bluuebunny/crossref_metadata_2025 huggingface dataset:
A novel single-beat approach to assess right ventricular systolic function
Authors: Bellofiore Alessandro , Vanderpool Rebecca , Brewis Melanie J. , Peacock Andrew J. , Chesler Naomi C.
Published: October 2017

Clinical assessment of right ventricular (RV) contractility in diseases such as pulmonary arterial hypertension (PAH) has been hindered by the lack of a robust methodology. Here, a novel, clinically viable, single-beat method was developed to assess end-systolic elastance (Ees), a measure of right ventricular (RV) contractility. We hypothesized that this novel approach reduces uncertainty and interobserver variability in the estimation of the maximum isovolumic pressure (Piso), the key step in single-beat methods. The new method was designed to include a larger portion of the RV pressure data and minimize subjective adjustments by the operator. Data were obtained from right heart catheterization of PAH patients in a multicenter prospective study ( data set 1) and a single-center retrospective study ( data set 2). To obtain Piso, three independent observers used an established single-beat method (based on the first derivative of the pressure waveform) and the novel method (based on the second derivative). Interobserver variability analysis included paired t-test, one-way ANOVA, interclass correlation (ICC) analysis, and a modified Bland-Altman analysis. The Piso values obtained from the two methods were linearly correlated for both data set 1 ( R2 = 0.74) and data set 2 ( R2 = 0.91). Compared with the established method, the novel method resulted in smaller interobserver variability ( P < 0.001), nonsignificant differences between observers, and a narrower confidence interval. By reducing uncertainty and interobserved variability, this novel approach may pave the way for more effective clinical management of PAH.

NEW & NOTEWORTHY A novel methodology to assess right ventricular contractility from clinical data is demonstrated. This approach significantly reduces interobserver variability in the analysis of ventricular pressure data, as demonstrated in a relatively large population of subjects with pulmonary hypertension. This study may enable more accurate clinical monitoring of systolic function in subjects with pulmonary hypertension.
Correlation between Insulin Resistance and Thyroid Nodule in Type 2 Diabetes Mellitus
Authors: Tang Yunzhao , Yan Tiantian , Wang Gang , Chen Yijun , Zhu Yanjuan , Jiang Zhenhuan , Yang Min , Li Chenguang , Li Zhu , Yu Ping , Wang Shanshan , Zhu Nannan , Ren Qiuyue , Ni Changlin
Published: October 2017

Objective. The present study explored the association between insulin resistance (IR) and the clinical characteristics of thyroid nodules in patients with type 2 diabetes mellitus (T2DM).Methods. All the patients were newly diagnosed with T2DM. 201 patients with thyroid nodule disease and 308 patients without the nodular thyroid disease. The participants were evaluated by relevant examination. Correlation analyses and regression analyses were performed to examine the relationships between the two groups.Results. HOMA-IR values, serum FT4 (free thyroxine) levels, and age were higher in the thyroid nodule group than in the control group. The proportion of women in the thyroid nodule group is greater than the proportion of women in the control group. Logistic regression analysis showed that age, sex, FT4, and HOMA-IR were positive factors for thyroid nodule. The volume and size of the thyroid nodule were positively correlated with HOMA-IR, irrespective of gender. The thyroid nodule volume and size and the TSH (thyroid stimulating hormone) were greater in females than in males, whereas FT3 (free triiodothyronine) was lower in females.Conclusion. IR might be a risk factor for thyroid nodule. Whether alleviating the IR might slow the growth, or diminish the volume and size of the thyroid nodules, is yet to be elucidated.
An Approach to Integrating Tactical Decision-Making in Industrial Maintenance Balance Scorecards Using Principal Components Analysis and Machine Learning
Authors: Rodríguez-Padial Néstor , Marín Marta , Domingo Rosario
Published: October 2017

The uncertainty of demand has led production systems to become increasingly complex; this can affect the availability of the machines and thus their maintenance. Therefore, it is necessary to adequately manage the information that facilitates decision-making. This paper presents a system for making decisions related to the design of customized maintenance plans in a production plant. This paper addresses this tactical goal and aims to provide greater knowledge and better predictions by projecting reliable behavior in the medium-term, integrating this new functionality into classic Balance Scorecards, and making it possible to extend their current measuring function to a new aptitude: predicting evolution based on historical data. In the proposed Custom Balance Scorecard design, an exploratory data phase is integrated with another analysis and prediction phase using Principal Component Analysis algorithms and Machine Learning that uses Artificial Neural Network algorithms. This new extension allows better control over the maintenance function of an industrial plant in the medium-term with a yearly horizon taken over monthly intervals which allows the measurement of the indicators of strategic productive areas and the discovery of hidden behavior patterns in work orders. In addition, this extension enables the prediction of indicator outcomes such as overall equipment efficiency and mean time to failure.
Analysis of a No Equilibrium Linear Resistive-Capacitive-Inductance Shunted Junction Model, Dynamics, Synchronization, and Application to Digital Cryptography in Its Fractional-Order Form
Authors: Takougang Kingni Sifeu , Fautso Kuiate Gaetan , Kengne Romanic , Tchitnga Robert , Woafo Paul
Published: October 2017

A linear resistive-capacitive-inductance shunted junction (LRCLSJ) model obtained by replacing the nonlinear piecewise resistance of a nonlinear resistive-capacitive-inductance shunted junction (NRCLSJ) model by a linear resistance is analyzed in this paper. The LRCLSJ model has two or no equilibrium points depending on the dc bias current. For a suitable choice of the parameters, the LRCLSJ model without equilibrium point can exhibit regular and fast spiking, intrinsic and periodic bursting, and periodic and chaotic behaviors. We show that the LRCLSJ model displays similar dynamical behaviors as the NRCLSJ model. Moreover the coexistence between periodic and chaotic attractors is found in the LRCLSJ model for specific parameters. The lowest order of the commensurate form of the no equilibrium LRCLSJ model to exhibit chaotic behavior is found to be 2.934. Moreover, adaptive finite-time synchronization with parameter estimation is applied to achieve synchronization of unidirectional coupled identical fractional-order form of chaotic no equilibrium LRCLSJ models. Finally, a cryptographic encryption scheme with the help of the finite-time synchronization of fractional-order chaotic no equilibrium LRCLSJ models is illustrated through a numerical example, showing that a high level security device can be produced using this system.
Squamous Cell Carcinoma of the Thyroid as a Result of Anaplastic Transformation from BRAF-Positive Papillary Thyroid Cancer
Authors: Basnet Alina , Pandita Aakriti , Fullmer Joseph , Sivapiragasam Abirami
Published: October 2017

Papillary thyroid carcinoma (PTC) is the most common malignant neoplasm of the thyroid. Majority of the PTC carries an excellent prognosis. However, patients with tall cell variant (TCV) of papillary thyroid carcinoma have a worse prognosis than those with the classic variant. On the other hand, squamous cell carcinoma of the thyroid (SCT) is an unusual neoplasm thought to arise as a primary tumor or as a component of an anaplastic or undifferentiated carcinoma. We report a patient with TCV of PTC presenting years later with squamous transformation. In addition, the patient was found to have BRAF mutation. Such dedifferentiation is considered to be a rare phenomenon and has been reported only in the form of case reports in the literature. The relationship between BRAFV600E mutation and squamous cell transformation of papillary thyroid cancer is unknown at this time. Meticulous pathology is needed to identify such variants. Our patient responded to treatment with concurrent chemotherapy with carboplatin and paclitaxel along with radiation.
Flood Risk Zoning by Using 2D Hydrodynamic Modeling: A Case Study in Jinan City
Authors: Cheng Tao , Xu Zongxue , Hong Siyang , Song Sulin
Published: October 2017

Climate change and rapid urbanization have aggravated the rainstorm flood in Jinan City during the past decades. Jinan City is higher in the south and lower in the north with a steep slope inclined from the south to the north. This results in high‐velocity overland flow and deep waterlogging, which poses a tremendous threat to pedestrians and vehicles. Therefore, it is vital to investigate the rainstorm flood and further perform flood risk zoning. This study is carried out in the “Sponge City Construction” pilot area of Jinan City, where the InfoWorks ICM 2D hydrodynamic model is utilized for simulating historical and designed rainfall events. The model is validated with observations, and the causes for errors are analyzed. The simulated water depth and flow velocity are recorded for flood risk zoning. The result shows that the InfoWorks ICM 2D model performed well. The flood risk zoning result shows that rainfalls with larger recurrence intervals generate larger areas of moderate to extreme risk. Meanwhile, the zoning results for the two historical rainfalls show that flood with a higher maximum hourly rainfall intensity is more serious. This study will provide scientific support for the flood control and disaster reduction in Jinan City.
A Crowdsensing-Based Real-Time System for Finger Interactions in Intelligent Transport System
Authors: Song Chengqun , Cheng Jun , Feng Wei
Published: October 2017

Crowdsensing leverages human intelligence/experience from the general public and social interactions to create participatory sensor networks, where context-aware and semantically complex information is gathered, processed, and shared to collaboratively solve specific problems. This paper proposes a real-time projector-camera finger system based on the crowdsensing, in which user can interact with a computer by bare hand touching on arbitrary surfaces. The interaction process of the system can be completely carried out automatically, and it can be used as an intelligent device in intelligent transport system where the driver can watch and interact with the display information while driving, without causing visual distractions. A single camera is used in the system to recover 3D information of fingertip for hand touch detection. A linear-scanning method is used in the system to determine the touch for increasing the users’ collaboration and operationality. Experiments are performed to show the feasibility of the proposed system. The system is robust to different lighting conditions. The average percentage of correct hand touch detection of the system is 92.0% and the average time of processing one video frame is 30 milliseconds.
Methylmalonic Acidemia with Novel MUT Gene Mutations
Authors: Panigrahi Inusha , Bhunwal Savita , Varma Harish , Singh Simranjeet
Published: October 2017

A 5-year-old boy presented with recurrent episodes of fever, feeding problems, lethargy, from the age of 11 months, and poor weight gain. He was admitted and evaluated for metabolic causes and diagnosed as having methylmalonic acidemia (MMA). He was treated with vit B12 and carnitine supplements and has been on follow-up for the last 3 years. Mutation analysis by next generation sequencing (NGS), supplemented with Sanger sequencing, revealed two novel variants in the MUT gene responsible for MMA in exon 5 and exon 3, respectively. Recently he developed dystonic movements including orofacial dyskinesia. With advent of NGS, judicious use of NGS with Sanger sequencing can help identify causative possibly pathogenic mutations.
Impact of Patient–Provider Race, Ethnicity, and Gender Concordance on Cancer Screening: Findings from Medical Expenditure Panel Survey
Authors: Malhotra Jyoti , Rotter David , Tsui Jennifer , Llanos Adana A.M. , Balasubramanian Bijal A. , Demissie Kitaw
Published: October 2017

Background: Racial and ethnic minorities experience lower rates of cancer screening compared with non-Hispanic whites (NHWs). Previous studies evaluating the role of patient–provider race, ethnicity, or gender concordance in cancer screening have been inconclusive.

Methods: In a cross-sectional analysis using the Medical Expenditure Panel Survey (MEPS), data from 2003 to 2010 were assessed for associations between patient–provider race, ethnicity, and/or gender concordance and, screening (American Cancer Society guidelines) for breast, cervical, and colorectal cancer. Multivariable logistic analyses were conducted to examine associations of interest.

Results: Of the 32,041 patient–provider pairs in our analysis, more than 60% of the patients were NHW, 15% were non-Hispanic black (NHB), and 15% were Hispanic. Overall, patients adherent to cancer screening were more likely to be non-Hispanic, better educated, married, wealthier, and privately insured. Patient–provider gender discordance was associated with lower rates of breast [OR, 0.83; 95% confidence interval (CI), 0.76–0.90], cervical (OR, 0.83; 95% CI, 0.76–0.91), and colorectal cancer (OR, 0.84; 95% CI, 0.79–0.90) screening in all patients. This association was also significant after adjusting for racial and/or ethnic concordance. Conversely, among NHWs and NHBs, patient–provider racial and/or ethnic concordance was not associated with screening. Among Hispanics, patient–provider ethnic discordant pairs had higher breast (58% vs. 52%) and colorectal cancer (45% vs. 39%) screening rates compared with concordant pairs.

Conclusions: Patient–provider gender concordance positively affected cancer screening. Patient–provider ethnic concordance was inversely associated with receipt of cancer screening among Hispanics. This counter-intuitive finding requires further study.

Impact: Our findings highlight the importance of gender concordance in improving cancer screening rates. Cancer Epidemiol Biomarkers Prev; 26(12); 1804–11. ©2017 AACR.
Role of Molecular Biology in Diagnosis and Characterization of Vulvo-Vaginitis in Clinical Practice
Authors: Donders Gilbert G.G. , Ravel Jacques , Vitali Beatrice , Netea Mihai G. , Salumets Andres , Unemo Magnus
Published: October 2017

The diagnosis of vulvo-vaginal complaints has always been enigmatic in obstetrics and gynecology. Patients with clear, pathognomonic symptoms end up with a proper diagnosis and treatment most of the time, but unfortunately we are now living in a world where women reach out to the Internet and readily get all information as to which disease their symptoms correspond to and also find the appropriate treatment “over-the-counter.” Because of this trend, we as specialists are increasingly confronted with patients with complex and combined conditions. At the same time, extremely sensitive and accurate diagnostic tools are now being developed at a rapid pace, allowing the physicians to diagnose vulvo-vaginal disease with a substantially increased precision. Moreover, many of these molecular biology (MB)-based tests have become so common and affordable that self-sampling and self-testing are no longer utopia. On the other hand, too much information that is too readily available and that is too affordable also encompasses pitfalls, leading to gross overtreatment and psychological burden. As experienced caregivers, we should supervise these evolutions, define their place and proper use as diagnostic tools, utilize their potential as ad hoc tools to follow-up treatment efficacy and guide how such tools can be used for responsible self-testing. In the present paper, responding to the need for appropriate, quality assured and accessible tests for vulvo-vaginitis and the huge potential delivered by the rapidly developing MB methods, we recommend the need for a broad and regular discussion forum, composed of both clinical and technical experts and opinion makers, in order to match the needs with the huge opportunities and ideally combine the initiatives and forces into the same direction. This forum should then translate conceived strategies into regularly updated, evidence-based national and international guidelines.
Zinc Inhibits Collagenolysis by Cathepsin K and Matrix Metalloproteinases in Demineralized Dentin Matrix
Authors: Altinci Pinar , Seseogullari-Dirihan Roda , Can Gulsen , Pashley David , Tezvergil-Mutluay Arzu
Published: October 2017

The enzymatic degradation of dentin organic matrix occurs via both the action of matrix metalloproteinases (MMPs) and cysteine cathepsins (CCs). Zinc can prevent collagen hydrolysis by MMPs. However, its effect on the activity of dentin-bound CCs is not known. The aim of this study was to investigate the effect of zinc on matrix-bound cathepsin K and MMP activity in dentin. Completely demineralized dentin beams were divided into test groups (n = 9) and incubated at 37°C in an incubation media (1 mL) containing ZnCl2 of 0.02 (physiological level, control), 0.2, 0.5, 1, 5, 10, 20, 30, or 40 mM. The dry mass changes of the beams were determined, and incubation media were analyzed for cathepsin K- and MMP-specific collagen degradation end products - CTX (C-terminal cross-linked telopeptide of type I collagen) and ICTP (cross-linked carboxy-terminal telopeptide of type I collagen) - at 1, 3, and 7 days of incubation. The mass loss of the beams decreased when the zinc level in the incubation media was ≥5 mM (p < 0.05). The release of liberated collagen degradation telopeptides decreased in accordance with the decrease in the mass loss rates of the beams. Cathepsin K-induced dentin collagen degradation can be strongly inhibited by zinc. Zinc levels of ≥5 mM can be considered as a reliable threshold for the stabilization of dentin matrices.
Brain Metastases from Biliary Tract Cancer: A Monocentric Retrospective Analysis of 450 Patients
Authors: Frega Giorgio , Garajová Ingrid , Palloni Andrea , Barbera Maria Aurelia , Trossello Pastore Marco , Faccioli Luca , Spinardi Luca , De Lorenzo Stefania , Cubelli Marta , Pantaleo Maria Abbondanza , Biasco Guido , Brandi Giovanni
Published: October 2017

Objective: Brain metastases (BMs) from biliary tract cancer (BTC) are extremely rare. The aim of our study was to report the incidence of BMs in patients with BTC. Methods: We retrospectively analyzed a series of 450 patients with BTC. Presence of brain lesions was investigated only when symptoms were evident. Cumulative incidence, median overall survival (OS) from detection of BMs, median OS from cancer diagnosis, and median time from cancer diagnosis to detection of BMs were evaluated. Results: In our series, 6 patients developed BMs with an incidence of about 1.4%. Median OS from detection of BMs and from cancer diagnosis was, respectively, 3.7 (0.9-17.8) and 23 (9.9-57.6) months. Median time between cancer diagnosis and detection of BMs was 13.6 (7.3-52.8) months. Moreover, we observed a significant association between BMs and bone metastases (particularly vertebral lesions). Discussion: Despite the retrospective design, this is the first study evaluating the incidence of BMs among patients with BTC in Western countries. BMs from BTC remain atypical, although their incidence is probably a little higher than previously assumed. Patients with BMs had poor prognosis. Unpredictably, bone involvement occurred in 5 out of 6 patients.
The Socioeconomic Burden of Obesity
Authors: Kjellberg Jakob , Tange Larsen Arendse , Ibsen Rikke , Højgaard Betina
Published: October 2017

Objective: To evaluate the socioeconomic impact of obesity by estimating the direct and indirect costs associated with obesity in Denmark, based on individual level data. Methods: Costs were assessed for different BMI groups, and the relative risks for change in direct and indirect costs per BMI point above 30 were estimated. A fourth analysis estimated the odds ratio for comorbidities per BMI point above 30. Individual data on income, social transfer payments, healthcare costs and diagnoses were retrieved from national registries. Results: One BMI point above 30 was associated with a 2% decrease in income, a 3% increase in social transfer payments, and a 4% increase in healthcare costs. In absolute numbers, income contributed to most of the total economic burden. One BMI point above 30 was also associated with increased comorbidity, which explains the increase in both direct and indirect costs. Conclusion: Obesity is associated with increased comorbidity, giving rise to an increase in both direct and indirect costs. Especially income is affected, which emphasizes the importance of including both measures when evaluating the total socioeconomic burden of obesity. Our findings draw attention to the potential for saving public resources and preventing loss of income by preventing obesity.
Collection, Evaluation, and Coagulum Dissolution of Semen from Goeldi's Monkey, Callimico goeldii
Authors: Arakaki Paloma Rocha , de Carvalho Fernanda Maria , de Castro Paulo Henrique Gomes , Muniz José Augusto Pereira Carneiro , Folia Primatologica Editors
Published: October 2017

Research on Neotropical primates' reproduction is necessary due to the lack of available information and the increasing threat to these species. Callimico goeldii is listed as Vulnerable on the IUCN Red List of Threatened Species. This study aimed to test rectal electrostimulation for semen collection and evaluate seminal characteristics. Therefore, semen from 6 captive Goeldi's monkeys was collected and, for the first time, seminal characteristics are described. Coagulum formation was noted in all ejaculates, and we obtained partial or complete liquefaction of the samples. Results were (means ± SD): volume = 26.9 ± 11.87 μL; pH = 7.61 ± 0.28; concentration = 143.18 ± 174.96 × 106 spermatozoa/mL; total sperm motility = 83.33 ± 5.16%; linear progressive motility = 46 ± 24.08%; plasma membrane integrity = 36.38 ± 16.11%; acrosome integrity using fast-green/bengal-rose staining = 63.41 ± 11.72%, and kit Spermac® = 69.36 ± 11.81%; abnormal sperm = 72.5 ± 17.7%, with 16.2 ± 7.7% major defects and 56.3 ± 10% minor defects; sperm with high mitochondrial activity class I = 16.45 ± 22.25%. Rectal electrostimulation was an efficient method for semen collection in this species. Investigations are required to improve semen collection and handling, including cryopreservation methods.
Body Weight Changes after Deep Brain Stimulation for Obsessive-Compulsive Disorder or Depression
Authors: Linssen Rosalie S.N. , Oudijn Marloes S. , Mantione Mariska , van den Munckhof Pepijn , Denys Damiaan , Schuurman P. Richard
Published: October 2017

Background: In 2010, we published an often-cited case report describing smoking cessation and substantial weight loss after deep brain stimulation (DBS) for obsessive-compulsive disorder (OCD) in an obese patient. To test whether this single observation was also observed in the treated population at large, the weight changes of a larger cohort of patients who underwent DBS for OCD or major depressive disorder (MDD) were studied. Results: Data were available for 46 patients (30 OCD and 16 MDD patients; mean age 46.2 years, SD 10.9) with an average baseline body mass index (BMI) of 28.0 (SD 7.3), 26 of whom (57%) were overweight (n = 11), obese (n = 12), or morbidly obese (n = 3). Mean follow-up was 3.8 years (range 10 months to 8.7 years, SD 2.3), after which the average BMI was 28.1 (SD 7.0), not significantly different from baseline. The average BMI of the 15 patients with (morbid) obesity at baseline decreased from 36.8 to 34.6 (ns), while the average BMI of the 31 normal or “only” overweight patients at baseline increased from 23.8 to 25.0 (ns). Conclusion: There was no significant change in body weight on group level after DBS for either OCD or MDD.
The Clinical Significance of Physical Activity in Maintenance Dialysis Patients
Authors: Kang Seok Hui , Do Jun Young , Jeong Hye Yun , Lee So-Young , Kim Jun Chul
Published: October 2017

Background: The aim of the present study was to evaluate the effects of physical activity on various aspects in Asian dialysis patients. Methods: This was a retrospective cohort study. Study participants were recruited from 27 hospitals or dialysis centers in Korea (n = 1611). The participants were divided into 3 groups according to the degree of regular exercise: Inactive group, Intermediate group, and Active group. Results: The proportions of patients with frailty and the presence of each component decreased as physical activity increased. The presence and numbers of disabilities decreased as physical activity increased. The number of participants with a history of fall during the last 12 months was 149 (20.5%) in the Inactive group, 88 (16.9%) in the Intermediate group, and 48 (13.2%) in the Active group. Physical component scale and mental component scale scores increased as physical activity increased. The survival rate for all-cause death at 500 days was 95.5% in the Active group, 95.2% in the Intermediate group, and 93.5% in the Inactive group. Conclusion: High physical activity was associated with favorable results for most health-related quality of life scale scores, including frailty, disability, and exhaustion, in Korean dialysis patients.
The Relationship between Vitamin D and Type 2 Diabetes Is Intriguing: Glimpses from the Spect-China Study
Authors: Lu You , Zheng Yanjun , Wang Ningjian , Chen Yingchao , Li Qin , Han Bing , Chen Yi , Cheng Jing , Zhai Hualing , Xia Fangzhen , Meng Ying , Lu Yingli
Published: October 2017

Objective: Vitamin D is a multifunctional vitamin for our body. Type 2 diabetes mellitus (T2DM) is a common metabolic disease. Whether T2DM affects the serum 25(OH)D level has not been reported. The objective of this study was to reveal the extent to which vitamin D is present in the population in East China and to explore the relationship between serum 25(OH)D and T2DM. Methods: The cohort was selected based on a large investigation named Survey on Prevalence in East China including 12,702 participants aged 21-92 years old. All the participants completed the questionnaire and went through a physical examination. Fasting blood samples were collected to test serum 25(OH)D and other metabolism-related indicators. AVONA was used to test the significance of differences among groups. Multinomial logistic regression was used to assess the association of T2DM with serum 25(OH)D level. Results: The overall percentage of vitamin D deficiency was 80.55% (male 74.1%, female 85.0%). Men with lower serum 25(OH)D level had high value in homeostasis model assessment of insulin resistance and HbA1c. The serum 25(OH)D level of those who were diagnosed with T2DM was higher than that in non-diabetics. The serum 25(OH)D level of pre-diabetes was the highest. T2DM patients trended to have higher serum 25(OH)D levels. Conclusion: Vitamin D deficiency is common among the people in East-China. T2DM patients had higher levels of serum 25(OH)D. The relationship between vitamin D and T2DM is intriguing. It seemed that vitamin D was either irrelevant directly to T2DM or resisted in T2DM patients.
Multiple Sclerosis and Clinical Gait Analysis before and after Fampridine: A Systematic Review
Authors: Lecat Magaly , Decavel Pierre , Magnin Eloi , Lucas Brigitte , Gremeaux Vincent  , Sagawa Yoshimasa
Published: October 2017

Background: Gait impairment is one of the most disabling symptoms in people with multiple sclerosis (PwMS). Fampridine, has demonstrated a positive effect on gait speed in PwMS after 14 days of treatment but the long-term effects have not yet been demonstrated. This study reviews the long-term effects of fampridine on gait in PwMS. Summary: This systematic review was conducted according to the PRISMA statement. Studies were considered long term if treatment exceeded 28 days. From the 498 studies identified, 18 (2,200 patients) fulfilled all eligibility criteria. Only 3 studies followed-up patients for >1 year and one of these showed a non-significant improvement in the gait speed. Key Messages: Fampridine seems to be beneficial at improving gait speed in PwMS in the long term. Further long-term studies are needed on related gait and functional parameters.
Hepatic T Cell Tolerance Induction in An Inflammatory Environment
Authors: Dywicki Janine , Noyan Fatih , Misslitz Ana Clara , Hapke Martin , Galla Melanie , Schlue Jerome , Liblau Roland S. , Taubert Richard , Manns Michael P. , Jaeckel Elmar , Hardtke-Wolenski Matthias
Published: October 2017

For the development of autoimmune hepatitis (AIH), genetic predisposition and environmental triggers are of major importance. Although experimental AIH can be induced in genetically susceptible mice, the low precursor frequency of autoreactive T cells hampers a deeper analysis of liver-specific T cells. Here, we established a system where the model antigen hemagglutinin (HA) is expressed exclusively in hepatocytes of Rosa26-HA mice following administration of a replication deficient adenovirus expressing Cre recombinase (Ad-Cre). Under these conditions, hepatocytes mimic the generation of altered-self neoantigens. To follow autoreactive T cells during AIH, we adoptively transferred HA-­specific Cl4-TCR and 6.5-TCR T cells into Ad-Cre infected ­Rosa26-HA mice. Alternatively, Rosa26-HA mice have been crossed with TCR transgenic mice that were infected with Ad-Cre to break hepatic tolerance and induce the expression of the HA antigen as a hepatic self-antigen. Surprisingly, neither adoptive transfer nor a very high precursor frequency of autoreactive T cells was able to break tolerance in the context of adenoviral infection. The low proliferation of the antigen experienced autoreactive T cells despite the presence of the autoantigen and inflammation points to anergy as a potential tolerance mechanism. This model underscores the crucial importance of genetic susceptibility to break tolerance against hepatic autoantigens.
Insulin Regimens to Treat Hyperglycemia in Hospitalized Patients on Nutritional Support: Systematic Review and Meta-Analyses
Authors: Verçoza Viana Marina , Verçoza Viana Luciana , Tavares Ana Laura , de Azevedo Mirela Jobim
Published: October 2017

Background: The best insulin regimen to treat hyperglycemia in hospitalized patients on nutritional support (NS) is unclear. Methods: We searched electronic databases to identify cohort studies or randomized clinical trials in order to evaluate the efficacy of different insulin regimens used to treat hyperglycemia in hospitalized patients on NS on diverse outcomes: mean blood glucose (MBG), hypoglycemia, length of stay in hospital, and mortality. Results: Seventeen studies from a total of 5,030 were included. Enteral Group included 8 studies; 1,203 patients using rapid, glargine, NPH, or Premix insulin; MBG 108-225 mg/dL; hypoglycemia 0-13%. In indirect meta-analyses, NPH insulin ranked best for glucose control (MD 95% CI -2.50 mg/dL [2.65 to -2.35]). Parenteral Group included 4 studies; 228 patients using regular and glargine or NPH insulin; MBG 137-202 mg/dL; hypoglycemia 0-40%. In meta-analyses comparing regular insulin added to parenteral nutrition bag with glargine, MBG (MD 95% CI -3.78 mg/dL [-11.93 to 4.37]; I2 = 0%) or hypoglycemia frequency (RR 95% CI 1.37 [0.43-4.32]; I2 = 70.7%) did not differ. The description related to hospital length of stay and mortality was inconsistent between groups. Conclusions: The best insulin regimen to treat hyperglycemia in hospitalized patients on NS has not been established; best results using insulin regimens with NPH in enteral nutrition do not seem to be clinically relevant.
Pepsin and Its Importance for Functional Dyspepsia: Relic, Regulator or Remedy?
Authors: Petersen Karl-Uwe
Published: October 2017

Background: Functional dyspepsia is a heterogeneous disorder lacking an established therapeutic strategy. Historical treatment attempts with pepsin products were shrugged off, as a simple calculation shows that quantitative substitution is pointless. However, such attempts might have been right for the wrong reason. Summary: Today, the role of pepsins is primarily seen in the provision of signalling amino acids (especially phenylalanine and tryptophan) and peptides, which initiate processes promoting digestion. Proteolysis benefits from pepsin variants showing, contrary to common belief, activities of up to a pH value of 5.0. Non-clinical and clinical studies support the view that liberated amino acids produce a variety of direct and indirect effects. Signal chains stimulated by (mostly aromatic) amino acids lead to secretion of gastrin and cholecystokinin (CCK), mediated, respectively, by CCK2 (gastrin) and Ca2+-sensing receptors in the parietal cell, and Ca2+-sensing receptors in the antral and duodenal mucosa. Thus, CCK effects such as secretion of pancreatic enzymes and promotion of gastric accommodation are (also) consequential to peptic liberation of amino acids. Key Message: As functional dyspepsia represents a heterogeneous disorder, it may be intriguing to view pepsin as a potential (although still to be proven) treatment modality, distinguished by a diversity of pro-digestive effects.
Between Fear and Hope at the Bangladesh-Assam Border
Authors: Hölzle Éva Rozália
Published: October 2017

This paper is about the inhabitants of a small village in Bangladesh, which lies on the border with the Indian state of Assam. Due to an Indo-Bangladesh agreement, inhabitants are confronted with losing their agricultural lands. In addition, since 2010, the Border Security Force of India (BSF) impedes residents in approaching their gardens, an action that has led to repeated confrontations between the BSF and the villagers. Both threats instigate high levels of fear among the residents. However, their hopes are also high. How can we explain equally high levels of fear and hope among the residents? I suggest that the simultaneous surfacing of fear and hope sheds light on “bipolar” state practices on the ground (i.e., at the same time targeting and protecting lives), as well as the entanglement of the existential and the political (i.e., vulnerability and a demand for recognition) in the everyday lives of the residents.
This Kind of Collective Is Not That Kind of Collective—In Search of a Path of Communitarian and Integrated Cooperatives (此集体非彼集体——为社区性、综合性乡村合作组织探路)
Authors: Yang (杨团) Tuan
Published: October 2017

This paper combs through more than 30 years of the rural collective economic system reforms and distinguishes the conceptual differences among the People's Communes collective, the joint stock cooperative collective, and the community cooperative collective, and among the cooperative economy, the collective economy, the shareholding economy, and the community economy. This paper argues that it is not suitable to simply and rashly push forward the practice of China’s most developed areas’ rural collective economy property rights system to the whole country.

Taking the Puhan model and Jindian model as examples, this paper shows that by absorbing the experiences of the East Asian farmers’ integrated cooperatives, their experiences in local community development, and also the comprehensive rural cooperative organizations in mainland China, there exists a third possible way to bring forth the vitality of village communities and generate healthy and sustainable rural development, in preference to the old rural collective Commune system and the corporate or joint stock co-op models.

本文梳理了围绕农村集体经济制度改革的30余年历史，分辨了人民公社集体、股份合作制集体和社区合作集体；合作经济、集体经济、股份经济与社区（社群）经济的不同，提出不宜将适合发达地区的农村集体经济产权制度改革推向全国。本文以蒲韩和金店两地的农民组织为例说明，借鉴东亚综合农协经验和本土经验的社区性、综合性乡村合作组织，是在公社集体制和公司制或股份合作制之外，能激发村庄活力和形成经济社会良性循环的第三条路。 (This article is in Chinese.)
World Catalogue of the Druid Flies (Diptera: Schizophora: Clusiidae)
Authors: LONSDALE OWEN
Published: October 2017

Family-, genus- and species-level groups in the family Clusiidae (Diptera: Schizophora) are catalogued, providing reference to occurrences of these taxa in the literature, including all those relevant to nomenclature. Full synonymies are provided, including generic combinations for species, and the collection locality, depository and sex of primary type specimens. Published species distributions are provided, noting country and biogeographic region; specimen data representing new country records for species are listed. The Clusiidae are known from 636 species in 14 genera and three subfamilies, with many additional species expected. Nearly half of all described species are Sobarocephala, with 269 species, followed by the clusiodine genera Heteromeringia (86 species), Allometopon (68), Hendelia (53 species), Czernyola (50 species) and Clusiodes (31 species); the remaining eight genera (seven extant, one fossil) are smaller, consisting of 1 to 16 species. Two other fossil genera, Acartophthalmites Hennig and Xenanthomyza Hennig, are also treated here, but are unlikely to belong to the family. Taxa formerly considered Clusiidae are listed. Tranomeringia scutellata Sasakawa is transferred to Heteromeringia, n. comb. Czernyola is maintained as the replacement name for Craspedochaeta, following Bezzi (1907), McAlpine (1971) and Lonsdale, et al. (2010), resulting in the following new combinations: Czernyola amazonensis (Lonsdale & Marshall) n. comb.; C. apsilutea (Lonsdale & Marshall) n. comb.; C. argoniae (Lonsdale & Marshall) n. comb.; C. biloba (Lonsdale & Marshall) n. comb.; C. brunneivibrissa (Lonsdale & Marshall) n. comb.; C. candida (Lonsdale & Marshall) n. comb.; C. chauliodon (Lonsdale & Marshall) n. comb.; C. chela (Lonsdale & Marshall) n. comb.; C. concinna (Williston) n. comb.; C. feminea (Lonsdale & Marshall) n. comb.; C. loreto (Lonsdale & Marshall) n. comb.; C. maai (Sasakawa) n. comb.; C. melanosoma (Lonsdale & Marshall) n. comb.; C. novaeguinea (Soós) n. comb.; C. pacaraima (Lonsdale & Marshall) n. comb.; C. parva (Sasakawa) n. comb.; C. phaios (Lonsdale & Marshall) n. comb.; C. pilosa (Sasakawa) n. comb.; C. pleuralis (Williston) n. comb.; C. pollostos (Lonsdale & Marshall) n. comb.; C. protomis (Lonsdale & Marshall) n. comb.; C. quinquespinula (Sasakawa) n. comb.; C. sasakawai (Lonsdale & Marshall) n. comb.; C. spinulifera (Sasakawa) n. comb.; C. unguicauda (Sasakawa) n. comb.; C. varicolor (Sueyoshi) n. comb.; C. vietnamensis (Sasakawa) n. comb.; C. weemsi (Lonsdale & Marshall) n. comb.; C. xanthonotum (Lonsdale & Marshall) n. comb.; C. xanthopleura (Sasakawa) n. comb.; C. zongo (Lonsdale & Marshall) n. comb.
Submesoscale Coherent Structures on the Continental Shelf
Authors: Dauhajre Daniel P. , McWilliams James C. , Uchiyama Yusuke
Published: October 2017

Discovery and analysis of submesoscale variability O(0.3–30) km on the continental shelf is made possible by a high-resolution (Δx = 75 m) Regional Oceanic Modeling System (ROMS) simulation of the Southern California Bight (SCB). This variability is manifest in ubiquitous yet ephemeral coherent structures: fronts, filaments, and vortices. Similar to their open-ocean counterparts, fronts and filaments on the shelf are identified by their strong vertical velocity, surface convergence, cyclonic vorticity, and horizontal density gradient. Life cycles of these features typically last 3–5 days, with the formation dominated by a horizontal advective tendency that increases density and velocity gradients (i.e., frontogenesis). The shape of the coastline and depth of the water column both influence the abundance and spatial orientation of shallow-water fronts and filaments. Closer to shore, fronts and filaments often align themselves parallel to isobaths, and headlands often act as sites of intense vorticity generation through bottom stress. A quasi-steady, approximate momentum balance among rotation, pressure gradient, and vertical mixing—known as turbulent thermal wind (TTW)—often is valid in the strong secondary circulations local to fronts and filaments. However, front and filament circulations subject to strong diurnal variation in surface heating and vertical mixing are inconsistent with steady-state TTW balance. The secondary circulations can induce ephemeral material trapping and substantial vertical heat fluxes on the shelf.
Challenges in Screening for Pediatric Nonalcoholic Fatty Liver Disease
Authors: Ferguson Anna E. , Xanthakos Stavra A. , Siegel Robert M.
Published: October 2017

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of elevated liver enzymes in children in the United States. Screening for NAFLD in children with obesity is recommended by several published guidelines, but the application of these recommendations in pediatric weight management programs is uncertain. Our study aimed to describe the screening practices for NAFLD in a large pediatric weight management program. During 2014, 1312 patients were seen, with a liver enzyme panel obtained in 847 (64.5%). Only 47/847 (5.5%) had elevated liver enzymes twice the upper limit of normal. Of the 47, 33 (70%) patients had persistently elevated liver enzymes. Of those 33, 22 (67%) had further exclusionary laboratory testing. Screening for NAFLD is challenging even in a pediatric weight management program with clearly established protocols. Those with elevated liver enzymes do not always complete recommended exclusionary testing. Barriers to completing further evaluation need to be addressed.
Marginal Effects in Interaction Models: Determining and Controlling the False Positive Rate
Authors: Esarey Justin , Sumner Jane Lawrence
Published: October 2017

When a researcher suspects that the marginal effect of [Formula: see text] on [Formula: see text] varies with [Formula: see text], a common approach is to plot [Formula: see text] at different values of [Formula: see text] along with a pointwise confidence interval generated using the procedure described in Brambor, Clark, and Golder to assess the magnitude and statistical significance of the relationship. Our article makes three contributions. First, we demonstrate that the Brambor, Clark, and Golder approach produces statistically significant findings when [Formula: see text] at a rate that can be many times larger or smaller than the nominal false positive rate of the test. Second, we introduce the interactionTest software package for R to implement procedures that allow easy control of the false positive rate. Finally, we illustrate our findings by replicating an empirical analysis of the relationship between ethnic heterogeneity and the number of political parties from Comparative Political Studies.
Lay Catholic Support for Exiled Polish Intellectuals in Britain, 1942–1962
Authors: Bush Jonathan
Published: October 2017

This article examines the hitherto unexplored role of lay Catholics in the tertiary education of Polish exiles in Britain, from the early 1940s to the beginning of the Second Vatican Council in 1962. It will examine the work of the Newman Association, a predominantly lay Catholic graduate society, as a case study to reveal how lay activism towards European exiles was influenced by a range of social, theological and political factors. It will highlight the ways in which support for Polish Catholic education could be manifested, including the establishment of a cultural hub in London, a scholarship programme to assist Polish students in British and Irish universities, and the development of cultural links with individuals and organisations within Poland. Ultimately, this article demonstrates the growing confidence of educated lay Catholics in breaking out of their historically subordinate role within the English Catholic Church in the years prior to Vatican II.
Capecitabine, Oxaliplatin, and Bevacizumab (BCapOx) Regimen for Metastatic Colorectal Cancer
Authors: Garrett Meghan J. , Waddell J. Aubrey , Solimando Dominic A.
Published: October 2017

The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases. Questions or suggestions for topics should be addressed to Dominic A. Solimando, Jr, President, Oncology Pharmacy Services, Inc, 4201 Wilson Blvd #110-545, Arlington, VA 22203, e-mail: OncRxSvc@comcast.net ; or J. Aubrey Waddell, Professor, University of Tennessee College of Pharmacy; Oncology Pharmacist, Pharmacy Department, Blount Memorial Hospital, 907 E. Lamar Alexander Parkway, Maryville, TN 37804, e-mail: waddfour@charter.net. The information presented in this review is based on published data and clinical expertise and includes information not included in the product labeling. Incorporation of such published data provides a more robust assessment of the drugs and assists pharmacists in evaluation of orders for off-label use of these agents.
Clinical Pharmacy Discharge Counseling Service and the Impact on Readmission Rates in High-Risk Patients
Authors: Aniemeke Emmanuel , Crowther Barrett , Younts Stephanie , Hughes Darrel , Franco-Martinez Crystal
Published: October 2017

Background: A number of patient safety and transition of care initiatives have highlighted the benefits of incorporating a clinical pharmacist in the discharge medication process. Numerous studies have identified the prominent and consequential role of medication therapy errors occurring at hospital discharge. Objective: The objective of this study was to evaluate the effects of a discharge medication counseling service on readmission rates, emergency department (ED) visits, and days to first readmission or ED visit in patients deemed high risk for hospital readmission. Methods: A retrospective chart review was conducted from October 2014 to December 2014 in adult patients admitted to a general medicine unit and identified as being at high risk for readmission. Endpoints were compared between patients who received discharge counseling (study group) and those who did not (control group). Results: Eighty-nine high-risk patient charts were reviewed. Forty-four patients were in the study group and 45 patients were in the control group. There were no differences between the baseline characteristics of both groups. There were no differences between the study and control groups in 30-day readmission rates (18.2% vs 26.7%; P = .45) and in 30-day ED visits (4.6% vs 11.1%; P = .43). The number of days to first readmission or ED visit between the study and control groups was 22 versus 12 ( P = .26). Conclusion: Although no statistical difference was found between groups in this study, integration of a clinical pharmacist as part of an interdisciplinary approach in the discharge medication process resulted in numerical improvements in outcomes. Additional investigation is warranted to further highlight the potential benefits of this service.