bluuebunny/crossref_metadata_2025 huggingface dataset:
Reliability and Concurrent Validity of a Chinese Version of the Alberta Infant Motor Scale Administered to High-Risk Infants in China
Authors: Wang Hui , Li Haifeng , Wang Jiangping , Jin Huiying
Published: June 2018

The Alberta Infant Motor Scale (AIMS) is widely used to screen for delays in motor development in high-risk infants, but its reliability and validity in Chinese infants have not been investigated. To examine the reliability and concurrent validity of AIMS in high-risk infants aged 0-9 months in China, this single-center study enrolled 50 high-risk infants aged 0-9 months (range, 0.17-9.27; average, 4.14±2.02), who were divided into two groups: 0-3 months (n=23) and 4-9 months (n=27). A physical therapist evaluated the infants with AIMS, with each evaluation video-recorded. To examine interrater reliability, two other evaluators calculated AIMS scores by observing the videos. To measure intrarater reliability, the two evaluators rescored AIMS after >1 month, using the videos. Concurrent validity was assessed by comparing results between AIMS and the Peabody Developmental Motor Scale-2 (PDMS-2). For all age groups analyzed (0-3, 4-9, and 0-9 months), intraclass correlation coefficients (ICCs) for AIMS total score were high for both intrarater comparisons (0.811-0.995) and interrater comparisons (0.982-0.997). AIMS total scores were well correlated with all PDMS-2 subtest scores (ICC=0.751-0.977 for reflexes, stationary, locomotion, grasping, and visual-motor integration subsets). However, the fifth percentile of AIMS total score was only moderately correlated with the gross motor quotient, fine motor quotient, and total motor quotient subtests of PDMS-2 (kappa=0.580, 0.601, and 0.724, respectively). AIMS has acceptable reliability and concurrent validity for screening of motor developmental delay in high-risk infants in China.
Noninvasive Biomarkers of Colorectal Cancer: Role in Diagnosis and Personalised Treatment Perspectives
Authors: Pellino Gianluca , Gallo Gaetano , Pallante Pierlorenzo , Capasso Raffaella , De Stefano Alfonso , Maretto Isacco , Malapelle Umberto , Qiu Shengyang , Nikolaou Stella , Barina Andrea , Clerico Giuseppe , Reginelli Alfonso , Giuliani Antonio , Sciaudone Guido , Kontovounisios Christos , Brunese Luca , Trompetto Mario , Selvaggi Francesco
Published: June 2018

Colorectal cancer (CRC) is the third leading cause of cancer-related deaths worldwide. It has been estimated that more than one-third of patients are diagnosed when CRC has already spread to the lymph nodes. One out of five patients is diagnosed with metastatic CRC. The stage of diagnosis influences treatment outcome and survival. Notwithstanding the recent advances in multidisciplinary management and treatment of CRC, patients are still reluctant to undergo screening tests because of the associated invasiveness and discomfort (e.g., colonoscopy with biopsies). Moreover, the serological markers currently used for diagnosis are not reliable and, even if they were useful to detect disease recurrence after treatment, they are not always detected in patients with CRC (e.g., CEA). Recently, translational research in CRC has produced a wide spectrum of potential biomarkers that could be useful for diagnosis, treatment, and follow-up of these patients. The aim of this review is to provide an overview of the newer noninvasive or minimally invasive biomarkers of CRC. Here, we discuss imaging and biomolecular diagnostics ranging from their potential usefulness to obtain early and less-invasive diagnosis to their potential implementation in the development of a bespoke treatment of CRC.
New Certificateless Aggregate Signature Scheme for Healthcare Multimedia Social Network on Cloud Environment
Authors: Wu Libing , Xu Zhiyan , He Debiao , Wang Xianmin
Published: June 2018

With the application of sensor technology in the field of healthcare, online data sharing in healthcare industry attracts more and more attention since it has many advantages, such as high efficiency, low latency, breaking the geographical location, and time constraints. However, due to the direct involvement of patient health information, the privacy and integrity of medical data have become a matter of much concern to the healthcare industry. To retain data privacy and integrity, a number of digital signature schemes have been introduced in recent years. Unfortunately, most of them suffer serious security attacks and do not perform well in terms of computation overhead and communication overhead. Very recently, Pankaj Kumar et al. proposed a certificateless aggregate signature scheme for healthcare wireless sensor network. They claimed that their signature scheme was able to withstand a variety of attacks. However, in this paper, we find that their scheme fails to achieve its purpose since it is vulnerable to signature forgery attack and give the detailed attack process. Then, we propose a new certificateless aggregate signature scheme to fix the security flaws and formally prove that our proposed scheme is secure under the computationally hard Diffie-Hellman assumption. Security analysis and performance evaluation demonstrate that the security of our proposal is improved while reducing the computation cost. Compared with Pankaj Kumar et al.'s scheme, our proposed scheme is more efficient and suitable for the healthcare wireless sensor networks (HWSNs) to maintain security at various levels.
Recognition of Daily Human Activity Using an Artificial Neural Network and Smartwatch
Authors: Kwon Min-Cheol , Choi Sunwoong
Published: June 2018

Human activity recognition using wearable devices has been actively investigated in a wide range of applications. Most of them, however, either focus on simple activities wherein whole body movement is involved or require a variety of sensors to identify daily activities. In this study, we propose a human activity recognition system that collects data from an off‐the‐shelf smartwatch and uses an artificial neural network for classification. The proposed system is further enhanced using location information. We consider 11 activities, including both simple and daily activities. Experimental results show that various activities can be classified with an accuracy of 95%.
Pinnipeds and PTSD: An Analysis of a Human-Animal Interaction Case Study Program for a Veteran
Authors: Wortman Rachel A. , Vallone Theresa , Karnes Michele , Walawander Christine , Daly Dion , Fox-Garrity Bonnie
Published: June 2018

The objective of this study was to examine the impact of a pinniped (grey and harbor seals) facilitated human-animal interaction pilot program on the self-reported PTSD-like symptoms of a veteran. This study analyzed preexisting, deidentified data that represented the participant’s scores on the Post-Traumatic Stress Disorder Checklist (PCL-5). The PCL-5 was completed as part of a pilot program operated in partnership between the Veteran and Military Affiliated Research Center (VMARC) and a local aquarium. Scores on the PCL-5 were collected prior to (T1), midway (T2), and immediately after (T3) completion of the Project Seal to Heal program. Changes in the scores of each item were reported for the participant, for aggregated items that represented different clusters of PTSD symptoms, and for overall scores. Results revealed decreased scores in 11 of the 20 PTSD symptom-related items, improvement in the sum scores for each criteria symptom cluster, and a 15-point decrease in the overall PCL-5 score, indicating clinical significance. These results serve as a call to motivate future research investigating pinniped interactions with veterans who have PTSD in order to determine therapeutic clinical application and outcomes.
Could Prolonged Usage of GPS Navigation Implemented in Augmented Reality Smart Glasses Affect Hippocampal Functional Connectivity?
Authors: Fajnerová Iveta , Greguš David , Hlinka Jaroslav , Nekovářová Tereza , Škoch Antonín , Zítka Tomáš , Romportl Jan , Žáčková Eva , Horáček Jiří
Published: June 2018

Background. Augmented reality (AR) glasses with GPS navigation represent the rapidly evolving technology which spares (and externalizes) navigational capacities. Regarding the expected everyday usage of this device, its impact on neuroplastic brain changes and navigation abilities should be evaluated. Aims. This study aimed to assess possible changes in functional connectivity (FC) of hippocampus and other brain regions involved in spatial navigation. Methods. Thirty-three healthy participants completed two resting state functional magnetic resonance imaging (rsfMRI) measurements at the baseline and after 3 months. For this period, the experimental group (n = 17) has had used AR device (Vuzix M100) with incorporated GPS guidance system during navigation in real world. Participants from the control group (n = 16) have not used any GPS device while navigating during walking. The rsfMRI FC of right and left hippocampi was analyzed using a seed-driven approach. Virtual city task was used to test navigational abilities both before and after the usage of AR device. Results. We identified strong functional coupling of right and left hippocampi at the baseline (p < 0.05, FDR corrected). Mild changes in bilateral hippocampal FC (p < 0.05, FDR uncorrected) were observed in both assessed groups mainly between the bilateral hippocampi and between each hippocampus and temporal regions and cerebellum. However, the experimental group showed FC decrease after three months of using GPS navigation implemented in AR glasses in contrast to FC increase in the control group without such intervention. Importantly, no effect of intervention on navigational abilities was observed. Discussion. Our observation supports the assumption that externalization of spatial navigation to technological device (GPS in AR glasses) can decrease the functional coupling between hippocampus and associated brain regions. Considering some limitations of the present study, further studies should elucidate the mechanism of the observed changes and their impact on cognitive abilities.
Macroscopic Portal Vein Thrombosis in HCC Patients
Authors: Akkiz Hikmet , Carr Brian I. , Kuran Sedef , Karaoğullarından Ümit , Üsküdar Oguz , Tokmak Salih , Arslan Burcu , Doran Figen , Balli Hüseyin Tugsan , Ülkü Abdulalh , Akçam Tolga Atılgan , Bahçeci Halil İbrahim , Polat Kamil Yalçın , Örmeci Necati , Şimşek Halis , Sonsuz Abdullah , Demir Ali , Altıntaş Engin , Demir Mehmet , Yalçın Kendal , Ekinci Nazım , Harmancı Özakyol Ayşegül , Yücesoy Mehmet , Uygun Ahmet , Guerra Vito , Delik Anıl , Tokat Yaman , Yilmaz Sezai , Bektaş Ahmet , Kılıç Murat
Published: June 2018

Macroscopic portal vein invasion (PVT) by hepatocellular carcinoma (HCC) in the liver is one of the most important negative prognostic factors for HCC patients. The characteristics of a large cohort of such patients were examined. We found that the percent of patients with PVT significantly increased with increasing maximum tumor diameter (MTD), from 13.7% with tumors of MTD <5cm to 56.4% with tumors of MTD >10cm. There were similar numbers of HCC patients with very large tumors with and without PVT. Thus, MTD alone was insufficient to explain the presence of PVT, as were high AFP levels, since less than 50% of high AFP patients had PVT. However, the percent of patients with PVT was also found to significantly increase with increasing blood alpha-fetoprotein (AFP) levels and tumor multifocality. A logistic regression model that included these 3 factors together showed an odds ratio of 17.9 for the combination of MTD>5.0cm plus tumor multifocality plus elevated AFP, compared to low levels of these 3 parameters. The presence or absence of macroscopic PVT may therefore represent different HCC aggressiveness phenotypes, as judged by a significant increase in tumor multifocality and AFP levels in the PVT positive patients. Factors in addition to MTD and AFP must also contribute to PVT development.
Oblique Incidence of Seismic Wave Reflecting Two Components of Design Ground Motion
Authors: Cen W. J. , Du X. H. , Li D. J. , Yuan L. N.
Published: June 2018

The wave field on the artificial boundary was separated into the free field without local topography effect and scattering field induced by local topography effect. The simulation of the free field under obliquely incident waves was conducted. Based on the assumption that the components of design ground motion were treated as the coincidence of oblique P wave and oblique SV wave, the relationship between the oblique input waves and the design ground motion was established in the free field. Further, the contributions to the two components of design ground motion of obliquely incident waves were discussed. The calculation model in time domain was achieved by the combination of the propagation characteristics of obliquely incident waves and the artificial boundary in the free field. The seismic response to the design ground motion was produced on the free surface. The verification of the 2D half‐space model under oblique input waves indicated that the wave input method can accurately reflect the design ground motion on the free surface. Application of an earth‐rock dam showed that oblique incidence of seismic waves results in significantly different dynamic response compared with the normal incidence. The proposed method can also be employed in the seismic analysis of large span structures with nonuniform ground motion input.
Treatment with Lobeglitazone Attenuates Hepatic Steatosis in Diet-Induced Obese Mice
Authors: Choung Sorim , Joung Kyong Hye , You Bo Ram , Park Sang Ki , Kim Hyun Jin , Ku Bon Jeong
Published: June 2018

Nonalcoholic fatty liver disease (NAFLD) is strongly associated with insulin resistance. The peroxisome proliferator-activated receptor (PPAR) activators, thiazolidinediones, (TZDs), are insulin sensitizers used as a treatment for NAFLD. However, TZDs are a controversial treatment for NAFLD because of conflicting results regarding hepatic steatosis and fibrosis. To evaluate a possible effective drug for treatment of NAFLD, we investigated the effects of a newly developed TZD, lobeglitazone, with an emphasis on hepatic lipid metabolism. Lobeglitazone treatment for 4 weeks in high fat diet- (HFD-) induced obese mice (HL group) improved insulin resistance and glucose intolerance compared to HFD-induced obese mice (HU group). The gene levels related to hepatic gluconeogenesis also decreased after treatment by lobeglitazone. The livers of mice in the HL group showed histologically reduced lipid accumulation, with lowered total plasma cholesterol and triglyceride levels. In addition, the HL group significantly decreased the hepatic expression of genes associated with lipid synthesis, cholesterol biosynthesis, and lipid droplet development and increased the hepatic expression of genes associated with fatty acid β-oxidation, thus suggesting that lobeglitazone decreased hepatic steatosis and reversed hepatic lipid dysregulation. Livers with steatohepatitis contained increased levels of PPARγ and phosphorylated PPARγ at serine 273, leading to downregulation of expression of genes associated with insulin sensitivity. Notably, the treatment of lobeglitazone increased the protein levels of PPARα and diminished levels of PPARγ phosphorylated at serine 273, which were increased by a HFD, suggesting that induction of PPARα and posttranslational modification of PPARγ in livers by lobeglitazone might be an underlying mechanism of the improvement seen in NAFLD. Taken together, our data showed that lobeglitazone might be an effective treatment for NAFLD.
Evaluation of Dynamic Microchamber as a Quick Factory Formaldehyde Emission Control Method for Industrial Particleboards
Authors: Hemmilä Venla , Zabka Michal , Adamopoulos Stergios
Published: June 2018

The most common formaldehyde control method for wood panels in Europe, the perforator method, measures formaldehyde content, while most of the legal requirements in the world are based on emissions. Chamber methods typically used for emission measurements require too much time to reach steady state for factory quality control. The aim of this study was therefore to investigate whether emission values of particleboards measured one day after production would be usable for quality control purposes. The correlation between 1‐day and 7‐day emission values was determined using a dynamic microchamber (DMC). Three industrial board types that differed in density and emission levels were used for the evaluation. The online emission measuring equipment Aero‐laser AL4021 connected to the 1 m3 chamber was used to gain further information on the emission reduction behaviour of the different board types. Only the two particleboard types with higher densities showed good correlation between the 1‐day and 7‐day emissions. The overall results suggested that 1‐day emission values can be used for factory quality control purposes; however, if the initial 1‐day values are above the permitted level, extensive evaluation for each individual board type needs to be performed.
Diagnosis of Superficial Gastric Lesions Together with Six Gastric Lymphoma Cases via Probe-Based Confocal Laser Endomicroscopy: A Retrospective Observational Study
Authors: Chen Qian , Cheng Heng-Hui , Deng Shuang , Kuang Dong , Shu Chang , Cao Li , Liao Guang-Quan , Guo Qiao-Zhen , Zhou Qi
Published: June 2018

Objective. To evaluate the performance of probe-based confocal laser endomicroscopy (pCLE) in diagnosis of gastric lesions.Methods. An outpatient department- (OPD-) based retrospective study was conducted for patients with suspected upper gastrointestinal (GI) tract lesions who underwent pCLE between 2014 and 2016 at a tertiary hospital in China. Final diagnosis was based on the histopathological reports. CLE reports were compared to histopathological reports to evaluate the diagnostic ability, including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy.Results. 322 of 380 patients were diagnosed with gastric lesions via pCLE, including inflammation and benign ulcers (n=110), atrophy and intestinal metaplasia (n=152), intraepithelial neoplasia (n=27), adenocarcinoma (n=27), and lymphoma (n=6). In total, the diagnostic ability of CLE in evaluation of gastric lesions showed sensitivity 72.4% (95% confidence interval (CI): 67.1–77.2%); specificity 93.1% (95% CI: 5.6–8.4%); PPV 72.4% (95% CI: 67.1–77.2%); NPV 93.1% (95% CI: 5.6–8.4%); and accuracy 88.9% (95% CI: 87.3–90.4%), respectively. We further observed the capability of pCLE in diagnosing six gastric lymphoma showing those affected mucosa densely infiltrated with identical and round-shaped abnormal cells. Immunohistochemistry analysis confirmed one patient with diffuse large B-cell non-Hodgkin’s lymphoma (DLBCL) and five with mucosa-associated lymphoid tissue (MALT) lymphoma.Conclusion. pCLE is an accurate tool for the detection of gastric lesions and shows optimal values of sensitivity and negative predictivity. Moreover, combining pCLE with white light endoscopy (WLE) may be a promising adjunct to conventional biopsy sampling in evaluating GI tract with suspected lymphoma.
The Signaling Pathways Involved in the Antiatherosclerotic Effects Produced by Chinese Herbal Medicines
Authors: Lu Li , Sun Xiaodong , Qin Yating , Guo Xiaomei
Published: June 2018

Cardiovascular diseases (CVDs) are considered to be the predominant cause of death in the world. Chinese herb medicines (CHMs) have been widely used for the treatment of CVDs in Asian countries for thousands of years. One reason of high efficacy of CHMs in treating CVDs is attributed to their inhibition in atherosclerosis (AS) development, a critical contributor to CVDs occurrence. Cumulative studies have demonstrated that CHMs alleviate atherogenesis via mediating pathophysiologic events involved in AS. However, there is deficiency in the summaries regarding antiatherogenic signal pathways regulated by CHMs. In this review, we focus on the signal cascades by which herb medicines and relevant extractives, derivatives, and patents improve proatherogenic processes including endothelium dysfunction, lipid accumulation, and inflammation. We mainly elaborate the CHMs-mediated signaling pathways in endothelial cells, macrophages, and vascular smooth muscle cells of each pathogenic event. Moreover, we briefly describe the other AS-related factors such as thrombosis, autophagy, immune response, and noncoding RNAs and effects of CHMs on them in the way of cascade regulation, which is helpful to further illustrate the molecular mechanisms of AS initiation and progression and discover newly effective agents for AS management.
Quasi‐Static Cyclic Test on a Concrete‐Encased Frame‐Reinforced Concrete Tube Building Model
Authors: Zeng Lei , Xiao Yunfeng , Chen Juan , Chen Yiguang
Published: June 2018

This paper experimentally investigated the seismic behavior of a 1:5 reduced‐scale model of concrete‐encased steel frame‐reinforced concrete core tube building. The quasi‐static testing with multipoint loading was carried out, and mode‐superposition response spectrum method was adopted to control the amplitude of displacement. The damage process, crack pattern, and failure mode were observed. Various parameters were obtained, including lateral deformation, hysteretic characteristics, strain distribution, ductility, and energy dissipation capacity. The test revealed the distributions of base shear between the core tube and frame. The result indicated that the core tube bears major loading and exhibited overturning failure, afterwards frame carry the surplus load and exhibited column tensile failure and joint panel shear failure. The characteristic of two seismic resistant systems are reflected by the excellent cooperation of core tube and frame.
Use of a Radiomics Model to Predict Tumor Invasiveness of Pulmonary Adenocarcinomas Appearing as Pulmonary Ground-Glass Nodules
Authors: Xue Xing , Yang Yong , Huang Qiang , Cui Feng , Lian Yuqing , Zhang Siying , Yao Linpeng , Peng Wei , Li Xin , Pang Peipei , Yan Jianhua , Chen Feng
Published: June 2018

Background. It is important to distinguish the classification of lung adenocarcinoma. A radiomics model was developed to predict tumor invasiveness using quantitative and qualitative features of pulmonary ground-glass nodules (GGNs) on chest CT. Materials and Methods. A total of 599 GGNs [including 202 preinvasive lesions and 397 minimally invasive and invasive pulmonary adenocarcinomas (IPAs)] were evaluated using univariate, multivariate, and logistic regression analyses to construct a radiomics model that predicted invasiveness of GGNs. In primary cohort (comprised of patients scanned from August 2012 to July 2016), preinvasive lesions were distinguished from IPAs based on pure or mixed density (PM), lesion shape, lobulated border, and pleural retraction and 35 other quantitative parameters (P <0.05) using univariate analysis. Multivariate analysis showed that PM, lobulated border, pleural retraction, age, and fractal dimension (FD) were significantly different between preinvasive lesions and IPAs. After logistic regression analysis, PM and FD were used to develop a prediction nomogram. The validation cohort was comprised of patients scanned after Jan 2016. Results. The model showed good discrimination between preinvasive lesions and IPAs with an area under curve (AUC) of 0.76 [95% CI: 0.71 to 0.80] in ROC curve for the primary cohort. The nomogram also demonstrated good discrimination in the validation cohort with an AUC of 0.79 [95% CI: 0.71 to 0.88]. Conclusions. For GGNs, PM, lobulated border, pleural retraction, age, and FD were features discriminating preinvasive lesions from IPAs. The radiomics model based upon PM and FD may predict the invasiveness of pulmonary adenocarcinomas appearing as GGNs.
Transmission Error Analysis and Disturbance Optimization of Two‐Stage Spur Gear Space Driven Mechanism with Large Inertia Load
Authors: Ma Jianfeng , Li Chao , Cui Lingli
Published: June 2018

For the nonlinear disturbance actual issues of the model space drive mechanism two‐stage spur gear system, a nonlinear dynamic model of 14‐DOF (degree of freedom) two‐stage spur gear with time‐varying stiffness and damping was established. This model has been developed previously by the authors to access the large inertia on the dynamic response of spur gear space driving mechanism, and its effectiveness was proved by a motion simulation experiment. In this paper, the profile error (PE) and the index error (IE) were enhanced in the dynamic model. The effects of profile error, index error, and variable load torque on transmission error (TE) were analyzed, while the optimization was proposed according to the analyzed result. The peak‐to‐peak value of the optimized load transmission error (LTE) was reduced by 60.7%, which improved the transmission accuracy and reduced the phenomenon of disturbance. The research of nonlinear dynamical model of two‐stage spur gear and the TE of the large inertia load were enriched, which provided an important reference for the actual design of the gear system.
Association between HLA-DP Gene Polymorphisms and Cervical Cancer Risk: A Meta-Analysis
Authors: Cheng Lin , Guo Yan , Zhan Shipeng , Xia Peiyuan
Published: June 2018

Objective. We aimed to derive a more precise estimation of the associations between human leukocyte antigens DP (HLA-DP) gene polymorphisms and cervical cancer risk by meta-analysis. Methods. PubMed, EMBASE, ScienceDirect, Web of Science, Chinese National Knowledge Infrastructure (CNKI), and Wanfang databases were systematically searched to identify studies investigating the relationship between HLA-DP gene polymorphisms and cervical cancer. The associations between them were evaluated by pooled OR and 95% CI. Results. A total of 11 studies including 5008 cases and 9322 controls with 11 HLA-DP alleles were included in the current meta-analysis. Results. The results showed that HLA-DPB1⁎03:01 was significantly associated with an increased risk of cervical cancer (OR=1.252, 95%CI: 1.116-1.403, Pz=0.001), while HLA-DPB1⁎04:02 and HLA-DP rs3117027 G allele were significantly associated with a decreased risk of cervical cancer (OR=0.744, 95%CI: 0.652-0.848, Pz=0.001; OR=0.790, 95%CI: 0.745-0.837, Pz=0.001), and HLA-DP rs9277535 G allele was significantly associated with a decreased risk of cervical cancer in Asia (OR=0.802, 95%CI: 0.753-0.855, Pz=0.001). Subgroup analyses based on race system showed that HLA-DPB1⁎13:01 was significantly associated with an increased risk of cervical cancer in Asia (OR=1.834, 95%CI: 1.107-3.039, Pz=0.019). No significant association was established for the HLA-DP following alleles: DPB1⁎02:01, DPB1⁎02:02, DPB1⁎04:01, DPB1⁎05:01, rs4282438, and rs3077. Conclusion. HLA-DP gene polymorphisms (HLA-DPB1⁎03:01, DPB1⁎04:02, DPB1⁎13:01, rs9277535, and rs3117027) were significantly associated with cervical cancer.
The Effects ofMomordica balsaminaMethanolic Extract on Kidney Function in STZ-Induced Diabetic Rats: Effects on Selected Metabolic Markers
Authors: Siboto Anelisiwe , Sibiya Ntethelelo , Khathi Andile , Ngubane Phikelelani
Published: June 2018

Background. Studies suggest thatMomordica balsamina(intshungu) possesses hypoglycaemic effects. The effects ofMomordica balsaminaon diabetic complications such as DN, however, have not been established. Accordingly, this study seeks to investigate the effects ofM. balsaminaon kidney function in STZ-induced diabetic rats.Methods. Methanolic extracts (ME) ofM. balsamina’s leaves were used in this study. Short-term effects ofM. balsaminamethanolic extract on kidney function and MAP were studied in STZ-induced diabetic rats treated twice daily withM. balsaminamethanolic extract (250 mg/kg), insulin (175 μg/kg, s.c.), and metformin (500 mg/kg) for 5 weeks.Results.M. balsaminamethanolic extract significantly increased Na+excretion outputs in STZ-induced diabetic rats by comparison to STZ-diabetic control rats.M. balsaminamethanolic extract significantly increased GFR in STZ-diabetic rats with a concomitant decrease in creatinine concentration and also reduced kidney-to-body ratio, albumin excretion rate (AER), and albumin creatinine ratio (ACR).M. balsaminamethanolic extract significantly reduced MAP in STZ-diabetic animals by comparison with STZ-diabetic control animals. These results suggest thatM. balsaminamethanolic extract not only lowers blood glucose but also has beneficial effects on kidney function and blood pressure.Conclusion. These findings suggest thatM. balsaminamay have beneficial effects on some processes that are associated with renal derangement in STZ-induced diabetic rats.
HbA1c Cutoff Point of 5.9% Better Identifies High Risk of Progression to Diabetes among Chinese Adults: Results from a Retrospective Cohort Study
Authors: Liang Kai , Wang Chuan , Yan Fei , Wang Lingshu , He Tianyi , Zhang Xiuping , Li Chengqiao , Yang Weifang , Ma Zeqiang , Ma Aixia , Hou Xinguo , Chen Li
Published: June 2018

Aims. This article performed a retrospective cohort study to estimate the annual incidence rates of diabetes and to assess the utility of HbA1c as a predictor for progression to diabetes in Chinese community adults aged 40 years or older. Methods. In all, 2778 nondiabetic subjects (including 1901 women) underwent HbA1c testing and oral glucose tolerance test (OGTT) measurements at baseline and after 3 years. Diabetes and prediabetes were defined using the WHO criteria. The HbA1c cutoff points were evaluated to predict the future risks of diabetes. Relative risk (RR) was calculated using the chi-square test. The area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate the predictive efficiency of fasting plasma glucose (FPG), 2 hr postprandial plasma glucose (2hPG), and HbA1c for progression to diabetes. A superior cutoff point was defined as the point on the ROC curve with a larger Youden index. Results. Overall, 7.5% (210/2778) of the subjects progressed to diabetes, yielding an annual 2.5% diabetes incidence rate. Additionally, 4.5% (100/2227) of the subjects with normal glucose tolerance (NGT) and 19.6% (110/561) of the subjects with prediabetes progressed to diabetes, and the relative risk of progression to diabetes was 5.188 times higher in subjects with prediabetes than in subjects with NGT (p<0.001). Compared to subjects with HbA1c values ≤ 5.6%, the RRs of progression to diabetes in subjects whose HbA1c ranged from 5.7 to 5.8%, 5.9 to 6.2%, 6.3 to 6.4%, and ≥6.5% were 1.165, 2.582, 5.732, and 16.619, respectively. However, the RRs for subjects with HbA1c ranging from 5.7 to 5.8% and those with HbA1c ≤ 5.6% did not differ significantly (p=0.615). The AUCs for predicting diabetes after 3 years by FPG, 2hPG, and HbA1c were 0.752 (95% confidence interval 0.718–0.787), 0.710 (95% confidence interval 0.671–0.748), and 0.756 (95% confidence interval 0.720–0.793), respectively. The HbA1c cutoff point of 5.9% (sensitivity of 0.771 and specificity of 0.580) may better identify individuals at high risk of progression to diabetes than the 5.7% value (sensitivity of 0.862 and specificity of 0.371) due to the former’s larger Youden index of 0.351, which exceeded the indices for FPG and 2hPG. Conclusions. The use of HbA1c values ≥ 5.9% may provide greater accuracy in evaluating the risk of progression to diabetes and identify individuals with prediabetes with greater reliability among Chinese adults.
A Rare Case of Human Diphallia Associated with Hypospadias
Authors: Frolov Andrey , Tan Yun , Rana Mohammed Waheed-Uz-Zaman , Martin John R.
Published: June 2018

Diphallia or penile duplication is a rare congenital variant with an estimated frequency of 1 per 5 to 6 million live births. The extent of duplication varies widely and typically occurs with other malformations including urogenital, gastrointestinal, and musculoskeletal anomalies. Here we present a case of human diphallia that was detected during routine dissection of an 84-year-old cadaver. Upon thorough examination, this case was characterized as a complete bifid penis which was accompanied by hypospadias with no other anatomical abnormalities detected. To gain insights into the etiology of this case, we analyzed DNA procured from the body for putative genetic variants using Next Generation Sequencing (NGS) technology. Our results support clinical observations consistent with human diphallia being a polygenic syndrome and identify new genetic variants that might underlie its etiology.
Reaching 100 in the Countryside: Health Profile and Living Circumstances of Portuguese Centenarians from the Beira Interior Region
Authors: Afonso Rosa Marina , Ribeiro Oscar , Vaz Patto Maria , Loureiro Marli , Loureiro Manuel Joaquim , Castelo-Branco Miguel , Patrício Susana , Alvarinhas Sara , Tomáz Tatiana , Rocha Clara , Jerónimo Ana Margarida , Gouveia Fátima , Amaral Ana Paula
Published: June 2018

The interest in studying a specific population of centenarians who lives in the country’s interior region (PT100-BI) emerged during the first Portuguese systematic study about centenarians (PT100 Oporto Centenarian Study). This region of Portugal is predominantly rural and is one of the regions with the largest number of aged people. The aim of this study is to provide information on the centenarians who live in the Beira Interior region, specifically in terms of their health status and the health services they use. A total of 101 centenarians (mean age: 101.1 years; SD = 1.5 years), 14 males and 87 females, were considered. Most centenarians lived in the community, and 47.6% lived in nursing homes. Nearly half (47.5%) presented cognitive functioning without deficits. A noteworthy percentage presented conditioned mobility and sensory problems. The most common self-reported diseases include urinary incontinence (31.7%), high blood pressure (23.8%), and heart conditions (19.8%). Despite these health and functional characteristics, formal support services and technical assistance were found to be scarcely used. Further research is needed to understand how the role of contextual variables and the countryside environment contribute to the centenarians’ adaptation to advanced longevity.
Information-Based Medicine in Glioma Patients: A Clinical Perspective
Authors: Senders Joeky Tamba , Harary Maya , Stopa Brittany Morgan , Staples Patrick , Broekman Marike Lianne Daphne , Smith Timothy Richard , Gormley William Brian , Arnaout Omar
Published: June 2018

Glioma constitutes the most common type of primary brain tumor with a dismal survival, often measured in terms of months or years. The thin line between treatment effectiveness and patient harm underpins the importance of tailoring clinical management to the individual patient. Randomized trials have laid the foundation for many neuro-oncological guidelines. Despite this, their findings focus on group-level estimates. Given our current tools, we are limited in our ability to guide patients on what therapy is best for them as individuals, or even how long they should expect to survive. Machine learning, however, promises to provide the analytical support for personalizing treatment decisions, and deep learning allows clinicians to unlock insight from the vast amount of unstructured data that is collected on glioma patients. Although these novel techniques have achieved astonishing results across a variety of clinical applications, significant hurdles remain associated with the implementation of them in clinical practice. Future challenges include the assembly of well-curated cross-institutional datasets, improvement of the interpretability of machine learning models, and balancing novel evidence-based decision-making with the associated liability of automated inference. Although artificial intelligence already exceeds clinical expertise in a variety of applications, clinicians remain responsible for interpreting the implications of, and acting upon, each prediction.
Behaviour Preservation across Code Versions in Erlang
Authors: Insa David , Pérez Sergio , Silva Josep , Tamarit Salvador
Published: June 2018

In any alive and nontrivial program, the source code naturally evolves along the lifecycle for many reasons such as the implementation of new functionality, the optimization of a bottleneck, or the refactoring of an obscure function. Frequently, these code changes affect various different functions and modules, so it can be difficult to know whether the correct behaviour of the previous version has been preserved in the new version. In this paper, we face this problem in the context of the Erlang language, where most developers rely on a previously defined test suite to check the behaviour preservation. We propose an alternative approach to automatically obtain a test suite that specifically focusses on comparing the old and new versions of the code. Our test case generation is directed by a sophisticated combination of several already existing tools such as TypEr, CutEr, and PropEr; and it introduces novel ideas such as allowing the programmer to choose one or more expressions of interest that must preserve the behaviour, or the recording of the sequences of values to which those expressions are evaluated. All the presented work has been implemented in an open-source tool that is publicly available on GitHub.
Impact of Nasopharyngeal FilmArray Respiratory Panel Results on Antimicrobial Decisions in Hospitalized Patients
Authors: Sakata Kenneth K. , Azadeh Natalya , Brighton Anjuli , Temkit M’hamed , Klassen Christine L. , Grys Thomas E. , Vikram Holenarasipur R.
Published: June 2018

Objective. To determine whether results of the nasopharyngeal FilmArray respiratory panel (NP-FARP) influenced antibiotic decisions. Methods. We reviewed the medical records of nonintensive care unit (ICU) inpatients that had an NP-FARP performed at our institution between June 2013 and June 2014. The inpatient records were reviewed 48 hours after the NP-FARP for the following data: demographic information; NP-FARP, serum procalcitonin, and methicillin-resistant Staphylococcus aureus nasal swab (MRSA NS) results; antibiotics prior and post-48 hours of the NP-FARP result; and the current immunosuppression status. Clinical outcome data were not obtained. Patients were categorized into those who had a positive (+) or a negative (−) NP-FARP. We further subdivided these two categories into groups A, B, and C based on the antibiotic modifications 48 hours after their NP-FARP result. Group A included patients who were never initiated on antimicrobial therapy. Patients whose antibiotics were discontinued or deescalated were placed in group B. Patients with antibiotic escalation or continuation without change constituted group C. We compared and analyzed groups A, B, and C in the (+) and (−) NP-FARP cohorts. Results. A total of 545 patients were included. There were 143 (26%) patients with positive and 402 (74%) patients with negative NP-FARPs. Comparison of groups A, B, and C between those with a (+) and (−) NP-FARP were as follows: (+) A and (−) A, 28/143 (20%) and 84/402 (21%); (+) B and (−) B, 59/143 (41%) and 147/402 (37%); and (+) C and (−) C, 56/143 (39%) and 171/402 (43%), respectively. We found no statistically significant differences between groups (+) A versus (−) A, (+) B versus (−) B, and (+) C versus (−) C with respect to age, gender, MRSA NS result, procalcitonin result, or concurrent immunosuppression. Conclusion. In non-ICU inpatients, NP-FARP alone or in combination with procalcitonin or MRSA NS did not influence antibiotic decisions during the study period.
Integrated Treatment during the Intravitreal Melphalan Era: Concurrent Intravitreal Melphalan and Systemic Chemoreduction
Authors: Berry Jesse L. , Shah Sona , Kim Fiona , Jubran Rima , Kim Jonathan W.
Published: June 2018

Background: Intravitreal injection of melphalan (IVM) is safe and effective for the treatment of seeding in retinoblastoma. Current protocols require weekly injections during examination under anesthesia (EUA). To avoid additional anesthesia exposure for these children, IVM was initiated at the EUA concurrent with the 4th cycle of systemic chemoreduction in a series of 6 patients with persistent seeding. Methods: A retrospective review was completed to assess treatment response compared to all patients at our center treated with IVM and systemic chemotherapy. Overall, 6 eyes of 6 patients were included; salvage therapy included systemic chemoreduction with vincristine, etoposide, and carboplatin and IVM for persistent seeding. Results: IVM was initiated in all eyes at cycle 4 of their chemotherapy. Success in eradicating vitreous seeds was 100%; overall salvage rate was 67%. Anterior toxicity was observed in 2 out of 6 eyes and posterior toxicity in 4 out of 6 eyes. Conclusion: The concurrent chemoreduction and IVM protocol demonstrated a similar efficacy of globe salvage while sparing children additional EUAs. However, the increased rates of observed melphalan-related toxicities for concurrent therapy are concerning. Further clinical experience is necessary to define the best initiation time and dosing schedule for IVM.
Surface-Coil MRI for Small Peripheral Choroidal Melanoma: Imaging in a Rabbit Eye Model
Authors: Ioannidi Larissa , Seliniotakis Konstantinos , Bontzos Georgios , Sourvinos George , Haniotis Viktor , Tsiapa Irene , Maris Thomas G. , Detorakis Efstathios T.
Published: June 2018

Introduction: Imaging of small peripheral choroidal melanomas remains challenging in clinical and experimental settings, requiring wide-field ophthalmoscopy modalities. In this study, we applied surface-coil MRI to assess imaging feasibility for small peripherally located choroidal melanoma in a rabbit eye model. Methods: A female albino rabbit with a body weight of 2.8 kg was immunosuppressed with intramuscular cyclosporine 15 mg/kg daily for 3 days prior to inoculation of 14 million 92.1 line melanoma cells into the peripheral suprachoroidal space of the right eye. The experimental animal continued to receive the same dosage of cyclosporine daily for 26 days postinoculation until the day of sacrifice. On that interval, it underwent surface-coil MRI scanning using various protocols and models subsequently sacrificed to allow histological evaluation. A comparative examination of various MRI sequences for optimal lesion imaging was performed, based on semiquantitative criteria. Results: Imaging quality and superimposed artifacts varied across different sequences and the optimal tumor delineation from adjacent tissues was achieved in T1-weighted sequences. Conclusions: MRI of small peripheral choroidal melanomas is feasible in a rabbit model using surface coils, particularly in T1-weighted sequences. Findings may be used as a basis for further development of this technique for experimental and clinical applications.
Body Composition Changes from Infancy to 4 Years and Associations with Early Childhood Cognition in Preterm and Full-Term Children
Authors: Scheurer Johannah M. , Zhang Lei , Plummer Erin A. , Hultgren Solveig A. , Demerath Ellen W. , Ramel Sara E.
Published: June 2018

Background: Infants born prematurely are at risk for neurodevelopmental complications. Early growth is associated with improved later cognition. The relationship of early proportionality and body composition with later cognition is not well established. Objectives: To assess differences in fat-free mass and adiposity (fat mass, percent body fat) changes in preterm and full-term infants through preschool age and examine associations with early childhood cognition. Methods: This is a prospective, observational study in an appropriate for gestational age cohort of 71 patients (20 preterm and 51 full-term) from infancy through preschool age. Anthropometric and body composition measurements via air displacement plethysmography were obtained during infancy at term and 3–4 months (preterm corrected ages), and at 4 years. Cognitive testing occurred at 4 years. Associations of body composition changes between visits with cognitive function were tested using linear regression. Results: In the preterm group, higher term to 4-month corrected age percent body fat gains were associated with lower working memory performance (p = 0.01), and higher 4-month corrected age to 4-year fat-free mass gains were associated with higher full-scale IQ (p = 0.03) and speed of processing performance (p ≤ 0.02). In the full-term group, higher 4-month to 4-year fat mass gains were associated with lower full-scale IQ (p = 0.03). Conclusions: Body composition gains during different time periods are associated with varying areas of cognitive function. These findings may inform interventions aimed at optimal growth.
Neurofilament Subunit L Levels in the Cerebrospinal Fluid and Serum of Patients with Amyotrophic Lateral Sclerosis
Authors: Gong Zhong-Ying , Lv Gao-Peng , Gao Li-Na , Lu Yi , Guo Jie , Zang Da-Wei
Published: June 2018

Background: There are no reliable biomarkers that could evaluate the disease burden in amyotrophic lateral sclerosis (ALS). Objectives: The aim of our study is to evaluate the changes in cerebrospinal fluid (CSF) and serum neurofilament subunit L (NF-L) in patients with ALS and to analyze the correlations between the levels of NF-L and clinical parameters. Method: CSF and serum samples were obtained from 80 ALS patients and 40 controls. The levels of NF-L in CSF and serum were assessed, and disease progression parameters including duration, revised ALS Functional Rating Scale (ALSFRS-r) score, disease progression rate (DPR), upper motor neuron (UMN) score, and survival were analyzed by registered neurologists. All samples were measured using a commercial enzyme-linked immunosorbent assay. Statistical analyses were performed using Prism software. Results: Compared to the controls, the ALS patients displayed significantly increased levels of NF-L; these values were negatively correlated with the ALSFRS-r score and positively correlated with the decrease in ALSFRS-r score, DPR, and UMN score. There was no correlation between levels of NF-L and duration. In addition, the cumulative survival rate in ALS patients with a low level of NF-L was higher than in patients with a high level of NF-L. Conclusions: NF-L levels increased in CSF and serum of patients with ALS. NF-L may thus be a neurodegenerative biomarker for predicting ALS severity and progression, and the survival of patients with this disease.
Cell-Free DNA Analysis in Maternal Blood: Differences in Estimates between Laboratories with Different Methodologies Using a Propensity Score Approach
Authors: Bevilacqua Elisa , Jani Jacques C. , Letourneau Alexandra , Duiella Silvia F. , Kleinfinger Pascale , Lohmann Laurence , Resta Serena , Cos Sanchez Teresa , Fils Jean-François , Mirra Marilyn , Benachi Alexandra , Costa Jean-Marc
Published: June 2018

Objectives: To evaluate the failure rate and performance of cell-free DNA (cfDNA) testing, mainly in terms of detection rates for trisomy 21, performed by 2 laboratories using different analytical methods. Methods: cfDNA testing was performed on 2,870 pregnancies with the HarmonyTM Prenatal Test using the targeted digital analysis of selected regions (DANSR) method, and on 2,635 pregnancies with the “Cerba test” using the genome-wide massively parallel sequencing (GW-MPS) method, with available outcomes. Propensity score analysis was used to match patients between the 2 groups. A comparison of the detection rates for trisomy 21 between the 2 laboratories was made. Results: In all, 2,811 patients in the Harmony group and 2,530 patients in the Cerba group had no trisomy 21, 18, or 13. Postmatched comparisons of the patient characteristics indicated a higher no-result rate in the Harmony group (1.30%) than in the Cerba group (0.75%; p = 0.039). All 41 cases of trisomy 21 in the Harmony group and 93 cases in the Cerba group were detected. Conclusions: Both methods of cfDNA testing showed low no-result rates and a comparable performance in detecting trisomy 21; yet GW-MPS had a slightly lower no-result rate than the DANSR method.