bluuebunny/crossref_metadata_2025 huggingface dataset:
A Rare Case of Vasculitis Patched Necrosis of Cecum due to Behçet’s Disease
Authors: Shahverdi Ehsan , Morshedi Mehdi , Oraei-Abbasian Faraneh , Allahverdi Khani Maryam , Khodayarnejad Roya
Published: May 2017

Isolated cecal necrosis is a rare form of acute ischemic colitis and a rare cause of surgical abdomen. Behçet’s disease is a multisystemic autoimmune condition which can induce vasculitis. This can result in cecal necrosis while disease involves colon vessels. We describe a patient with complicated Behçet’s disease and ischemic colitis admitted to our hospital. Patient was a 62-year-old female with more accompanying diseases. Histopathologic findings confirmed the diagnosis of ischemic colitis and regarding patient’s vision problem and skin lesions, rheumatologic tests were performed which were positive for HLAB5 and HLAB51 suggestive of Behçet’s disease; the patient was improved with surgery. Abdominal pain can indicate a disease with vascular involvement like Behçet’s disease, especially in the presence of other clinical findings suggestive of the disease including blurred vision and skin lesions. An abdominal computerized tomography (CT) scan is very diagnostic in the same patients.
Depression and Anxiety Scores Are Associated with Amygdala Volume in Cushing’s Syndrome: Preliminary Study
Authors: Santos Alicia , Granell Esther , Gómez-Ansón Beatriz , Crespo Iris , Pires Patricia , Vives-Gilabert Yolanda , Valassi Elena , Webb Susan M. , Resmini Eugenia
Published: May 2017

Introduction. Cushing’s syndrome (CS) has repeatedly been associated with hippocampal volume reductions, while little information is available on the amygdala, another structure rich in glucocorticoid receptors. The aim of the study was to analyze amygdala volume in patients with CS and its relationship with anxiety, depression, and hormone levels. Material and Methods. 39 CS patients (16 active and 23 patients in remission) and 39 healthy controls matched for age, sex, and education level completed anxiety (STAI) and depression tests (BDI-II) and underwent a 3 Tesla brain MRI and endocrine testing. Amygdala volumes were analysed with FreeSurfer software. Results. Active CS patients had smaller right (but not left) amygdala volumes when compared to controls (P=0.045). Left amygdala volumes negatively correlated with depression scores (r=-0.692, P=0.003) and current anxiety state scores (r=-0.617, P=0.011) in active CS patients and with anxiety trait scores (r=-0.440, P=0.036) in patients in remission. No correlations were found between current ACTH, urinary free cortisol or blood cortisol levels, and amygdala volumes in either patient group. Conclusion. Patients with active CS have a smaller right amygdala volume in comparison to controls, while left amygdala volumes are associated with mood state in both patient groups.
Novel Opportunistic Network Routing Based on Social Rank for Device-to-Device Communication
Authors: Wang Tong , Zhou Yongzhe , Wang Yunfeng , Tang Mengbo
Published: May 2017

In recent years, there has been dramatic proliferation of research concerned with fifth-generation (5G) mobile communication networks, among which device-to-device (D2D) communication is one of the key technologies. Due to the intermittent connection of nodes, the D2D network topology may be disconnected frequently, which will lead to failure in transmission of large data files. In opportunistic networks, in case of encountering nodes which never meet before a flood message blindly to cause tremendous network overhead, a novel opportunistic network routing protocol based on social rank and intermeeting time (SRIT) is proposed in this paper. An improved utility approach applied in utility replication based on encounter durations and intermeeting time is put forward to enhance the routing efficiency. Meanwhile, in order to select better candidate nodes in the network, a social graph among people is established when they socially relate to each other in social rank replication. The results under the scenario show an advantage of the proposed opportunistic network routing based on social rank and intermeeting time (SRIT) over the compared algorithms in terms of delivery ratio, average delivery latency, and overhead ratio.
Type A Quadricuspid Aortic Valve Infective Endocarditis Complicated by Multiple Aortocardiac Fistulae: Case Report and Brief Literature Review
Authors: Ghalem Amine , Bachrif Mohammed , Hbali Anass , Beghi Mostapha , Ismaili Nabila , El Ouafi Noha
Published: May 2017

Aortocardiac fistulae (ACF) are exceptionally due to infective endocarditis; they are usually congenital, posttraumatic, or complicate aortic dissection. In infective endocarditis setting, their presence should prompt urgent surgery as patients can deteriorate rapidly. We report the case of a 78-year-old female patient with the first ever reported quadricuspid aortic valve infective endocarditis complicated by multiple aortocardiac fistulae. Additionally, we provide a brief review of ACF, in infective endocarditis and quadricuspid aortic valve.
Pseudoaneurysm of the Anterior Tibial Artery following Ankle Arthroscopy in a Soccer Player
Authors: Tonogai Ichiro , Matsuura Tetsuya , Iwame Toshiyuki , Wada Keizo , Takasago Tomoya , Goto Tomohiro , Hamada Daisuke , Kawatani Yohei , Fujimoto Eiki , Kitagawa Tetsuya , Takao Shyoichiro , Iwamoto Seiji , Yamanaka Moriaki , Harada Masafumi , Sairyo Koichi
Published: May 2017

Ankle arthroscopy carries a lower risk of vascular complications when standard anterolateral and anteromedial portals are used. However, the thickness of the fat pad at the anterior ankle affords little protection for the thin-walled anterior tibial artery, rendering it susceptible to indirect damage during procedures performed on the anterior ankle joint. To our knowledge, only 11 cases of pseudoaneurysm involving the anterior tibial artery after ankle arthroscopy have been described in the literature. Here we reported a rare case of a 19-year-old soccer player who presented with pseudoaneurysm of the anterior tibial artery following ankle arthroscopy using an ankle distraction method and underwent anastomosis for the anterior tibial artery injury. Excessive distraction of the ankle puts the neurovascular structures at greater risk for iatrogenic injury of the anterior tibial artery during ankle arthroscopy. Surgeons should look carefully for postoperative ankle swelling and pain after ankle arthroscopy.
Experimental Investigation of Laws during Deformation of Circular Roadway in 10° Inclined Layered Rock
Authors: Sun Xiaoming , Han Qiang , Zhang Yingqi , Liu Xin , Gong Weili
Published: May 2017

In order to analyze the deformation characteristics and mechanisms caused by high tectonic stress in gentle dip strata, a physical modeling with circular tunnel was designed. The model was constructed by the so-called “Physically Finite Elemental Slab Assemblage (PFESA)” to bring about the structural effect of the deep strata. The gravity was fixed while the lateral pressure increased step by step to mimic high tectonic stress. In order to observe the displacement in different area, the sketches of monitoring points and frame in the model surface were drawn down through video pictures in different periods and to be compared. For the sake of analyzing the deformation and failure mechanism of layers, rock structural mechanics models were set up for the left side and right side in the same stratum, respectively. For verifying the experimental phenomenon and its mechanism, infrared images were utilized based on the temperature variation mechanisms of material. Through systematic study, this paper enriches the research methods of model test and can provide a certain reference for practical engineering of similar conditions.
Genetic Epidemiology of Type 2 Diabetes in Mexican Mestizos
Authors: García-Chapa Eiralí Guadalupe , Leal-Ugarte Evelia , Peralta-Leal Valeria , Durán-González Jorge , Meza-Espinoza Juan Pablo
Published: May 2017

There are currently about 415 million people with diabetes worldwide, a figure likely to increase to 642 million by 2040. In 2015, Mexico was the second Latin American country and sixth in the world in prevalence of this disorder with nearly 11.5 million of patients. Type 2 diabetes (T2D) is the main kind of diabetes and its etiology is complex with environmental and genetic factors involved. Indeed, polymorphisms in several genes have been associated with this disease worldwide. To estimate the genetic epidemiology of T2D in Mexican mestizos a systematic bibliographic search of published articles through PubMed, Scopus, Google Scholar, and Web of Science was conducted. Just case-control studies of candidate genes about T2D in Mexican mestizo inhabitants were included. Nineteen studies that met the inclusion criteria were found. In total, 68 polymorphisms of 41 genes were assessed; 26 of them were associated with T2D risk, which were located in ABCA1, ADRB3, CAPN10, CDC123/CAMK1D, CDKAL1, CDKN2A/2B, CRP, ELMO1, FTO, HHEX, IGF2BP2, IRS1, JAZF1, KCNQ1, LOC387761, LTA, NXPH1, SIRT1, SLC30A8, TCF7L2, and TNF-α genes. Overall, 21 of the 41 analyzed genes were associated with T2D in Mexican mestizos. Such a genetic heterogeneity compares with findings in other ethnic groups.
Unilateral Enlarged Vestibular Aqueduct Syndrome and Bilateral Endolymphatic Hydrops
Authors: Ralli Massimo , Nola Giuseppe , Sparvoli Luca , Ralli Giovanni
Published: May 2017

Enlarged vestibular aqueduct (EVA) syndrome is a common congenital inner ear malformation characterized by a vestibular aqueduct with a diameter larger than 1.5 mm, mixed or sensorineural hearing loss that ranges from mild to profound, and vestibular disorders that may be present with a range from mild imbalance to episodic objective vertigo. In our study, we present the case of a patient with unilateral enlarged vestibular aqueduct and bilateral endolymphatic hydrops (EH). EH was confirmed through anamnestic history and audiological exams; EVA was diagnosed using high-resolution CT scans and MRI images. Therapy included intratympanic infusion of corticosteroids with a significant hearing improvement, more evident in the ear contralateral to EVA. Although most probably unrelated, EVA and EH may present with similar symptoms and therefore the diagnostic workup should always include the proper steps to perform a correct diagnosis. Association between progression of hearing loss and head trauma in patients with a diagnosis of EVA syndrome is still uncertain; however, these individuals should be advised to avoid activities that increase intracranial pressure to prevent further hearing deterioration. Intratympanic treatment with steroids is a safe and well-tolerated procedure that has demonstrated its efficacy in hearing, tinnitus, and vertigo control in EH.
Supply Chain Model with Stochastic Lead Time, Trade‐Credit Financing, and Transportation Discounts
Authors: Kim Sung Jun , Sarkar Biswajit
Published: May 2017

This model extends a two‐echelon supply chain model by considering the trade‐credit policy, transportations discount to make a coordination mechanism between transportation discounts, trade‐credit financing, number of shipments, quality improvement of products, and reduced setup cost in such a way that the total cost of the whole system can be reduced, where the supplier offers trade‐credit‐period to the buyer. For buyer, the backorder rate is considered as variable. There are two investments to reduce setup cost and to improve quality of products. The model assumes lead time‐dependent backorder rate, where the lead time is stochastic in nature. By using the trade‐credit policy, the model gives how the credit‐period would be determined to achieve the win‐win outcome. An iterative algorithm is designed to obtain the global optimum results. Numerical example and sensitivity analysis are given to illustrate the model.
A Case of Fracture-Redislocation of the Hip Caused by a Depressed Fracture of the Femoral Head Similar to a Hill-Sachs Lesion
Authors: Okudera Yoshihiko , Kijima Hiroaki , Yamada Shin , Konishi Natsuo , Kubota Hitoshi , Tazawa Hiroshi , Tani Takayuki , Suzuki Norio , Kamo Keiji , Sasaki Ken , Kawano Tetsuya , Iwamoto Yosuke , Miyakoshi Naohisa , Shimada Yoichi
Published: May 2017

The present case shows a case of fracture-redislocation of the hip caused by a depressed fracture of the femoral head similar to a Hill-Sachs lesion. A 59-year-old man fell from a roof and his left hip joint was dislocated posteriorly. He was admitted to a nearby hospital, and he was referred to our hospital more than 24 hours after injury. Computed tomography (CT) suggested a bone chip from the posterior wall of the acetabulum roof and a depressed femoral head that cut into the posterior margin of the acetabulum roof. Immediate manual repositioning was performed under general anesthesia on the same day. He left our hospital to go home on day 26 after repositioning, but his left hip joint was dislocated again when he went down the stairs. It was thought that this patient’s redislocation occurred due to a femoral head depressed fracture involving the same mechanism as the Hill-Sachs injury seen with dislocation of the shoulder. The remplissage method for the Hill-Sachs injury is difficult for the femoral head. Therefore, total hip replacement was performed, and the patient’s postoperative course was good. We conclude that total hip arthroplasty should be considered as one of the best treatment methods for such cases.
Saphenovenous Graft Aneurysm: A Rare Complication of CABG
Authors: Connell James Thomas
Published: May 2017

Saphenovenous graft aneurysm is a rare complication of coronary artery bypass grafts that is likely underdiagnosed. It is typically asymptomatic, slow growing, and often diagnosed incidentally on angiography or following catastrophic rupture. There is no consensus on best management but PCI and surgery appear to have more favourable mortality outcomes relative to conservative management. We present the case of a 48-year-old male with a cardiovascular risk profile hallmarked by diabetes mellitus, end stage renal failure, recalcitrant hyperlipidaemia, and IHD previously treated with CABG. 11 years following his CABG, he was retrieved from remote Australia to a tertiary cardiology centre with stabbing chest pain. Serial cardiac enzymes were negative. Echocardiogram identified a mass compressing the right ventricular wall. Noncontrast coronary angiogram ultimately identified a large aneurysm at the proximal end of SVG to PDA. He was managed with aggressive risk factor modification prior to planned surgical intervention once medically optimized. His case supports the role of aggressive medical management combined with surgical intervention.
Modular Middleware for Gestural Data and Devices Management
Authors: Milazzo Fabrizio , Gentile Vito , Vitello Giuseppe , Gentile Antonio , Sorce Salvatore
Published: May 2017

In the last few years, the use of gestural data has become a key enabler for human-computer interaction (HCI) applications. The growing diffusion of low-cost acquisition devices has thus led to the development of a class of middleware aimed at ensuring a fast and easy integration of such devices within the actual HCI applications. The purpose of this paper is to present a modular middleware for gestural data and devices management. First, we describe a brief review of the state of the art of similar middleware. Then, we discuss the proposed architecture and the motivation behind its design choices. Finally, we present a use case aimed at demonstrating the potential uses as well as the limitations of our middleware.
C60 Filling Rate in Carbon Peapods: A Nonresonant Raman Spectra Analysis
Authors: Fergani Fatima , Ait Abdelkader Sidi Abdelmajid , Chadli Hassane , Fakrach Brahim , Rahmani Abdelhai , Hermet Patrick , Rahmani Abdelali
Published: May 2017

We calculated the nonresonant Raman spectra of C60 peapods to determine the concentration of C60 fullerenes inside single-walled carbon nanotubes. We focus on peapods with large diameters for which C60 molecules can adopt a double helix configuration or a two-molecule layer configuration. Our calculations are performed within the framework of the bond-polarizability model combined with the spectral moment’s method. The changes in the Raman spectra as a function of C60 filling rate and the configuration of C60 molecules inside the nanotubes are identified and discussed. Our calculations support the experimental method proposed by Kuzmany to evaluate the concentration of C60 molecules inside nanotubes.
On J/ψ and Υ Transverse Momentum Distributions in High Energy Collisions
Authors: Li Bao-Chun , Bai Ting , Guo Yuan-Yuan , Liu Fu-Hu
Published: May 2017

The transverse momentum distributions of final-state particles are very important for high energy collision physics. In this work, we investigate J/ψ and Υ meson distributions in the framework of a particle-production source, where Tsallis statistics are consistently incorporated. The results are in good agreement with the experimental data in p-p and p-Pb collisions at LHC energies. The temperature of the emission source and the nonequilibrium degree of the collision system are extracted.
A Randomized Double-Blind Placebo-Controlled Trial of the Effect of Vitamin D3 Supplementation on Breast Density in Premenopausal Women
Authors: Brisson Jacques , Bérubé Sylvie , Diorio Caroline , Mâsse Benoît , Lemieux Julie , Duchesne Thierry , Delvin Edgar , Vieth Reinhold , Yaffe Martin J. , Chiquette Jocelyne
Published: May 2017

Background: This double-blind, placebo-controlled parallel group trial assessed whether oral supplementation with 1,000, 2,000, or 3,000 IU/day vitamin D3 over one year reduces percent mammographic breast density in premenopausal women.

Methods: The trial was conducted between October 2012 and June 2015, among premenopausal female volunteers from Quebec City (Quebec, Canada). Women were randomized with ratio 1:1:1:1 to one of four study arms (1,000, 2,000, or 3,000 IU/day vitamin D3 or placebo). The primary outcome was mean change in percent mammographic breast density. Participants and research team were blinded to study arm assignment.

Results: Participants (n = 405) were randomized to receive 1,000 (n = 101), 2,000 (n = 104), or 3,000 IU/day (n = 101) vitamin D3, or a placebo (n = 99). The primary analysis included 391 participants (96, 99, 100, and 96, respectively). After the one-year intervention, mean ± SE change in percent breast density in the arms 1,000 IU/day (–5.5% ± 0.5%) and 2,000 IU/day (–5.9% ± 0.5%) vitamin D3 was similar to that in the placebo arm (−5.7% ± 0.5%) (P values = 1.0). In the 3,000 IU/day vitamin D3 arm, percent breast density also declined but slightly less (–3.8% ± 0.5%) compared with placebo arm (P = 0.03). Adherence to intervention was excellent (92.8%), and reporting of health problems was comparable among study arms (P ≥ 0.95). All participants had normal serum calcium.

Conclusions: In premenopausal women, one-year supplementation with 1,000, 2,000, or 3,000 IU/day vitamin D3 resulted in a reduction of percent breast density no greater than that seen with the placebo.

Impact: At doses of 1,000–3,000 IU/day, vitamin D supplementation will not reduce breast cancer risk through changes in breast density. Cancer Epidemiol Biomarkers Prev; 26(8); 1233–41. ©2017 AACR.
Racial Differences in Adjuvant Endocrine Therapy Use and Discontinuation in Association with Mortality among Medicare Breast Cancer Patients by Receptor Status
Authors: Farias Albert J. , Du Xianglin L.
Published: May 2017

Background: There are racial disparities in breast cancer mortality. Our purpose was to determine whether racial/ethnic differences in use and discontinuation of adjuvant endocrine therapy (AET) differed by hormone receptor status and whether discontinuation was associated with mortality.

Methods: We conducted a retrospective cohort study with SEER/Medicare dataset of women age ≥65 years diagnosed with stage I–III breast cancer in Medicare Part-D from 2007 to 2009, stratified by hormone receptor status. We performed multivariable logistic regressions to assess racial differences for the odds of AET initiation and Cox proportional hazards models to determine the risk of discontinuation and mortality.

Results: Of 14,902 women, 64.5% initiated AET <12 months of diagnosis. Among those with hormone receptor–positive cancer, 74.8% initiated AET compared with 5.6% of women with negative and 54.0% with unknown-receptor status. Blacks were less likely to initiate [OR, 0.76; 95% confidence interval (CI), 0.66–0.88] compared with whites. However, those with hormone receptor–positive disease were less likely to discontinue (HR, 0.89; 95% CI, 0.80–0.98). Women who initiated with aromatase inhibitors had increased risk of discontinuation compared with women who initiated tamoxifen (HR, 1.12; 95% CI, 1.05–1.20). Discontinuation within 12 months was associated with higher risk of all-cause (HR, 1.75; 95% CI, 1.74–2.00) and cancer-specific mortality (HR, 2.76; 95% CI, 1.74–4.38) after controlling for race/ethnicity.

Conclusions: There are racial/ethnic differences in AET use and discontinuation. Discontinuing treatment was associated with higher risk of all-cause and cancer-specific mortality regardless of hormone receptor status.

Impact: This study underscores the need to study factors that influence discontinuation and the survival benefits of receiving AET for hormone receptor–negative breast cancer. Cancer Epidemiol Biomarkers Prev; 26(8); 1266–75. ©2017 AACR.
The Yield of Abdominal Ultrasound in the Evaluation of Elevated Liver Enzymes during the Second and the Third Trimester of Pregnancy
Authors: Mohr-Sasson Aya , Schiff Eyal , Suday Ramy Rahamim , Hayman Zehava , Kleinbaum Yeruham , Kalter-Farber Anat , Mashiach Roy , Yinon Yoav , Dulitzki Moti , Sivan Eyal , Mazaki-Tovi Shali
Published: May 2017

Aims: To determine the clinical yield of abdominal ultrasound in the evaluation of elevated liver enzymes (ELEs) in the second and the third trimester of pregnancy. Methods: A retrospective cohort study including all pregnant women admitted to a single tertiary care center was conducted between April 2011 and January 2015 with ELE. Inclusion criteria included gestational age above 24 weeks and ELEs, abdominal ultrasound report, and live fetus. Exclusion criteria included known maternal liver disease, structural or chromosomal fetal anomalies, and positive serology for viral hepatitis. All patients underwent abdominal ultrasound. A significant finding of this study led to a change in treatment. Results: One hundred and twenty patients (41.8%) met inclusion criteria: 93 (77.5%) had a normal scan and 27 (22.5%) had abnormal findings. Significant ultrasound findings were found only in 2 (1.6%) patients: gallstones in the common bile duct and suspected autoimmune hepatitis. There were no significant differences between patients with and without ultrasound findings in the rate of cholestasis of pregnancy, preeclampsia, chronic hypertension, and gestation diabetes. Conclusion: Abdominal ultrasound examination in this population has a low clinical yield. The decision to perform an abdominal ultrasound must be individualized based on the obstetric history, clinical findings, and the level of liver enzymes.
Breastfeeding, Childhood Asthma, and Allergic Disease
Authors: Oddy Wendy H.
Published: May 2017

The worldwide prevalence of childhood asthma has been increasing considerably, and the protection afforded by breastfeeding in its development has been the subject of controversy for more than 80 years. Previous systematic reviews have generally found a protective effect of breastfeeding on allergic outcomes, although many studies have methodological limitations. Although breastfeeding is protective against lower respiratory tract infection during infancy, such protection has not been demonstrated for asthma in all studies. Breastfeeding has health benefits for the mother and child. Exclusive breastfeeding for the first 6 months of an infant's life, with continued breastfeeding for up to 2 years or longer, is recognized as the “gold” standard for infant feeding because human milk is uniquely suited to the human infant, and its nutritional content and bioactivity promote a healthy development. There is increasing concern that the practice of delaying complementary foods until 6 months may exacerbate the risk of allergic disease. Breast milk contains immunological components that protect against infections and allergic disease in infancy. The composition of human breast milk is complex, containing factors that interact with the infant immune system and intestinal milieu including allergens, cytokines, immunoglobulins, polyunsaturated fatty acids, and chemokines. Transforming growth factor β is a cytokine in human milk involved in maintaining intestinal homeostasis, inflammation regulation, and oral tolerance development. Modern day society, with increased standards of hygiene, has changed the gut flora of Western infants, potentially impacting the risk of developing immune-mediated diseases including allergic disease and asthma. Microbial diversity is intrinsic to healthy immune maturation and function. Compared to breastfed infants, formula-fed infants had lower bacterial diversity and an altered intestinal microbiota in the first few weeks of life associated with an increased risk of eczema and asthma. Favorable gut colonization through continued breastfeeding may promote tolerance as well as protection when complementary feeding is initiated.
Romantic Relationships of People with Borderline Personality: A Narrative Review
Authors: Navarro-Gómez Sara , Frías Álvaro , Palma Carol
Published: May 2017

Background: Romantic relationships are one of the most interesting areas of interpersonal functioning in people with borderline personality. The aim of this narrative review was to synthesise empirical findings on this issue. Sampling and Methods: The PubMed and PsycINFO databases were searched for pertinent materials published between 1980 and March 2016. Thirty articles met the inclusion criteria. Results: Several longitudinal and cross-sectional studies showed that people with borderline personality disorder (BPD) or BPD traits had more - but less prolonged - romantic relationships than people without BPD. The stable relationships of people with BPD or with BPD traits were also less satisfying and more hostile than those of people without BPD. People with BPD or BPD traits had relationships characterised by insecure attachment and passive-aggressive communications. Personality disorders and anxious attachment were more prevalent among the partners of people with BPD or with BPD traits when compared with partners of people without BPD. Conclusion: Unstable and chaotic romantic relationships are at the core of interpersonal dysfunction in BPD. More longitudinal research is needed to delineate the relationship between BPD symptoms and romantic relationship dysfunction, including the modulating role of the partner's clinical features in such an association.
Internal Carotid Artery and the Proximal M1 Segment Are Optimal Targets for Mechanical Thrombectomy
Authors: Sillanpää Niko , Protto Sara , Saarinen Jukka T. , Pienimäki Juha-Pekka , Seppänen Janne , Numminen Heikki , Rusanen Harri
Published: May 2017

Background and Purpose: Mechanical thrombectomy (MT) is an established treatment of acute anterior circulation stroke caused by large vessel occlusion (LVO). We compared the clinical outcome (3-month modified Rankin Scale, mRS) in hyperacute (<3h from the onset of symptoms) ischemic stroke between an MT and an intravenous thrombolysis (IVT) cohort in proximal (ICA and the proximal M1 segment of the middle cerebral artery) and distal (the distal M1 and the M2 segment) LVOs. Methods: We prospectively reviewed 67 patients who underwent MT with newer-generation stent retrievers. The IVT cohort consisted of 98 patients who received IVT without MT. We recorded baseline clinical, procedural and imaging variables, technical outcome, 24-h imaging outcome, and the clinical outcome. Differences between the groups were studied with theoretically appropriate statistical tests and binary logistic regression analysis. Results: The proportion of patients who had a proximal LVO and experienced good (mRS ≤2) or excellent (mRS ≤1) clinical outcome was significantly larger in the MT group (62 vs. 7%, p < 0.001; 47 vs. 3%, p < 0.001, respectively). In a regression model including relevant confounding variables, good clinical outcome was seen significantly more often among patients with proximal occlusions (OR = 6.0, CI 95% 1.9-18.3, p = 0.002). In a similar model, no statistically significant differences were observed in patients with more distal occlusions. Conclusions: MT is superior to IVT in achieving good clinical outcome in hyperacute anterior circulation stroke in the most proximal occlusions (ICA and proximal M1 segment). In the distal M1 and M2 segments neither of these therapies clearly outperforms the other.
Low discriminating power of the modified Ottawa VTE risk score in a cohort of patients with cancer from the RIETE registry
Authors: Alatri Adriano , Mazzolai Lucia , Font Carme , Tafur Alfonso , Valle Reina , Marchena Pablo , Ballaz Aitor , Tiraferri Eros , Font Llorenç , Monreal Manuel ,   the RIETE Investigators
Published: May 2017

Treatment of patients with cancer-associated venous thromboembolism (VTE) remains a major challenge. The modified Ottawa score is a clinical prediction rule evaluating the risk of VTE recurrences during the first six months of anticoagulant treatment in patients with cancer-related VTE. We aimed to validate the Ottawa score using data from the RIETE registry. A total of 11,123 cancer patients with VTE were included in the analysis. According to modified Ottawa score, 2,343 (21%) were categorised at low risk for VTE recurrences, 4,525 (41%) at intermediate risk, and 4,255 (38%) at high risk. Overall, 477 episodes of VTE recurrences were recorded during the course of anticoagulant therapy, with an incidence rate for low, intermediate, and high risk groups of 6.88% (95% CI 5.31–8.77), 11.8% (95% CI 10.1–13.6), and 21.3% (95% CI 18.8–24.1) patient-years, respectively. Overall mortality had an incidence rate of 21.1% (95% CI 18.2–24.3), 79.4% (95% CI: 74.9–84.1), and 134.7% (95% CI: 128.3–141.4) patient-years, respectively. The accuracy and discriminating power of the modified Ottawa score for VTE recurrence was modest, with low sensitivity, specificity and positive predictive value, and a C-statistics of 0.58 (95% CI: 0.56–0.61). In our analysis, the modified Ottawa score did not accurately predict VTE recurrence among patients with cancer-associated thrombosis, thus hindering its use in clinical practice. It is time to define a new score including other clinical predictors.
Editorial
Authors: Braga Felipe Eduardo Lázaro
Published: May 2017

Editorial da edição n. 8 da Revista Primeiros Estudos.
Guerra “selvagem” e guerra “civilizada”: da existência à supressão do inimigo
Authors: Piaia Danilo Mendes
Published: May 2017

O choque do Velho Mundo frente à belicosidade do Novo Mundo pode ser pensado com o auxílio de textos etnográficos e filosóficos que nos permitem questionar se o homem ocidental e o ameríndio entendiam e praticavam a guerra da mesma forma. Desde a perspectiva essencialista de Pierre Clastres a guerra é o meio das sociedades primitivas atingirem um fim político, seu ideal de autarquia e indivisão. Por outro lado, desde a perspectiva heracliteana adotada por Carneiro da Cunha e Viveiros de Castro, a guerra é o elemento fundante em relação ao ser social tupinambá. Ainda que de maneiras diferentes, a guerra primitiva observada por estes três autores parece convergir, quanto a seus efeitos, em direção à existência do inimigo, do Outro não-aliado, promovendo a diferença e a multiplicidade. Já a guerra estatal-ocidental, conforme pensada por Deleuze e Guattari, ainda que conduzida pelos Estados de acordo com seus fins políticos particulares, obedecem sua essência de suprimir o inimigo, de anular toda diferença reduzindo-a ao Um. As diferentes formas como a guerra é entendida no seio destas sociedades ameríndias e no seio das sociedades estatais-ocidentais revelam, portanto, maneiras opostas de se relacionar com a diferença.
Apresentação
Authors: Oliveira Thiago Rodrigues
Published: May 2017

Apresentação do dossiê temático Violência, Justiça e Direitos Humanos.
Induced Pluripotent Stem Cell–Derived Cardiomyocytes Provide In Vivo Biological Pacemaker Function
Authors: Chauveau Samuel , Anyukhovsky Evgeny P. , Ben-Ari Meital , Naor Shulamit , Jiang Ya-Ping , Danilo Peter , Rahim Tania , Burke Stephanie , Qiu Xiaoliang , Potapova Irina A. , Doronin Sergey V. , Brink Peter R. , Binah Ofer , Cohen Ira S. , Rosen Michael R.
Published: May 2017

Background—

Although multiple approaches have been used to create biological pacemakers in animal models, induced pluripotent stem cell–derived cardiomyocytes (iPSC-CMs) have not been investigated for this purpose. We now report pacemaker function of iPSC-CMs in a canine model.

Methods and Results—

Embryoid bodies were derived from human keratinocytes, their action potential characteristics determined, and their gene expression profiles and markers of differentiation identified. Atrioventricular blocked dogs were immunosuppressed, instrumented with VVI pacemakers, and injected subepicardially into the anterobasal left ventricle with 40 to 75 rhythmically contracting embryoid bodies (totaling 1.3–2×10
6
cells). ECG and 24-hour Holter monitoring were performed biweekly. After 4 to 13 weeks, epinephrine (1 μg kg
−1
min
−1
) was infused, and the heart removed for histological or electrophysiological study. iPSC-CMs largely lost the markers of pluripotency, became positive for cardiac-specific markers. and manifested
I
f
-dependent automaticity. Epicardial pacing of the injection site identified matching beats arising from that site by week 1 after implantation. By week 4, 20% of beats were electronically paced, 60% to 80% of beats were matching, and mean and maximal biological pacemaker rates were 45 and 75 beats per minute. Maximum night and day rates of matching beats were 53±6.9 and 69±10.4 beats per minute, respectively, at 4 weeks. Epinephrine increased rate of matching beats from 35±4.3 to 65±4.0 beats per minute. Incubation of embryoid bodies with the vital dye, Dil, revealed the persistence of injected cells at the site of administration.

Conclusions—

iPSC-CMs can integrate into host myocardium and create a biological pacemaker. Although this is a promising development, rate and rhythm of the iPSC-CMs pacemakers remain to be optimized.
Exploring the Causal Pathway From Telomere Length to Coronary Heart Disease
Authors: Zhan Yiqiang , Karlsson Ida K. , Karlsson Robert , Tillander Annika , Reynolds Chandra A. , Pedersen Nancy L. , Hägg Sara
Published: May 2017

Rationale:

Observational studies have found shorter leukocyte telomere length (TL) to be a risk factor for coronary heart disease (CHD), and recently the association was suggested to be causal. However, the relationship between TL and common metabolic risk factors for CHD is not well understood. Whether these risk factors could explain pathways from TL to CHD warrants further attention.

Objective:

To examine whether metabolic risk factors for CHD mediate the causal pathway from short TL to increased risk of CHD using a network Mendelian randomization design.

Methods and Results:

Summary statistics from several genome-wide association studies were used in a 2-sample Mendelian randomization study design. Network Mendelian randomization analysis—an approach using genetic variants as the instrumental variables for both the exposure and mediator to infer causality—was performed to examine the causal association between telomeres and CHD and metabolic risk factors. Summary statistics from the ENGAGE Telomere Consortium were used (n=37 684) as a TL genetic instrument, CARDIoGRAMplusC4D Consortium data were used (case=22 233 and control=64 762) for CHD, and other consortia data were used for metabolic traits (fasting insulin, triglyceride, total cholesterol, low-density lipoprotein cholesterol, fasting glucose, diabetes mellitus, glycohemoglobin, body mass index, waist circumference, and waist:hip ratio). One-unit increase of genetically determined TL was associated with −0.07 (95% confidence interval, −0.01 to −0.12;
P
=0.01) lower log-transformed fasting insulin (pmol/L) and 21% lower odds (95% confidence interval, 3–35;
P
=0.02) of CHD. Higher genetically determined log-transformed fasting insulin level was associated with higher CHD risk (odds ratio, 1.86; 95% confidence interval, 1.01–3.41;
P
=0.04).

Conclusions:

Overall, our findings support a role of insulin as a mediator on the causal pathway from shorter telomeres to CHD pathogenesis.
Risk Factors for Heart Failure in Patients With Chronic Kidney Disease: The CRIC (Chronic Renal Insufficiency Cohort) Study
Authors: He Jiang , Shlipak Michael , Anderson Amanda , Roy Jason A. , Feldman Harold I. , Kallem Radhakrishna Reddy , Kanthety Radhika , Kusek John W. , Ojo Akinlolu , Rahman Mahboob , Ricardo Ana C. , Soliman Elsayed Z. , Wolf Myles , Zhang Xiaoming , Raj Dominic , Hamm Lee , Appel Lawrence J. , Go Alan S. , Lash James P. , Townsend Raymond R.
Published: May 2017

Background

Heart failure is common in patients with chronic kidney disease. We studied risk factors for incident heart failure among 3557 participants in the CRIC (Chronic Renal Insufficiency Cohort) Study.

Methods and Results

Kidney function was assessed by estimated glomerular filtration rate (
eGFR
) using serum creatinine, cystatin C, or both, and 24‐hour urine albumin excretion. During an average of 6.3 years of follow‐up, 452 participants developed incident heart failure. After adjustment for age, sex, race, and clinical site, hazard ratio (95%
CI
) for heart failure associated with 1
SD
lower creatinine‐based
eGFR
was 1.67 (1.49, 1.89), 1 SD lower cystatin C‐based‐
eGFR
was 2.43 (2.10, 2.80), and 1 SD higher log‐albuminuria was 1.65 (1.53, 1.78), all
P
<0.001. When all 3 kidney function measures were simultaneously included in the model, lower cystatin C‐based
eGFR
and higher log‐albuminuria remained significantly and directly associated with incidence of heart failure. After adjusting for
eGFR
, albuminuria, and other traditional cardiovascular risk factors, anemia (1.37, 95%
CI
1.09, 1.72,
P
=0.006), insulin resistance (1.16, 95%
CI
1.04, 1.28,
P
=0.006), hemoglobin A1c (1.27, 95%
CI
1.14, 1.41,
P
<0.001), interleukin‐6 (1.15, 95%
CI
1.05, 1.25,
P
=0.002), and tumor necrosis factor‐α (1.10, 95%
CI
1.00, 1.21,
P
=0.05) were all significantly and directly associated with incidence of heart failure.

Conclusions

Our study indicates that cystatin C‐based
eGFR
and albuminuria are better predictors for risk of heart failure compared to creatinine‐based
eGFR
. Furthermore, anemia, insulin resistance, inflammation, and poor glycemic control are independent risk factors for the development of heart failure among patients with chronic kidney disease.
Remote Ischemic Perconditioning to Reduce Reperfusion Injury During Acute ST‐Segment–Elevation Myocardial Infarction: A Systematic Review and Meta‐Analysis
Authors: McLeod Shelley L. , Iansavichene Alla , Cheskes Sheldon
Published: May 2017

Background

Remote ischemic conditioning (
RIC
) is a noninvasive therapeutic strategy that uses brief cycles of blood pressure cuff inflation and deflation to protect the myocardium against ischemia–reperfusion injury. The objective of this systematic review was to determine the impact of
RIC
on myocardial salvage index, infarct size, and major adverse cardiovascular events when initiated before catheterization.

Methods and Results

Electronic searches of Medline, Embase, and Cochrane Central Register of Controlled Trials were conducted and reference lists were hand searched. Randomized controlled trials comparing percutaneous coronary intervention (
PCI
) with and without
RIC
for patients with ST‐segment–elevation myocardial infarction were included. Two reviewers independently screened abstracts, assessed quality of the studies, and extracted data. Data were pooled using random‐effects models and reported as mean differences and relative risk with 95% confidence intervals. Eleven articles (9 randomized controlled trials) were included with a total of 1220 patients (
RIC
+
PCI
=643,
PCI
=577). Studies with no events were excluded from meta‐analysis. The myocardial salvage index was higher in the
RIC
+
PCI
group compared with the
PCI
group (mean difference: 0.08; 95% confidence interval, 0.02–0.14). Infarct size was reduced in the
RIC
+
PCI
group compared with the
PCI
group (mean difference: −2.46; 95% confidence interval, −4.66 to −0.26). Major adverse cardiovascular events were lower in the
RIC
+
PCI
group (9.5%) compared with the
PCI
group (17.0%; relative risk: 0.57; 95% confidence interval, 0.40–0.82).

Conclusions

RIC
appears to be a promising adjunctive treatment to
PCI
for the prevention of reperfusion injury in patients with ST‐segment–elevation myocardial infarction; however, additional high‐quality research is required before a change in practice can be considered.
Cardiopulmonary Resuscitation Training Disparities in the United States
Authors: Blewer Audrey L. , Ibrahim Said A. , Leary Marion , Dutwin David , McNally Bryan , Anderson Monique L. , Morrison Laurie J. , Aufderheide Tom P. , Daya Mohamud , Idris Ahamed H. , Callaway Clifton W. , Kudenchuk Peter J. , Vilke Gary M. , Abella Benjamin S.
Published: May 2017

Background

Bystander cardiopulmonary resuscitation (
CPR
) is associated with increased survival from cardiac arrest, yet bystander CPR rates are low in many communities. The overall prevalence of
CPR
training in the United States and associated individual‐level disparities are unknown. We sought to measure the national prevalence of
CPR
training and hypothesized that older age and lower socioeconomic status would be independently associated with a lower likelihood of
CPR
training.

Methods and Results

We administered a cross‐sectional telephone survey to a nationally representative adult sample. We assessed the demographics of individuals trained in
CPR
within 2 years (currently trained) and those who had been trained in
CPR
at some point in time (ever trained). The association of
CPR
training and demographic variables were tested using survey weighted logistic regression. Between September 2015 and November 2015, 9022 individuals completed the survey; 18% reported being currently trained in
CPR
, and 65% reported training at some point previously. For each year of increased age, the likelihood of being currently
CPR
trained or ever trained decreased (currently trained: odds ratio, 0.98; 95%
CI,
0.97–0.99;
P
<0.01; ever trained:
OR
, 0.99; 95%
CI
, 0.98–0.99;
P
=0.04). Furthermore, there was a greater then 4‐fold difference in odds of being currently
CPR
trained from the 30–39 to 70–79 year old age groups (95%
CI
, 0.10–0.23). Factors associated with a lower likelihood of
CPR
training were lesser educational attainment and lower household income (
P
<0.01 for each of these variables).

Conclusions

A minority of respondents reported current training in
CPR
. Older age, lesser education, and lower income were associated with reduced likelihood of
CPR
training. These findings illustrate important gaps in US
CPR
education and suggest the need to develop tailored
CPR
training efforts to address this variability.
Globalisation Interrupted? The Case of Opium in the Circulation of Medical Knowledge in Ming Dynasty China
Authors: Álvarez José Antonio Cantón
Published: May 2017

The spread of Western medical practices to China, initiated during the Mongol dynasty, is often considered an example of “medical globalisation,” but few studies have looked at the actual level of adoption of Western medicine in the period after the Yuan dynasty. This essay analyses eighteen Ming dynasty medical sources in order to assess the role of opium, a Western drug, in post-Yuan medical practice. This essay concludes that opium was not widely used in the first centuries of the Ming dynasty, and, when finally adopted in the sixteenth century, its use was disconnected from the Yuan dynasty medical tradition. These findings make us question the continuity and even the existence of the “Mongol medical globalisation,” as well as the validity of the use of synchronic methodology for the study of centuries-long processes such as globalisation.
Civil-Servant Aspirants: Ottoman Social Mobility in the Second Half of the Nineteenth Century
Authors: Paz Omri
Published: May 2017

With the transition from a government led by the military-administrative ruling class to that managed by the civil-servant sector during the Tanzimat reforms, the socioeconomic nature of the Ottoman bureaucracy changed dramatically. Studies have tended to focus on the new civil servants educated in therüşdiye(state secondary schools), but poor, unskilled Ottomans seeking to improve their socioeconomic status found the newly established Ottoman police a vehicle to social mobility. A job as a policeman was one of the few these men could qualify for, allowing them to earn a steady income and receive social benefits. Gradually, service in the police force entailed becoming part of an evolving civil-servant sector.
Mapping the Growth of an Arabian Gulf Town: The Case of Doha, Qatar
Authors: Fletcher Richard , Carter Robert A.
Published: May 2017

This paper is based on research undertaken for the Origins of Doha Project. It is a unique attempt to interrogate the construct of the Arab city against rigorously collected evidence and meticulous analysis of historical urban geography. We have found that Doha in its urban layout, physical development, architecture, and pre-oil demographics, combined its disparate cosmopolitan elements into a blend that probably typified the historic Gulf town, simultaneously encapsulating aspects of the generalised “Arab and Islamic town.” We have found strong structural principles at work in both the traditional and the early modern town, many of which correlate strongly with tribal social organisation, although the historic population of Doha was neither overwhelmingly tribal in character nor entirely Arab in origin. Rather, these constituted prevailing ideologies, social structures, and identities in a diverse and cosmopolitan population
Bees of the Hemihalictus series of Lasioglossum Curtis (Hymenoptera, Halictidae) in South Korea
Authors: MURAO RYUKI
Published: May 2017

The South Korean fauna of the Hemihalictus series belonging to the genus Lasioglossum Curtis are reviewed. Twenty-seven species are recognized for the country. Lasioglossum laevoides Ebmer is recorded from the Korean Peninsula for the first time. The following species are newly recorded from South Korea: L. albipes villosum Ebmer, L. calceatum (Scopoli), L. kiautschouense (Strand), L. sakagamii Ebmer, L. speculinum (Cockerell), L. subfulvicorne subfulvicorne (Blüthgen), L. villosulum (Kirby), and L. vulsum (Vachal). Illustrated keys to females and males of South Korean species are provided. Bionomical data such as flight and flower records in South Korea are given.
World checklist of flea-beetles of the genus Epitrix (Coleoptera: Chrysomelidae: Galerucinae: Alticini)
Authors: BIEŃKOWSKI ANDRZEJ O. , ORLOVA-BIENKOWSKAJA MARINA J.
Published: May 2017

The world checklist of the genus Epitrix (Coleoptera: Chrysomelidae: Galerucinae: Alticini) is necessary, since many species of this genus are serious pests of potato and other Solanaceae, and since some species have been inadvertedly introduced from one continent to another and established. We have compiled the catalogue of all species described to date. There are 162 species and 11 subspecies in the world. The geographic distribution is indicated for each species.