Sun , Yu Kweon , Lee Jeong-Soo
Published: May 2019

DYRK1A is a major causative gene in Down syndrome (DS). Reduced incidence of solid tumors such as neuroblastoma in DS patients and increased vascular anomalies in DS fetuses suggest a potential role of DYRK1A in angiogenic processes, but in vivo evidence is still scarce. Here, we used zebrafish dyrk1aa mutant embryos to understand DYRK1A function in cerebral vasculature formation. Zebrafish dyrk1aa mutants exhibited cerebral hemorrhage and defects in angiogenesis of central arteries in the developing hindbrain. Such phenotypes were rescued by wild-type dyrk1aa mRNA, but not by a kinase-dead form, indicating the importance of DYRK1A kinase activity. Chemical screening using a bioactive small molecule library identified a calcium chelator, EGTA, as one of the hits that most robustly rescued the hemorrhage. Vascular defects of mutants were also rescued by independent modulation of calcium signaling by FK506. Furthermore, the transcriptomic analyses supported the alterations of calcium signaling networks in dyrk1aa mutants. Together, our results suggest that DYRK1A plays an essential role in angiogenesis and in maintenance of the developing cerebral vasculature via regulation of calcium signaling, which may have therapeutic potential for DYRK1A-related vascular diseases.
Changes in vitellogenin expression caused by nematodal and fungal infections in insects
Authors: Kodrík Dalibor , Ibrahim Emad , Gautam Umesh K. , Frydrychová Radmila Čapková , Bednářová Andrea , Krištůfek Václav , Jedlička Pavel
Published: May 2019

This study examined the expression and role of vitellogenin (Vg) in the body of the firebug Pyrrhocoris apterus (Heteroptera, Insecta) during the infection elicited by two entomopathogenic organisms, the nematode Steinernema carpocapsae and the fungus Isaria fumosorosea. Infection by S. carpocapsae significantly up-regulated Vg mRNA expression in the male body. The corresponding increase in Vg protein expression was also confirmed by electrophoretic and immunoblotting analyses. Remarkably, in females, the tendency was opposite. Nematodal infection significantly reduced both Vg mRNA and Vg protein expression levels in fat body and hemolymph, respectively. We speculate that infection of reproductive females reduces Vg expression to the level, which is still sufficient for defense, but insufficient for reproduction. This circumstance reduces energy expenditure and helps the individual to cope with the infection. Importantly, purified Vg significantly inhibited growth of Xenorhabdus spp., an entomotoxic bacteria isolated from S. carpocapsae. However, the effect of Vg against I. fumosorosea was not so obvious. The fungus significantly stimulated Vg gene expression in males, however, a similar increase was not recapitulated on the protein level. Nevertheless, in females, both mRNA and protein Vg levels were significantly reduced after the fungal infection. The obtained data demonstrate that Vg is likely an important defense protein, possibly with a specific activity. This considerably expands the known spectrum of Vg functions, as its primary role was thought to be limited to regulating egg development in the female body.
Are Home Buyers Inattentive? Evidence from Capitalization of Energy Costs
Authors: Myers Erica
Published: May 2019

This paper explores whether home buyers are attentive to energy costs. The cost-effectiveness of market-based pollution policies crucially depends on whether consumers are attentive to energy costs when purchasing energy-using durables. I exploit energy-cost variation from fuel-price changes in Massachusetts where there is significant overlap in the geographic and age distributions of oil-heated and gas-heated homes. The results strongly reject that home buyers are unresponsive to energy costs under a wide range of consumption and discount-rate assumptions. Furthermore, my preferred specification is consistent with full capitalization of fuel expenditures at discount rates similar to mortgage interest rates. (JEL D14, L71, Q41, Q53, Q58, R31)
Infant contact in day-care centres in Vietnam: A cross-sectional study to understand infant infection risk
Authors: Toizumi Michiko , Yoshida Lay-Myint , Suzuki Motoi , Nguyen Hien Anh Thi , Pinsent Amy , Dang Duc Anh , Flasche Stefan
Published: May 2019

Background: Infant contact information (skin-to-skin contact between infants and others) is important to understand Streptococcus pneumoniae transmission patterns. A few studies have investigated infant contact patterns by asking the mother/guardian to record all contacts a child makes in one day. However, this approach does not capture contact behaviour in day-care. Our study describes the frequency and nature of physical contacts of infants in day-care to understand infant infection risk in day-care in Nha Trang, central Vietnam.

Methods: This cross-sectional study enrolled infants aged less than 12 months, attending 10 randomly selected day-care centres in Nha Trang. Physical contacts of each infant for one day at the day-care centre were observed and recorded. The mean number of contacts of infants and its factors were assessed using negative binomial regression.

Results: In total 14 infants, aged 6 to 11 months, were enrolled, and a total of 96 contacts were observed. The mean number of contacts an infant made in one day was 6.9. Infants who walked independently (age-adjusted rate ratio 1.68, 95% confidence interval 1.06-2.68) and those cared for in a larger group (1.99, 1.42-2.79) had more contacts at day-care. About 50% of infants made contact with at least one person from a commune different from the infant’s, and 50% made contact with at least one other infant at day-care.

Conclusion: This study found that day-care attendance may be one factor that increases contact rates of infants in Nha Trang and diversifies them in terms of age and geographical spread. In this study, day-care attendance not only increased contact rates beyond those usually experienced by young children cared at home but specifically increased the contact rates with other children and adults from other communes. Day-care may play a key role in the transmission of respiratory pathogens like Streptococcus pneumoniae to infants.
Exact First-Choice Product Line Optimization
Authors: Bertsimas Dimitris , Mišić Velibor V.
Published: May 2019

Which products should a firm offer based on its customers’ preferences? This is the question posed in the problem of product line design, a well-studied and notoriously difficult problem that is central in marketing science. In “Exact First-Choice Product Line Optimization” by Dimitris Bertsimas and Velibor V. Mišić, the authors propose a new approach for solving this problem when segments of customers choose products according to a ranking. They propose a new mixed-integer optimization model of the problem, which they show to be tighter than prior formulations, and a solution approach based on Benders decomposition, which exploits the surprising fact that the subproblem can be solved efficiently for both integer and fractional master solutions. A well-known product line instance based on a conjoint data set of over 3,000 products and 300 respondents, which required a week of computation time to solve in prior work, is solved by the authors’ approach in just over 10 minutes.
Laparohernioscopic right colectomy for bowel ischaemia within a strangulated inguinal hernia
Authors: Tebala GD , Yee J , Kola-Adejumo A
Published: May 2019

Visual inspection of the content of the hernia sac is a crucial step of the emergency repair of strangulated inguinal hernias, to rule out the presence of bowel ischaemia which would need resection. Occasionally the content of the hernia sac reduces spontaneously into the abdomen after the induction of general anaesthesia and cannot be assessed. We present a case where hernioscopy t(i.e. laparoscopy through the hernia sac) has been used to confirm the ischaemia of the strangulated bowel and perform a hybrid laparohernioscopic right colectomy with intracorporeal anastomosis without the need for a formal laparotomy.

Hernioscopy is an easy and reliable method to assess the viability of the content of the hernia sac in strangulated hernias that have spontaneously reduced before it could be visually inspected. It can also be associated with a laparoscopic access in a hybrid laparohernioscopic technique to perform complex procedures.
Tendência temporal da sífilis congênita em Sergipe, Brasil, 2006 -2017
Authors: Costa João Santos , Dos Santos-Júnior Fernando Menezes , Moreira Rebeca Silva , Góes Marco Aurélio de Oliveira
Published: May 2019

Introdução: A sífilis congênita (SC) ainda se mantem como um problema de saúde pública no mundo e no Brasil, onde se verifica um aumento nas taxas de detecção nos últimos dez anos. Sergipe figurou entre os estados com taxas dedetecção maiores que a nacional. Objetivo: Este trabalho objetivou analisar a tendência temporal dos casos de SC notificados em Sergipe nos últimos doze anos. Metodologia: Estudo ecológico, tipo série temporal, utilizou casos desífilis congênita notificados no Sistema de Informação de Agravos de Notificação no estado de Sergipe, de 2006 a 2017. Foram analisadas as variáveis sociodemográficas maternas, a tendência relativa e a distribuição espacial daSC no estado. Resultados: Quase 60% das mães possuíam ensino fundamental incompleto; 67% delas possuíam de 20 a 34 anos e 84,91% eram pardas. No período avaliado, Sergipe apresentou tendência temporal crescente (percentualde crescimento anual de 14,78% e p<0,05). Verificou-se também aumento do número de municípios com 15 ou mais casos/1.000 nascidos-vivos. Conclusões: Este estudo evidenciou padrão de tendência crescente da SC no período avaliado, além de um incremento nas suas taxas de detecção. Tais resultados reforçam a necessidade de ações voltadas para o controle desse agravo no estado.
A Ousadia de Ensinar e Pesquisar “o” e “no” Estado de Exceção
Authors: Coelho Thereza Christina Bahia
Published: May 2019

A educação e a pesquisa nunca sofreram tantos golpes em tão pouco tempo. A conjuntura já dava sinais do que viria, desde o impeachment da presidenta Dilma Roussef e a aprovação da Emenda Constitucional 95 que limita por 20 anos os gastos públicos, ambos eventos do fatídico ano de 2016, quando foi implantado um processo de desestruturação (ou reestruturação) do Estado com vistas à canalização do financiamento das políticas sociais para áreas econômicas de interesse do setor privado, em especial, do subsetor financeiro.  Do ponto de vista da pesquisa, faz-se crucial valorizar e não deixar morrer as políticas de transparência e suporte à gestão, implementadas por ações governamentais passadas que criaram e aperfeiçoaram nossos sistemas de informação que fornecem apoio para o conhecimento da realidade da saúde e consequente tomada de decisão. A Revista de Saúde Coletiva, em seu Volume 9, busca privilegiar as pesquisas que aproveitam essa imensidão de dados secundários gerados pelas bases nacionais, de forma criativa e consciente das suas limitações.