bluuebunny/crossref_metadata_2025 huggingface dataset:
Seismic Performance Evaluation of Double‐Skin Semi‐Base‐Isolated Building Using Incremental Dynamic Analysis
Authors: Parsaeimaram Mohammad , Fang Congqi , Luo Xianqi , Shakya Chandan
Published: June 2018

Base isolation is a widely accepted earthquake damage prevention technique. This method decouples the superstructure from the base by putting a flexible layer under each column, thereby elongating the time period of structures. Semi‐base isolation (SBI) in double‐skin structures is an effective technique to reduce the dynamic responses of structures due to earthquake motions, by utilizing the isolation devices in part of it instead of the entire base. This study presents a double‐skin structure consisting of outer fixed base frames with shear walls that have been detached from the inner core with a minor gap. The inner core of the structure has been dissociated from the base using the elastomeric bearings. Seismic response of 10‐story double‐skin structure with inner isolated core was compared to that of inner fixed base core to consider the yielding and collapse probability of the structure using the incremental dynamic analyses (IDA). The results showed that the time period in SBI buildings can be adjusted with the use of coupling beams between the inner and outer frames. Also, the time period and interstory drift ratio are both reduced as more floors are given coupling beams. However, these coupling beams are the most effective at the topmost floors.
Fabrication of AChE/SnO2-cMWCNTs/Cu Nanocomposite-Based Sensor Electrode for Detection of Methyl Parathion in Water
Authors: Dhull Vikas
Published: June 2018

The work highlights inhibition-based Acetylcholinesterase (AChE) fabrication using composite nanomaterial comprising tin oxide nanoparticles (SnO2) and carboxylated multiwalled carbon nanotubes (cMWCNTs) for detection of pesticide methyl parathion (MP) in water samples. Working electrode AChE/SnO2-cMWCNTs/Cu exhibited high sensitivity with a linearity range of 1.0 μM to 160 μM and a minimum detection limit of 0.1 μM for MP in water. The fabricated electrode was found biocompatible and nontoxic which can be used to detect low concentrations of pesticide in water samples. The synergistic and facilitated electron transferring properties of SnO2-cMWCNTs/Cu made it an excellent support for immobilization of enzyme in sensing technology. The enzyme AChE was covalently immobilized with cMWCNTs using glutaraldehyde as crosslinking agent which has enhanced the storage stability and reusability of the method. The reusability attained was 30 times for 40 days when AChE/SnO2-cMWCNTs/Cu was stored at low temperature of 4°C. Developed sensor showed excellent analytical recovery of pesticide in water sample with negligible effect of interfering species. Also, AChE/SnO2-cMWCNTs/Cu was easily reactivated simply by varying pH of phosphate buffer. This method is fast, reliable, and accurate showing successful development of amperometric biosensor for detection of MP in water sample.
Aesthetic Rehabilitation of a Severe Dental Fluorosis Case with Ceramic Veneers: A Step-by-Step Guide
Authors: El Mourad Aminah M.
Published: June 2018

The selection of an appropriate treatment plan for cases of dental fluorosis depends on the severity of the condition. Ceramic veneers are considered the treatment of choice for moderate to severe cases of fluorosis given the optimum aesthetics, wear resistance, biocompatibility, and long-term results of these veneers. This case report describes a step-by-step rehabilitation of fluorosed teeth, using ceramic veneers in a 26-year-old Yemeni male. The patient presented at the restorative dentistry clinics at King Saud University complaining of an unpleasant smile and generalized tooth discoloration.
Utilizing Connection Usage Characteristics for Faster Web Data Transport
Authors: Moktan Gautam Raj , Varis Nutti , Manner Jukka
Published: June 2018

The quest for faster data transport to improve web user experience is ongoing and attempts are conducted from various fronts to realize it. On top of improving user experience, the implications of improving web data transport are also on the energy efficiency of wireless devices as well as user retention rates of service providers. HTTP/1.x allow the opening of multiple TCP connections per server and then using those connections for fetching multiple web objects through the use of HTTP pipelining. With the advent of HTTP/2.0, multiplexing is done inside a single connection to fetch multiple objects. In this paper, we analyze the TCP connections between the browser and the servers and examine their characteristics. We describe how an enhanced TCP variant can take advantage of data transport connection patterns. We show the benefits that enhanced TCP system can bring with the understanding of connection usage patterns. We find that such transport protocol can have effect in the page idle times as well as the connection concurrency during web page transfer. The results show significant improvement of page load times for both encryption heavy and unencrypted pages. We discuss the effect of the transport protocol on object transfer, connection duration, idle times during the page load, connections, and concurrency of flows that cumulate into page load times.
Jinlida Granules Improve Dysfunction of Hypothalamic-Pituitary-Thyroid Axis in Diabetic Rats Induced by STZ
Authors: Wang Chaoqun , Dai Xianliang , Zhang Danfeng , Liu Zhimin , Huang Qin
Published: June 2018

Objective. We aim to explore the effects and mechanisms of Jinlida granules on the dysfunction of hypothalamic-pituitary-thyroid (HPT) axis in diabetic rats induced by streptozotocin. Methods. A total of 48 SD rats were randomized into normal control group (NC, n=6) and diabetic group (n=42). Rats in diabetic group were randomly divided into diabetes mellitus (DM) control group, low, medium, and high doses of Jinlida group (JL, JM, and JH), medium dose of Jinlida plus Tongxinluo group (JM + T), metformin group (Met), and Saxagliptin group (Sax) (n=6 in each group). Diabetic rats were obtained by intraperitoneal injection of streptozotocin and sacrificed at 8 weeks to examine the function of HPT axis. Results. Levels of fasting blood glucose (P<0.05), pIκB, TNFα (P<0.05), pNF-κB, and IL-6 (P<0.01) in liver tissue and TSHR mRNA expression (P<0.01) in diabetic group were significantly increased, while levels of serum T3 and T4, thyroid hormone receptor (TR) mRNA and Dio1 mRNA in liver tissue, and sodium iodide symporter (NIS) mRNA in thyroid tissue in diabetic group were significantly decreased compared with those in NC group (P<0.01). Among diabetic groups, level of fasting blood glucose in JH, JM + T and Met group was lower (P<0.05) compared with DM group. However, levels of serum T3 and T4, TR mRNA in liver tissue, TSHR, and NIS mRNA in thyroid tissue in JH, JM + T, Met, and Sax group were significantly increased (P<0.01) compared to DM group. In contrast, levels of Dio1 mRNA, pI-κB in Met and JM + T groups, pNF-κB in JH, JM + T, and Met group, and TNFα and IL-6 in JM, JH, JM + T, and Met group were significantly decreased (P<0.05). HE staining showed reduced thyroid follicular epithelium and follicular area, as well as increased colloid area in DM group, indicating impaired synthesis, reabsorption, and secretory of TH in diabetes, which was significantly improved in JH, JM + T, and Met groups. Conclusion. HPT axis dysfunction in DM could be significantly improved by Jinlida granules. The mechanism might be associated with the anti-inflammatory effects involving NF-κB pathway. Our findings suggested the potential benefit of Jinlida granules for patients with HPT axis dysfunction and DM, which was to be verified by more experimental and clinical studies.
Microalbuminuria and Retinopathy among Hypertensive Nondiabetic Patients at a Large Public Outpatient Clinic in Southwestern Uganda
Authors: Kangwagye Peter , Rwebembera Joselyn , Wilson Tony , Bajunirwe Francis
Published: June 2018

Background. Routine testing of microalbuminuria and retinopathy is not done among patients with high blood pressure in resource-limited settings. We determined the prevalence of microalbuminuria and retinopathy and their risk factors among hypertensive patients at a large hospital in western Uganda. Methods. We consecutively recruited nondiabetic patients with hypertension at the outpatients’ clinic over a period of 3 months. Spot urine samples were tested for urine albumin. Direct fundoscopy was done to assess retinal vasculature and optic disc for signs of hypertensive retinopathy. Logistic regression was done with retinopathy and microalbuminuria as primary outcomes. Results. We enrolled 334 patients and, of these, 208 (62.3%) were females, with median age of 55 years (range: 25–90). The prevalence of microalbuminuria was 59.3% (95% CI: 50.1–72.2) and that of retinopathy was 66.8% (95% CI: 58.6–76.5). The independent correlates of retinopathy and microalbuminuria were systolic blood pressure (SBP) > 140 mmHg (OR = 2.76, 95% CI: 1.29–5.93) and treatment with beta-blockers (OR = 2.16, 95% CI: 1.05–4.44). Use of ACEIs was unrelated to the study outcomes. Conclusion. The prevalence of retinopathy and microalbuminuria is high. Clinicians should aim for better control of blood pressure and routinely perform fundoscopy and urine albumin, especially for patients with poorly controlled blood pressure.
Acute Diffuse Peritonitis Caused by Urinary Retention: A Rare Case of Gangrenous Cystitis
Authors: Kotoulas Konstantinos , Georgellis Chrysostomos , Kigitzi Engkin , Liappis Apostolos , Spounos Marios , Tsalkidou Vasiliki , Patris Emmanouil
Published: June 2018

Gangrenous cystitis is an umbrella term encompassing conditions from necrosis of the mucosa and submucosa to necrosis of the entire bladder wall that can result in acute peritonitis. Timely diagnosis is challenging as the symptoms are nonspecific and resemble other conditions such as cystitis. We report a case of gangrenous cystitis in a 63-year-old woman who was diagnosed with peritonitis preoperatively by a CT scan of the abdomen. Overdistension of the bladder due to chronic urinary retention was the primary cause. The patient underwent partial cystectomy, excising nonviable detrusor with preservation of the trigone and ureters, but conclusively succumbed. Etiopathology, symptoms, and treatment of this rare disease are also considered.
Frequency of Red Blood Cell Alloimmunization in Patients with Sickle Cell Disease in Palestine
Authors: Samarah Fekri , Srour Mahmoud A. , Yaseen Dirgham , Dumaidi Kamal
Published: June 2018

Background. Transfusion of red blood cells (RBC) is an essential therapeutic tool in sickle cell disease (SCD). Repeated RBC transfusions can cause alloimmunization which causes difficulty in cross-matching and finding compatible blood for transfusions. This study aimed to investigate the frequency of RBC alloimmunization and related risk factors among Palestinian SCD patients.Materials and Methods. A multicenter cross-sectional study on 116 previously transfused SCD patients from three centers in West Bank, Palestine. Demographic, medical data and history of transfusion were recorded. Blood samples were collected from transfused consenting SCD patients. Gel card method was used for antibody screening and identification. In all patients, autocontrol and direct antiglobulin (DAT) test were performed using polyspecific (anti-IgG + C3d) anti-human globulin (AHG) gel cards for the detection of autoantibodies.Results. Of the SCD patients, 62 (53.4%) patients were HbSS and 54 (46.6%) patients were sickleβ-thalassemia (S/β-thal). There were 53 (45.7%) females and 63 (54.3%) males. Mean age was 18.8 years (range 3-53 years). The frequency of RBC alloimmunization among SCD patients was 7.76%, with anti-K showing the highest frequency (33.3%) followed by anti-E (22.2%), anti-D (11.1%), anti-C (11.1%), and anti-c (11.1%). All reported IgG alloantibodies were directed against antigens in the Rh (66.7%) and Kell (33.3%) systems. Older ages of patients, increased number of blood units transfused, and splenectomy were the commonest risk factors for alloimmunization in our study.Conclusions. RBC alloimmunization rate among Palestinian SCD patients is low compared to neighboring countries and countries all over the world but still warrants more attention. Phenotyping of donors/recipients’ RBC for Rh antigens and K1(partial phenotype matching) before their first transfusion may reduce the incidence of alloimmunization.
Update on the Treatment of Metastatic Urothelial Carcinoma
Authors: Bukhari Nedal , Al-Shamsi Humaid O. , Azam Faisal
Published: June 2018

Platinum-based combination chemotherapy has been the standard of care in the first-line treatment of metastatic urothelial carcinoma (mUC). Treatment of metastatic disease following progression on platinum-based regimens has evolved significantly in the last few years. Clinical trials are currently ongoing to determine how best to use and sequence these treatments. In this minireview, we will review current first-line treatment options in both cisplatin fit and cisplatin unfit patients and advances in first- and second-line treatments including chemotherapy and immunotherapy. This review reports key findings from the clinical trials especially highlighting the importance of PD-1 and PD-L1 inhibitors in the treatment of bladder/urothelial carcinomas.
Influence of Induced Blood Pressure Variability on the Assessment of Cerebral Autoregulation in Patients after Cardiac Arrest
Authors: van den Brule J. M. D. , van Kaam C. R. , van der Hoeven J. G. , Claassen J. A. H. R. , Hoedemaekers C. W. E.
Published: June 2018

Objective. To determine if increasing variability of blood pressure influences determination of cerebral autoregulation. Methods. A prospective observational study was performed at the ICU of a university hospital in the Netherlands. 13 comatose patients after cardiac arrest underwent baseline and intervention (tilting of bed) measurements. Mean flow velocity (MFV) in the middle cerebral artery and mean arterial pressure (MAP) were measured. Coefficient of variation (CV) was used as a standardized measure of dispersion in the time domain. In the frequency domain, coherence, gain, and phase were calculated in the very low and low frequency bands. Results. The CV of MAP was significantly higher during intervention compared to baseline. On individual level, coherence in the VLF band changed in 5 of 21 measurements from unreliable to reliable and in 6 of 21 measurements from reliable to unreliable. In the LF band 1 of 21 measurements changed from unreliable to reliable and 3 of 21 measurements from reliable to unreliable. Gain in the VLF and LF band was lower during intervention compared to baseline. Conclusions. For the ICU setting, more attention should be paid to the exact experimental protocol, since changes in experimental settings strongly influence results of estimation of cerebral autoregulation.
Synthesis and Electrocatalytical Application of Hybrid Pd/Metal Oxides/MWCNTs
Authors: Chiou Yuh-Jing , Wu Guo-Hao , Lin Hong Ming , Borodziński Andrzej , Kedzierzawski Piotr , Stobinski Leszek
Published: June 2018

The performance of Pd electrocatalysts for formic acid electrooxidation was improved by application of metal oxide-multiwall carbon nanotubes composites as a catalyst support. Hybrid oxides/MWCNTs were synthesized by two different methods: chemical reduction method and impregnation method. Pd based catalysts were synthesized by polyol method on the MWCNTs or oxide/MWCNTs composites. The In2O3was deposited on MWCNTs by impregnation method (In2O3/MWCNTs-IM support) and in the presence of NaBH4(In2O3/MWCNTs-NaBH4support). The physical properties of the Pd/In2O3/MWCNTs-IM, Pd/In2O3/MWCNTs-NaBH4, Pd/SnO2/MWCNTs, and Pd/MWCNTs catalysts were characterized and their electrocatalytical performance in formic acid oxidation was compared. During Pd deposition on In2O3/MWCNTs-NaBH4support, InPd2structure was formed as observed by XRD. The electrochemical tests indicate that the two Pd/ In2O3/MWCNTs electrocatalysts have higher electrocatalytic activity than those of Pd/SnO2/MWCNTs and Pd/MWCNTs. The best performance was observed for the catalyst obtained by In2O3impregnation of MWCNTs denoted by Pd/In2O3/MWCNTs-IM.
Transforming Growth Factor-β Protects against Inflammation-Related Atherosclerosis in South African CKD Patients
Authors: Hassan Muzamil Olamide , Duarte Raquel , Dix-Peek Therese , Dickens Caroline , Naidoo Sagren , Vachiat Ahmed , Grinter Sacha , Manga Pravin , Naicker Saraladevi
Published: June 2018

Background. Transforming growth factor-β (TGF-β) may inhibit the development of atherosclerosis. We evaluated serum levels of TGF-β isoforms concurrently with serum levels of endotoxin and various inflammatory markers. In addition, we determined if any association exists between polymorphisms in the TGF-β1 gene and atherosclerosis in South African CKD patients. Methods. We studied 120 CKD patients and 40 healthy controls. Serum TGF-β1, TGF-β2, TGF-β3, endotoxin, and inflammatory markers were measured. Functional polymorphisms in the TGF-β1 genes were genotyped using a polymerase chain reaction-sequence specific primer method and carotid intima media thickness (CIMT) was assessed by B-mode ultrasonography. Results. TGF-β isoforms levels were significantly lower in the patients with atherosclerosis compared to patients without atherosclerosis (p<0.001). Overall, TGF-β isoforms had inverse relationships with CIMT. TGF-β1 and TGF-β2 levels were significantly lower in patients with carotid plaque compared to those without carotid plaque [TGF-β1: 31.9 (17.2 – 42.2) versus 45.9 (35.4 – 58.1) ng/ml, p=0.016; and TGF-β2: 1.46 (1.30 – 1.57) versus 1.70 (1.50 – 1.87) ng/ml, p=0.013]. In multiple logistic regression, age, TGF-β2, and TGF-β3 were the only independent predictors of subclinical atherosclerosis in CKD patients [age: odds ratio (OR), 1.054; 95% confidence interval (CI): 1.003 – 1.109, p=0.039; TGF-β2: OR, 0.996; 95% CI: 0.994–0.999, p=0.018; TGF-β3: OR, 0.992; 95% CI: 0.985–0.999, p=0.029). TGF-β1 genotypes did not influence serum levels of TGF-β1 and no association was found between the TGF-β1 gene polymorphisms and atherosclerosis risk. Conclusion. TGF-β isoforms seem to offer protection against the development of atherosclerosis among South African CKD patients.
Beneath the Retinal Pigment Epithelium: Histopathologic Findings in Metastatic Extranodal Natural Killer/T-Cell Lymphoma, Nasal Type
Authors: Thompson Atalie C. , McCall Chad M. , Proia Alan D.
Published: June 2018

Purpose: To report a case of extranodal natural killer/T-cell lymphoma (ENKTCL), nasal type metastatic to the space beneath the retinal pigment epithelium (RPE) with coincident paraneoplastic lymphoma-associated retinopathy. Methods: Findings of clinical and histopathologic examination are presented with differential diagnoses and a literature review. Case Report: A 53-year-old man presented with bilateral blindness and had exudative retinal detachments overlying subretinal masses in both eyes. Flow cytometry of pericardial fluid revealed malignant T lymphocytes. After two cycles of chemotherapy, the patient was hospitalized and quickly expired. Autopsy revealed lymphoma involving the eyes, heart, right lung, and two subcarinal lymph nodes focally. Histopathologic examination of the eyes revealed intraocular metastases from ENKTCL, nasal type. Expression of CD3 and CD56, along with expression of Epstein-Barr virus by in situ hybridization, confirmed the diagnosis. Lymphomatous infiltrates were confined to the space beneath the neurosensory retina and between the RPE and the Bruch membrane, sparing the uveal tissue, similar to other metastatic T-cell lymphomas. Extensive RPE and photoreceptor loss in regions with and without underlying tumor was typical of a concurrent paraneoplastic lymphoma-associated retinopathy. Conclusion: Patients diagnosed with ENKTCL should be evaluated by an ophthalmologist, as ophthalmic involvement portends a poor prognosis.
Alcohol, Diet and Drug Use Preceding Alcoholic Hepatitis
Authors: Parker Richard , Neuberger James M.
Published: June 2018

Background: Alcoholic hepatitis (AH) is a severe manifestation of alcohol-related liver disease characterised by jaundice and liver failure. It is not known what might trigger an episode of AH. We interviewed patients to investigate changes in behaviour before the onset of AH. Methods: Structured interviews were performed with patients with AH to examine their alcohol use, diet, drug use and smoking habit. Clinical and laboratory results were noted. Patients were followed up for 12 months after interview. Results: Data from 39 patients was analysed. No single behavioural change occurred before the onset of jaundice, although reductions in alcohol and/or dietary intake were common. Reduction in alcohol use was seen to occur approximately 14 days before the onset of jaundice. Increased alcohol intake was not common. Clinical and laboratory data varied between types of behaviour changes, although these were not statistically significant. No changes in drug use or tobacco were reported before AH. Those who had not reduced alcohol intake or had increased their drinking had better survival. Conclusions: No single type of behaviour change is associated with AH. Contrary to previous assertions, increased alcohol intake was not common; in fact, participants were much more likely to have reduced their alcohol intake.
Non-Puerperal Uterine Inversion: A Systematic Review
Authors: Rosa Silva Bruno , de Oliveira Meller Fernanda , Uggioni Maria Laura , Grande Antonio Jose , Chiaramonte Silva Napoleão , Colonetti Tamy , Rebello Jorge Roberto , da Rosa Maria Inês
Published: June 2018

Background: Non-puerperal uterine inversions are rare. The objective of the study was to investigate the frequency, causes, clinical presentations, and management of published case reports of non-puerperal uterine inversion. Material and Methods: We searched MEDLINE, EMBASE, LILACS, the Cochrane Central Register of Controlled Trials, IBECS, BIOSIS, the Web of Science, SCOPUS, Conference Abstracts, and grey literature (Google scholar; the British Library) for papers published from January 1940 through March 2017. Results: We found a total of 170 case reports. The most common cause was leyomioma (57.2%) followed by sarcoma (13.5%). The definitive treatment of most cases was hysterectomy (86.8%). The median hemoglobin levels were seven, showing the severity of the condition by previous vaginal bleeding. All reported cases had a correct management demonstrated by the prognosis until hospital discharge. All patients were discharged, most of them without serious postoperative events. Cancer cases were referred for proper treatment. Only 2 cases of death were reported in 6 weeks and 3 months, respectively, both cases of cancer in advanced stages. Conclusion: Non-puerperal uterine inversion is rare. There have been 170 cases reports in the literature since 1940.
Experience of a Tertiary-Level Urology Center in the Clinical Urological Events of Rare and Very Rare Incidence. VI. Unusual Events in Urolithiasis: 1. Long-Standing Urethral Stones without Underlying Anatomical Abnormalities in Male Children
Authors: Gadelkareem Rabea A. , Shahat Ahmed A. , Abdelhafez Mohamed F. , Moeen Ahmed M. , Ibrahim Abdelrady S. , Safwat Ahmed S.
Published: June 2018

Objectives: The study aimed to present our center’s experience with long-standing urethral stones in male children with normal urethra. Materials and Methods: Retrospective search of our center data was done for the cases of long-standing urethral stones with normal urethra in male children during the period July 2001 – June 2016. Demographic and clinical data were studied. Results: Of more than 54,000 urolithiasis procedures, 17 male children (0.031%) were operated for long-standing urethral stones with normal urethra. In 14 cases (82.4%), residence was rural and parental education levels were low or none. All children were regularly prompted voiding with a history of difficulty or dysuria. All the stones lodged in the posterior urethra with an approximate mean duration of 2 months. The mean stone size of 11.29 ± 3.88 mm and rough surfaces in 88.2% of cases represented the main predisposing factors. Major complications included rectal prolapse in 1 case and vesicoureteral reflux in 3 cases. Endoscopic push-back was followed by disintegration in 76.5% or cystolithotomy in 17.7%, while it failed in 1 case that was treated by cystolithotomy. Conclusions: Long-standing urethral stones in male children with normal urethra are very rare misdiagnoses. Stone topography and sociocultural factors predisposed to their lodgments and negligence. Endoscopic treatment is the best approach.
The Role of Retinal Vascular Density as a Screening Tool for Ageing and Stroke
Authors: Sprödhuber Andrea , Wolz Johannes , Budai Attila , Laumeier Inga , Audebert Heinrich J. , Michelson Georg
Published: June 2018

Objectives: To measure the density of retinal vessels from digitized fundus photographs in patients with recent stroke and age-matched controls. To investigate whether the parameter retinal vascular density (RVD) served as a quantitative marker for cerebrovascular events. Methods: Digitized fundus photographs of n = 158 subjects with stroke or transient ischemic attack within 1 year at the time of examination and n = 1,250 age-matched controls without any remarkable medical history were examined. Sex, hypertension, and diabetes were considered to be cofactors. Measurement of RVD was performed with a computer-aided image-analyzing program by segmenting automatically all visible retinal vessels and measuring areas of vessels in distinct circles around the optic disk. Results: In controls RVD dwindles with increasing distance from the optic disk. RVD decreased significantly with age (p = 0.000). Stroke patients showed significantly lower values of RVD of –15% in comparison to age-matched controls. In old subjects, stroke in combination with hypertension is associated with a significant decreased RVD, and in middle-aged subjects diabetes and stroke are associated with a significant decreased RVD (p = 0.01). Conclusion: Age and stroke are significant risk factors for decreased RVD. Diabetes and arterial hypertension are additional significant risk factors in patients with stroke with respect to RVD.
Fluoride Penetration and Clearance Are Higher in Exopolysaccharide-Containing Bacterial Pellets
Authors: Spinola Manuela S. , Nóbrega Diego Figueiredo , Del Bel Cury Altair Antoninha , Ricomini Filho Antonio Pedro , Cury Jaime Aparecido , Tenuta Livia Maria Andaló
Published: June 2018

Extracellular polysaccharides (EPS) could increase the penetration of fluoride through dental biofilm, reducing its cariogenicity. We measured the concentration of fluoride in EPS-containing (EPS+) or not-containing (EPS–) Streptococcus mutans bacterial pellets resembling test biofilms, before and up to 60 min after a 0.05% NaF rinse in situ. Fluoride penetration and clearance were higher in EPS+ bacterial pellets. The data suggest that EPS enhances fluoride penetration, but also accelerates fluoride clearance from dental biofilms.
Trends in the Management of Nonviable Pregnancies of Unknown Location in the United States
Authors: Parks Melissa A. , Barnhart Kurt T. , Howard David L.
Published: June 2018

Background: When managing a nonviable pregnancy of unknown location (PUL), a debate has emerged in the literature whether to perform uterine curettage for definitive diagnosis of pregnancy location or administer methotrexate for a presumed ectopic pregnancy. The purpose of this study is to describe the treatment patterns when managing a PUL. Methods: A prospective, anonymous Internet based-electronic survey of PUL case scenarios was administered to a random sample of physicians across the United States. Results: A total of 214 physicians responded. When presented with a PUL by ultrasound and a βhCG measurement of 3,270 mIU/mL, which is above the discriminatory level, 88.3% (188) would choose an additional βhCG measurement before recommending any intervention. When presented with a PUL by ultrasound and serial βhCG measurements demonstrating an inappropriate trend for a viable gestation, 36.5% would offer uterine curettage and 31.3% would offer methotrexate. Resident and private clinicians had a fourfold lower adjusted odds of choosing uterine curettage compared to academic physicians. Conclusions: Based on our findings, there does not appear to be a consensus regarding the management of a PUL.
Differential Stiffening between the Abdominal and Thoracic Aorta: Effect of Salt Loading in Stroke-Prone Hypertensive Rats
Authors: Lindesay George , Bézie Yvonnick , Ragonnet Christophe , Duchatelle Véronique , Dharmasena Chandima , Villeneuve Nicole , Vayssettes-Courchay Christine
Published: June 2018

Central artery stiffening is recognized as a cardiovascular risk. The effects of hypertension and aging have been shown in human and animal models but the effect of salt is still controversial. We studied the effect of a high-salt diet on aortic stiffness in salt-sensitive spontaneously hypersensitive stroke-prone rats (SHRSP). Distensibility, distension, and β-stiffness were measured at thoracic and abdominal aortic sites in the same rats, using echotracking recording of the aortic diameter coupled with blood pressure (BP), in SHRSP-salt (5% salted diet, 5 weeks), SHRSP, and normotensive Wistar-Kyoto (WKY) rats. Hemodynamic parameters were measured at BP matched to that of WKY. Histological staining and immunohistochemistry were used for structural analysis. Hemodynamic isobaric parameters in SHRSP did not differ from WKY and only those from the abdominal aorta of SHRSP-salt presented decreased distensibility and increased stiffness compared with WKY and SHRSP. The abdominal and thoracic aortas presented similar thickening, increased fibrosis, and remodeling with no change in collagen content. SHRSP-salt presented a specific increased elastin disarray at the abdominal aorta level but a decrease in elastin content in the thoracic aorta. This study demonstrates the pro-stiffening effect of salt in addition to hypertension; it shows that only the abdominal aorta presents a specific pressure-independent stiffening, in which elastin disarray is likely a key mechanism.
Practice Patterns for Chronic Respiratory Diseases in the Asia-Pacific Region: A Cross-Sectional Observational Study
Authors: Wang De Yun , Cho Sang-Heon , Lin Horng-Chyuan , Ghoshal Aloke Gopal , Bin Abdul Muttalif Abdul Razak , Thanaviratananich Sanguansak , Tunceli Kaan , Urdaneta Eduardo , Zhang Dongmu , Faruqi Rab
Published: June 2018

Background: Allergic rhinitis (AR), asthma, chronic obstructive pulmonary disease (COPD), and rhinosinusitis are common and little studied in the Asia-Pacific region. Objectives: We sought to investigate real-world practice patterns for these respiratory diseases in India, Korea, Malaysia, Singapore, Taiwan, and Thailand. Methods: This cross-sectional observational study enrolled adults (age ≥18 years) presenting to general practitioners (GP) or specialists for physician-diagnosed AR, asthma, COPD, or rhinosinusitis. Physicians and patients completed study-specific surveys at one visit, recording patient characteristics, health-related quality of life (QoL), work impairment, and healthcare resource use. Findings by country and physician category (GP or specialist) were summarized. Results: Of the 13,902 patients screened, 7,243 (52%) presented with AR (18%), asthma (18%), COPD (7%), or rhinosinusitis (9%); 5,250 of the 7,243 (72%) patients were eligible for this study. Most eligible patients (70–100%) in India, Korea, Malaysia, and Singapore attended GP, while most (83–85%) in Taiwan and Thailand attended specialists. From 42% (rhinosinusitis) to 67% (AR) of new diagnoses were made by GP. On average, patients with COPD reported the worst health-related QoL, particularly to GP. Median losses of work productivity for each condition and activity impairment, except for asthma, were numerically greater for patients presenting to GP vs. specialists. GP prescribed more antibiotics for AR and asthma, and fewer intranasal corticosteroids for AR, than specialists (p < 0.001 for all comparisons). Conclusions: Our findings, albeit mostly descriptive and influenced by between-country differences, suggest that practice patterns differ between physician types, and the disease burden may be substantial for patients presenting in general practice.
Ranibizumab for the Treatment of Diabetic Macular Oedema in the Real-World Clinical Setting in Portugal: A Multicentre Study
Authors: Farinha Cláudia , Martins Amélia , Neves Arminda , Soares Raquel , Ruão Miguel , Ornelas Mário , Neves Pedro , Gomes Rodrigues Filipa , Coelho Constança , Silva Rufino
Published: June 2018

Purpose: The purpose of this study was to evaluate the 2-year outcome of ranibizumab for diabetic macular oedema (DME) in the real-life clinical practice of five ophthalmology departments of the National Health Service (NHS) in Portugal. Methods: This is a retrospective multicentre study. The clinical records on consecutive patients with DME from clinical practice treated with 0.5 mg intravitreal ranibizumab and followed up for 24 months were reviewed. Efficacy outcomes comprised the change in best corrected visual acuity (BCVA) and central macular thickness (CMT) evaluated by SD-OCT. Multivariate regression analysis was performed to explore predictors of BCVA. Results: A total of 122 eyes of 93 patients were included. The median BCVA change by 24 months was +5.0 letters (IQR 12.0) (p < 0.001) and the CMT change was –89.0 µm (IQR 165.0) (p < 0.001). By 24 months, 21.4% of the eyes had gained ≥15 letters and 8.6% had lost ≥15 letters. The median number of injections given during follow-up was 5.0 (IQR 4.0). A greater baseline CMT and a more disrupted status of the external limiting membrane were predictive of worse BCVA at 24 months (p ≤ 0.015). Conclusion: DME treatment with ranibizumab in the Portuguese NHS is associated with anatomic and functional improvement by 2 years; however, our results are below those reported in major clinical trials, and undertreatment is probably the cause.
IL-1α and MMP-9 Tear Levels of Patients with Active Ocular Rosacea before and after Treatment with Systemic Azithromycin or Doxycycline
Authors: Lam-Franco Lorena , Perfecto-Avalos Yocanxochitl , Patiño-Ramírez Beatriz E. , Rodríguez García Alejandro
Published: June 2018

Aims: The purpose of this paper was to determine the lacrimal concentration of IL-1α and MMP-9 in patients with active ocular rosacea before and after systemic treatment with azithromycin or doxycycline. Methods: After 4 weeks of therapy with azithromycin (500 mg/day, 3 days a week PO) or doxycycline (200 mg/day PO), lacrimal samples were analyzed using an enzyme-linked immunosorbent assay multiplex. Results: There was a significant difference between baseline IL-1α (37.9 pg/mL) and MMP-9 (26.7 ng/mL) in rosacea eyes compared to controls (0.001 pg/mL for IL-1α and 0.2 ng/mL for MMP-9) (p < 0.001). IL-1α decreased from 47.0 pg/mL before azithromycin to 23.5 pg/mL after treatment (p = 0.024), but not after doxycycline therapy. On the contrary, baseline MMP-9 tear levels (10.28 ng/mL) decreased after treatment (8.36 pg/mL) with doxycycline (p = 0.054) but not with azithromycin. There was a strong clinical correlation of higher baseline IL-1α tear levels between patients who responded to doxycycline therapy and those who failed (p = 0.043). Patients unresponsive to azithromycin had significantly higher baseline MMP-9 levels than those with doxycycline (p = 0.040). Conclusions: While IL-1α levels decreased after azithromycin therapy, MMP-9 did so after doxycycline treatment. Baseline cytokine tear levels tend to be markedly elevated in patients with antibiotic failure, suggesting their potential role as therapeutic biomarkers for the disease.
Evaluation of Sienna Cancer Diagnostics hTERT Antibody on 500 Consecutive Urinary Tract Specimens
Authors: Allison Derek B. , Sharma Rajni , Cowan Morgan L. , VandenBussche Christopher J.
Published: June 2018

Objectives: Telomerase activity can be detected in up to 90% of urothelial carcinomas (UC). Telomerase activity can also be detected in urinary tract cytology (UTC) specimens and indicate an increased risk of UC. We evaluated the performance of a commercially available antibody that putatively binds the telomerase reverse transcriptase (hTERT) subunit on 500 UTC specimens. Study Design: Unstained CytospinTM preparations were created from residual urine specimens and were stained using the anti-hTERT antibody (SCD-A7). Two algorithms were developed for concatenating the hTERT result and cytologic diagnosis: a “no indeterminates algorithm,” in which a negative cytology and positive hTERT result are considered positive, and a “high-specificity algorithm,” in which a negative cytology and positive hTERT result are considered indeterminate (and thus negative for comparison to the gold standard). Results: The “no indeterminates algorithm” and “high-specificity algorithm” yielded a sensitivity of 60.6 and 52.1%, a specificity of 70.4 and 90.7%, a positive predictive value of 39.1 and 63.8%, and a negative predictive value of 85.0 and 85.8%, respectively. Conclusions: A positive hTERT result may identify a subset of patients with an increased risk of high-grade UC (HGUC) who may otherwise not be closely followed, while a negative hTERT immunocytochemistry result is associated with a reduction in risk for HGUC.
Vida média e obsolescência da literatura em educação indígena
Authors: Maroldi Alexandre Masson , Lima Luis Fernando Maia , Hayashi Maria Cristina Piumbato Innocentini
Published: June 2018

A vida média e a obsolescência da literatura são utilizadas para determinar a utilização da literatura com o passar do tempo em determinada área de conhecimento, ou seja, a vida útil e a taxa de envelhecimento. A vida média é um indicativo da razão de obsolescência da literatura científica e permite determinar a idade e o declínio da literatura utilizada em uma determinada área de conhecimento. O objetivo desse trabalho consiste em identificar qual é a vida média, a obsolescência e a perda da atualidade da informação da literatura de livros sobre educação indígena citada nas dissertações e teses. Essa pesquisa pretende ainda discutir a questão dos livros clássicos no âmbito da Ciência da Informação, da Literatura e da Sociologia, bem como apresentar um cálculo padronizado para se obter a vida média e a obsolescência da literatura para tipologia livros. Adotou-se a abordagem metodológica da Bibliometria para analisar 173 trabalhos de pós-graduação em educação indígena na BDTD. Os resultados finais apontam uma literatura considerada clássica, uma vez que possuem uma vida média mais longa.
O que pacientes e profissionais de saúde precisam saber sobre a Internet?
Authors: Galvão Maria Cristiane Barbosa
Published: June 2018

Resenha de:PLUYE, Pierre, GRAD, Roland, BARLOW, Julie. Look it up!: what patients, doctors, nurses, and pharmacists need to know about the Internet and primary health care. Montreal; Kingston; London; Chicago: McGill-Queen's University Press, 2017.
Taxonomy and ultrastructure of Sinerima, a new genus of diatoms (Bacillariophyta), with a description of a new species, S. marigela
Authors: NESTEROVICH ANNA , CAISSIE BETH E.
Published: June 2018

Based on light, scanning and transmission electron microscopy observations, a detailed description of a new marine fultoportulate diatom Sinerima marigela gen. et sp. nov. is presented. This new taxa is rare (<3% of the thanatocoenosis) in surface sediments in the Bering and Chukchi seas, but appears to have an association with high spring sea ice concentrations. The new monotypic genus is distinct due to its 1) lack of rimoportulae, 2) one-layer valves with marginal pseudoloculi, 3) characteristic velum composed of a cluster of short tubes, and 4) central part without either central fultoportulae or an annulus. This set of characters, especially the lack of rimoportulae, makes S. marigela unique and easily distinguishable from other fultoportulate diatoms.
A new, distinctly coloured species of Lysmata Risso, 1816 (Malacostraca: Decapoda: Lysmatidae) from the south-central Atlantic
Authors: GRAVE SAMMY DE , ANKER ARTHUR
Published: June 2018

A new species of the caridean shrimp genus Lysmata Risso, 1816 is described from St. Helena and Ascension Island in the south-central Atlantic. Lysmata napoleoni sp. nov. is part of the so-called “long-branch group” of the genus and shows a strong morphological similarity with the eastern Atlantic L. seticaudata Risso, 1816, from which it can be distinguished by details of the accessory branch of the antennular flagellum. The new species also displays a unique and bright colour pattern and therefore can be easily recognised in the field. Furthermore, it is typically found in proximity of sea anemones, Telmatactis cricoides (Duchassaing), and appears to be an occasional fish cleaner.
Anthropogenic and Natural Contributions to the Lengthening of the Summer Season in the Northern Hemisphere
Authors: Park Bo-Joung , Kim Yeon-Hee , Min Seung-Ki , Lim Eun-Pa
Published: June 2018

Observed long-term variations in summer season timing and length in the Northern Hemisphere (NH) continents and their subregions were analyzed using temperature-based indices. The climatological mean showed coastal–inland contrast; summer starts and ends earlier inland than in coastal areas because of differences in heat capacity. Observations for the past 60 years (1953–2012) show lengthening of the summer season with earlier summer onset and delayed summer withdrawal across the NH. The summer onset advance contributed more to the observed increase in summer season length in many regions than the delay of summer withdrawal. To understand anthropogenic and natural contributions to the observed change, summer season trends from phase 5 of the Coupled Model Intercomparison Project (CMIP5) multimodel simulations forced with the observed external forcings [anthropogenic plus natural forcing (ALL), natural forcing only (NAT), and greenhouse gas forcing only (GHG)] were analyzed. ALL and GHG simulations were found to reproduce the overall observed global and regional lengthening trends, but NAT had negligible trends, which implies that increased greenhouse gases were the main cause of the observed changes. However, ALL runs tend to underestimate the observed trend of summer onset and overestimate that of withdrawal, the causes of which remain to be determined. Possible contributions of multidecadal variabilities, such as Pacific decadal oscillation and Atlantic multidecadal oscillation, to the observed regional trends in summer season length were also assessed. The results suggest that multidecadal variability can explain a moderate portion (about ±10%) of the observed trends in summer season length, mainly over the high latitudes.
Incorporation of Social Determinants of Health in the Peer-Reviewed Literature: A Systematic Review of Articles Authored by the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Authors: Friedman Eleanor E. , Dean Hazel D. , Duffus Wayne A.
Published: June 2018

Objectives:

Social determinants of health (SDHs) are the complex, structural, and societal factors that are responsible for most health inequities. Since 2003, the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) has researched how SDHs place communities at risk for communicable diseases and poor adolescent health. We described the frequency and types of SDHs discussed in articles authored by NCHHSTP.

Methods:

We used the MEDLINE/PubMed search engine to systematically review the frequency and type of SDHs that appeared in peer-reviewed publications available in PubMed from January 1, 2009, through December 31, 2014, with a NCHHSTP affiliation. We chose search terms to identify articles with a focus on the following SDH categories: income and employment, housing and homelessness, education and schooling, stigma or discrimination, social or community context, health and health care, and neighborhood or built environment. We classified articles based on the depth of topic coverage as “substantial” (ie, one of ≤3 foci of the article) or “minimal” (ie, one of ≥4 foci of the article).

Results:

Of 862 articles authored by NCHHSTP, 366 (42%) addressed the SDH factors of interest. Some articles addressed >1 SDH factor (366 articles appeared 568 times across the 7 categories examined), and we examined them for each category that they addressed. Most articles that addressed SDHs (449/568 articles; 79%) had a minimal SDH focus. SDH categories that were most represented in the literature were health and health care (190/568 articles; 33%) and education and schooling (118/568 articles; 21%).

Conclusions:

This assessment serves as a baseline measurement of inclusion of SDH topics from NCHHSTP authors in the literature and creates a methodology that can be used in future assessments of this topic.
Statewide Evaluation of New HIV Diagnoses in Rhode Island: Implications for Prevention
Authors: Chan Philip A. , Montgomery Madeline C. , Rose Jennifer , Tributino Alec , Crowley Christina , Medina Martha M. , Patel Rupa , Mayer Kenneth , Kantor Rami , Nunn Amy S.
Published: June 2018

Objectives:

Patterns of HIV transmission vary widely across demographic groups. Identifying and engaging these groups are necessary to prevent new infections and diagnose disease among people who are unaware of their infection. The objective of this study was to determine characteristics of newly diagnosed individuals across an entire state to determine patterns of HIV transmission.

Methods:

We evaluated data on people with new HIV diagnoses in Rhode Island from 2013 through 2015. We performed a latent class analysis (LCA) to identify underlying demographic and behavioral characteristics of people with newly diagnosed HIV.

Results:

Of 167 people with new HIV diagnoses interviewed in Rhode Island from 2013 through 2015, 132 (79%) were male, 84 (50%) were nonwhite, 112 (67%) were men who have sex with men (MSM), 112 (67%) were born in the United States, and 61 (37%) were born in Rhode Island. LCA revealed 2 major classes. Of the 98 people in class 1, 96% were male, 85% were MSM, 80% were white, 94% were born in the United States, and 80% believed they acquired HIV in Rhode Island. Class 2 was 63% male and 69% Hispanic/Latino; 29% were born in the United States, and 61% believed they acquired HIV in Rhode Island.

Conclusions:

Most new HIV diagnoses in Rhode Island were among MSM born in the United States, and a substantial number were likely infected in-state. People with newly diagnosed HIV who were foreign-born, including Hispanic/Latino and heterosexual groups, were less likely to have acquired HIV in Rhode Island than were MSM. HIV prevention approaches, including pre-exposure prophylaxis, should be adapted to the needs of specific groups. Rhode Island offers lessons for other states focused on eliminating HIV transmission.
H∞ control of integrated rollover prevention system based on improved lateral load transfer rate
Authors: Zhao Wanzhong , Ji Lin , Wang Chunyan
Published: June 2018

A rollover dynamic model that merges the active front steering model and differential braking model is established in this paper. After analyzing and improving the existing rollover evaluation method, a new evaluation method that takes both sprung mass and under-sprung mass into consideration is proposed. The reliability of the improved LTR (lateral load transfer rate) is confirmed by simulation results obtained from MATLAB and CARSIM where, all of three evaluation methods are taken under the same condition. The accuracy of the rollover evaluation index depends on the centroid height of under-sprung mass and the ratio of under-sprung mass and under-sprung mass. In order to achieve the desired tracking effect and anti-jamming capability, an integrated rollover control system based on active steering and differential braking is designed where a H∞ controller is adopted. The results of simulation under J-turn condition indicate that the control system has strong stability and robustness. When the vehicle is under the risk of rollover and reaches the setting threshold, the designed H∞ controller will actively keep the vehicle under the critical state.