bluuebunny/crossref_metadata_2025 huggingface dataset:
Ehlers–Danlos Syndrome: Not Just Joint Hypermobility
Authors: Bregant Tina , Klopcic Spevak Milica
Published: August 2018

Ehlers–Danlos syndrome is an umbrella term for a group of heritable soft connective tissue disorders which is characterized by joint hypermobility, skin texture and elasticity abnormalities, and visceral and vascular fragility or dysfunctions. As the syndrome is rare, it is often underdiagnosed. Patients usually present late, with chronic moderate to severe pain which is attributed to the joint hypermobility and joint subluxations. If the clinician is aware of the syndrome, he/she can identify affected patients in order to prevent complications. We report a 60-year-old woman with arthralgia and back pain lasting for several months and recent metatarsophalangeal luxation of the left toe who was discovered to have Ehlers–Danlos syndrome.
Association between Polymorphisms of Antioxidant Gene (MnSOD, CAT, and GPx1) and Risk of Coronary Artery Disease
Authors: Yeh Hseng-Long , Kuo Li-Tang , Sung Fung-Chang , Yeh Chih-Ching
Published: August 2018

Objective. Reactive oxygen species (ROS) been cited as one of the major causes of atherosclerosis and coronary artery disease which are possible agents inducing DNA damage. Manganese superoxide dismutase (MnSOD), catalase (CAT), and glutathione peroxidase-1 (GPx1) have evolved to address primary defense against free radical mediated damage in mitochondria. The aim of this study was to delineate the association ofMnSOD,CAT, andGPx1polymorphisms and risk of CAD in Taiwan.Methods. We conducted a case-control study with 657 participants recruited at a medical center. All subjects were evaluated by noninvasive stress test and then quantitative coronary angiography to confirm the diagnosis of CAD. 447 CAD cases were defined as >50% stenosis of coronary artery and 210 controls were stenosed below 50%. Polymorphisms ofMnSOD(Val16Ala),CAT(C-262T), andGPx1(Pro198Leu) genes were determined by polymerase chain reaction methods. Multivariate logistic regression model was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs).Results. TheMnSODVal/Ala+Ala/Ala genotype was significantly associated with an increased risk of CAD compared to the Val/Val genotype (OR = 1.86, 95% CI = 1.15-3.01). This polymorphism was also associated with the severity of CAD of single and two vessel diseases. The corresponding ORs were 2.31 (95% CI = 1.32-4.03) and 1.92 (95% CI = 1.02-3.61), respectively. Among cigarette smokers, the harmful genetic effect ofMnSODAla allele on CAD risk was much higher (OR = 2.23, 95% CI = 1.02-4.88). However, the interaction betweenMnSODgenotype and cigarette smoking on CAD risk was not significant. No significant association betweenCATandGPx1polymorphisms and CAD risk was observed.Conclusion. Our results suggest thatMnSODpolymorphism is an independent risk factor for susceptibility to CAD in the Chinese population.
Patient-Reported and Performance Outcomes Significantly Improved in Elderly Patients with Vestibular Impairment following Rehabilitation: A Retrospective Study
Authors: Verdecchia Daniel Héctor , Monzón Agustina Maria , Urbina Jaimes Valentina , Oliveira Fernando Rocha , Paiva Laércio da Silva , Carvalho Tatiana Dias de
Published: August 2018

Objective. To describe the results of a vestibular rehabilitation (VR) program in the timed up and go (TUG), gait speed (GS), and dizziness handicap inventory (DHI) scores for elderly vestibular patients in a developing country.Methods. Descriptive study with retrospective data collected from the clinical records of vestibular patients. The following information was recorded: sex, age, type of vestibular disorder, DHI score, and performance in TUG and GS, before and after participation in a VR program taking place from January 1 to August 30, 2017. The VR program consisted of 10 twice weekly sessions in the clinic and daily exercises at the patient’s home. We used Student’st-test for paired and Wilcoxon’s test according to the data distribution. The level of significance was 5%.Results. Data from 57 patients (49 females; 78 ± 5.8 years old) were used. There were statistically significant differences in TUG (12.52 versus 11.56), GS (0.81 versus 0.90 m/s), DHI total handicap (46 versus 24), physical (14 versus 8), emotional (14 versus 6), and functional (18 versus 12) domains.Conclusion. The functional outcome measures reported, including TUG, gait speed, and DHI, reflect statistically significant improvements in elderly patients after vestibular rehabilitation; the DHI improvements are clinically relevant.
When the Benign Pneumatosis Intestinalis Becomes No Longer Benign: A Rare Case of Bowel Perforation in a Patient with Systemic Sclerosis
Authors: Guan Jian , Munaf Alvina , Simmonds Alric V. , Inayat Irteza
Published: August 2018

Systemic sclerosis is a multisystem disease featured with autoimmunity and organ fibrosis. Although gastrointestinal (GI) tract involvement is common in patients with systemic sclerosis, colonic perforation is extremely rare. Benign pneumatosis intestinalis, a phenomenon more frequently seen in rheumatologic conditions, makes the diagnosis of colonic perforation even more challenging. We report a unique case of colonic perforation in a patient with chronic systemic sclerosis. This patient initially presented with mild abdominal pain and hematemesis. Urgent upper endoscopy was unremarkable and radiology showed stable pneumatosis intestinalis. Due to worsening abdominal pain, laparotomy exploration was performed and colonic perforation with transmural ischemic necrosis was found.
Transcriptome Analysis of Rainbow Trout (Oncorhynchus mykiss) Eggs Subjected to the High Hydrostatic Pressure Treatment
Authors: Gurgul Artur , Pawlina-Tyszko Klaudia , Bugno-Poniewierska Monika , Szmatoła Tomasz , Jasielczuk Igor , Dobosz Stefan , Ocalewicz Konrad
Published: August 2018

High hydrostatic pressure (HHP) causes depolymerization of the spindle microtubules. HHP applied to fish eggs prevents extrusion of the second polar body and inhibits the first cell cleavage, and it is used to produce triploids and diploid gynogenetic and androgenetic individuals. HHP has been also found to affect biomolecules including nucleic acids, and it may be presumed that HHP administered to the rainbow trout (Oncorhynchus mykiss) eggs disturbs cytoplasmic maternal RNA indispensable for the early embryogenesis. To verify this assumption, quality and quantity of RNA extracted from the rainbow trout eggs subjected to the high hydrostatic pressure shock were analyzed. Provided results exhibited that maternal transcriptome was resistant to a three-minute exposure to 65.5 MPa of HHP treatment. Some trend showing increase of the RNA integrity was observed in the HHP-treated eggs; however, the difference was not statistically significant. Alterations in the expression profiles in the rainbow trout eggs subjected to HHP were also negligible. Greater differences in the maternal gene expression were observed between eggs from different clutches than between HHP-treated and untreated eggs from the same clutch. It may be assumed that exposure to HHP shock was too short to modify significantly maternal transcripts in the rainbow trout eggs.
Antibiotics Resistance Genes Screening and Comparative Genomics Analysis of Commensal Escherichia coli Isolated from Poultry Farms between China and Sudan
Authors: Abdelgader Sheikheldin A. , Shi Donglin , Chen Mianmian , Zhang Lei , Hejair Hassan M. A. , Muhammad Umair , Yao Huochun , Zhang Wei
Published: August 2018

Escherichia coli (E. coli) strains, from the gut of animals and humans, harbor wide range of drug resistance genes. A comparative study is conducted on the intestinal E. coli from fecal samples of healthy chicken from China and Sudan in order to monitor the antimicrobial sensitivity pattern. A number of 250 E. coli isolates from chicken farms, including 120 from China and 130 from Sudan, were isolated and identified. All isolates were subjected to susceptibility tests against 10 antibiotics and the distribution of antibiotic resistant genes was confirmed by PCR amplification, involving genes such as ampC, tetA, pKD13, acrA, ermA, ermB, ermC, tetB, mphA, aadA14, aadA1, aac3-1, and aac3- III. Many isolates were found to exhibit resistance against more than one antibiotic. However, the Chinese isolates showed more antibiotics resistance and resistance genes compared to the Sudanese isolates. For better understanding of the multidrug resistance factors, we conducted whole genome analyses of E. coli D107 isolated from China, which revealed that the genome possesses multiple resistance genes including tetracycline, erythromycin, and kanamycin. Furthermore, E. coli D4 isolate from Sudan was more sensitive to antibiotics such as erythromycin, tetracycline, and gentamicin. After analysis by RAST and MAUVE, the two strains showed 89% average nucleotide identity. However, the genomes mostly differed at the number of antibiotics-related genes, as the genome of D107 revealed a considerable number of antibiotics resistance genes such as ermA and mphD which were found to be absent in D4 genome. These outcomes provided confirmation that the poultry farms environment in different countries (China and Sudan) may serve as a potential reservoir of antimicrobial resistance genes and also indicated the evolutionary differences of strains in terms of resistant genes expression.
Robust Optimization for the Newsvendor Problem with Discrete Demand
Authors: Zhai Jia , Yu Hui , Sun Caihong
Published: August 2018

A robust newsvendor model with discrete demand is initiatively studied, and the steps to obtain the optimal ordering decision are provided. The study shows that the optimal ordering decision with discrete demand is very different from that with continuous demand. Besides, the total number of demand points has almost no effect on the performance of both ordering decisions. Furthermore, for an ultralow-profit product, the ordering decision with discrete demand performs significantly better than that with continuous demand.
Detection, Characterization, and Clinical Application of Mesenchymal Stem Cells in Periodontal Ligament Tissue
Authors: Tomokiyo Atsushi , Yoshida Shinichiro , Hamano Sayuri , Hasegawa Daigaku , Sugii Hideki , Maeda Hidefumi
Published: August 2018

Mesenchymal stem cells (MSCs) are a kind of somatic stem cells that exert a potential to differentiate into multiple cell types and undergo robust clonal self-renewal; therefore, they are considered as a highly promising stem cell population for tissue engineering. MSCs are identified in various adult organs including dental tissues. Periodontal ligament (PDL) is a highly specialized connective tissue that surrounds the tooth root. PDL also contains MSC population, and many researchers have isolated them and performed their detailed characterization. Here, we review the current understanding of the features and functions of MSC population in PDL tissues and discuss their possibility for the application of PDL regeneration.
Effects of Gd211 Particles Characteristic in the Precursor Pellets on the Levitation Force of Single‐Domain GdBCO Bulks Prepared by the Gd + 011 TSIG Method
Authors: Yuan Xiaochun , Yang Wanmin
Published: August 2018

In this paper, single‐domain GdBCO bulks have been fabricated by a new Gd + 011 TSIG method with precursor solid phase pellets (PSPPs) of different Gd211 particle sizes and distributions, prepared by solid state reaction with well‐mixed (Gd2O3 + BaCuO2) pellets at different temperatures. The novel results indicated that (1) the average size of Gd211 particles in PSPP is monotonically increasing with increasing the sintering temperature up to 1200°C. (2) With increasing the sintering temperature from 950 to 1200°C, the porous ratio and the density of the PSPP are, respectively, monotonically decreasing and increasing. Furthermore when the sintering temperature is less than 1000°C, the porous ratio is higher and the density is lower than the values of the pressed pellets. (3) With increasing the sintering temperature, the average size of Gd211 particles in the GdBCO bulk first decreases and then increases. In addition, the smallest Gd211 particles are obtained in the sample sintered at 1050°C. (4) The maximum levitation force is obtained in the sample sintered at 1150°C with a relatively larger size of Gd211 particles and lower porosity. This result is significant when fabricating high‐quality GdBCO bulk superconductors by controlling the porosity, Gd211 particle size, and their distribution characteristic.
Tribulus terrestris Protects against Male Reproductive Damage Induced by Cyclophosphamide in Mice
Authors: Pavin Natasha Frasson , Izaguirry Aryele Pinto , Soares Melina Bucco , Spiazzi Cristiano Chiapinotto , Mendez Andreas Sebastian Loureiro , Leivas Fábio Gallas , dos Santos Brum Daniela , Cibin Francielli Weber Santos
Published: August 2018

Tribulus terrestris (TT) has been considered as a potential stimulator of testosterone production, which has been related with steroidal saponins prevailing in this plant. Cyclophosphamide (CP) is the most commonly used anticancer and immunosuppressant drug, which causes several toxic effects, especially on the reproductive system. Patients who need to use CP therapy exhibit reduced fertility or infertility, which impacts both physically and emotionally on the decision to use this drug, especially among young men. We hypothesized that the treatment with TT dry extract would protect the male reproductive system against CP toxicity. Mice received dry extract of TT (11 mg/kg) or vehicle by gavage for 14 days. Saline or CP was injected intraperitoneally at a single dose (100 mg/kg) on the 14th day. Animals were euthanized 24 h after CP administration, and testes and epididymis were removed for biochemical and histopathological analysis and sperm evaluation. The dry extract of TT was evaluated by HPLC analysis and demonstrated the presence of protodioscin (1.48%, w/w). CP exposure increased lipid peroxidation, reactive species, and protein carbonylation and altered antioxidant enzymes (SOD, CAT, GPx, GST, and GR). Moreover, acute exposure to CP caused a reduction on 17 β‐HSD activity, which may be related to the reduction in serum testosterone levels, histopathological changes observed in the testes, and the quality of the semen. The present study highlighted the role of TT dry extract to ameliorate the alterations induced by CP administration in mice testes, probably due to the presence of protodioscin.
Epidemiology of Depression and Associated Factors among Asthma Patients in Addis Ababa, Ethiopia
Authors: Woledesenbet Mebrat Abera , Shumet Mekonen Shegaye , Sori Lamesa Melese , Abegaz Tadesse Melaku
Published: August 2018

Background. Depression in asthma patients can cause worsening of respiratory symptoms. Addressing mental illness in those with asthma improves asthma outcomes. This study aimed to assess the epidemiology of depression and associated factors among asthma patients attending government hospitals in Ethiopia. Methods. Institutional based cross-sectional study was conducted on patients with asthma at three governmental hospitals of Addis Ababa from June to July 2017. Patient health questionnaire (PHQ-9) depression scale was used to assess prevalence of depression among asthmatic patients. The data were entered and analyzed using SPSS version 20 statistical software. Binary logistic regression analysis was conducted to identify associated factors for depression. To indicate the strength of association, odds ratios (OR) and 95% confidence intervals (95% CI) were used. Result. A total of 405 participants were enrolled in the study giving an overall response rate of 96%. The respondents had mean age of 54.46 and standard deviation (SD) of 10.01 years. About 273 (67.4%) were females. The prevalence of depression among asthma patients was 85 (21%). The odds of developing depression among single asthma patients were increased by 1.63 with 95% CI [1. 8, 3.493]. Depression among asthma patients who had comorbid cardiac illness was 6.2 times higher than those who do not have at CI [1.145, 24.109]. The prevalence of depression among uncontrolled asthma patients was 8 times higher than those with well-controlled asthma at CI [1.114, 19.025]. Conclusion. One-fifth of asthmatic patients were experiencing depression. Uncontrolled asthma, comorbid cardiac illness, and single patients were important predictors of depression among asthmatic patients. Proper control of asthmatic attack and cardiac illnesses is very important to reduce the burden of depression.
All-Trans Retinoic Acid Enhances Matrix Metalloproteinase 2 Expression and Secretion in Human Myeloid Leukemia THP-1 Cells
Authors: Vu Hien Thi , Hoang Thi Xoan , Kim Jae Young
Published: August 2018

All-trans retinoic acid (ATRA) is an effective drug for the induction therapy of acute promyelocytic leukemia. However, the treatment is associated with adverse events such as retinoic acid syndrome (RAS) in some patients, whose histologic characteristics included organ infiltration by leukemic cells. Matrix metalloproteinase 2 (MMP-2) is often upregulated in tumor cells and plays a role in tumor cell migration and invasion by degrading the extracellular matrix. In this study, we examined the possible modulatory effects of ATRA on MMP-2 expression and secretion in human myeloid leukemia cell line THP-1. The cells were treated with various concentrations of ATRA, and MMP-2 expression and secretion were examined. MMP-2 expression and secretion started to increase with ATRA concentration as low as 0.1 nM and gradually increased thereafter. Agonists of retinoic acid receptor (RAR) or retinoid X receptor (RXR) alone could enhance MMP-2 secretion, and RAR or RXR antagonists alone could reverse ATRA-induced MMP-2 secretion. ATRA increased intracellular calcium ion levels, and a calcium-channel blocker inhibited ATRA-induced MMP-2 secretion. Dexamethasone suppressed ATRA-induced MMP-2 secretion. Our results suggest that ATRA enhances MMP-2 expression and secretion in human myeloid leukemia THP-1 cells in a calcium ion dependent manner through RAR/RXR signaling pathways, and this enhanced expression and secretion may be associated with the possible mechanisms of RAS.
Elegance as Complexity Reduction in Systems Design
Authors: Iandoli Luca , Piantedosi Letizia , Salado Alejandro , Zollo Giuseppe
Published: August 2018

Elegance is often invoked as a characteristic of good design, but it cannot be pursued as a design objective because of the absence of actionable definitions that can be translated into design strategies and metrics. In this work, we analyze elegance in the context of systems engineering using a perspective that integrates visual art, Gestalt psychology, neuroscience, and complexity theory. In particular, we measure elegance as effective complexity and theorize that it can be achieved by a process of complexity resolution based on the adoption of eight visual heuristics. We present an empirical study in which a sample of systems engineers were asked to assess alternative representations of a same system and show that effective complexity is strongly correlated to perceived elegance and systems effectiveness. Our results are consistent with independent findings obtained in other fields including design and psychology of perception showing that good design must embed an effective level of complexity achievable through a mix of familiarity and novelty.
Novel Neutrino-Floor and Dark Matter Searches with Deformed Shell Model Calculations
Authors: Papoulias D. K. , Sahu R. , Kosmas T. S. , Kota V. K. B. , Nayak B.
Published: August 2018

Event detection rates for WIMP-nucleus interactions are calculated for  71Ga,  73Ge,  75As, and  127I (direct dark matter detectors). The nuclear structure form factors, which are rather independent of the underlying beyond the Standard Model particle physics scenario assumed, are evaluated within the context of the deformed nuclear shell model (DSM) based on Hartree-Fock nuclear states. Along with the previously published DSM results for  73Ge, the neutrino-floor due to coherent elastic neutrino-nucleus scattering (CEνNS), an important source of background to dark matter searches, is extensively calculated. The impact of new contributions to CEνNS due to neutrino magnetic moments and Z′ mediators at direct dark matter detection experiments is also examined and discussed. The results show that the neutrino-floor constitutes a crucial source of background events for multi-ton scale detectors with sub-keV capabilities.
Venetoclax in Combination with Decitabine for Relapsed T-Cell Acute Lymphoblastic Leukemia after Allogeneic Hematopoietic Cell Transplant
Authors: Rahmat Leena T. , Nguyen Anna , Abdulhaq Haifaa , Prakash Sonam , Logan Aaron C. , Mannis Gabriel N.
Published: August 2018

Long-term disease-free survival in adults with T-cell acute lymphoblastic leukemia (T-ALL) remains poor, particularly after relapse, with few available salvage options. Preclinical data suggest that inhibition of the antiapoptotic protein BCL-2 (B-cell lymphoma 2) either alone or in combination with other agents, may be a unique therapeutic approach for the treatment of T-ALL. We present a case of a young male with T-ALL, relapsed after allogeneic hematopoietic stem cell transplant, who achieved a second complete remission following salvage therapy with combined venetoclax and decitabine. Assessment of measurable residual disease by next generation sequencing showed no evidence of residual disease of a sensitivity of 1 × 10−6. While the combination of venetoclax and hypomethylating agents has shown promise in the treatment of relapsed/refractory AML, and to our knowledge, this is the first report of this combination demonstrating clinical activity in relapsed/refractory T-ALL.
miR-125a Suppresses TrxR1 Expression and Is Involved in H2O2-Induced Oxidative Stress in Endothelial Cells
Authors: Chen Fangjie , Liu Hong , Wu Jingjing , Zhao Yanyan
Published: August 2018

Thioredoxin reductase (TrxR), an antioxidant enzyme dependent on nicotinamide adenine dinucleotide phosphate, plays a vital role in defense against oxidative stress. However, the role of microRNAs targeting TrxR under oxidative stress has not yet been determined. In this study, we tested the involvement of miRNA-mediated posttranscriptional regulation in H2O2-induced TrxR1 expression in endothelial cells. Dual luciferase assay combined with expression analysis confirmed that miR-125a suppressed TrxR1 expression by targeting its 3′-UTR. Furthermore, H2O2 induced TrxR1 expression partly through downregulation of miR-125a. These findings indicate that miRNA-mediated posttranscriptional mechanism is involved in H2O2-induced TrxR1 expression in endothelial cells, suggesting an important role of miRNAs in the response to oxidative stress.
Preparation of Anodic Aluminum Oxide Masks with Size-Controlled Pores for 2D Plasmonic Nanodot Arrays
Authors: Jung Mi , Kim Ji-Hoon , Choi Young-Wan
Published: August 2018

Anodic aluminum oxide (AAO) layers with nano-sized pores have been used as shadow masks for the fabrication of two-dimensional (2D) metal nanodot arrays (NDAs). However, the localized surface plasmon resonance (LSPR) of size-controlled NDAs fabricated using AAO masks has not been much studied. In this study, we report on the improved preparation method and utilization of an ultrathin AAO mask for the fabrication of 2D plasmonic metal NDAs. The greatest challenge in preparing an AAO mask is to control the pore diameter and to make it reproducible. AAO masks with size-controlled pores were reproducibly prepared using a two-step chemical wet etching method. Ag NDAs with different dot diameters (42, 60, and 80 nm) and Ag, Cu, and Au NDAs with dot a diameter of 80 ± 5 nm were fabricated on indium tin oxide glass substrates using AAO masks. The wavelengths corresponding to LSPR of 2D metal NDAs were investigated using ultraviolet–visible spectroscopy. Our results show that AAO masks with tunable pores can be used as shadow masks for the fabrication of 2D plasmonic NDAs.
OperaBLE: An IoT-Based Wearable to Improve Efficiency and Smart Worker Care Services in Industry 4.0
Authors: Roda-Sanchez Luis , Garrido-Hidalgo Celia , Hortelano Diego , Olivares Teresa , Ruiz M. Carmen
Published: August 2018

Industry 4.0 is leading the Fourth Industrial Revolution transforming traditional factories into smart factories governed by the Internet of Things (IoT). In order to assist smart factory employees, this paper introduces OperaBLE, a Bluetooth Low Energy (BLE) wearable proposal which is aimed at enhancing working conditions and efficiency in Industry 4.0 scenarios. We have developed two innovative algorithms for OperaBLE focused on power awareness as the key-enabling attribute towards success: Low-Frequency Movement Characterisation Algorithm (LoMoCA) and Adaptive Heart Rate Algorithm (AHRA). Novel experiments have been carried out using OperaBLE to determine its operability, reliability, and lifespan. Results obtained during experimentation demonstrate how OperaBLE empowers human-machine collaboration embedding workers in closed-loop performance and ensuring nonharmful working conditions by means of power-aware algorithms. OperaBLE is due to bring digitalisation into smart factories, playing an essential role in the emerging wearable revolution to arise in the following years towards smart production systems.
Emergency Laparotomy in the Critically Ill: Futility at the Bedside
Authors: Martin Niels D. , Patel Sagar P. , Chreiman Kristen , Pascual Jose L. , Braslow Benjamin , Reilly Patrick M. , Kaplan Lewis J.
Published: August 2018

Background. Critically ill patients are often evaluated for an intra-abdominal catastrophe. In the absence of a preoperative diagnosis, abdominal exploration may be offered despite desperate circumstances. We hypothesize that (1) abdominal exploration for such patients is associated with a high mortality and (2) commonly obtained physiologic measures at laparotomy anticipate mortality. Methods. All acute care surgery (ACS) patients undergoing emergency laparotomy at a quaternary referral center during a 3-year period were reviewed. Inclusion was defined by emergency laparotomy in the operating room (OR) in a patient with an American Society of Anesthesiologists (ASA) score ≥4 or bedside laparotomy in the ICU (BSL). Mortality was the primary endpoint and was stratified by demographics, admitting service, surgical findings, and physiology. Comparisons between OR and BSL were by Fisher’s exact and Mann–Whitney tests. Results. 144 patients underwent emergency laparotomy (45 BSL vs. 99 OR). Overall mortality was 55.6% (77.8% BSL vs. 45.5% OR; p<0.001). Mortality by admitting service was cardiac 71.4% (n=42), medical 70% (n=30), ACS 42% (n=50), and other 36.4% (n=22) services. Preoperative lactate levels were higher in nonsurvivors (2.7 vs. 8.5 mmol/L, p<0.001), as was vasopressor use (62.5% vs. 97.5%, p<0.001), acute kidney injury (51.6% vs. 72.5%, p<0.01), leukocytosis (53.1% vs. 71.3%, p<0.04), and anemia (45.3% vs. 71.3%, p<0.01). The presence of any identifiable abdominal pathology established a 90% mortality rate. Conclusions. The need for BSL portends an extremely high mortality rate and is likely useful in preintervention counselling. Emergency OR laparotomy leads to mortality in nearly half of such patients and is anticipatable based on concurrent abnormal physiology.
Perceptions on Diet and Dietary Modifications during Postpartum Period Aiming at Attenuating Progression of GDM to DM: A Qualitative Study of Mothers and Health Care Workers
Authors: Sundarapperuma Thamudi D. , Wijesinghe Champa J. , Hettiarachchi Priyadarshika , Wasalathanthri Sudharshani
Published: August 2018

Background. Gestational diabetes mellitus (GDM) is a global concern. GDM mothers have a 7-fold relative risk of developing type 2 diabetes mellitus (T2DM) in their later life. User-friendly and culturally acceptable dietary interventions can minimize this risk. Therefore, this study aims at exploring the perceptions of GDM mothers and health care workers regarding factors that influence postpartum dietary practices aimed at attenuating the trajectory from GDM to DM. Methods. The study was conducted in selected MOH areas in three districts of Sri Lanka. Six focus group discussions were conducted with thirty mothers with a history of GDM and six in-depth interviews with six health care workers. The phenomenon of interest was to obtain inputs of two stakeholder groups on healthy food habits of GDM mothers during the postpartum period. Framework analysis was used to analyse the data. Data were coded using the analytical framework, abstracted from transcripts, and summarized verbatim in Microsoft Excel in a matrix comprised of one row per participant and one column per code. Finally, the matrix was reviewed intensely and themes were generated. Results. Overall, seven themes emerged from both cases: (1) myths and traditions specific to the postpartum period, (2) lack of motivation, (3) time pressure, (4) financial barriers, (5) negligence of mothers and families, (6) lack of awareness regarding GDM and its postpartum dietary recommendations, and (7) cultural barriers. Conclusions. This study provides an insight into the existing knowledge, common practices, and attitudes regarding food habits among postpartum mothers with a history of GDM. Since the postpartum period is unique, identifying barriers is crucial when introducing dietary modification protocols in order to prevent or attenuate the progression of GDM to T2DM in these mothers. The knowledge gained will be used to introduce feasible, scientifically sound, and culturally acceptable postpartum dietary recommendations for GDM mothers.
Dynamic Three-Dimensional Contrast-Enhanced Ultrasound to Predict Therapeutic Response of Radiofrequency Ablation in Hepatocellular Carcinoma: Preliminary Findings
Authors: Cao Jiaying , Dong Yi , Mao Feng , Wang Wenping
Published: August 2018

Background & Aims. To investigate the value of dynamic three-dimensional contrast-enhanced ultrasound (3D-CEUS) in the assessment of therapeutic response of hepatocellular carcinoma (HCC) treated with radiofrequency ablation (RFA).Methods. Forty-two patients (31 men and 11 women; mean age (52.1 ± 13.1 years)) with 42 clinical diagnosed HCC lesions (size range 14-48 mm; mean size 28.4 ± 9.9 mm) treated by RFA were included. All patients underwent two-dimensional contrast-enhanced ultrasound (2D-CEUS) and 3D-CEUS 1 month after treatment. Two radiologists assessed the absence (complete response, CR) or presence (residual tumor, RT) of any arterially hyperenhancing nodules within or along the margin of the treated HCC lesions. Complete response on magnetic resonance (MR) imaging acted as standard of reference (SOR).Results. After RFA treatment, 3D-CEUS was successfully conducted in 34 HCC lesions. CR was observed on both 2D-CEUS and 3D-CEUS in 25/42 (59.5%) HCC and RT in 6/42 (14.3%) HCC lesions. In 3/42 (7.1%) HCC lesion, RT was documented by SOR and 3D-CEUS, but it was not appreciable at 2D-CEUS. In 3/42 (7.1%) HCC lesion, the presence of peripheral RT was suspected by both 2D-CEUS and 3D-CEUS, but it was not confirmed by SOR. No statistically significant difference between 2D-CEUS and 3D-CEUS in depicting either CR or RT was found (P= 0.25). Combined with dynamic 3D-CEUS, the diagnostic accuracy was improved from 85.7% to 92.9%.Conclusions. 3D-CEUS might be helpful in better diagnostic performance in the assessment of therapeutic response of HCC treated after RFA.
Strangulated Hernia Can Be a Risk Factor of Seroma following Laparoscopic Transabdominal Preperitoneal Repair
Authors: Matsumoto Ryu , Nagahisa Yoshio , Hashida Kazuki , Yokota Mitsuru , Okabe Michio , Kawamoto Kazuyuki
Published: August 2018

Purposes. Seroma is a postoperative complication following laparoscopic transabdominal preperitoneal repair (TAPP) for inguinal hernioplasty. Seroma naturally resolves in most cases, but it can lead to an increased amount of visits to the outpatient clinic and can result in anxiety of the patient. Local inflammation of the inguinal area is etiology of seroma formation. Strangulated hernia involves severe inguinal pain and can lead to severe inflammation and subsequent seroma. There have been no reports demonstrating the links of seroma and strangulated hernia. This study aimed to retrospectively evaluate the risk of seroma after TAPP and to identify the association between strangulated hernia and seroma. Methods. We treated 300 inguinal hernias by TAPP between 2013 and 2016 at Kurashiki Central Hospital. We used the Chi-square test. Factors significant in each association were further examined using multiple subsequent logistic regressions. Results. A total of 222 hernias were eligible for analysis. The incidence of seroma was 11% (n=25). There were nine cases of strangulated hernias, and three (33%) resulted in seroma. The ratio of strangulated hernia of seroma group is significantly high (p<0.03). Multiple subsequent logistic regressions showed that strangulated hernia was associated with a significantly increased risk for seroma formation (p = 0.023; OR 6.564; 95% CI 1.29-33.3). Conclusion. This study shows that strangulated hernia can be a risk factor in seroma formation. This risk should be incorporated into a management plan of TAPP for strangulated hernia, with careful consideration of patients’ concerns.
Current Strategies to Generate Human Mesenchymal Stem Cells In Vitro
Authors: Steens Jennifer , Klein Diana
Published: August 2018

Mesenchymal stem cells (MSCs) are heterogeneous multipotent stem cells that are involved in the development of mesenchyme-derived evolving structures and organs during ontogeny. In the adult organism, reservoirs of MSCs can be found in almost all tissues where MSCs contribute to the maintenance of organ integrity. The use of these different MSCs for cell-based therapies has been extensively studied over the past years, which highlights the use of MSCs as a promising option for the treatment of various diseases including autoimmune and cardiovascular disorders. However, the proportion of MSCs contained in primary isolates of adult tissue biopsies is rather low and, thus, vigorous ex vivo expansion is needed especially for therapies that may require extensive and repetitive cell substitution. Therefore, more easily and accessible sources of MSCs are needed. This review summarizes the current knowledge of the different strategies to generate human MSCs in vitro as an alternative method for their applications in regenerative therapy.
Synthesis of MgFe2O4/Reduced Graphene Oxide Composite and Its Visible-Light Photocatalytic Performance for Organic Pollution
Authors: Wu Fengmin , Duan Wenlu , Li Mei , Xu Hang
Published: August 2018

Recently, binary metal oxides have been proven to be the most investigated semiconductors due to their high activity for the removal of organic pollutants. In this paper, to improve the photocatalytic efficiency of MgFe2O4, a MgFe2O4/reduced graphene oxide (MFO/rGO) photocatalyst was synthesized by a facile generalized solvothermal method. The morphology, structure, and photocatalytic activities in the degradation of methyl orange (MO) reaction were systematically characterized by scanning electron microscopy, transmission electron microscopy, X-ray diffraction, and UV-vis absorption spectroscopy, respectively. The results showed that the MFO/rGO composite exhibited enhanced photocatalytic performance in the photodegradation of MO under visible-light irradiation and reached a maximum degradation rate of 99% within 60 min of irradiation. This excellent photocatalytic performance is attributed to the introduction of rGO in the composite, which can effectively reduce the photoproduction of the electron-hole pair recombination rate. The excellent photocatalytic activity reveals that the MFO/rGO composite photocatalyst is a promising photocatalyst with good visible-light response and has potential applications in the field of water treatment.
Purpura Fulminans and Septic Shock due to Capnocytophaga Canimorsus after Dog Bite: A Case Report and Review of the Literature
Authors: Mantovani Elena , Busani Stefano , Biagioni Emanuela , Venturelli Claudia , Serio Lucia , Girardis Massimo
Published: August 2018

Primary infection by Capnocytophaga canimorsus after dog bite is rare but may be difficult to identify and rapidly lethal. We describe a case of fatal septic shock with fulminant purpura occurred in a patient without specific risk factor two days after an irrelevant dog bite. The patient was brought to hospital because of altered mental status, fever, and abdominal pain. In a few hours patient became hypoxic and cyanotic. The patient became extremely hypotensive with shock refractory to an aggressive fluid resuscitation (40 ml/kg crystalloids). She received vasoactive drugs, antibiotic therapy, and blood purification treatment, but cardiac arrest unresponsive to resuscitation maneuvers occurred. Case description and literature review demonstrated that, also in patients without specific risk factors, signs of infection after dog bite should be never underestimated and should be treated with a prompt antibiotic therapy initiation even before occurrence of organ dysfunction.
Usefulness of Cryoprobe in Office Hysteroscopy for Removal of Polyps and Myomas
Authors: Sobociński Kamil , Doniec Jacek , Biela Magdalena , Szafarowska Monika , Paśnik Krzysztof , Kamiński Paweł
Published: August 2018

Hysteroscopy is a gold standard in 21st-century gynaecology for both diagnosis and treatment procedures of intrauterine pathologies. Miniaturisation of the equipment and better techniques of performing this procedure allowed it to become the gold standard. Nevertheless, hysteroscopy has its limitations, which is the size of the endometrial polyps or submucous myomas. We have invented a new device for the 5Fr working channel hysteroscopes for possessing and resecting intrauterine structures: the cryoprobe. The retrospective cryobiopsy study presented here was conducted at the Department of Gynaecology and Oncological Gynaecology, Military Institute of Medicine in Warsaw, Poland, from October 2017 to January 2018. Its purpose was to assess the usefulness of the new device in office hysteroscopy for the removal of polyps and myomas with a diameter over 10 mm. Thirteen patients with an initial diagnosis of an endometrial polyp or submucous myoma were enrolled in the trial. All procedures took place in day-surgery settings, with a total resection of the pathological intrauterine structure, without complications. The application of the cryoprobe may enhance the usefulness of office hysteroscopy, without extending the procedure. The cryoprobe efficiency is still under research in a bigger group.
Exhaled Nitric Oxide and Exhaled Breath Temperature as Potential Biomarkers in Patients with Pulmonary Hypertension
Authors: Carpagnano Giovanna Elisiana , Radaeli Alessandro , Lacedonia Donato , Correale Michele , Carpagnano Giuseppe , Palmiotti Antonio , Barbaro Maria Pia Foschino , Di Biase Matteo , Brunetti Natale , Scioscia Giulia , Malerba Mario
Published: August 2018

Background. Pulmonary hypertension (PH) is a progressive fatal disease thus, noninvasive prognostic tools are needed to follow these patients. The aim of our study was to evaluate fractional exhaled nitric oxide (FeNO) and exhaled breath temperature (EBT) values in patients with PH from different causes and to correlate them with respiratory functional data. Methods. Twenty-four PH patients underwent spirometry, carbon monoxide diffusion (DLCO) test, transthoracic echocardiography, right-heart catheterization, and FeNO and EBT measurements. Results. We studied 3 groups according to the type of PH: 10 patients with pulmonary arterial hypertension (PAH) (group A), 11 patients with PH due to chronic obstructive pulmonary disease (COPD) (group B), and 3 patients with PH associated with left heart disease (group C). Mean FeNO values tend to be higher in group B (15.0 ± 9.3ppb) compared with other groups (respectively, 9.9 ± 5.7 and 8.5 ± 5.2 ppb in groups A and C; p = 0.271) but no statistical significance has been reached. Mean values of alveolar NO concentration (CANO) were higher in groups A and B compared to group C (respectively, 16.9 ± 12.6; 13.9 ± 6.8; and 6.7 ± 2.0 ppb) (p = 0.045). EBT mean values were significantly lower in group C when compared with other groups (group C: 29.0 +- 1.3°C, groups A and B: 30.9 ± 1.3 and 31.2 ± 1.2°C, respectively: p = 0.041). EBT levels were inversely correlated to mean pulmonary artery pressure (PAPm) levels (Spearman coefficient -0.481; p = 0.017). Conclusions. eNO, CANO, and EBT have been evaluated in three groups of PH patients. Interestingly EBT reduction was correlated with PAPm increase, whereas FeNO was higher in COPD patients and CANO in PAH and COPD groups. Further studies are needed to clarify EBT, FeNO, and CANO roles as biomarkers in the monitoring of patients with PH.
Visfatin Serum Levels Predict Mortality in Critically Ill Patients
Authors: Koch Alexander , Weiskirchen Ralf , Krusch Alexander , Bruensing Jan , Buendgens Lukas , Herbers Ulf , Yagmur Eray , Koek Ger H. , Trautwein Christian , Tacke Frank
Published: August 2018

The adipokine visfatin, also termed pre-B-cell colony-enhancing factor (PBEF), is mainly derived from adipose tissue but has been implicated in the regulation of innate immune responses. We hypothesized that visfatin could be a potential circulating biomarker in critical illness and sepsis. We therefore measured serum levels of visfatin in a cohort of 229 critically ill medical patients upon admission to the intensive care unit (ICU). In comparison to 53 healthy controls, visfatin levels were significantly elevated in medical ICU patients, especially in patients with sepsis. Visfatin serum concentrations were strongly associated with disease severity and organ failure but did not differ between patients with or without obesity or type 2 diabetes. Visfatin levels correlated with biomarkers of renal failure, liver dysfunction, and other adipokines (e.g., resistin, leptin, and adiponectin) in critically ill patients. High visfatin levels at ICU admission indicated an increased mortality, both at the ICU and during long-term follow-up of approximately two years. Our data therefore demonstrate that circulating visfatin is a valuable biomarker for risk and prognosis assessment in critically ill patients. Furthermore, visfatin seems to be involved in the pathogenesis of excessive systemic inflammation, supporting further research on visfatin as a therapeutic target.
A Novel Short-Medium Term Satellite Clock Error Prediction Algorithm Based on Modified Exponential Smoothing Method
Authors: Liu Qiang , Chen Xihong , Zhang Yongshun , Liu Zan , Li Chenlong , Hu Denghua
Published: August 2018

Clock error prediction is important for satellites while their clocks could not transfer time message with the stations in earth. It puts forth a novel short-medium term clock error prediction algorithm based on modified differential exponential smoothing (ES). Firstly, it introduces the basic double ES (DES) and triple ES (TES). As the weighted parameter in ES is fixed, leading to growing predicted errors, a dynamic weighted parameter based on a sliding window (SW) is put forward. And in order to improve the predicted precision, it brings in grey mode (GM) to learn the predicted errors of DES (TES) and combines the DES (TES) predicted results with the results of GM prediction from error learning. From examples' analysis, it could conclude that the short term predicted precisions of algorithms based on ES with GM error learning are less than 0.4ns, where GM error learning could better the performances slightly. And for the medium term, it could conclude that the fusion algorithm in DES (TES) with error learning in GM based on SW could reduce the predicted errors in 35.37% (66.34%) compared with DES (TES) alone. In medium term clock error prediction, the predicted precision of TES is worse than DES, which is roughly in the same level of GM.
Complement System and Age-Related Macular Degeneration: Implications of Gene-Environment Interaction for Preventive and Personalized Medicine
Authors: Maugeri Andrea , Barchitta Martina , Mazzone Maria Grazia , Giuliano Francesco , Agodi Antonella
Published: August 2018

Age-related macular degeneration (AMD) is the most common cause of visual loss in developed countries, with a significant economic and social burden on public health. Although genome-wide and gene-candidate studies have been enabled to identify genetic variants in the complement system associated with AMD pathogenesis, the effect of gene-environment interaction is still under debate. In this review we provide an overview of the role of complement system and its genetic variants in AMD, summarizing the consequences of the interaction between genetic and environmental risk factors on AMD onset, progression, and therapeutic response. Finally, we discuss the perspectives of current evidence in the field of genomics driven personalized medicine and public health.
Catheter-Associated Urinary Tract Infection and Obstinate Biofilm Producers
Authors: Maharjan Govinda , Khadka Priyatam , Siddhi Shilpakar Gomik , Chapagain Ganesh , Dhungana Guna Raj
Published: August 2018

Background. Biofilms, or colonies of uropathogen growing on the surface of indwelling medical devices, can inflict obstinate or recurring infection, thought-provoking antimicrobial therapy.Methods. This prospective analysis included 105 urine samples from catheterized patients receiving intensive care. Ensuing phenotypic identification, antibiotic sensitivity test was performed by modified Kirby–Bauer disc diffusion method following CLSI guidelines; MDR isolates were identified according to the combined guidelines of the European Centre for Disease Prevention and Control (ECDC) and the Centers for Disease Control and Prevention (CDC). Biofilm-forming uropathogens were detected by the tissue culture plate (TCA) method.Results. The predominant uropathogen in catheter-associated UTIs (CAUTIs) wasEscherichia coli57%, followed byKlebsiella pneumonia15%,Pseudomonas aeruginosa12%,Staphylococcus aureus8%,Enterobacterspp. 3%,Enterococcus faecalis,Acinetobacterspp., andProteus mirabilis1.5%, of which 46% isolates were biofilm producers. Prime biofilm producers wereEscherichia coli33%, followed byKlebsiella pneumoniae30%,Pseudomonas aeruginosa20%,Staphylococcus aureus10%,Acinetobacter, andEnterobacter3.33%. Multidrug resistance associated with biofilm producers were greater than biofilm nonproducers. The Gram-negative biofilm producers found 96.15%, 80.76%, 73.07%, 53.84%, 53.84%, 46.15%, 19.23%, and 11.5% resistant to amoxyclave, ceftazidime, tetracycline, gentamicin, meropenem, nitrofurantoin, amikacin, imipenem, and fosfomycin, respectively. Gram-positive biofilm producers, however, were found 100% resistant to tetracycline, cloxacillin, and amoxyclave: 66.67% resistant to ampicillin while 33.33% resistant to gentamicin, ciprofloxacin, and nitrofurantoin.Conclusion. High antimicrobial resistance was observed in biofilm producers than non-biofilm producers. Of recommended antimicrobial therapies for CAUTIs, ampicillin and amoxicillin-clavulanate were the least active antibiotics, whereas piperacillin/tazobactam and imipenem were found as the most effectual for gram-negative biofilm producer. Likewise, amoxicillin-clavulanate and tetracycline were the least active antibiotics, whereas vancomycin, fosfomycin, piperacillin-tazobactam, and meropenem were found as the most effective antibiotic for Gram-positive biofilm producer. In the limelight, the activity fosfomycin was commendable against both Gram-positive and Gram-negative biofilm producers.