bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of High Volume Haemodiafiltration on Inflammatory Response Profile and Microcirculation in Patients with Septic Shock
Authors: Tamme Kadri , Maddison Liivi , Kruusat Rein , Ehrlich Hans-Erik , Viirelaid Mirjam , Kern Hartmut , Starkopf Joel
Published: April 2015

Background. High volumes of haemofiltration are used in septic patients to control systemic inflammation and improve patient outcomes. We aimed to clarify if extended intermittent high volume online haemodiafiltration (HVHDF) influences patient haemodynamics and cytokines profile and/or has effect upon sublingual microcirculation in critically ill septic shock patients.Methods. Main haemodynamic and clinical variables and concentrations of cytokines were evaluated before and after HVHDF in 19 patients with septic shock requiring renal replacement therapy due to acute kidney injury. Sublingual microcirculation was assessed in 9 patients.Results. The mean (SD) time of HVHDF was 9.4 (1.8) hours. The median convective volume was 123 mL/kg/h. The mean (SD) dose of norepinephrine required to maintain mean arterial pressure at the target range of 70–80 mmHg decreased from 0.40 (0.43) μg/kg/min to 0.28 (0.33) μg/kg/min (p= 0.009). No significant changes in the measured cytokines or microcirculatory parameters were observed before and after HVHDF.Conclusions. The single-centre study suggests that extended HVHDF results in decrease of norepinephrine requirement in patients with septic shock. Haemodynamic improvement was not associated with decrease in circulating cytokine levels, and sublingual microcirculation was well preserved.
Experimental and Numerical Method for the Analysis of Warm Titanium Sheet Stamping of an Automotive Component
Authors: Fiorentino Antonio , Ceretti Elisabetta , Giardini Claudio
Published: April 2015

Product design involves many aspects as geometry and material or mechanical requirements that have to be chosen on the base of the part requirements. Manufacturing process is the link between them representing a fundamental aspect of the product design process. Designers and technicians have a consolidated set of tools and knowledge based on long time experience, but the request of more new performing products characterized by more complex geometries or harder to form materials as Titanium alloys stimulated the use of numerical models. They allow us to study the product feasibility but they require reliable inputs for their development and validation. The present research focuses on sheet stamping processes and proposes a methodology that uses the Nakazima test to characterize the formability of the material and to develop and validate the model. In particular, the method is applied to cold (20°C) and warm (300°C) stamping of a complex automotive component made of CP Titanium. After characterizing the material and validating the model at the different temperatures, the stamping process is studied and results are compared. In particular, this approach allowed joining the experimental tests required to develop and validate the model, therefore reducing the resources required for the product design.
The Feasibility of Using Tartary Buckwheat as a Se-Containing Food Material
Authors: Golob Aleksandra , Stibilj Vekoslava , Kreft Ivan , Germ Mateja
Published: April 2015

Tartary buckwheat (Fagopyrum tataricum) is a semiwild plant grown in the Himalaya region. Due to its high concentration of flavonoids and trace elements it is of interest for cultivation in other countries as well. The feasibility of increasing the concentration of Se in grain and in green parts of Tartary buckwheat has not yet been investigated. The aim of this investigation was thus to determine the concentration of Se in different edible parts of Tartary buckwheat treated with different concentrations of Na selenate using different techniques. In plants grown in soil fertilized once with 0.5 and 10 mg Se L−1, Se was efficiently translocated from the roots to the leaves and seeds. Foliar spraying with 0.5 mg Se L−1increased Se content in leaves and seeds. Among the edible parts of Tartary buckwheat plants the highest content of Se in control and in treated groups was found in leaves, followed by seeds and stems. Regarding recommended Se concentration, edible parts of Tartary buckwheat were safe for human consumption. Soil fertilization with 0.5 and 10 mg Se L−1and foliar fertilization with 0.5 mg Se L−1are applicable for cultivation of Tartary buckwheat as a functional food enriched with Se.
Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development
Authors: Huffman Jeff C. , DuBois Christina M. , Millstein Rachel A. , Celano Christopher M. , Wexler Deborah
Published: April 2015

Most patients with type 2 diabetes (T2D) have suboptimal adherence to recommended diet, physical activity, and/or medication. Current approaches to improve health behaviors in T2D have been variably effective, and successful interventions are often complex and intensive. It is therefore vital to develop interventions that are simple, well-accepted, and applicable to a wide range of patients who suffer from T2D. One approach may be to boost positive psychological states, such as positive affect or optimism, as these constructs have been prospectively and independently linked to improvements in health behaviors. Positive psychology (PP) interventions, which utilize systematic exercises to increase optimism, well-being, and positive affect, consistently increase positive states and are easily delivered to patients with chronic illnesses. However, to our knowledge, PP interventions have not been formally tested in T2D. In this paper, we review a theoretical model for the use of PP interventions to target health behaviors in T2D, describe the structure and content of a PP intervention for T2D patients, and describe baseline data from a single-arm proof-of-concept (N=15) intervention study in T2D patients with or without depression. We also discuss how PP interventions could be combined with motivational interviewing (MI) interventions to provide a blended psychological-behavioral approach.
The Levels and Duration of Sensory and Motor Blockades of Spinal Anesthesia in Obese Patients That Underwent Urological Operations in the Lithotomy Position
Authors: Ciftci Taner , Kepekci Ali Bestemi , Yavasca Hatice Pınar , Daskaya Hayrettin , İnal Volkan
Published: April 2015

Obesity has a significant effect on the cephalic spread of a spinal block (SB) due to a reduction in cerebrospinal fluid (CSF). SB is controlled by the tissue blood flow in addition to the CSF. Some positions and techniques of surgery used can cause changes in hemodynamics. We investigated effects of hemodynamic changes that may occur during Transurethral prostate resection (TUR-P) and lithotomy position (LP) at the SB level in obese versus nonobese individuals. Sixty patients who had undergone TUR-P operation under spinal anesthesia were divided into a nonobese (BMI<25 kg/m2, Group N) or obese (BMI≥30 kg/m2, Group O) group. SB assessments were recorded afterthe LP. SB at 6 and 120 min and the peak SB level were compared between two groups. Hemodynamics were recorded after LP. Peak and 6 min SB levels were similar between the groups, while 120 min SB levels were significantly higher for Group O (P<0.05). Blood pressure (BP) after the LP was significantly higher for Group N (P<0.05). LP and TUR-P increased the BP in Group N when compared to Group O. The increase in hemodynamics enhances the blood flow in the spinal cord and may form similar SB levels in nonobese patients to those in obese patients. However, SB time may be longer in obese patients.
Coccoloba uvifera(L.) (Polygonaceae) Fruit: Phytochemical Screening and Potential Antioxidant Activity
Authors: Segura Campos Maira Rubi , Ruiz Ruiz Jorge , Chel-Guerrero Luis , Betancur Ancona David
Published: April 2015

The flora of Latin America attracts gaining interest as it provides a plethora of still unexplored or underutilized fruits that can contribute to human well-being due to their nutritional value and their content of bioactive compounds. Antioxidant compounds are now of considerable interest due to their effect of preventing or delaying aging and their apparent involvement in prevention of numerous human diseases, including cancer, atherosclerosis, Alzheimer’s disease, inflammation, and rheumatoid arthritis. In this work, the fruit ofCoccoloba uvifera(L.) was investigated for theirin vitroantioxidant capacity using two assays based on reactions with a relatively stable single reagent radical (Trolox equivalent antioxidant capacity, TEAC; and DPPH free radical scavenging assay, DPPH), two assays based on chelating of metallic cations, and one based on the reduction of oxidized species. The TEAC value on ABTS radical, DPPH scavenging activity, ion chelation, and reducing power were found to be 897.6 μM of Trolox/100 g of sample, 22.8% of DPPH free radical scavenging, 11.3% of Cu2+-chelating activity, 23.9% of Fe2+-chelating activity, and a Fe2+-reducing power of 0.76 mg/mL, respectively. The free radical scavenging and antioxidant characteristics ofC. uviferamay be due to the presence of diverse phytochemicals in the fruit as anthocyanins, ascorbic acid, phenolic compounds, and flavonoids.
Serum Enzyme Profiles Differentiate Five Types of Muscular Dystrophy
Authors: Zhu Yuling , Zhang Huili , Sun Yiming , Li Yaqin , Deng Langhui , Wen Xingxuan , Wang Huaqiao , Zhang Cheng
Published: April 2015

Background.Differentiation among types of muscular dystrophy (MD) has remained challenging. In this retrospective study, we sought to develop a methodology for differentiation of MD types using analysis of serum enzyme profiles.Methods.The serum levels of enzymes from 232 patients, including 120 with DMD, 36 with BMD, 36 with FSHD, 46 with LGMD, and 11 with EDMD, were evaluated.Results.The characteristic profiles of serum enzymes facilitated differentiation of these five types of MD. DMD was characterized by simultaneous elevation of ALT, AST, LDH, and ALP; BMD and LGMD were characterized by elevation of ALT, AST, and LDH; and FSHD and EDMD were characterized by a lack of abnormal serum enzyme levels. We further developed discriminant functions to distinguish BMD and LGMD. For LGMD, LGMD2B patients had significantly higher ALP levels than non-LGMD2B patients (98±59 U/L versus45±9 U/L, resp.,p<0.05).Conclusions.Our approach enabled the determination of MD subtypes using serum enzyme profiles prior to genetic testing, which will increase the chance a mutation will be found in the first gene analyzed.
In VivoMicroCT Monitoring of Osteomyelitis in a Rat Model
Authors: Stadelmann Vincent A. , Potapova Inga , Camenisch Karin , Nehrbass Dirk , Richards R. Geoff , Moriarty T. Fintan
Published: April 2015

Infection associated with orthopedic implants often results in bone loss and requires surgical removal of the implant. The aim of this study was to evaluate morphological changes of bone adjacent to a bacteria-colonized implant, with the aim of identifying temporal patterns that are characteristic of infection. In anin vivostudy with rats, bone changes were assessed usingin vivomicroCT at 7 time points during a one-month postoperative period. The rats received either a sterile orStaphylococcus aureus-colonized polyetheretherketone screw in the tibia. Bone-implant contact, bone fraction, and bone changes (quiescent, resorbed, and new bone) were calculated from consecutive scans and validated against histomorphometry. The screw pullout strength was estimated from FE models and the results were validated against mechanical testing. In the sterile group, bone-implant contact, bone fraction, and mechanical fixation increased steadily until day 14 and then plateaued. In the infected group, they decreased rapidly. Bone formation was reduced while resorption was increased, with maximum effects observed within 6 days. In summary, the model presented is capable of evaluating the patterns of bone changes due to implant-related infections. The combined use of longitudinalin vivomicroCT imaging and image-based finite element analysis provides characteristic signs of infection within 6 days.
ESBLEscherichia coliVentriculitis after Aneurysm Clipping: A Rare and Difficult Therapeutic Challenge
Authors: Zeiler F. A. , Silvaggio J.
Published: April 2015

Background. Extended spectrum beta-lactamase (ESBL) producedEscherichia coli(E. coli) ventriculitis is a rare infection of the central nervous system, with increasing rarity in the adult population. The therapeutic strategy to achieve cure may need to involve a combination of intraventricular and intravenous (IV) therapy.Objective. To describe a case of ESBLE. colimeningitis/ventriculitis in an adult and outline the antimicrobial therapy that leads to cure.Methods. We retrospectively reviewed the records of a patient admitted to the neurosurgical department for aneurysmal subarachnoid hemorrhage, who developed ESBLE. coliventriculitis.Results. A 55-year-old female, admitted for a Fisher grade 3, World Federation of Neurological Surgeons grade 1, subarachnoid hemorrhage, developed ESBLE. coliventriculitis requiring a combination of intraventricular gentamicin and high dose intravenous meropenem for clearance. Cerebrospinal fluid clearance occurred at 7 days after initiation of combined therapy. The patient remained shunt dependent.Conclusions. Meningitis and ventriculitis caused by ESBLE. colispecies are rare and pose significant challenges to the treating physician. Early consideration for combined intraventricular and IV therapy should be made.
Flow Mediated Dilatation Is Reduced with the Progressive Stages of Glomerular Filtration Rate and Albuminuria in Type 2 Diabetic Patients without Coronary Heart Disease
Authors: Ito Hiroyuki , Nakashima Mina , Meguro Kentaro , Furukawa Haruki , Yamashita Hitomi , Takaki Akifusa , Yukawa Chizuko , Omoto Takashi , Shinozaki Masahiro , Nishio Shinya , Abe Mariko , Antoku Shinichi , Mifune Mizuo , Togane Michiko
Published: April 2015

We aimed to clarify the usefulness of measuring the flow mediated dilatation (FMD) in patients with type 2 diabetes mellitus without and with coronary heart disease (CHD). The FMD was measured in 480 patients with type 2 diabetes and in 240 nondiabetic subjects. The FMD was significantly lower in the subjects with CHD (n= 145,5.4±3.2%) than in those without CHD (n= 95,6.9±3.5%) among the nondiabetic subjects. The FMD was also lower in the subjects both with CHD (n= 161,5.6±2.8%) and without CHD (n= 319,6.1±3.3%) among the patients with diabetes compared to those without both diabetes and CHD. The FMD showed a significant positive correlation with the estimated glomerular filtration rate (eGFR) in the diabetic patients without CHD, while there was no significant association in those with CHD. The FMD was significantly lower with the progressive stages of the GFR or albuminuria in the patients without CHD among those with diabetes, although the FMD was not different in those with CHD. In conclusion, the FMD is considered to be useful for the detection of atherosclerosis in patients with type 2 diabetes, even if overt macroangiopathy is not diagnosed.
Spatiotemporal Complexity of the Nutrient-Phytoplankton Model
Authors: Mei Debing , Zhao Min , Yu Hengguo , Dai Chuanjun
Published: April 2015

We consider the mathematical formulation, analysis, and numerical solution of a nonlinear system of nutrient-phytoplankton, which consists of a series of reaction-advection-diffusion equations. We derive the critical conditions for Turing instability without an advection term and define the range of Turing instability with the change of nutrient concentration. We show that horizontal movement of phytoplankton could influence the system and that it is unstable when the horizontal velocity exceeds a critical value. We also compare reaction-diffusion equations with reaction-advection-diffusion equations through simulations, with spotted, banded, and crenulate patterns produced from our model. We found that different spatial constructions could occur, impacted by the diffusion and sinking of nutrients and phytoplankton. The new model may help us better understand the dynamics of an aquatic community.
A Comprehensive Review on Measurement and Correlation Development of Capillary Pressure for Two-Phase Modeling of Proton Exchange Membrane Fuel Cells
Authors: Si Chao , Wang Xiao-Dong , Yan Wei-Mon , Wang Tian-Hu
Published: April 2015

Water transport and the corresponding water management strategy in proton exchange membrane (PEM) fuel cells are quite critical for the improvement of the cell performance. Accuracy modeling of water transport in porous electrodes strongly depends on the appropriate constitutive relationship for capillary pressure which is referred to aspc-scorrelation, wherepcis the capillary pressure andsis the fraction of saturation in the pores. In the present PEM fuel cell two-phase models, the Leverett-Udellpc-scorrelation is widely utilized which is proposed based on fitting the experimental data for packed sands. However, the size and structure of pores for the commercial porous electrodes used in PEM fuel cells differ from those for the packed sands significantly. As a result, the Leverett-Udell correlation should be improper to characterize the two-phase transport in the porous electrodes. In the recent decade, many efforts were devoted to measuring the capillary pressure data and developing newpc-scorrelations. The objective of this review is to review the most significant developments in recent years concerning the capillary pressure measurements and the developedpc-scorrelations. It is expected that this review will be beneficial to develop the improved PEM fuel cell two-phase model.
Study on the Protective Effect of a New Manganese Superoxide Dismutase on the Microvilli of Rabbit Eyes Exposed to UV Radiation
Authors: Grumetto Lucia , Del Prete Antonio , Ortosecco Giovanni , Barbato Francesco , Del Prete Salvatore , Borrelli Antonella , Schiattarella Antonella , Mancini Roberto , Mancini Aldo
Published: April 2015

We present a study on the protective effects against UV radiation of a gel formulation containing a new recombinant form of manganese superoxide dismutase on the conjunctiva and corneal epithelia of rabbit eyes. The integrity of the microvilli of both ocular tissues has been considered as an indicator of the health of the tissues. Samples, collected by impression cytology technique, were added of 80 µL of a gel formulation containing superoxide dismutase (2.0 µg/mL) and irradiated with UV rays for 30 minutes and were evaluated with scanning electron microscopy. Wilcoxon test was used to verify the possible occurrence of statistically significant differences between damage for treated and nontreated tissues. Application of gel produces a significant reduction of damage by UV irradiation of ocular epithelia; both epithelia present a significant reduction of damaged microvilli number if treated with the superoxide dismutase gel formulation: thepvalues (differences between damage found for treated and nontreated both ocular tissues) for conjunctiva and cornea samples werep≪0.01andp≪0.0001, respectively, at confidence level of 95%. The administration of this gel formulation before UV exposure plays a considerable protective role in ocular tissues of rabbit eye with a significant reduction of the damage.
Ipilimumab-Induced Encephalopathy with a Reversible Splenial Lesion
Authors: Conry Robert M. , Sullivan Joseph C. , Nabors Louis B.
Published: April 2015

Ipilimumab, an anticytotoxic T-lymphocyte antigen (CTLA)-4 monoclonal antibody, is a first-line therapy for stage IV melanoma. Although high-grade immune-related adverse events occur in 25% of patients receiving ipilimumab, serious neurologic toxicity, primarily consisting of transient sensory and motor neuropathies, affects less than 1% of patients. We present a case report of a patient with melanoma who received high-dose ipilimumab at 10 mg/kg as first-line therapy for metastatic disease. After the third dose, the patient developed “mild” encephalopathy with a reversible splenial lesion (MERS) of the corpus callosum by MRI and neurogenic bladder, two novel immune-related adverse events during checkpoint inhibition. In addition to headache, delirium, and altered consciousness commonly seen with MERS, the patient also developed tremor, gait instability, paresthesias, and neurogenic bladder. The latter two symptoms were thought to represent sensory and autonomic neuropathies, respectively. The syndrome gradually resolved following intravenous methylprednisolone at 2 mg/kg divided twice daily for 5 days and a slow taper of oral prednisone over 8 weeks. Cancer Immunol Res; 3(6); 598–601. ©2015 AACR.
Established and Potential Predictive Biomarkers in Gastrointestinal Cancer - c-Kit, Her2, Ras and Beyond
Authors: Koch Christine , Trojan Joerg
Published: April 2015

Background: Gastrointestinal cancers are among the leading causes of cancer-related deaths worldwide. In different tumor types, personalized systemic treatment strategies based upon biomarker-selection were established over the last years. Although there is a flood of targeted agents in clinical development, only a few targeted agents with a predictive biomarker could be established for the treatment of patients with gastrointestinal cancer patients so far. Summary: Currently, predictive biomarkers for gastrointestinal cancers include Her2 overexpression or amplification (gastroesophageal adenocarcinoma), c-Kit overexpression (gastrointestinal stromal tumors) and RAS wild-type (colorectal cancer). Selection of patients based on these biomarkers allows the efficient use of targeted agents. The presence of a BRAF mutation and/or high microsatellite instability is prognostic and rather a predictive marker in CRC. Promising candidate markers in advanced clinical development are MET amplification in gastroesophageal adenocarcinoma, Met overexpression and high AFP serum levels in hepatocellular carcinoma. Key Message: Biomarker-guided systemic treatment is established in a subset of patients with gastrointestinal cancer. Ongoing clinical trials and further advances in high-throughput technologies will hopefully result in more personalized systemic treatment strategies for these patients in the near future.
Chronic Elevation of Tumor Necrosis Factor-α Mediates the Impairment of Leptomeningeal Arteriogenesis in db/db Mice
Authors: Yukami Toshiro , Yagita Yoshiki , Sugiyama Yukio , Oyama Naoki , Watanabe Akihiro , Sasaki Tsutomu , Sakaguchi Manabu , Mochizuki Hideki , Kitagawa Kazuo
Published: April 2015

Background and Purpose—

Leptomeningeal collateral growth is a key factor that defines the severity of ischemic stroke. Patients with stroke generally have vascular risk factors, such as diabetes mellitus; however, consensus is lacking on how diabetes mellitus affects leptomeningeal arteriogenesis. We investigate the influence of diabetes mellitus on the leptomeningeal arteriogenesis.

Methods—

We measured the vessel diameter of the leptomeningeal anastomoses 14 days after the common carotid artery occlusion in db/db, db/+, and streptozotocin-induced hyperglycemic mice. In another set of these mice, we measured the infarct volume attributed to subsequent middle cerebral artery occlusion 14 days after the common carotid artery occlusion. Mac-2–positive cells on the dorsal brain surface and the mRNA expression of several macrophage-related factors in the cerebral cortex were examined. Finally, we tested whether the leptomeningeal arteriogenesis could be restored by pharmaceutical intervention in the db/db mice.

Results—

Cerebral hypoperfusion led to significant ipsilateral leptomeningeal collateral growth in db/+ mice and streptozotocin-induced hyperglycemic mice. The collateral growth contributed to reduced infarct volume. In contrast, leptomeningeal arteriogenesis was impaired in the db/db mice. The number of Mac-2–positive cells was increased and tumor necrosis factor-α mRNA expression was induced after common carotid artery occlusion in the db/+ mice. However, these responses were not observed in the db/db mice. Administration of the tumor necrosis factor-α inhibitor etanercept before common carotid artery occlusion restored the hypoperfusion-induced leptomeningeal collateral growth in db/db mice.

Conclusions—

These results indicate that leptomeningeal arteriogenesis is impaired in db/db mice and that suppression of the tumor necrosis factor-α response to hypoperfusion is the major contributing factor.
Myeloperoxidase Is Increased in Human Cerebral Aneurysms and Increases Formation and Rupture of Cerebral Aneurysms in Mice
Authors: Chu Yi , Wilson Katina , Gu He , Wegman-Points Lauren , Dooley Sarah A. , Pierce Gary L. , Cheng Guangjie , Pena Silva Ricardo A. , Heistad Donald D. , Hasan David
Published: April 2015

Background and Purpose—

Cerebral aneurysm (CA) affects 3% of the population and is associated with hemodynamic stress and inflammation. Myeloperoxidase, a major oxidative enzyme associated with inflammation, is increased in patients with CA, but whether myeloperoxidase contributes to CA is not known. We tested the hypotheses that myeloperoxidase is increased within human CA and is critical for formation and rupture of CA in mice.

Methods—

Blood was drawn from the lumen of CAs and femoral arteries of 25 patients who underwent endovascular coiling of CA, and plasma myeloperoxidase concentrations were measured with ELISA. Effects of endogenous myeloperoxidase on CA formation and rupture were studied in myeloperoxidase knockout mice and wild-type (WT) mice using an angiotensin II–elastase induction model of CA. In addition, effects of myeloperoxidase on inflammatory gene expression in endothelial cells were analyzed.

Results—

Plasma concentrations of myeloperoxidase were 2.7-fold higher within CA than in femoral arterial blood in patients with CA. myeloperoxidase-positive cells were increased in aneurysm tissue compared with superficial temporal artery of patients with CA. Incidence of aneurysms and subarachnoid hemorrhage was significantly lower in myeloperoxidase knockout than in WT mice. In cerebral arteries, proinflammatory molecules, including tumor necrosis factor-α, cyclooxygenase-2 (COX2), chemokine (C-X-C motif) ligand 1 (CXCL1), chemokine (C motif) ligand (XCL1), matrix metalloproteinase (MMP) 8, cluster of differentiation 68 (CD68), and matrix metalloproteinase 13, and leukocytes were increased, and α-smooth muscle actin was decreased, in WT but not in myeloperoxidase knockout mice after induction of CA. Myeloperoxidase per se increased expression of vascular cell adhesion molecule-1 and intercellular adhesion molecule-1 in endothelial cells.

Conclusions—

These findings suggest that myeloperoxidase may contribute importantly to formation and rupture of CA.
Cancer in Young Adults With Ischemic Stroke
Authors: Aarnio Karoliina , Joensuu Heikki , Haapaniemi Elena , Melkas Susanna , Kaste Markku , Tatlisumak Turgut , Putaala Jukka
Published: April 2015

Background and Purpose—

Cancer is a risk factor for ischemic stroke. Little is known about cancer among young adults with ischemic stroke. We studied the frequency of cancer and its association with long-term risk of death among young patients with first-ever ischemic stroke.

Methods—

1002 patients aged 15 to 49 years, registered in the Helsinki Young Stroke Registry, and with a median follow-up of 10.0 years (interquartile range 6.5–13.8) after stroke were included. Historical and follow-up data were derived from the Finnish Care Register and Statistics Finland. Survival between groups was compared with the Kaplan–Meier life-table method, and Cox proportional hazard models were used to identify factors associated with mortality.

Results—

One or more cancer diagnosis was made in 77 (7.7%) patients, of whom 39 (3.9%) had cancer diagnosed prestroke. During the poststroke follow-up, 41 (53.2%) of the cancer patients died. Median time from prestroke cancer to stroke was 4.9 (1.0–9.5) years and from stroke to poststroke cancer was 6.7 (2.7–10.9) years. Poststroke cancer was associated with age >40 years, heavy drinking, and cigarette smoking. The cumulative mortality was significantly higher among the cancer patients (68.6%, 95% confidence interval 52.0%–85.3%) compared with patients without cancer (19.7%, 95% confidence interval 16.3%–23.2%). Active cancer at index stroke, melanoma, and lung/respiratory tract cancer had the strongest independent association with death during the follow-up when adjusted for known poststroke mortality prognosticators.

Conclusions—

Cancer, and especially active cancer and no other apparent cause for stroke, is associated with unfavorable survival among young stroke patients.
On the Dimension of Self-cultivation of Li in Xuncian Philosophy
Authors: Wang Kai
Published: April 2015

From the perspective of macro-politics, previous studies of Xunzi’s theory ofLi禮 (Rituals and Social Norms/Propriety/Rules of Proper Conduct) mainly concern the function and value ofLias a means of social control/governance that provides regulations and institutions (Dianzhang Zhidu典章制度). As a study of moral philosophy, this article adopts a micro-perspective to examine the individual agent [who practicesLi], and focuses on the dimension of individual self-cultivation throughLias discussed by Xunzi. This article argues that, based on the Confucian notion of moral community, even at the level of laws and institutions, the social stratification and social order established byLialso contain the value of “constructive morality.” The value foundation ofLilies not only in the propriety of external behavior but also in its performance of inner virtues. This article also points out thatLiis a notion of virtue precisely because it is the realization and expression ofYi. In addition,Li-performance is the cultivation and nourishing of the agents’ emotions and ethics in which natural emotion is elevated into moral sentiment. In short, according to Xunzi,Li-performance is a fundamental process and means of individual moral self-cultivation.
Type specimens of Colletes Latreille (Hymenoptera, Colletidae) deposited in the Zoological Institute of the Russian Academy of Sciences, St. Petersburg, with description of a new species
Authors: PROSHCHALYKIN MAXIM YU. , KUHLMANN MICHAEL
Published: April 2015

The type specimens of Colletes Latreille 1802 deposited in the Zoological Institute, Russian Academy of Sciences (St. Petersburg) are reviewed. Precise information about types of 30 taxa are provided (12 described by J. Noskiewicz; 9 by F. Morawitz; 8 by M. Kuhlmann and M. Proshchalykin; 1 by H. Friese). Lectotypes are designated here and illustrated for the following six nominal taxa: Colletes alpinus Morawitz 1872, C. caspicus Morawitz 1874, C. montana Morawitz 1876, C. squamosus Morawitz 1877, C. tuberculatus Morawitz 1893, and C. wollmanni Noskiewicz 1936. Colletes alpinus was synonymized with C. impunctatus Nylander 1852 but is now recognized as a synonym of C. floralis Eversmann 1852. Colletes morawitzensis Kuhlmann & Proshchalykin, sp. nov. is described based on a male specimen from Turkmenistan and deposited in the Morawitz collection.
Two new species of Phlogophora Treitschke (Lepidoptera: Noctuidae) from China and Vietnam
Authors: GYULAI PETER , RONKAY LÁSZLÓ , RONKAY GÁBOR , SALDAITIS AIDAS
Published: April 2015

The genus Phlogophora Treitschke (type species Phlogophora meticulosa (Linnaeus)) comprises some 60 known species. Phlogophora is a widely distributed genus, mostly with Trans-Palaearctic and Oriental distribution, however species of the genus are known from the Ethiopian Region, and some from the Nearctic, as well. Phlogophora displays the highest diversity from the monsoon influenced regions of the Central and Southern Himalaya (Nepal, India, Myanmar and Vietnam) to the Indonesian islands in the South. A number of the species are endemic in islands from the Azores throughout Madagascar, Taiwan and, particularly, in the Sundaland (The Philippines and the Sunda Islands, towards to the east to New Guinea).
Management and Outcomes Among Chinese Hospitalized Patients With Established Cardiovascular Disease or Multiple Risk Factors
Authors: Yang Jingang , Yang Yuejin , Gu Hongqiu , Li Wei , Hu Dayi
Published: April 2015

We assessed the management and outcomes among hospitalized patients with coronary artery disease (CAD), stroke, peripheral artery disease (PAD), or with multiple (≥2) cardiovascular (CV) risk factors (multiple risk factors [MRFs]). We retrospectively studied 3732 hospitalized patients of either CV disease or ≥2 risk factors for atherothrombosis from October 2004 to January 2005. Outcomes included CV death, myocardial infarction (MI), stroke, and hospitalization for atherothrombotic events. About one-third had disease involving ≥1 vascular bed. Medication was more intense in patients with CAD than in others. The lowest use of statins and antiplatelet treatment was in the PAD-only group. Patients with PAD experienced a higher CV mortality (5.1%) than the patients with CAD (3.73%) or stroke (4.1%), P < .001. Cardiovascular death ranged from 1.2% for patients with MRFs, 2.8% for patients with 1-bed disease, 4.7% for patients with 2-bed disease to 6.4% for patients with 3-bed disease ( P for trend <.001). For hospitalized patients with established atherosclerotic arterial disease, a substantial increase in CV event rates occurs with increasing numbers of affected arterial beds. Patients with PAD were at an especially high risk.
Gpr177-mediated Wnt Signaling Is Required for Secondary Palate Development
Authors: Liu Y. , Wang M. , Zhao W. , Yuan X. , Yang X. , Li Y. , Qiu M. , Zhu X.-J. , Zhang Z.
Published: April 2015

Cleft palate represents one of the major congenital birth defects in humans. Despite the essential roles of ectodermal canonical Wnt and mesenchymal Wnt signaling in the secondary palate development, the function of mesenchymal canonical Wnt activity in secondary palate development remains elusive. Here we show that Gpr177, a highly conserved transmembrane protein essential for Wnt trafficking, is required for secondary palate development. Gpr177 is expressed in both epithelium and mesenchyme of palatal shelves during mouse development. Wnt1Cre-mediated deletion of Gpr177 in craniofacial neural crest cells leads to a complete cleft secondary palate, which is formed mainly due to aberrant cell proliferation and increased cell death in palatal shelves. By BATGAL staining, we reveal an intense canonical Wnt activity in the anterior palate mesenchyme of E12.5 wild-type embryos but not in Gpr177Wnt1-Cre embryos, suggesting that mesenchymal canonical Wnt signaling activated by Gpr177-mediated mesenchymal Wnts is critical for secondary palate development. Moreover, phosphorylation of JNK and c-Jun is impaired in the Gpr177Wnt1-Cre palate and is restored by implantation of Wnt5a-soaked beads in the in vitro palate explants, suggesting that Gpr177 probably regulates palate development via the Wnt5a-mediated noncanonical Wnt pathway in which c-Jun and JNK are involved. Importantly, certain cellular processes and the altered gene expression in palates lacking Gpr177 are distinct from that of the Wnt5a mutant, further demonstrating involvement of other mesenchymal Wnts in the process of palate development. Together, these results suggest that mesenchymal Gpr177 is required for secondary palate development by regulating and integrating mesenchymal canonical and noncanonical Wnt signals.
Oleanolic Acid Improves Gut Atrophy Induced by Parenteral Nutrition
Authors: Jain Ajay Kumar , Wen Joy X. , Blomenkamp Keith S. , Arora Sumit , Blaufuss Timothy A. , Rodrigues Jonathan , Long John P. , Neuschwander‐Tetri Brent A. , Teckman Jeffery H.
Published: April 2015

Background:Nutrition support with parenteral nutrition (PN) is associated with gut atrophy. Prior studies have shown improvement with enteral chenodeoxycholic acid, a dual agonist for the farnesoid X receptor (FXR) and bile acid receptor TGR5. We hypothesized that gut growth is induced by TGR5 activation, and gut atrophy during PN administration could be prevented with the TGR5‐specific agonist oleanolic acid (OA).Methods: Neonatal pigs were implanted with duodenal and jugular vein catheters. Animals were provided equi‐nutritious PN or enteral swine milk. A PN subgroup received enteral OA at 50 mg/kg/d.Results: PN caused marked gut atrophy compared with enterally fed (EN) control animals. OA treatment led to preservation of gut mass demonstrated grossly and histologically. The mean ± SD gut weight as a percentage of body weight was 4.30 ± 0.26 for EN, 1.92 ± 0.06 for PN (P< .05, EN vs PN), and 3.39 ± 0.79 for PN+OA (P< .05, PN+OA vs PN). Mean ± SD gut density (g/cm) was 0.31 ± 0.03 for EN, 0.18 ± 0.03 for PN (P< .05 EN vs PN), and 0.27 ± 0.01 for PN+OA (P< .05 PN+OA vs PN). Histologically, a markedly decreased villous to crypt ratio was noted with PN, and OA significantly prevented this decrease. The mean ± SD v/c ratio was 3.51 ± 0.59 for EN, 1.69 ± 0.10 for PN (P< .05, EN vs PN), and 2.90 ± 0.23 for PN+OA (P< .05, PN+OA vs PN). Gut TGR5 messenger RNA expression was significantly elevated with OA treatment compared with both PN and EN.Conclusion: The bile acid–activated G protein–coupled receptor TGR5 agonist OA prevented gut atrophy associated with PN.
The role of timing in assessing oral reading fluency and comprehension in Kenya
Authors: Piper Benjamin , Zuilkowski Stephanie Simmons
Published: April 2015

Despite rapid growth in literacy-related programmes and evaluation in sub-Saharan Africa, little critical attention has been paid to the relevance of assumptions that underlie existing assessment methods. This study focuses on the issue of timing in the assessment of oral reading fluency, a critical component of successful reading (Chard, Vaughn, & Tyler, 2002; National Institute of Child Health and Human Development (NICHD), 2000; Pikulski & Chard, 2005). Within the context of the Primary Math and Reading Initiative, a randomized controlled trial of several instructional interventions in Kenya, timed and untimed Early Grade Reading Assessment (EGRA) oral reading fluency and reading comprehension tasks were administered to 4385 students in 95 government and 125 informal schools. Using the data from the EGRA – whose administration has expanded within sub-Saharan Africa recently – we found that students did not perform significantly better on the assessments when they had more time. This pattern largely held when we examined the effects disaggregated over student ability level. This suggests that timed assessments, which are faster to administer and logistically easier, are appropriate for use in Kenya.
Dying in the hospital setting: A systematic review of quantitative studies identifying the elements of end-of-life care that patients and their families rank as being most important
Authors: Virdun Claudia , Luckett Tim , Davidson Patricia M , Phillips Jane
Published: April 2015

Background:

The majority of expected deaths occur in hospitals where optimal end-of-life care is not yet fully realised, as evidenced by recent reviews outlining experience of care. Better understanding what patients and their families consider to be the most important elements of inpatient end-of-life care is crucial to addressing this gap.

Aim and design:

This systematic review aimed to ascertain the five most important elements of inpatient end-of-life care as identified by patients with palliative care needs and their families.

Data sources:

Nine electronic databases from 1990 to 2014 were searched along with key internet search engines and handsearching of included article reference lists. Quality of included studies was appraised by two researchers.

Results:

Of 1859 articles, 8 met the inclusion criteria generating data from 1141 patients and 3117 families. Synthesis of the top five elements identified four common end-of-life care domains considered important to both patients and their families, namely, (1) effective communication and shared decision making, (2) expert care, (3) respectful and compassionate care and (4) trust and confidence in clinicians. The final domains differed with financial affairs being important to families, while an adequate environment for care and minimising burden both being important to patients.

Conclusion:

This review adds to what has been known for over two decades in relation to patient and family priorities for end-of-life care within the hospital setting. The challenge for health care services is to act on this evidence, reconfigure care systems accordingly and ensure universal access to optimal end-of-life care within hospitals.
Midbrain raphe 5-HT1A receptor activation alters the effects of ghrelin on appetite and performance in the elevated plus maze
Authors: Wauson Shelby ER , Sarkodie Kwaku , Schuette Lindsey M , Currie Paul J
Published: April 2015

Prior research suggests that midbrain serotonergic signaling and hypothalamic ghrelinergic signaling both play critical roles in appetitive and emotional behaviors. In the present study, we investigated the effects of median raphe nucleus (MRN) somatodentritic 5-HT1A receptor activation on the feeding-stimulant and anxiogenic action of paraventricular nucleus (PVN) ghrelin. In an initial experiment, adult male Sprague-Dawley rats were injected with either ghrelin (200–800 pmol) into the PVN or 8-OH-DPAT (2.5–10 nmol), a 5-HT1A receptor agonist, into the MRN. Performance on the elevated plus maze (EPM) was then assessed. In separate rats, MRN 8-OH-DPAT (2.5–5 nmol) was administered 5 min prior to PVN injection of ghrelin (400 pmol) followed by EPM testing. The orexigenic effects of MRN 8-OH-DPAT (0.1–1.6 nmol) paired with PVN ghrelin (50 pmol) were also examined. When administered alone into the PVN, ghrelin significantly decreased the number of entries and time spent in the open arms of the EPM. This anxiogenic effect was blocked if rats were allowed to eat immediately after ghrelin administration and then tested in the plus maze. MRN injections of 8-OH-DPAT were anxiolytic, and when rats were pretreated with 8-OH-DPAT prior to ghrelin, the anxiogenic action of the peptide was attenuated. In contrast, MRN administration of 8-OH-DPAT potentiated the eating-stimulant effect of PVN ghrelin. Overall, our findings demonstrate that ghrelinergic and serotonergic circuits interact in the neural control of eating and anxiety-like behaviors, with 5-HT1A receptor mechanisms potentiating the orexigenic action of ghrelin while inhibiting ghrelin-induced anxiogenesis as measured via the EPM.
The relative values of CD8+CD25+Foxp3brigh Treg cells correlate with selected lung function parameters in asthma
Authors: Eusebio M , Kuna P , Kraszula L , Kupczyk M , Pietruczuk M
Published: April 2015

The study aimed to detect CD8 +CD25 +FoxP3brigh Tregs and investigate their possible association with selected lung function values. CD8+CD25+FoxP3brigh Tregs were detected by flow cytometry in the peripheral blood of 25 patients with severe asthma (SA), 25 patients with mild-to-moderate asthma (MA), and 25 age-matched healthy donors (NC). The percentages of CD8+CD25+FoxP3brigh Tregs of the patients with severe (3.4 ± 4.55), and mild-to-moderate asthma (7.5 ± 8.15), were markedly lower than those of controls (12.1 ± 13.2). The mean forced expiratory volume in 1 s (FEV1) % predicted value in severe asthma subpopulation was significantly lower (67.05 ± 15.98%) when compared with that of mild-to-moderate asthma subgroup (87.71 ± 16.12%). Interestingly, the percentages of CD8+CD25+FoxP3brigh Tregs correlate with mean peak expiratory flow (PEF)% predicted values in severe (r = 0.7, P <0.01) and mild-to-moderate (r = 0.73, P <0.01) asthma. In contrast, this parameter was positively correlated with FEV1% predicted values in the severe asthmatics only (r = 0.71, P <0.01). In summary, this study establishes a link between the percentage of CD8+CD25+FoxP3brigh Tregs and selected lung function parameters, suggesting that this parameter has potential as a marker for inflammation and airflow obstruction.
A review on assembly sequence generation and its automation
Authors: Bahubalendruni MVA Raju , Biswal Bibhuti Bhusan
Published: April 2015

Sequence of feasible mechanical assembly operations plays significant role in overall cost optimisation process for manufacturing industry and thus great importance is given to assembly sequence generation from past four decades. Though achieving at least one feasible sequence is focused in the earlier stages of research, the introduction of soft computing techniques attracted the industrial engineers towards cost-effective, optimised assembly sequences to attain economical manufacturing process. The integration of assembly sequence generation methods with computer aided design environment ensures more correctness and flexibility to automate the process. In this paper, a detailed review on various methods, their applications and limitations is presented and well discussed.
Anatomical Reconstruction of Lateral Ankle Ligaments Using Free Tendon Allografts and Biotenodesis Screws
Authors: Jung Hong-Geun , Shin Min-Ho , Park Jong-Tae , Eom Joon-Sang , Lee Dong-Oh , Lee Sang-Hun
Published: April 2015

Background:

Lateral ankle instability is one of the most common musculoskeletal disorders and can result in ankle damage. This study reports on the results of the anatomical reconstruction of ligaments using semitendinosus tendon allograft and bioabsorbable tenodesis screws for chronic lateral ankle instability, as well as the functional and radiological results of this procedure.

Methods:

From February 2007 to January 2013, 70 patients (72 ankles) underwent this procedure. Six patients were lost to follow-up, and ultimately 64 patients (66 ankles) were evaluated. Visual Analog Scale (VAS) pain scores, American Orthopaedic Foot & Ankle Society (AOFAS) scores, Karlsson-Peterson ankle scores, and patient satisfaction were evaluated at a mean of 22.1 months (range, 12-68 months) postoperatively. The talar tilt angle and anterior translation were assessed radiographically in pre- and postoperative ankle stress views. The mean patient age at surgery was 30.1 years (range, 16-59 years).

Results:

The mean VAS pain score decreased from 5.5 to 1.3 ( P < .05), and the mean AOFAS improved from 71.0 to 90.9 ( P < .05). The mean Karlsson-Peterson score improved from 55.1 to 90.3, whereas talar tilt decreased from 14.8 degrees to 3.9 degrees. There was no significant difference in clinical outcomes between the pretensioned and nonpretensioned groups.

Conclusion:

This procedure yielded successful results, including satisfactory ankle stability and clinical outcomes, in ankles with poor lateral ligament tissues.

Level of Evidence:

Level IV, case series.
Treatment of acute relapses in neuromyelitis optica: Steroids alone versus steroids plus plasma exchange
Authors: Abboud Hesham , Petrak Alex , Mealy Maureen , Sasidharan Sarana , Siddique Laila , Levy Michael
Published: April 2015

Background:

Although adding plasma exchange (PLEX) to steroids in severe neuromyelitis optica (NMO) attacks is common practice in steroid-resistant cases, the benefit of this strategy has not been previously quantified.

Objective:

The objective of this paper is to compare the efficacy of high-dose intravenous methylprednisolone (IVMP) versus IVMP+PLEX in treatment of acute NMO relapses.

Methods:

We conducted a retrospective review of the last 83 NMO admissions to the Johns Hopkins Hospital treated with IVMP alone versus IVMP+PLEX (for steroid-resistant cases). Extended Disability Status Scale (EDSS) score was calculated at baseline, at presentation, at discharge, and on follow-up.

Results:

Eighteen NMO relapses (16 patients, 87% female, mean age at relapse: 33.9±23.8, median baseline EDSS 2.5) were treated with IVMP alone and 65 relapses (43 patients, 95% female, mean age at relapse: 43.8±15.7, median baseline EDSS 5.75) were treated with IVMP + PLEX. Sixty-five percent of IVMP + PLEX patients achieved an EDSS equal or below their baseline at follow-up while only 35% of the IVMP-only patients achieved their baseline EDSS on follow-up (odds ratio=3.36, 95% CI 1.0657 to 10.6004, p = 0.0386). PLEX was more effective in improving EDSS in patients on preventive immunosuppressive medications at time of relapse.

Conclusions:

PLEX+IVMP are more likely to improve EDSS after NMO relapses compared to IVMP alone, especially in patients taking preventive medications.