bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality indicators for palliative and end of life care: a review of Swedish policy documents
Authors: Lind Susanne , Adolfsson Jan , Axelsson Bertil , Fürst Carl Johan
Published: November 2015

Background

All patients with palliative and end of life care needs should be guaranteed equal and safe treatment and care, regardless of their disease or site of care. The inclusion of quality indicators in national guidelines and other guiding documents supports quality assurance and improvement in provision of care. The aim of this paper was to review existing quality indicators in national Swedish policy documents relevant to palliative and end of life care.

Methods

We reviewed existing guidelines for diseases expected to require palliative care issued by the National Board of Health and Welfare, existing regional clinical practice guidelines and the annual report of the Swedish Register of Palliative Care (SRPC) up until 2010.

Results

We found 11 quality indicators pertinent to palliative and end of life care in the guidelines for cancer diseases and ‘The care and nursing of the elderly’. The indicators included assessment and treatment of pain, communication with the patient and the family, documentation in the patient record and registration in the SRPC. In the national guidelines for cardiology, pulmonary diseases, stroke, diabetes and dementia, there were no indicators relevant for palliative or end of life care.

Conclusions

In the existing Swedish national guidelines for many different diseases, there is still a great need to define clinically relevant and feasible outcome measures of quality of palliative and end of life care.
Characterising the immune profile of the kidney biopsy at lupus nephritis flare differentiates early treatment responders from non-responders
Authors: Parikh Samir V , Malvar Ana , Song Huijuan , Alberton Valeria , Lococo Bruno , Vance Jay , Zhang Jianying , Yu Lianbo , Rovin Brad H
Published: November 2015

Introduction

The kidney biopsy is used to diagnose and guide initial therapy in patients with lupus nephritis (LN). Kidney histology does not correlate well with clinical measurements of kidney injury or predict how patients will respond to standard-of-care immunosuppression. We postulated that the gene expression profile of kidney tissue at the time of biopsy may differentiate patients who will from those who will not respond to treatment.

Methods

The expression of 511 immune-response genes was measured in kidney biopsies from 19 patients with proliferative LN and 4 normal controls. RNA was extracted from formalin-fixed, paraffin-embedded kidney biopsies done at flare. After induction therapy, 5 patients achieved a complete clinical response (CR), 10 had a partial response (PR) and 4 patients were non-responders (NRs). Transcript expression was compared with normal controls and between renal response groups.

Results

A principal component analysis showed that intrarenal transcript expression from normal kidney, CR biopsies and NR biopsies segregated from each other. The top genes responsible for CR clustering included several interferon pathway genes (STAT1,IRF1,IRF7,MX1,STAT2,JAK2), while complement genes (C1R,C1QB,C6,C9,C5,MASP2) were mainly responsible for NR clustering. Overall, 35 genes were uniquely expressed in NR compared with CR. Pathway analysis revealed that interferon signalling and complement activation pathways were upregulated in both groups, while BAFF, APRIL, nuclear factor-κB and interleukin-6 signalling were increased in CR but suppressed in NR.

Conclusions

These data suggest that molecular profiling of the kidney biopsy at LN flare may be useful in predicting treatment response to induction therapy.
Voltage and Frequency Control of Stand Alone Self-Excited Induction Generator Using Photovoltaic System Based STATCOM
Authors: Dhanapal S. , Anita R.
Published: November 2015

This paper proposes the photovoltaic (PV) interfaced static synchronous compensator (STATCOM) for voltage and frequency control of wind turbine driven self-excited induction generator (SEIG) system. The PV interfaced STATCOM mainly is used for sustainable control of load voltage and frequency of the SEIG system. In addition, PV based STATCOM acts as reactive power compensator, harmonic eliminator and load balancer under balanced/unbalanced nonlinear loads. The energy storage system is incorporated to PV based STATCOM to sustain the active power under variable wind power. The proposed control method extracts the reference current with the use of fuzzy logic controller (FLC) employed in alternating current (AC) voltage control loop. The proposed topology utilizes the PV energy with an energy storage unit to meet the active power requirement of the wind power generating system. Besides, it exports the power generated in the PV system to the load during the unavailability of wind. The PV based STATCOM controlled SEIG system is subjected to different types of loads in order to assess the performance of the system under steady-state and dynamic conditions. The results obtained from the simulation and experimental setup are analyzed to ensure the performance of the proposed controller.
Rotational virtual knots and quantum link invariants
Authors: Kauffman Louis H.
Published: November 2015

This paper studies rotational virtual knot theory and its relationship with quantum link invariants. Every quantum link invariant for classical knots and links extends to an invariant of rotational virtual knots and links. We give examples of non-trivial rotational virtuals that are undectable by quantum invariants.
Divergent signaling via SUMO modification: potential for CFTR modulation
Authors: Ahner Annette , Gong Xiaoyan , Frizzell Raymond A.
Published: November 2015

The cystic fibrosis transmembrane conductance regulator (CFTR) is generally responsible for the cAMP/PKA regulated anion conductance at the apical membranes of secretory epithelial cells. Mutations in CFTR underlie cystic fibrosis (CF), in which the most common variant, F508del, causes protein misfolding and its proteasome-mediated degradation. A new pathway that contributes to mutant CFTR degradation is mediated by the small heat shock protein, Hsp27, which cooperates with Ubc9, the E2 enzyme for SUMOylation, to selectively conjugate mutant CFTR with SUMO-2/3. This SUMO paralog can form polychains, which are recognized by the ubiquitin E3 enzyme, RNF4, leading to CFTR ubiquitylation and recognition by the proteasome. We found also that F508del CFTR could be modified by SUMO-1, a paralog that does not support SUMO polychain formation. The use of different SUMO paralogs to modify and target a single substrate for divergent purposes is not uncommon. In this short review we discuss the possibility that conjugation with SUMO-1 could protect mutant CFTR from disposal by RNF4 and similar ubiquitin ligases. We hypothesize that such a pathway could contribute to therapeutic efforts to stabilize immature mutant CFTR and thereby enhance the action of therapeutics that correct CFTR trafficking to the apical membranes.
Properties of VIP+ synapses in the suprachiasmatic nucleus highlight their role in circadian rhythm
Authors: Achilly Nathan P.
Published: November 2015

Circadian rhythms coordinate cyclical behavioral and physiological changes in most organisms. In humans, this biological clock is located within the suprachiasmatic nucleus (SCN) of the hypothalamus and consists of a heterogeneous neuron population characterized by their enriched expression of various neuropeptides. As highlighted here, Fan et al. ( J Neurosci 35: 1905–1029, 2015) developed an elegant experimental system to investigate the synaptic properties of vasoactive intestinal peptide (VIP)-expressing neurons between day and night, and further delineate their broader architecture and function within the SCN.
Comparing Two Approaches for Point-Like Scatterer Detection
Authors: Dell’Aversano Angela , Leone Giovanni , Solimene Raffaele
Published: November 2015

Many inverse scattering problems concern the detection and localisation of point-like scatterers which are sparsely enclosed within a prescribed investigation domain. Therefore, it looks like a good option to tackle the problem by applying reconstruction methods that are properly tailored for such a type of scatterers or that naturally enforce sparsity in the reconstructions. Accordingly, in this paper we compare the time reversal-MUSIC and the compressed sensing. The study develops through numerical examples and focuses on the role of noise in data and mutual coupling between the scatterers.
Molecular Characterization ofCandida africanain Genital Specimens in Shanghai, China
Authors: Hu Yang , Yu Aihua , Chen Xiangming , Wang Guojiang , Feng Xiaobo
Published: November 2015

Candida africana, an emerging yeast pathogen, is closely related toCandida albicansand most commonly involved in vulvovaginal candidiasis (VVC). However, its prevalence in candidal balanoposthitis is still unclear. In this study, the prevalence ofC. africanain both candidal balanoposthitis and VVC in a sexually transmitted diseases (STD) clinic in Shanghai, China, was analyzed, and the molecular characterization and susceptible profiles ofC. africanaisolates were investigated. As results,C. africanawas only isolated in 5 out of 79 (6.3%) cases of candidal balanoposthitis rather than cases with vulvovaginal candidiasis. Among them, 4 out of 5 isolates share the same genotype of DST 782 with an isolate from vaginal swab in Japan published previously. AllC. africanaisolates were susceptible to amphotericin B, flucytosine, fluconazole, itraconazole, voriconazole, posaconazole, caspofungin, and micafungin.
Effects of Etanercept against Transient Cerebral Ischemia in Diabetic Rats
Authors: Iwata Naohiro , Takayama Hiroko , Xuan Meiyan , Kamiuchi Shinya , Matsuzaki Hirokazu , Okazaki Mari , Hibino Yasuhide
Published: November 2015

Diabetes mellitus is known to exacerbate acute cerebral ischemic injury. Previous studies have demonstrated that infarction volumes caused by transient cerebral ischemia were greater in diabetic rats than in nondiabetic rats. Tumor necrosis factor-α(TNF-α) is a proinflammatory protein produced in the brain in response to cerebral ischemia that promotes apoptosis. Etanercept (ETN), a recombinant TNF receptor (p75)-Fc fusion protein, competitively inhibits TNF-α. Therefore, we evaluated the neuroprotective effects of chronic or acute treatment with ETN on cerebral injury caused by middle cerebral artery occlusion/reperfusion (MCAO/Re) in rats with streptozotocin-induced diabetes. Furthermore, we evaluated the effects of ETN against the apoptosis and myeloperoxidase activity. Single administration of ETN before MCAO significantly suppressed exacerbation of cerebral damage in nondiabetic rats, as assessed by infarct volume. In contrast, the diabetic state markedly aggravated MCAO/Re-induced cerebral damage despite ETN treatment within 24 h before MCAO. However, the damage was improved by repeated administration of ETN at 900 μg/kg/daily in rats in an induced diabetic state. These results suggested that repeated administration of ETN can prevent exacerbation of cerebral ischemic injury in the diabetic state and is mainly attributed to anti-inflammatory effects.
User Utility Oriented Queuing Model for Resource Allocation in Cloud Environment
Authors: Zhang Zhe , Li Ying
Published: November 2015

Resource allocation is one of the most important research topics in servers. In the cloud environment, there are massive hardware resources of different kinds, and many kinds of services are usually run on virtual machines of the cloud server. In addition, cloud environment is commercialized, and economical factor should also be considered. In order to deal with commercialization and virtualization of cloud environment, we proposed a user utility oriented queuing model for task scheduling. Firstly, we modeled task scheduling in cloud environment as anM/M/1 queuing system. Secondly, we classified the utility into time utility and cost utility and built a linear programming model to maximize total utility for both of them. Finally, we proposed a utility oriented algorithm to maximize the total utility. Massive experiments validate the effectiveness of our proposed model.
Prevalence of Plasmodium falciparum Malaria among Pregnant Students in Dodoma Region, Tanzania: No Cases Have Been Detected
Authors: Zablon Karen N. , Kakilla Charles , Lykina Tatiana , Minakova Victoria , Chibago Alphaxad , Bochkaeva Zanda
Published: November 2015

Malaria in pregnancy, being often asymptomatic, is a major problem in endemic African countries. It is characterized by anemia and placental malaria leading to poor pregnancy outcomes. In 2001 Tanzania adopted an intermittent-preventive treatment of malaria in pregnancy (IPTp) policy, which recommends receiving doses of antimalarial drugs every planned visit to the antenatal care centre (ANC), starting from the second trimester. Currently the policy is valid across the whole country, regardless that there are regions with very low malaria endemicity in Tanzania, such as Dodoma region. The current study aimed to show the real prevalence of malaria among young pregnant women in Dodoma region, by measuring the prevalence of malaria among University of Dodoma (UDOM) students, and to describe the social health care features of student female community. Two methods of malaria diagnostic, microscopy, and rapid test, as well as retrospective inspection of ANC registry book, showed the very low prevalence of malaria disease among pregnant students, approximately 0.3%. Additionally, the sociodemographic data from the questionnaires showed that all students use different malaria preventive measures, and most of them have the regular sexual partner. This fact approves the correlation between illiteracy of woman and the risk of malaria infection transmission.
Source-Space Cross-Frequency Amplitude-Amplitude Coupling in Tinnitus
Authors: Zobay Oliver , Adjamian Peyman
Published: November 2015

The thalamocortical dysrhythmia (TCD) model has been influential in the development of theoretical explanations for the neurological mechanisms of tinnitus. It asserts that thalamocortical oscillations lock a region in the auditory cortex into an ectopic slow-wave theta rhythm (4–8 Hz). The cortical area surrounding this region is hypothesized to generate abnormal gamma (>30 Hz) oscillations (“edge effect”) giving rise to the tinnitus percept. Consequently, the model predicts enhanced cross-frequency coherence in a broad range between theta and gamma. In this magnetoencephalography study involving tinnitus and control cohorts, we investigated this prediction. Using beamforming, cross-frequency amplitude-amplitude coupling (AAC) was computed within the auditory cortices for frequencies (f1,f2) between 2 and 80 Hz. We find the AAC signal to decompose into two distinct components at low (f1,f2<30 Hz) and high (f1,f2>30 Hz) frequencies, respectively. Studying the correlation of AAC with several key covariates (age, hearing level (HL), tinnitus handicap and duration, and HL at tinnitus frequency), we observe a statistically significant association between age and low-frequency AAC. Contrary to the TCD predictions, however, we do not find any indication of statistical differences in AAC between tinnitus and controls and thus no evidence for the predicted enhancement of cross-frequency coupling in tinnitus.
Detection of Lard in Ink Extracted from Printed Food Packaging Using Fourier Transform Infrared Spectroscopy and Multivariate Analysis
Authors: Ramli Syazwani , Talib Rosnita A. , Rahman Russly A. , Zainuddin Norhazlin , Othman Siti Hajar , Rashid Norma M.
Published: November 2015

Fourier transform infrared (FTIR) spectroscopy combined with chemometrics was utilised to discriminate the presence of lard in extracted ink of printed food packaging. Two spectral regions (full spectra, 3999–649 cm−1, and combination of two regions, 3110–2630 cm−1and 1940–649 cm−1) of lard, commercial gravure ink, and the blends of both were selected and used to develop a Soft Independent Modelling of Class Analogy (SIMCA) model. The score plots obtained from the Principal Component Analysis (PCA) revealed that the maximum number of factors (7 factors) was needed to explain 84% of the total variance. SIMCA was employed as the method to classify the samples into their specific groups.SiversusHiplots showed that the calibration standards can be classified as lard-containing standards. Sample 2 was deduced to have the highest possibility of containing lard, while only samples 5 and 7 cannot be classified as lard-containing samples. These results demonstrated that FTIR spectroscopy, when combined with multivariate analysis, can provide a rapid method with no excessive sample preparation to detect the presence of lard in ink of foodstuff packaging.
Herpes Zoster-Induced Ogilvie’s Syndrome
Authors: Masood Irfan , Majid Zain , Rind Waqas , Zia Aisha , Riaz Haris , Raza Sajjad
Published: November 2015

Ogilvie’s syndrome due to herpes zoster infection is a rare manifestation of VZV reactivation. The onset of rash of herpes zoster and the symptoms of intestinal obstruction can occur at different time intervals posing a significant diagnostic challenge resulting in avoidable surgical interventions. Herein, we describe a case of 35-year-old male who presented with 6-day history of constipation and colicky abdominal pain along with an exquisitely tender and vesicular skin eruption involving the T8–T11 dermatome. Abdominal X-ray and ultrasound revealed generalized gaseous distention of the large intestine with air up to the rectum consistent with paralytic ileus. Colonoscopy did not show any obstructing lesion. A diagnosis of Ogilvie’s syndrome associated with herpes zoster was made. He was conservatively managed with nasogastric decompression, IV fluids, and acyclovir. The patient had an uneventful recovery and was later discharged.
Determination of Cefoperazone Sodium in Presence of Related Impurities by Linear Support Vector Regression and Partial Least Squares Chemometric Models
Authors: Naguib Ibrahim A. , Abdelaleem Eglal A. , Zaazaa Hala E. , Hussein Essraa A.
Published: November 2015

A comparison between partial least squares regression and support vector regression chemometric models is introduced in this study. The two models are implemented to analyze cefoperazone sodium in presence of its reported impurities, 7-aminocephalosporanic acid and 5-mercapto-1-methyl-tetrazole, in pure powders and in pharmaceutical formulations through processing UV spectroscopic data. For best results, a 3-factor 4-level experimental design was used, resulting in a training set of 16 mixtures containing different ratios of interfering moieties. For method validation, an independent test set consisting of 9 mixtures was used to test predictive ability of established models. The introduced results show the capability of the two proposed models to analyze cefoperazone in presence of its impurities 7-aminocephalosporanic acid and 5-mercapto-1-methyl-tetrazole with high trueness and selectivity (101.87 ± 0.708 and 101.43 ± 0.536 for PLSR and linear SVR, resp.). Analysis results of drug products were statistically compared to a reported HPLC method showing no significant difference in trueness and precision, indicating the capability of the suggested multivariate calibration models to be reliable and adequate for routine quality control analysis of drug product. SVR offers more accurate results with lower prediction error compared to PLSR model; however, PLSR is easy to handle and fast to optimize.
Oral Lesions: The Clue to Diagnosis of Pemphigus Vulgaris
Authors: Kuriachan Diana , Suresh Rakesh , Janardhanan Mahija , Savithri Vindhya
Published: November 2015

Pemphigus is a group of potentially fatal dermatoses with both cutaneous and oral manifestations. Characterized by the appearance of vesicle or bullae, their manifestations in the oral cavity often precede those on the skin by many months or may remain as the only symptoms of the disease. It is therefore important that the oral manifestations of the disease are recognized on time, to make a proper diagnosis and initiate timely treatment. Here we present a case of Pemphigus Vulgaris (PV) that presented with oral lesions at multiple sites including tongue, to highlight the importance of timely recognition of the oral lesions during routine dental practice for the diagnosis and management of this disease.
Miniaturized Circularly Polarized Stacked Patch Antenna on Reactive Impedance Surface for Dual-Band ISM and WiMAX Applications
Authors: Agarwal Kush , Dutta Saugata
Published: November 2015

This paper proposes a compact microstrip patch antenna for operating in 2.4 GHz ISM and 3.5 GHz WiMAX bands with circularly polarized (CP) radiation. The CP radiation in dual-bands is a result of two multilayered truncated corner stacked square patches, while the reactive impedance surface (RIS) is used for antenna size miniaturization for the lower operating frequency band. Since the overall lateral antenna dimensions are controlled by the lower frequency band (higher wavelength), reducing the electrical size of the antenna for lower band results in overall smaller antenna dimensions. The measured 3-dB axial ratio bandwidths of the in-house fabricated antenna prototype are 6.1% (2.40–2.55 GHz) for the lower band and 5.7% (3.40–3.60 GHz) for the upper band, while the 10-dBS11bandwidths for the two bands are 8.1% (2.39–2.59 GHz) and 6.9% (3.38–3.62 GHz), respectively. The maximum gain at boresight for the lower band is 2.93 dBic at 2.5 GHz, while the gain for the upper band is 6.26 dBic at 3.52 GHz. The overall volume of the proposed antenna is 0.292λo × 0.292λo × 0.044λo, whereλois the corresponding free-space wavelength at 2.5 GHz.
Adrenergic Stimulation of DUSP1 Impairs Chemotherapy Response in Ovarian Cancer
Authors: Kang Yu , Nagaraja Archana S. , Armaiz-Pena Guillermo N. , Dorniak Piotr L. , Hu Wei , Rupaimoole Rajesha , Liu Tao , Gharpure Kshipra M. , Previs Rebecca A. , Hansen Jean M. , Rodriguez-Aguayo Cristian , Ivan Cristina , Ram Prahlad , Sehgal Vasudha , Lopez-Berestein Gabriel , Lutgendorf Susan K. , Cole Steven W. , Sood Anil K.
Published: November 2015

Purpose: Chronic adrenergic activation has been shown to associate with adverse clinical outcomes in cancer patients, but the underlying mechanisms are not well understood. The focus of the current study was to determine the functional and biologic effects of adrenergic pathways on response to chemotherapy in the context of ovarian cancer.

Experimental Design: Increased DUSP1 production by sympathetic nervous system mediators (e.g., norepinephrine) was analyzed by real-time quantitative RT-PCR and by Western blotting. In vitro chemotherapy-induced cell apoptosis was examined by flow cytometry. For in vivo therapy, a well-characterized model of chronic stress was used.

Results: Catecholamines significantly inhibited paclitaxel- and cisplatin-induced apoptosis in ovarian cancer cells. Genomic analyses of cells treated with norepinephrine identified DUSP1 as a potential mediator. DUSP1 overexpression resulted in reduced paclitaxel-induced apoptosis in ovarian cancer cells compared with control; conversely, DUSP1 gene silencing resulted in increased apoptosis compared with control cells. DUSP1 gene silencing in vivo significantly enhanced response to paclitaxel and increased apoptosis. In vitro analyses indicated that norepinephrine-induced DUSP1 gene expression was mediated through ADRB2 activation of cAMP–PLC–PKC–CREB signaling, which inhibits JNK-mediated phosphorylation of c-Jun and protects ovarian cancer cells from apoptosis. Moreover, analysis of The Cancer Genome Atlas data showed that increased DUSP1 expression was associated with decreased overall (P = 0.049) and progression-free (P = 0.0005) survival.

Conclusions: These findings provide a new understanding of the mechanisms by which adrenergic pathways can impair response to chemotherapy and have implications for cancer management. Clin Cancer Res; 22(7); 1713–24. ©2015 AACR.
Impact of Na+/Ca2+ Exchangers on Therapy Resistance of Ovary Carcinoma Cells
Authors: Pelzl Lisann , Hosseinzadeh Zohreh , Alzoubi Kousi , Al-Maghout Tamer , Schmidt Sebastian , Stournaras Christos , Lang Florian
Published: November 2015

Background/Aims: According to previous observations, enhanced store-operated Ca2+-entry (SOCE) accomplished by the pore forming ion channel unit Orai1 and its regulator STIM1 contribute to therapy resistance of ovary carcinoma cells. Ca2+ signaling is further shaped by Ca2+ extrusion through K+-independent (NCX) and/or K+-dependent (NCKX) Na+/Ca2+-exchangers. The present study thus explored whether therapy resistance is further paralleled by altered expression and/or function of Na+/Ca2+-exchangers. Methods: In therapy resistant (A2780cis) and therapy sensitive (A2780sens) ovary carcinoma cells transcript levels were estimated from RT-PCR, cytosolic Ca2+-activity ([Ca2+]i) from Fura-2-fluorescence, Na+/Ca2+-exchanger activity from the increase of [Ca2+]i (Δ[Ca2+]i) and from whole cell current (Ica) following abrupt replacement of Na+ containing (130 mM) and Ca2+ free extracellular perfusate by Na+ free and Ca2+ containing (2 mM) extracellular perfusate, as well as cell death from PI -staining in flow cytometry. Results: The transcript levels of NCX3, NCKX4, NCKX5, and NCKX6, slope and peak of Δ[Ca2+]i as well as Ica were significantly higher in therapy resistant than in therapy sensitive ovary carcinoma cells. The Na+/Ca2+-exchanger inhibitor KB-R7943 (10 µM) significantly blunted Δ[Ca2+]i and significantly augmented the cisplatin-induced cell death of therapy resistant ovary carcinoma cells without significantly modifying cisplatin-induced cell death of therapy sensitive ovary carcinoma cells. Conclusion: Enhanced Na+/Ca2+-exchanger activity may contribute to the therapy sensitivity of ovary carcinoma cells.
Characterization of Chondrogenic Gene Expression and Cartilage Phenotype Differentiation in Human Breast Adipose-Derived Stem Cells Promoted by Ginsenoside Rg1 In Vitro
Authors: Xu Fang-Tian , Li Hong-Mian , Zhao Cheng-Yi , Liang Zhi-Jie , Huang Min-Hong , Li Qing , Chen Ying-Chao , Chi Gang-Yi
Published: November 2015

Background/Aims: Investigating and understanding chondrogenic gene expression during the differentiation of human breast adipose-derived stem cells (HBASCs) into chondrogenic cells is a prerequisite for the application of this approach for cartilage repair and regeneration. In this study, we aim to characterize HBASCs and to examine chondrogenic gene expression in chondrogenic inductive culture medium containing ginsenoside Rg1. Methods: Human breast adipose-derived stem cells at passage 3 were evaluated based on specific cell markers and their multilineage differentiation capacity. Cultured HBASCs were treated either with basic chondrogenic inductive conditioned medium alone (group A, control) or with basic chondrogenic inductive medium plus 10 µg/ml (group B), 50 µg/ml (group C), or 100µg/ml ginsenoside Rg1 (group D). Cell proliferation was assessed using the CCK-8 assay for a period of 9 days. Two weeks after induction, the expression of chondrogenic genes (collagen type II, collagen type XI, ACP, COMP and ELASTIN) was determined using real-time PCR in all groups. Results: The different concentrations of ginsenoside Rg1 that were added to the basic chondrogenic inductive culture medium promoted the proliferation of HBASCs at earlier stages (groups B, C, and D) but resulted in chondrogenic phenotype differentiation and higher mRNA expression of collagen type II (CO-II), collagen type XI (CO-XI), acid phosphatase (ACP), cartilage oligomeric matrix protein (COMP) and ELASTIN compared with the control (group A) at later stages. The results reveal an obvious positive dose-effect relationship between ginsenoside Rg1 and the proliferation and chondrogenic phenotype differentiation of HBASCs in vitro. Conclusions: Human breast adipose-derived stem cells retain stem cell characteristics after expansion in culture through passage 3 and serve as a feasible source of cells for cartilage regeneration in vitro. Chondrogenesis in HBASCs was found to be prominent after chondrogenic induction in conditions containing ginsenoside Rg1.
Enhanced Store-Operated Calcium Entry in Platelets is Associated with Peripheral Artery Disease in Type 2 Diabetes
Authors: Xia Weijie , Li Yingsha , Wang Bin , Chen Jing , Wang Xiaojing , Sun Qianqian , Sun Fang , Li Zhiyong , Zhao Zhigang
Published: November 2015

Background/Aims: Platelet dysfunction plays an important role in thrombosis in diabetes with peripheral artery disease (PAD). Store-operated calcium entry (SOCE) and stromal interaction molecule 1 (STIM1) regulate platelet activity by modulating calcium influx. We hypothesized that enhanced SOCE in platelets is associated with diabetes with PAD. Methods: We studied the activity of platelets from healthy participants and from type 2 diabetic patients. Platelet calcium influx and protein expression of STIM1 and sarcoendoplasmic reticulum Ca2+-ATPase 3 (SERCA3) were investigated. Results: Compared with platelets from diabetic patients without PAD, platelets from diabetic patients with PAD exhibited significantly increased SOCE . Menthol administration completely inhibited calcium influx in platelets from diabetic patients without PAD, but this effect was blunted in those from diabetic patients with PAD. Furthermore, the increase in SOCE was correlated with the ankle brachial index (ABI) in diabetic patients. High glucose significantly up-regulated STIM1 and SERCA3 protein expression and induced the phosphorylation of phospholipase C (PLC) in platelets from healthy participants. This effect was attenuated in the presence of menthol or U73122, an inhibitor of PLC. Similarly, significant increases in STIM1 and SERCA3 protein expression were found in platelets from diabetic patients compared to those from healthy participants. Conclusion: Platelets from diabetic patients with PAD exhibited enhanced Store-operated calcium influx, which was associated with elevated STIM1/SERCA3 expression via a PLC-dependent pathway and was inhibited by menthol.
Hyaluronic Acid Binding Assay Is Highly Sensitive to Select Human Spermatozoa with Good Progressive Motility, Morphology, and Nuclear Maturity
Authors: Rashki Ghaleno Leila , Rezazadeh Valojerdi Mojtaba , Chehrazi Mohammad , Sahraneshin Samani Fazel , Salman Yazdi Reza
Published: November 2015

Objective: This study was performed to evaluate the correlation of hyaluronic acid binding assay (HBA) with conventional semen parameters, lipid peroxidation (LPO), intracellular reactive oxygen species (ROS), DNA fragmentation (DF), DNA maturity and mitochondrial membrane potential (MMP) level in human spermatozoa. Methods: The semen samples were obtained from 98 patients. The seminal plasma was separated for the study of LPO, and the pellet was employed for evaluation of intracellular ROS, DF, nuclear maturity (sperm chromatin structure assay) and MMP through flowcytometry. Results: The correlation and strength of HBA with respect to the studied parameters were estimated by the Pearson coefficient and multiple liner regression tests. While HBA indicated a positive correlation with progressive motility (β-coefficients = 0.449, p < 0.05) and normal morphology (β-coefficients = 2.722, p < 0.01), it had only negative relationship with DNA integrity (high DNA stain ability; β-coefficients = -0.517, p < 0.05). HBA also did not show any important correlation with other conventional and intracellular sperm parameters. Conclusions: The HBA is sensitive to morphological integrity, high progressive motility and nuclear maturation. Nonetheless, HBA is not a reliable test for prediction of sperm intracellular ROS, DF and MMP risks and healthy spermatozoa selection.
Risk of Stroke-Associated Pneumonia and Oral Hygiene
Authors: Wagner Cynthia , Marchina Sarah , Deveau Judith A. , Frayne Colleen , Sulmonte Kim , Kumar Sandeep
Published: November 2015

Background: Pneumonia is a major complication of stroke, but effective prevention strategies are lacking. Since aspiration of oropharyngeal secretions is the primary mechanism for development of stroke-associated pneumonia, strategies that decrease oral colonization with pathogenic bacteria may help curtail pneumonia risk. We therefore hypothesized that systematic oral care protocols can help decrease pneumonia risk in hospitalized stroke patients. In this study, we investigated the impact of a systematic oral hygiene care (OHC) program in reducing hospital-acquired pneumonia in patients with acute-subacute stroke. Methods: This study compared the proportion of pneumonia cases in hospitalized stroke patients before and after implementation of a systematic OHC intervention. All patients hospitalized with acute ischemic stroke or intracerebral hemorrhage admitted to a large, urban academic medical center in Boston, Mass., USA from May 31, 2008, to June 1, 2010 (epoch prior to implementation of OHC), and from January 1, 2012, to December 31, 2013 (epoch after full implementation of OHC), who were 18 years of age and hospitalized for ≥2 days were eligible for inclusion. The cohort in the first epoch constituted the control group whereas the cohort in the second epoch formed the intervention group. Multivariate logistic regression was used to control for confounders. The main outcome measure was hospital-acquired pneumonia, defined via International Classification of Diseases, Ninth Revision, Clinical Modification codes. Results: The cohort comprised 1,656 admissions (707 formed historical controls; 949 were in the intervention group). The unadjusted incidence of hospital-acquired pneumonia was lower in the group assigned to OHC compared to controls (14 vs. 10.33%; p = 0.022) with an unadjusted OR of 0.68 (95% CI 0.48-0.95; p = 0.022). After adjustment for influential confounders, the OR of hospital-acquired pneumonia in the intervention group remained significantly lower at 0.71 (95% CI 0.51-0.98; p = 0.041). Conclusion: In this large hospital-based cohort of patients admitted with acute stroke, systematic OHC use was associated with decreased odds of hospital-acquired pneumonia.
Longitudinal Assessment of Left and Right Myocardial Function in Preterm Infants Using Strain and Strain Rate Imaging
Authors: James Adam T. , Corcoran J.D. , Breatnach Colm R. , Franklin Orla , Mertens Luc , El-Khuffash Afif
Published: November 2015

Background: There is a paucity of longitudinal data on left ventricular (LV) and right ventricular (RV) function in preterm infants of less than 29 weeks' gestation. Objective: The aim of this study was to describe changes in tissue Doppler-derived basal longitudinal strain (BLS) and systolic (SRs), early (SRe) and late (SRa) diastolic strain rates in extremely premature infants from birth to 36 weeks postmenstrual age (PMA). Methods: Echocardiographic assessments were carried out on days 1, 2, 5-7 and at 36 weeks PMA. We assessed the following associations: correlation with systemic vascular resistance (SVR) on day 1, influence of a patent ductus arteriosus (PDA) during days 5-7, and the effect of chronic lung disease (CLD). Results: In total, 105 infants with a median gestation of 27.1 weeks (IQR 26.0-28.1) and a birthweight of 965 g (IQR 785-1,153) were included. There was an increase in most of the measurements across the four time points. On day 1, there was a weak negative correlation between SVR and LV BLS (r = -0.3, p = 0.01), SVR and septal BLS (r = -0.4, p < 0.001) and SVR and LV SRe (r = -0.4, p = 0.005). On days 5-7, infants with a PDA >1.5 mm had higher LV BLS [-13.0 (2.4) vs. -11.9 (1.9)%, p = 0.03]. At 36 weeks, infants with CLD (n = 28/47) had lower RV BLS [-26.4 (5.0) vs. -30.7 (5.5)%, p = 0.01] and lower RV SRa [4.2 (1.3) vs. 5.3 (1.9) s-1, p = 0.04]. Conclusion: Myocardial function undergoes important longitudinal changes in preterm infants. Left heart strain measurements appear to be weakly influenced by changes in preload and afterload. CLD appears to leave a negative impact on RV function.
Cardiopulmonary Exercise Testing in Patients with Asymptomatic or Equivocal Symptomatic Aortic Stenosis: Feasibility, Reproducibility, Safety and Information Obtained on Exercise Physiology
Authors: van Le Douet , Jensen Gunnar Vagn Hagemann , Carstensen Steen , Kjøller-Hansen Lars
Published: November 2015

Objective: The aim of this study was to determine the feasibility, reproducibility, safety and information obtained on exercise physiology from cardiopulmonary exercise testing (CPX) in patients with aortic stenosis. Methods: Patients with an aortic valve area (AVA) <1.3 cm2 who were judged asymptomatic or equivocal symptomatic underwent CPX and an inert gas rebreathing test. Only those where comprehensive evaluation of CPX results indicated haemodynamic compromise from aortic stenosis were referred for valve replacement. Results: The mean patient age was 72 (±9) years; an AVA index <0.6 cm2/m2 and equivocal symptomatic status were found in 90 and 70%, respectively. CPX was feasible in 130 of the 131 patients. The coefficients of repeatability by test-retest were 5.4% (pVO2) and 4.6% (peak O2 pulse). A pVO2 <83% of the expected was predicted by a lower stroke volume at exercise, lower peak heart rate and FEV1, and higher VE/VCO2, but not by AVA index. Equivocal symptomatic status and a low gradient but high valvulo-arterial impedance were associated with a lower pVO2, but not with an inability to increase stroke volume. In total, 18 patients were referred for valve replacement. At 1 year, no cardiovascular deaths had occurred. Conclusions: CPX was feasible and reproducible and provided comprehensive data on exercise physiology. A CPX-guided treatment strategy was safe up to 1 year.
Expression and Purification of Recombinant Human Basic Fibroblast Growth Factor Fusion Proteins and Their Uses in Human Stem Cell Culture
Authors: Imsoonthornruksa Sumeth , Pruksananonda Kamthorn , Parnpai Rangsun , Rungsiwiwut Ruttachuk , Ketudat-Cairns Mariena
Published: November 2015

To reduce the cost of cytokines and growth factors in stem cell research, a simple method for the production of soluble and biological active human basic fibroblast growth factor (hbFGF) fusion protein in Escherichia coli was established. Under optimal conditions, approximately 60-80 mg of >95% pure hbFGF fusion proteins (Trx-6xHis-hbFGF and 6xHis-hbFGF) were obtained from 1 liter of culture broth. The purified hbFGF proteins, both with and without the fusion tags, were biologically active, which was confirmed by their ability to stimulate proliferation of NIH3T3 cells. The fusion proteins also have the ability to support several culture passages of undifferentiated human embryonic stem cells and induce pluripotent stem cells. This paper describes a low-cost and uncomplicated method for the production and purification of biologically active hbFGF fusion proteins.
Uveal Melanoma Mimicking Advanced Coats' Disease in a Young Patient
Authors: Gupta Naina , Terrell William , Schoenfield Lynn , Kirsch Claudia , Cebulla Colleen M.
Published: November 2015

Background/Aims: To report a case and the unique histopathology of a necrotic uveal melanoma mimicking advanced Coats' disease in a young adult. Method: A 26-year-old male presented with a blind, painful eye, total exudative retinal detachment, and bulbous aneurysms consistent with Coats' disease. No masses were visualized on ultrasound or CT scan, and the patient underwent enucleation of the eye. Results: Histopathology of the involved eye confirmed a necrotic uveal melanoma with persistent spindle cells forming a collar around residual tumor vessels. Conclusion: Careful consideration is needed in approaching any patient with a blind, painful eye and opaque media, even in younger populations.
Charting the Course for a New Cancer Clinical Research Culture
Authors: Tejpar Sabine , Salgado Roberto ,   on behalf of the Working Groups ‘Biomarker'' and ‘Clinical Trial Framework'' of the European Alliance for Personalised Medicine (EAPM)
Published: November 2015

The convergence of new biological insights from sequencing, digital technologies and advanced bioinformatics tools are creating new opportunities to advance cancer care for individual patients. Fully realising this potential will require the integration and alignment of multiple stakeholders across the healthcare system. To increase the speed in which personalised medicine discoveries are translated into clinical practice and accessible to patients requires appropriately conducted clinical research with input and usage by patients, healthcare providers, regulatory authorities and policy makers. These stakeholders need to align in establishing the right evidence to facilitate clinical research and access to personalised treatments addressing the needs of targeted populations.
Chromosomal Abnormalities in Embryonic and Somatic Stem Cells
Authors: Rebuzzini Paola , Zuccotti Maurizio , Redi Carlo A. , Garagna Silvia
Published: November 2015

The potential use of stem cells (SCs) for tissue engineering, regenerative medicine, disease modeling, toxicological studies, drug delivery, and as in vitro model for the study of basic developmental processes implies large-scale in vitro culture. Here, after a brief description of the main techniques used for karyotype analysis, we will give a detailed overview of the chromosome abnormalities described in pluripotent (embryonic and induced pluripotent SCs) and somatic SCs, and the possible causes of their origin during culture.
Vaginal Pessary for Uterine Repositioning during High-Intensity Focused Ultrasound Ablation of Uterine Leiomyomas
Authors: Klepac Pulanic Tajana , Venkatesan Aradhana M. , Segars James , Sokka Sham , Wood Bradford J. , Stratton Pamela
Published: November 2015

In order to ensure safe magnetic resonance-guided, high-intensity focused, ultrasound ablation of uterine leiomyomas, the ultrasound beam path should be free of intervening scar and bowel. Pre-treatment MRI of a 9-cm long and 7.7-cm wide leiomyomatous uterus in a 39-year-old woman with menorrhagia and abdominopelvic pain initially demonstrated a focused ultrasound treatment path without a bowel between the uterus and the abdominal wall. On the day of ablation, however, multiple loops of bowel were observed in the ultrasound beam path by MRI. Uterine repositioning was accomplished with a 76-mm donut vaginal pessary, which anteverted the fundus and successfully displaced the bowel. A vaginal pessary may aid in repositioning an axial or retroverted uterus to enable ablation of uterine leiomyomas.
The Effect of Intrauterine Lidocaine and Rectal Indomethacin on Pain during Office Vaginoscopic Hysteroscopy: Randomized Double-Blind Controlled Study
Authors: Senturk Mehmet Baki , Guraslan Hakan , Babaoğlu Bülent , Yaşar Levent , Polat Mesut
Published: November 2015

Backgrounds/Aims: The aim of this study was to investigate the effect of rectal and intrauterine anesthesia during vaginoscopic hysteroscopy. Methods: This was a randomized, double-blind, placebo-controlled study. Patients were randomized to rectal indomethacin, intrauterine lidocaine and placebo groups. Patients with conditions that could cause or contribute to pelvic pain were excluded. Pain was evaluated with Visual Analog Scale, when the cervical canal was passed, while within the cavity and at 10 min after procedure. The Analog Pain Scale scores of the 3 groups were compared with the Kruskal-Wallis 1-way analysis of variance test. A value of p < 0.05 was accepted as statistically significant. Results: The study included a total of 206 patients. No difference was seen between the groups in respect of indication, age, gravid and duration of procedure. While the anesthesia was determined as superior to the placebo in reducing pain at all 3 stages (p < 0.05), intrauterine lidocaine was determined to be more effective than rectal indomethacin in reducing pain within the cavity and 10 min after the procedure (p < 0.05). Conclusion: Rectal or intrauterine anesthesia applied with the vaginoscopic technique is useful in hysteroscopy. However, intrauterine anesthesia is more effective in reducing pain.
Tonsillectomy in a European Cohort of 1,147 Patients with IgA Nephropathy
Authors: Feehally John , Coppo Rosanna , Troyanov Stéphan , Bellur Shubha S. , Cattran Daniel , Cook Terence , Roberts Ian S.D. , Verhave Jacobien C. , Camilla Roberta , Vergano Luca , Egido Jesus , Wiecek Andrzej , Karkoszka Henryk , Tesar Vladimir , Maixnerova Dita , Ots-Rosenberg Mai , Quaglia Marco , Rollino Cristiana , Magistroni Riccardo , Cusinato Stefano , Cravero Raffaella , Peruzzi Licia , Lundberg Sigrid , Gesualdo Loreto , Cancarini Giovanni , Feriozzi Sandro , Ferrario Franco ,   on behalf of the VALIGA study of the ERA-EDTA Immunonephrology Working Group
Published: November 2015

Background: Tonsillectomy has been considered a treatment for IgA nephropathy (IgAN). It is aimed at removing a source of pathogens, reducing mucosa-associated lymphoid tissue and decreasing polymeric IgA synthesis. However, its beneficial effect is still controversial. In Asia, favorable outcomes have been claimed mostly in association with corticosteroids. In Europe, small, single-center uncontrolled studies have failed to show benefits. Methods: The European validation study of the Oxford classification of IgAN (VALIGA) collected data from 1,147 patients with IgAN over a follow-up of 4.7 years. We investigated the outcome of progression to end-stage renal disease (ESRD) and/or 50% loss of estimated glomerular filtration rate (eGFR) and the annual loss of eGFR in 61 patients who had had tonsillectomy. Results: Using the propensity score, which is a logistic regression model, we paired 41 patients with tonsillectomy and 41 without tonsillectomy with similar risk of progression (gender, age, race, mean blood pressure, proteinuria, eGFR at renal biopsy, previous treatments and Oxford MEST scores). No significant difference was found in the outcome. Moreover, we performed an additional propensity score pairing 17 patients who underwent tonsillectomy after the diagnosis of IgAN and 51 without tonsillectomy with similar risk of progression at renal biopsy and subsequent treatments. No significant difference was found in changes in proteinuria, or in the renal end point of 50% reduction in GFR and/or ESRD, or in the annual loss of eGFR. Conclusion: In the large VALIGA cohort of European subjects with IgAN, no significant correlation was found between tonsillectomy and renal function decline.
Cardiac Involvement in Von Hippel-Lindau Disease
Authors: Valero Ernesto , Rumiz Eva , Pellicer Mauricio
Published: November 2015

Objective: The aim of this case report was to highlight the importance of ruling out pheochromocytoma in a patient with Von Hippel-Lindau disease (VHL) and cardiovascular manifestations. Clinical Presentation and Intervention: A 22-year-old woman with type IIb VHL presented with signs and symptoms of acute decompensated heart failure. Transthoracic echocardiography showed a dilated left ventricle with severely depressed ejection fraction, confirmed by MRI. Urinary catecholamine and metanephrine tests had elevated levels and an abdominal MRI showed the presence of two cystic masses at the left hypochondrium. Surgical resection of both masses was performed, confirming the diagnosis of pheochromocytoma and clear cell renal carcinoma on histology. Six-month echocardiography showed a left ventricle with normal diameters and preserved ejection fraction. Genetic analysis revealed a germline mutation (exon 3 deletion of VHL). As there was no family history of VHL, it was determined to be a de novo mutation. Conclusion: This case report showed an atypical manifestation in a patient with VHL and underlines the importance of screening for pheochromocytoma in such patients.