bluuebunny/crossref_metadata_2025 huggingface dataset:
The Singularity and the State of the Art in Artificial Intelligence
Authors: Davis Ernest
Published: November 2014

The state of the art in automating basic cognitive tasks, including vision and natural language understanding, is far below human abilities. Real-world reasoning, which is an unavoidable part of many advanced forms of computer vision and natural language understanding, is particularly difficult---suggesting the advent of computers with superhuman general intelligence is not imminent. The possibility of attaining a singularity by computers that lack these abilities is discussed briefly.
A Rare Presentation of Maydl’s Hernia
Authors: Weledji Elroy Patrick , Mokake Martin , Ngowe Marcelin Ngowe
Published: November 2014

We present a case of an unsual type of obstructed indirect inguinal hernia with impending strangulation. The operative findings revealed a sliding Maydl’s hernia with an ischemic inner ileal loop and an adherent inflamed appendix. This case highlights the importance of intraoperative examination of the intra-abdominal bowel loops proximal to the hernia sac of an incarcerated, obstructed, or strangulated hernia.
Air Embolism after Endoscopic Retrograde Cholangiopancreatography in a Patient with Budd Chiari Syndrome
Authors: Wills-Sanin Beatriz , Cárdenas Yenny R. , Polanco Lucas , Rivero Oscar , Suarez Sebastian , Buitrago Andrés F.
Published: November 2014

Endoscopic retrograde cholangiopancreatography is a procedure commonly used for the diagnosis and treatment of various pancreatic and biliary diseases. Air embolism is a rare complication, which may be associated with this procedure. This condition can be manifested as cardiopulmonary instability and/or neurological symptoms. Known risk factors include: sphincterotomy; application of air with high intramural pressure; anatomic abnormalities; and chronic hepatobiliary inflammation. It is important for the health-care staff, including anesthesiologists, interventional gastroenterologists, and critical care specialists, amongst others, to promptly recognize air embolism and to initiate therapy in a timely fashion, thus preventing potentially fatal outcomes. We submit a brief review of the literature and a case report of air embolism which occurred in the immediate postoperative stage of an endoscopic retrograde cholangiopancreatography, performed in a woman with a history of liver transplantation due to Budd Chiari syndrome and biliary stricture.
Numerical Simulation of Particles Deposition in a Human Upper Airway
Authors: Li Debo , Xu Qisheng , Liu Yaming , Libao Yin , Jun Jin
Published: November 2014

Based on the CT scanned images, a realistic geometric model from nasal cavity to upper six-generation bronchia is rebuilt. In order to effectively simulate the particle movement and deposition, LES model is used and the particles are tracked in the frame of Lagrange. Seven kinds of typical particles, including micron particles (1, 5, and 10 μm) and nanoparticles (1, 5, 20, and 100 nm), and three representative respiratory intensities are adopted as computational case, respectively. Deposition efficiency ( D E), deposition concentration ( D C), and capture efficiency ( C E) are introduced. Furthermore, the locations of particle deposition are visualized. The results indicate that the injecting particles from different nasal inlet present “transposition effect.”The D E values of micron particles are much higher than nanoparticles. The particle diameter plays a weaker role in nanoparticle depositions than micron particles. The highest values of D E and D C both occur in nasal cavity, while the highest C E up to 99.5% occurs in bronchus region.
Litter Production, Decomposition, and Nutrient Release in Subalpine Forest Communities of the Northwest Himalaya
Authors: Bisht Vinod K. , Nautiyal Bhagwati P. , Kuniyal Chandra P. , Prasad P. , Sundriyal Rakesh C.
Published: November 2014

Production, decomposition, and release of nutrients from leaf and nonleaf litter were investigated in four subalpine forests of North-West Himalaya, India. Total annual litter fall in four communities varied from 2950.00 to 4040.00 kg ha−1and was found significant (CD0.05= 118.2). Decomposition of leaf litter varied from 1.82–3.5% during autumn-winter to 36.14–45.51 during summer rainy season in all stands and percent of mass loss was significantly varied in stands (CD6.00). Similarly, decomposition in nonleaf litter was varied from 0.3–1.1% during autumn-winter to 19.59–30.05% during summer rainy season and was significantly varied irrespective of seasons. However, percent decomposition of leaf litter and the values of decay constant (k) were at par in all stands. Total standing state of nutrients in fresh litter as well as release of total nitrogen (N), phosphorus (P), and potassium (K) in due course of decomposition (12 months) was also varying significantly. The rate of nonleaf litter decomposition was significantly positively correlated with air temperature (r=0.63–0.74in all communities). The significant correlation(r=0.85)was observed only inRhododendron-Sorbusforest community (PRS). Study indicates that the air temperature is a major determinant for nonleaf litter decomposition in this region.
Therapeutic Efficacy of pH-Dependent Release Formulation of Mesalazine on Active Ulcerative Colitis Resistant to Time-Dependent Release Formulation: Analysis of Fecal Calprotectin Concentration
Authors: Kawashima Kousaku , Ishihara Shunji , Yuki Takafumi , Onishi Koji , Kushiyama Yoshinori , Fujishiro Hirofumi , Miyaoka Youichi , Yuki Mika , Komazawa Yoshinori , Tanimura Takashi , Sonoyama Hiroki , Tada Yasumasa , Kusunoki Ryusaku , Oka Akihiko , Fukuba Nobuhiko , Oshima Naoki , Moriyama Ichiro , Kinoshita Yoshikazu
Published: November 2014

Purpose. Few reports have compared the clinical efficacy of a pH-dependent release formulation of mesalazine (pH-5-ASA) with a time-dependent release formulation (time-5-ASA). We examined whether pH-5-ASA is effective for active ulcerative colitis (UC) in patients resistant to time-5-ASA.Methods. We retrospectively and prospectively analyzed the efficacy of pH-5-ASA in mildly to moderately active UC patients in whom time-5-ASA did not successfully induce or maintain remission. The clinical efficacy of pH-5-ASA was assessed by clinical activity index (CAI) before and after switching from time-5-ASA. In addition, the efficacy of pH-5-ASA on mucosal healing (MH) was evaluated in a prospective manner by measuring fecal calprotectin concentration.Results. Thirty patients were analyzed in a retrospective manner. CAI was significantly reduced at both 4 and 8 weeks after switching to pH-5-ASA. In the prospective study (n=14), administration of pH-5-ASA also significantly reduced CAI scores at 4 and 8 weeks in these patients who were resistant to time-5-ASA. In addition, fecal calprotectin concentration was significantly decreased along with improvement in CAI after switching to pH-5-ASA.Conclusions. Our results suggest that pH-5-ASA has clinical efficacy for mildly to moderately active patients with UC in whom time-5-ASA did not successfully induce or maintain remission.
MicroRNA Expression Profiling in PBMCs: A Potential Diagnostic Biomarker of Chronic Hepatitis C
Authors: Chang Chiu-Chun , Lin Chun-Che , Hsieh Wan-Ling , Lai Hsin-Wu , Tsai Chia-Hsun , Cheng Ya-Wen
Published: November 2014

The expression levels of miR-16, miR-193b, miR-199a, miR-222, and miR-324 in PBMCs were significantly higher in CHC patients compared with healthy controls and significantly different between CHC patients with HCV genotype 1 (GT-1) and non-genotype-1 (non-GT-1). Multivariate logistic regression analysis also showed that patients with high expression levels of the six target miRNAs had an approximately 7.202-fold risk of CHC compared with those with low expression levels of the target miRNAs. We concluded that the expression levels of miR-16, miR-193b, miR-199a, miR-222, and miR-324 target miRNAs in PBMCs of CHC may act as significant risk biomarkers for the development of CHC.
Shelf Life and Quality Study of Minced Tilapia with Nori and Hijiki Seaweeds as Natural Additives
Authors: Ribeiro Ingridy Simone , Shirahigue Ligianne Din , Ferraz de Arruda Sucasas Lia , Anbe Lika , da Cruz Pedro Gomes , Gallo Cláudio Rosa , Carpes Solange Teresinha , Marques Marcos José , Oetterer Marília
Published: November 2014

The extraction of mechanically separated meat has emerged as an attractive process. However, it increases the incorporation of oxygen and, consequently, of flavors due to rancidity. Thus, preservatives must be added. The objective of this study was to evaluate the shelf life of minced tilapia to replace synthetic preservatives with Hijiki and Nori seaweeds extracts. The application of the extracts had no effect on the chemical composition of the minced tilapia. The seaweed extracts had inhibitory effect on total volatile base nitrogen. The minced tilapia complied with the microbiological standard set by Brazilin law. The panelists detected no differences in the rancid aroma and only minor differences were detected in the color of the products. It can be concluded that the minced tilapia with added seaweed extracts were within quality standards during frozen storage.
Anticholinesterase and Antioxidative Properties of Aqueous Extract ofCola acuminataSeedIn Vitro
Authors: Oboh Ganiyu , Akinyemi Ayodele J. , Omojokun Olasunkanmi S. , Oyeleye Idowu S.
Published: November 2014

Background. Cola acuminataseed, a commonly used stimulant in Nigeria, has been reportedly used for the management of neurodegenerative diseases in folklore without scientific basis. This study sought to investigate the anticholinesterase and antioxidant properties of aqueous extracts fromC. acuminataseedin vitro.Methodology.The aqueous extract ofC. acuminataseed was prepared (w/v) and its effect on acetylcholinesterase (AChE) and butyrylcholinesterase activities, as well as some prooxidant (FeSO4, sodium nitroprusside (SNP), and quinolinic acid (QA)) induced lipid peroxidation in rat brainin vitro, was investigated.Results.The results revealed thatC. acuminataseed extract inhibited AChE (IC50= 14.6μg/mL) and BChE (IC50= 96.2μg/mL) activities in a dose-dependent manner. Furthermore, incubation of rat’s brain homogenates with some prooxidants caused a significant increaseP<0.05in the brain malondialdehyde (MDA) content and inhibited MDA production dose-dependently and also exhibited further antioxidant properties as typified by their high radicals scavenging and Fe2+chelating abilities.Conclusion.Inhibition of AChE and BChE activities has been the primary treatment method for mild Alzheimer’s disease (AD). Therefore, one possible mechanism through which the seed exerts its neuroprotective properties is by inhibiting cholinesterase activities as well as preventing oxidative-stress-induced neurodegeneration. However, this is a preliminary study with possible physiological implications.
Argon Laser Photoablation for Postburn Conjunctival Pigmentation
Authors: Ahn Seong Joon , Jeong Jae Hoon , Cho Hyo Jong , Lee Dong-Hoon , Kim Hyun Chul
Published: November 2014

We report a case of an ocular burn injury from boiling water which resulted in conjunctival pigmentation, 1 week following injury. For cosmetic purposes, 2 sessions of argon laser photoablation were performed. One month after laser treatment, conjunctival pigmentation had been successfully removed and the patient was very satisfied with the results. Argon laser photoablation may be an effective way to remove postburn conjunctival pigmentation.
Angiogenesis in Pituitary Adenomas: Human Studies and New Mutant Mouse Models
Authors: Cristina Carolina , Luque Guillermina María , Demarchi Gianina , Lopez Vicchi Felicitas , Zubeldia-Brenner Lautaro , Perez Millan Maria Ines , Perrone Sofia , Ornstein Ana Maria , Lacau-Mengido Isabel M. , Berner Silvia Inés , Becu-Villalobos Damasia
Published: November 2014

The role of angiogenesis in pituitary tumor development has been questioned, as pituitary tumors have been usually found to be less vascularized than the normal pituitary tissue. Nevertheless, a significantly higher degree of vasculature has been shown in invasive or macropituitary prolactinomas when compared to noninvasive and microprolactinomas. Many growth factors and their receptors are involved in pituitary tumor development. For example, VEGF, FGF-2, FGFR1, and PTTG, which give a particular vascular phenotype, are modified in human and experimental pituitary adenomas of different histotypes. In particular, vascular endothelial growth factor, VEGF, the central mediator of angiogenesis in endocrine glands, was encountered in experimental and human pituitary tumors at different levels of expression and, in particular, was higher in dopamine agonist resistant prolactinomas. Furthermore, several anti-VEGF techniques lowered tumor burden in human and experimental pituitary adenomas. Therefore, even though the role of angiogenesis in pituitary adenomas is contentious, VEGF, making permeable pituitary endothelia, might contribute to adequate temporal vascular supply and mechanisms other than endothelial cell proliferation. The study of angiogenic factor expression in aggressive prolactinomas with resistance to dopamine agonists will yield important data in the search of therapeutical alternatives.
Influence of the Hydrothermal Method Growth Parameters on the Zinc Oxide Nanowires Deposited on Several Substrates
Authors: Mejía-García Concepción , Díaz-Valdés Elvia , Ayala-Torres Marco Alberto , Romero-Ibarra Josué , López-López Máximo
Published: November 2014

We report the synthesis of ZnO nanowires grown on several substrates (PET, glass, and Si) using a two‐step process: (a) preparation of the seed layer on the substrate by spin coating, from solutions of zinc acetate dihydrate and 1‐propanol, and (b) growth of the ZnO nanostructures by dipping the substrate in an equimolar solution of zinc nitrate hexahydrate and hexamethylenetetramine. Subsequently, films were thermally treated with a commercial microwave oven (350 and 700 W) for 5, 20, and 35 min. The ZnO nanowires obtained were characterized structurally, morphologically, and optically using XRD, SEM, and UV‐VIS transmission, respectively. XRD patterns spectra revealed the presence of Zn(OH)2 on the films grown on glass and Si substrates. A preferential orientation along c-axis directions for films grown on PET substrate was observed. An analysis by SEM revealed that the growth of the ZnO nanowires on PET and glass is better than the growth on Si when the same growth parameters are used. On glass substrates, ZnO nanowires less than 50 nm in diameter and between 200 nm and 1200 nm in length were obtained. The ZnO nanowires band gap energy for the films grown on PET and glass was obtained from optical transmission spectra.
Effect of the Use of Pycnanthus angolensis and Different Supplements on Yields and on the Proximate Composition of Pleurotus sajor-caju
Authors: Fakoya Soji , Adejumo Abiodun Felix , Akinyele Julliet Bamidele
Published: November 2014

This study was undertaken with the aim of determining the growth, yield, and proximate composition of Pleurotus sajor-caju cultivated on Pycnanthus angolensis sawdust supplemented with 0, 5, 10, 15, and 20% palm kernel cake (PKC), oil palm fibre (OPF), rice bran (RB), wheat chaff (WC), and corn cobs (CC). P. sajor-caju harvested produced maximum yield of 31.22 g on P. angolensis sawdust supplemented with 15% wheat chaff. The biological efficiency of substrates used ranged from 6.09% to 37.39%. Results also showed a maximum crude protein of 26.33% of P. sajor-caju cultivated on P. angolensis sawdust without any supplement and fat content ranging from 0.25% to 2.21%. Fibre content of harvested mushrooms ranged from 5.05% to 9.29%. The study revealed that supplementing P. angolensis sawdust significantly influenced the growth, yield, and proximate compositions of P. sajor-caju.
Online Authentication and Key Establishment Scheme for Heterogeneous Sensor Networks
Authors: Khan Sarmad Ullah , Lavagno Luciano , Pastrone Claudio , Spirito Maurizio A.
Published: November 2014

In recent years, the adaptation of wireless sensor networks (WSNs) to application areas requiring mobility increased the security threats against confidentiality, integrity, and privacy of the information as well as against their connectivity. Since key management plays an important role in securing both information and connectivity, a proper authentication and key management scheme is required in mobility enabled applications where the authentication of a node with the network is a critical issue. In this paper, we present an authentication and key management scheme supporting node mobility in a heterogeneous WSN that consists of several mobile sensor nodes and a few fixed sensor nodes. We analyze our proposed solution by using the OMNET++ simulator to show that it requires less memory space and provides better connectivity and network resilience against node capture attacks compared to some existing schemes. We also propose two levels of secure authentication methods for the mobile sensor nodes for secure authentication and key establishment.
“Don Juan-Fracture” as a Hint to Aortic Isthmus Rupture
Authors: Suksompong Sirilak , von Bormann Benno
Published: November 2014

We report a case of thoracic aortic rupture after blunt trauma in a 23-year-old male patient. The initial investigation found no external injury or bleeding, only a slightly widened mediastinum and a broken left calcaneus. Abdominal lavage was negative, biochemistry was normal, and breathing and oxygenation were not compromised. When changing his position during diagnostics, the patient all of a sudden developed cardiac arrest and typical signs of hypovolemic shock. An immediate sternotomy was done without any further diagnostics on suspicion of aortic isthmus injury. A circular avulsion at the ligamentum arteriosum was found as assumed and repaired under cardiopulmonary bypass. The patient left the hospital for rehabilitation after 12 days in adequate health status. Biodynamics of blunt trauma after high-speed frontal impact and the relationship between calcaneus fracture, called “Don-Juan fracture,” and aortic rupture at the site of ligamentum arteriosum are discussed.
A Laboratory Based Investigation of a New Elastic Toothbrush Head
Authors: Mazza Lorenzo , Gatto Maria Rosaria , Monaco Giuseppe , Pelliccioni Gian Andrea
Published: November 2014

Purpose. To demonstrate the noninferiority of a new toothbrush head with retractile bristles compared to traditional toothbrush heads on dental models.Methods. The new toothbrush head, mounted on manual and electrical handles, presents retractile bristle groups that can singularly retract over its entire length and offer calibrated resistance. Fourteen gypsum models of dental arches, twelve with and two without anatomical impairments, were spread with a “plaque simulator.” Each arch was brushed twice with each of the four toothbrushes, one minute by the same operator, blinded to the study. The plaque index (PI) was recorded at the end of each brushing session. GLM for repeated measures analysed the data.Results. On all the casts, the manual prototype and the electric prototype, removed 11% and 14% more “plaque simulator” compared to the standard toothbrush. In presence of dental anomalies, the prototypes removed 13% and 16% more plaque, respectively, compared to standard toothbrushes (P=0.04). In both situations, the 95% confidence intervals of PI did not include −10% (the minimal margin of clinical relevance).Conclusions. The prototype is more effective in removing plaque from the casts with anomalies. The noninferiority of the prototype with respect to the standard toothbrushes was demonstrated.
Test of Robot Distance Error and Compensation of Kinematic Full Parameters
Authors: Zhang Tie , Du Liang , Dai Xiaoliang
Published: November 2014

In order to improve the positioning accuracy of robots in the workspace, the maximum cube of robots is solved according to ISO 9283:1998 standard. In addition, in order to efficiently test and identify the kinematic parameters of robots, a mapping from robot's distance error onto kinematic parameter errors is presented based on Hayati's modified D-H model. Then, by analyzing the condition number of distance error matrix, it is concluded that parameter d i can be deleted when parameter β i is added in the joint of the modified model. Furthermore, by analyzing the relationship among the parameters of the distance error model, it is found that the deletion of some unidentified kinematic parameters may not result in the accuracy decrease of kinematic error model. Finally, some compensation experiments of the proposed model without unidentified kinematic parameters are carried out by using a laser tracker system. The results show that the proposed method effectively reduces the distance error and greatly improves the positioning accuracy of robots.
Different Resting-State Functional Connectivity Alterations in Smokers and Nonsmokers with Internet Gaming Addiction
Authors: Chen Xue , Wang Yao , Zhou Yan , Sun Yawen , Ding Weina , Zhuang Zhiguo , Xu Jianrong , Du Yasong
Published: November 2014

This study investigated changes in resting-state functional connectivity (rsFC) of posterior cingulate cortex (PCC) in smokers and nonsmokers with Internet gaming addiction (IGA). Twenty-nine smokers with IGA, 22 nonsmokers with IGA, and 30 healthy controls (HC group) underwent a resting-state fMRI scan. PCC connectivity was determined in all subjects by investigating synchronized low-frequency fMRI signal fluctuations using a temporal correlation method. Compared with the nonsmokers with IGA, the smokers with IGA exhibited decreased rsFC with PCC in the right rectus gyrus. Left middle frontal gyrus exhibited increased rsFC. The PCC connectivity with the right rectus gyrus was found to be negatively correlated with the CIAS scores in the smokers with IGA before correction. Our results suggested that smokers with IGA had functional changes in brain areas related to motivation and executive function compared with the nonsmokers with IGA.
Bullosis Diabeticorum: Rare Presentation in a Common Disease
Authors: Gupta Vineet , Gulati Neha , Bahl Jaya , Bajwa Jaswinder , Dhawan Naveen
Published: November 2014

A 27-year-old African American male presented with a sudden onset of blisters. He had a past medical history of uncontrolled diabetes mellitus type I, diabetic vasculopathy, and neuropathy. The physical examination revealed nonerythematous skin denudations on both elbows and lateral aspect of arm bilaterally. Investigations which included skin biopsies confirmed the diagnosis of bullosis diabeticorum. The bullae were treated with hydrotherapy and healed with no complications in 4 weeks. We present this case to illustrate the rare occurrence of diabetic bulla in a diabetic patient especially with poor glycemic control. The case is also a reminder of the importance of diabetes screening in nondiabetic patients who are diagnosed with diabetic bulla.
Prick by Prick Induced Anaphylaxis in a Patient with Peanuts and Lupine Allergy: Awareness of Risks and Role of Component Resolved Diagnosis
Authors: Ciccarelli Anna , Calabrò Claudia , Imperatore Clara , Scala Guglielmo
Published: November 2014

A case of anaphylaxis is reported in the course of a prick by prick with Lupinus albus and roasted peanut in a 20-year-old woman. We focused on some main topics. First of all it seems important to underscore the potential risks connected to the practice of the prick-by-prick with fresh foods in allergic patients, especially when testing cross-reactive substances, such as White Lupine, peanuts, or soy. It is important that clinicians who perform prick tests be aware of the risk related with in vivo tests in allergic patients. Second, we discuss the problem of the hidden allergens, such as White Lupine flour, or soy flour which are utilized to improve wheat flour because of their lower cost. Patients with a demonstrated allergy to peanuts should be assessed for lupine allergy and informed about the “hidden allergens” issue. Finally, we believe that component resolved diagnosis, the serum specific IgE against molecular components, that is normally considered a second-level diagnostic step has an important role even as a first line approach at least in some selected cases.
Evaluation of Corneal Stromal Demarcation Line after Two Different Protocols of Accelerated Corneal Collagen Cross-Linking Procedures Using Anterior Segment Optical Coherence Tomography and Confocal Microscopy
Authors: Ozgurhan Engin Bilge , Sezgin Akcay Betul Ilkay , Yildirim Yusuf , Karatas Gonul , Kurt Tugba , Demirok Ahmet
Published: November 2014

Purpose. To evaluate the depth of corneal stromal demarcation line using AS-OCT and confocal microscopy after two different protocols of accelerated corneal collagen cross-linking procedures (CXL).Methods. Patients with keratoconus were divided into two groups. Peschke CXL device (Peschke CCL-VARIO Meditrade GmbH) applied UVA light with an intended irradiance of 18.0 mW/cm2for 5 minutes after applying riboflavin for 20 minutes (group 1) and 30 minutes (group 2). One month postoperatively, corneal stromal demarcation line was measured using AS-OCT and confocal microscopy.Results. This study enrolled 34 eyes of 34 patients (17 eyes in group 1 and 17 eyes in group 2). The mean depth of the corneal stromal demarcation line was208.64±18.41 μm in group 1 and240.37±18.89 μm in group 2 measured with AS OCT, while it was210.29±18.66 μm in group 1 and239.37±20.07 μm in group 2 measured with confocal microscopy. Corneal stromal demarcation line depth measured with AS OCT or confocal microscopy was significantly deeper in group 2 than group 1(P<0.01).Conclusion. The group in which riboflavin was applied for 30 minutes showed significantly deeper corneal stromal demarcation line than the group in which riboflavin was applied for 20 minutes.
An Efficient Diagnosis System for Parkinson’s Disease Using Kernel-Based Extreme Learning Machine with Subtractive Clustering Features Weighting Approach
Authors: Ma Chao , Ouyang Jihong , Chen Hui-Ling , Zhao Xue-Hua
Published: November 2014

A novel hybrid method named SCFW-KELM, which integrates effective subtractive clustering features weighting and a fast classifier kernel-based extreme learning machine (KELM), has been introduced for the diagnosis of PD. In the proposed method, SCFW is used as a data preprocessing tool, which aims at decreasing the variance in features of the PD dataset, in order to further improve the diagnostic accuracy of the KELM classifier. The impact of the type of kernel functions on the performance of KELM has been investigated in detail. The efficiency and effectiveness of the proposed method have been rigorously evaluated against the PD dataset in terms of classification accuracy, sensitivity, specificity, area under the receiver operating characteristic (ROC) curve (AUC),f-measure, and kappa statistics value. Experimental results have demonstrated that the proposed SCFW-KELM significantly outperforms SVM-based, KNN-based, and ELM-based approaches and other methods in the literature and achieved highest classification results reported so far via 10-fold cross validation scheme, with the classification accuracy of 99.49%, the sensitivity of 100%, the specificity of 99.39%, AUC of 99.69%, thef-measure value of 0.9964, and kappa value of 0.9867. Promisingly, the proposed method might serve as a new candidate of powerful methods for the diagnosis of PD with excellent performance.
Breast-Feeding and Health Consequences in Early Childhood: Is There an Impact of Time-Dependent Confounding
Authors: Groenwold R.H.H. , Tilling K. , Moons K.G.M. , Hoes A.W. , van der Ent C.K. , Kramer M.S. , Martin R.M. , Sterne J.A.C.
Published: November 2014

Background: Estimated effects of breast-feeding on childhood health vary between studies, possibly due to confounding by baseline maternal and child characteristics. Possible time-dependent confounding has received little consideration. Our aim was to evaluate the impact of such confounding. Methods: We estimated the relationship between cumulative exclusive breast-feeding up to 6 months and wheezing, rash and body mass index (BMI) at 12 months [in the Whistler cohort (n = 494) and PROBIT (n = 11,463)], and wheezing, rash, asthma, hay fever, eczema, allergy and BMI at age 6.5 years (PROBIT). We adjusted for time-dependent confounding by weight, length, rash, respiratory illness and day care attendance using marginal structural models (MSMs). Results: Weight and day care attendance appeared potential time-dependent confounders, since these predicted breast-feeding status and were influenced by previous breast-feeding. However, adjustment for time-dependent confounders did not markedly change the estimated associations. For example, in PROBIT the adjusted increase in BMI at 12 months per 1-month increase in exclusive breast-feeding was 0.04 (95% CI -0.09 to 0.01) using logistic regression and -0.06 (95% CI -0.11 to -0.01) using MSM. In Whistler, these estimates were each -0.05 (95% CI -0.10 to 0.00). Conclusions: In two cohort studies, there was little evidence of time-dependent confounding by weight, length, rash, respiratory illness or day care attendance of the effects of breast-feeding on early childhood health.
Overweight in Infancy: Which Pre- and Perinatal Factors Determine Overweight Persistence or Reduction A Birth Cohort Followed for 11 Years
Authors: van Rossem Lenie , Wijga Alet H. , Brunekreef Bert , de Jongste Johan C. , Kerkhof Marjan , Postma Dirkje S. , Gehring Ulrike , Smit Henriëtte A.
Published: November 2014

Background: A considerable proportion of children with early-life overweight attain a normal weight. To recognize infants at risk of persistent overweight, we compared early-life factors of children with a longitudinal pattern of persistent overweight to children with a pattern of overweight in early but not in later childhood. Methods: In 3,550 children participating in a birth cohort that started in 1996/1997 in the Netherlands, body mass index was repeatedly assessed until age 11 and dichotomized into with/without overweight. Latent class growth modeling was used to distinguish trajectories. Our analysis was focused on the comparison of early-life factors in children in a persistent overweight pattern with those in an overweight reduction pattern using multivariable log-binomial regression analyses. Results: Children (n = 133) in the persistent overweight pattern were more likely to have overweight parents [relative risk (RR)mother: 1.85, 95% CI: 1.37-2.49: RRfather: 1.75, 95% CI: 1.21-2.55] than children in the overweight reduction pattern (n = 303). Maternal education, child's gender, ethnicity, birth weight, breast-feeding and maternal smoking during pregnancy did not differ between the trajectories. Conclusion: Health care practitioners should focus on high-weight infants with overweight parents, as these children are less likely to resolve their overweight.
Mediation from Multilevel to Structural Equation Modeling
Authors: MacKinnon David P. , Valente Matthew J.
Published: November 2014

Background/Aims: The purpose of this article is to outline multilevel structural equation modeling (MSEM) for mediation analysis of longitudinal data. The introduction of mediating variables can improve experimental and nonexperimental studies of child growth in several ways as discussed throughout this article. Single-mediator individual-level and multilevel mediation models illustrate several current issues in the estimation of mediation with longitudinal data. The strengths of incorporating structural equation modeling (SEM) with multilevel mediation modeling are described. Summary and Key Messages: Longitudinal mediation models are pervasive in many areas of research including child growth. Longitudinal mediation models are ideally modeled as repeated measurements clustered within individuals. Further, the combination of MSEM and SEM provides an ideal approach for several reasons, including the ability to assess effects at different levels of analysis, incorporation of measurement error and possible random effects that vary across individuals.
Relapsing Pityriasis Rosea
Authors: Drago Francesco , Ciccarese Giulia , Rebora Alfredo , Parodi Aurora
Published: November 2014

To assess the prevalence of relapses of pityriasis rosea (PR), a retrospective cohort study investigated all PR cases diagnosed in Genoa between 2000 and 2013 and followed them up to today. Of 570 cases, 21 (3.7%) relapsed. Most of them had a single episode, but 4 had two episodes and 2 had three episodes. The herald patch was always absent, size and number of the lesions were reduced, and duration was shorter than that of the primary episodes. Constitutional symptoms were present, though less severe than in the primary eruption. Most recurrences occurred within 1 year (16/21, 76.2%). Men outnumbered women and the mean age of the relapsing patients (20.3 years) was higher than that for the primary episode. A pathogenetic hypothesis is provided: since PR is associated with reactivation of human herpesvirus 6/7, a parallelism with other typical reactivating human herpesviruses (varicella zoster virus and Epstein-Barr virus) has been established.
Macrophage Phenotype in Response to Implanted Synthetic Scaffolds: An Immunohistochemical Study in the Rat
Authors: Palmer Jason A. , Abberton Keren M. , Mitchell Geraldine M. , Morrison Wayne A.
Published: November 2014

Macrophages predominate among the cells that directly interact with biomaterials and are key orchestrators of host-biomaterial interactions. However, the macrophage response to synthetic scaffolds in particular has not been well studied. The aim of this study was therefore to characterise the macrophage response to several synthetic scaffolds in the rat using immunohistological techniques for a panel of markers of macrophage subclass or activation, including ED1 (CD68), ED2 (CD163), CD80, mannose receptor and inducible nitric oxide synthase (iNOS). Materials were implanted subcutaneously and collected after 6-8 weeks during the chronic phase of the host response. Unmodified polycaprolactone scaffolds uniquely demonstrated a total lack of both macrophage adherence to surfaces and a wider foreign body response compared to scaffolds composed of poly(lactic-co-glycolic acid) (PLGA) and polyurethanes (PURs), with those macrophages present having a clear M2 (MR+, CD80-, iNOS-) phenotype. PLGA scaffolds displayed an M1-dominant (CD80+, iNOS+, MR-) response with substantial foreign body giant cell (FBGC) formation, whilst PUR scaffold FBGCs had a more mixed M1 (CD80+, iNOS+) and M2 (MR+) phenotype. The study also identified that the use of the ED1 antibody in the rat as a pan-macrophage marker is problematic as there is a separate and substantial ED2-positive macrophage population that it does not label, both in response to biomaterials and in normal tissues. The biomaterial-dependent nature of activation for both macrophages and FBGCs was confirmed, and nuanced M1/M2 phenotypes were described.
The Effect of Early Catch-Up Growth on Health and Well-Being in Young Adults
Authors: van Dommelen Paula , van der Pal Sylvia M. , Bennebroek Gravenhorst Jack , Walther Frans J. , Wit Jan M. , van der Pal de Bruin Karin M.
Published: November 2014

Aim: To study the effect of catch-up growth in the 1st year on cognition, health-related quality of life (HRQoL), problem behavior and growth in young adults. Methods: We included individuals without severe complications and born small for gestational age (SGA; n = 228 for weight, n = 203 for length) or with a low head circumference (HC, n = 178) or a low weight adjusted for length (n = 64) in the Collaborative Project on Preterm and SGA Infants. Neonatal growth was standardized (standard deviation scores for gestational age, SDSGA) according to GA-specific reference charts. Catch-up growth was defined as SDSGA at 1 year of age adjusted for SDSGA at birth. Cognition was defined by the Multicultural Capacity Test-Intermediate Level, HRQoL by the London Handicap Scale (LHS) and the Health Utility Index Mark 3 categorized into 4 levels (Multi-Attribute Utility, MAU), and problem behavior by the Young Adult Self-Report. We adjusted for potential confounders. Results: Most adults were born preterm (93.7%). A higher catch-up growth in the 1st year was associated with better cognition (B = 2.57, 95% CI 0.08-5.05 for weight), less disabilities according to the LHS (B = 2.06, 95% CI 0.35-3.78 for HC) and the MAU (OR = 0.67, 95% CI 0.48-0.95 for HC) and higher final height (B = 0.33, 95% CI 0.18-0.47 for weight; B = 0.41, 95% 0.28-0.55 for length, and B = 0.18, 95% CI 0.04-0.33 for HC) in young adulthood. Conclusion: There are long-term benefits of catch-up growth.
Curve Matching: A Data-Driven Technique to Improve Individual Prediction of Childhood Growth
Authors: van Buuren Stef
Published: November 2014

Longitudinal growth data are valuable for predicting and interpreting future growth of individual children. This note explores the idea of ‘curve matching', a new technique to improve prediction of future growth of an individual child. The key idea is to find existing children in existing databases that are similar to the current child. The growth patterns of the matched children suggest how the current child might evolve in the future. This paper describes the various conceptual and practical issues that need to be addressed before the idea can take off. A demo implementation is available at http://vps.stefvanbuuren.nl:3838/frisodemo/.
Regulation of Early Human Growth: Impact on Long-Term Health
Authors: Koletzko Berthold , Chourdakis Michael , Grote Veit , Hellmuth Christian , Prell Christine , Rzehak Peter , Uhl Olaf , Weber Martina
Published: November 2014

Growth and development are central characteristics of childhood. Deviations from normal growth can indicate serious health challenges. The adverse impact of early growth faltering and malnutrition on later health has long been known. In contrast, the impact of rapid early weight and body fat gain on programming of later disease risk have only recently received increased attention. Numerous observational studies related diet in early childhood and rapid early growth to the risk of later obesity and associated disorders. Causality was confirmed in a large, double-blind randomised trial testing the ‘Early Protein Hypothesis'. In this trial we found that attenuation of protein supply in infancy normalized early growth and markedly reduced obesity prevalence in early school age. These results indicate the need to describe and analyse growth patterns and their regulation through diet in more detail and to characterize the underlying metabolic and epigenetic mechanisms, given the potential major relevance for public health and policy. Better understanding of growth patterns and their regulation could have major benefits for the promotion of public health, consumer-orientated nutrition recommendations, and the development of improved food products for specific target populations.
Importance of Characterizing Growth Trajectories
Authors: Regnault Nolwenn , Gillman Matthew W.
Published: November 2014

In the era of the obesity epidemic in children, characterizing childhood growth trajectories (weight, length/height, or body mass index/weight for length) is becoming essential for surveillance. Clinicians routinely use growth curves to identify abnormal growth trajectories. Clinical epidemiologists are interested in both the determinants of growth and the consequences of certain patterns of growth on later health and diseases. Characterizing growth trajectories is also helpful to predict future growth based on past growth and might be useful in the future to compare the impact of various interventions.
Timing of Pharmacological Treatment for Patent Ductus Arteriosus and Risk of Secondary Surgery, Death or Bronchopulmonary Dysplasia: A Population-Based Cohort Study of Extremely Preterm Infants
Authors: Gudmundsdottir Anna , Johansson Stefan , Håkansson Stellan , Norman Mikael , Källen Karin , Bonamy Anna-Karin
Published: November 2014

Background: The optimal timing of pharmacological treatment for patent ductus arteriosus (PDA) in extremely preterm infants is unknown. Objective: To investigate whether timing of pharmacological PDA treatment is associated with a risk of secondary PDA surgery or death before 3 months of age, or bronchopulmonary dysplasia (BPD) in extremely preterm infants. Methods: In this population-based cohort of infants born before 27 gestational weeks in Sweden in 2004-2007, 290/585 infants (50%) received pharmacological PDA treatment. Cox proportional hazards regression estimated the hazard ratio (HR, with 95% confidence interval, CI) of secondary PDA surgery or death as a composite outcome in relation to postnatal age at the start of pharmacological treatment: early (0-2 days); intermediate (3-6 days); late (≥7 days). Furthermore, the odds ratio (OR, with 95% CI) of BPD was estimated in relation to postnatal age at PDA treatment by conditional logistic regression. Results: The median postnatal age at the start of pharmacological PDA treatment was 4 days. 102 infants had secondary PDA surgery. Timing of PDA treatment was not associated with risk of PDA surgery or death; adjusted HRs were 0.89 (95% CI 0.57-1.39) after an intermediate start and 1.10 (95% CI 0.53-2.28) after a late start, compared to an early start of treatment. Compared to the early start of PDA treatment, the intermediate start was not associated with any risk of BPD, while late PDA treatment was associated with a lower BPD risk; adjusted ORs were 0.83 (95% CI 0.42-1.64) and 0.28 (95% CI 0.13-0.61), respectively. Conclusion: Timing of pharmacological PDA treatment after extremely preterm birth is not associated with the risk of secondary PDA surgery or death. Moreover, expectant PDA management is not associated with an increased risk of BPD. © 2014 S. Karger AG, Basel
Effect of Postnatal Nutrition Restriction on the Oxidative Status of Neonates with Intrauterine Growth Restriction in a Pig Model
Authors: Che Lianqiang , Xuan Yue , Hu Liang , Liu Yan , Xu Qin , Fang Zhengfeng , Lin Yan , Xu Shengyu , Wu De , Zhang Keying , Chen Daiwen
Published: November 2014

Objective: In offspring with intrauterine growth restriction (IUGR), where oxidative stress may play an important role in inducing metabolic syndrome, nutrition restriction has been shown to improve oxidative status. In this study, we aimed to investigate the effect of postnatal nutrition restriction on the oxidative status of IUGR neonates. Methods: A total of twelve pairs of piglets, of normal birth-weight (NBW) and with IUGR (7 days old), respectively, were randomly allocated to have adequate nutritional intake (ANI) and restricted nutritional intake (RNI) for a period of 21 days, respectively. This design produced 4 experimental groups: NBW-ANI, IUGR-ANI, NBW-RNI and IUGR-RNI (n = 6 per group). Serum, ileum and liver samples were analyzed for antioxidant parameters and the mRNA expression of genes with regard to oxidative status. The data were subjected to general linear model analysis and Duncan's test with a 5% significance level. Results: Irrespective of nutritional intake, the IUGR pigs had markedly lower activity of glutathione peroxidase (GPX), gene expressions of liver mitochondrial manganese superoxide dismutase (Mn-SOD) and ileum cytoplasmic copper/zinc (CuZn)-SOD and, accordingly, there was a markedly higher malondialdehyde concentration in the liver of these pigs compared to in the NBW pigs. Irrespective of body weight, pigs receiving ANI treatment had significantly lower activities of antioxidant enzymes in the serum (total antioxidative capability, CuZn-SOD and GPX) and liver (total SOD and glutathione reductase) and decreased gene expression of liver CuZn-SOD and Mn-SOD compared to the pigs receiving RNI. In addition, the IUGR pigs had a markedly lower concentration of liver reduced glutathione (GSH), ratio of GSH to oxidized glutathione, gene expression of ileum CuZn-SOD and extracellular SOD than the NBW pigs when receiving ANI, but not all of these differences were observed in those receiving RNI. Conclusion: IUGR neonates may have poor antioxidant defense systems, and postnatal nutrition restriction has the potential to prevent oxidative stress. © 2014 S. Karger AG, Basel
Adult Tuberculous Meningitis in Qatar: A Descriptive Retrospective Study from its Referral Center
Authors: Imam Yahia Z.B. , Ahmedullah Hasan S. , Akhtar Naveed , Chacko Kadavil C. , Kamran Saadat , Al Alousi Faraj , Alsuwaidi Zubaida , Almaslmani Muna , Al Khal A. Latif , Deleu Dirk
Published: November 2014

Background: Tuberculous meningitis is the severest and commonest form of central nervous system tuberculosis causing high mortality and morbidity. We aim to study the clinical, biochemical, and radiological characteristics of tuberculous meningitis in adult patients in Qatar and to calculate the incidence. Methods: A descriptive retrospective 7-year study was conducted at the Hamad General Hospital (the only tertiary referral center and sole health care provider for tuberculosis in Qatar) between the 1st of January 2006 and the 31st of December 2012, to describe the clinical presentation, diagnosis, treatment, outcome, and the incidence of adult tuberculous meningitis in Qatar. Results: Tuberculous meningitis was diagnosed in 80 patients (65 male, 15 female), with a mean age of 30.3 w 8.9. The majority of patients (76.3%) were from the Indian subcontinent. The commonest clinical features were fever (79%), headache (71%), and meningism (56%). Cerebrospinal fluid tuberculosis culture was positive in 44% of patients. Almost 39% of patients were in Stage I, 46% in Stage II and 15% in Stage III of the disease. The commonest neuroimaging features were leptomeningeal enhancement (34%) and hydrocephalus (33%). Cranial nerve palsy, limb weakness, and an elevated C-reactive protein were associated with a poorer outcome. Sixty eight percent had complete recovery, 10% had residual neurological sequelae without disability, 17% had disability, and 5% died. The average incidence of tuberculous meningitis over 7 years was 0.9 per 100,000 adult population. Conclusion: The characteristics of tuberculous meningitis were described in our population. Our data indicate that the incidence of tuberculosis meningitis in Qatar has increased. Tuberculous meningitis in Qatar is mainly an imported disease. i 2014 S. Karger AG, Basel
Effectiveness of a Tailored Behavioral Intervention to Improve Hypertension Control
Authors: Friedberg Jennifer P. , Rodriguez Maria A. , Watsula Michelle E. , Lin Iris , Wylie-Rosett Judith , Allegrante John P. , Lipsitz Stuart R. , Natarajan Sundar
Published: November 2014

Blood pressure (BP) control rates are suboptimal. We evaluated the effectiveness of 2 behavioral interventions to improve BP control via a 3-arm, randomized controlled trial of 533 adults with repeated uncontrolled BP, despite antihypertensive drug treatment for ≥6 months. The interventions were a tailored stage-matched intervention (SMI) or a nontailored health education intervention (HEI) of 6 monthly calls targeting diet, exercise, and medication. Control was usual care (UC). There were no baseline group differences. Baseline BP control was 42.6%, 40.6%, and 44.6% in SMI, HEI, and UC (
P
=0.74), respectively; systolic BP (with SEs) was 136 (0.89), 137 (1.33), and 137 (0.96) mm Hg. Six-month control was 64.6% (SMI), 54.3% (HEI), and 45.8% (UC) (
P
values for pairwise comparisons versus UC, 0.001 [SMI] and 0.108 [HEI]). At 6 months, systolic BP (SE) was 131.2 (1.05), 131.8 (0.99), and 134.7 (1.02) for SMI, HEI, and UC, respectively (
P
values for pairwise comparisons versus UC, 0.009 for SMI and 0.047 for HEI). SMI led to lower systolic BP and better BP control than UC. SMI constitutes a new, potent approach to assist patients with uncontrolled hypertension to reach BP goals.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00286754.