bluuebunny/crossref_metadata_2025 huggingface dataset:
Energy-Aware Sink Node Localization Algorithm for Wireless Sensor Networks
Authors: Fouad Mohamed Mostafa , Snasel Vaclav , Hassanien Aboul Ella
Published: July 2015

Wireless sensor networks (WSNs) are a family of wireless networks that usually operate with irreplaceable batteries. The energy sources limitation raises the need for designing specific protocols to prolong the operational lifetime of such networks. These protocols are responsible for messages exchanging through the wireless communications medium from the sensors to the base station (sink node). Therefore, the determination of the optimal location of the sink node becomes crucial to assure both the prolongation of the network's operation and the quality of the provided services. This paper proposes a novel algorithm based on a Particle Swarm Optimization (PSO) approach for designing an energy-aware topology control protocol. The deliverable of the algorithm is the optimal sink node location within a deployment area. The proposed objective function is based on a number of topology control protocol's characteristics such as numbers of neighbors per node, the nodes’ residual energy, and how they are far from the center of the deployment area. The simulation results show that the proposed algorithm reveals significant effectiveness to both topology construction and maintenance phases of a topology control protocol in terms of the number of active nodes, the topology construction time, the number of topology reconstructions, and the operational network's lifetime.
Feasibility Studies on Underwater Laser Surface Hardening Process
Authors: Jin Biao , Li Min , Hwang TaeWoo , Moon YoungHoon
Published: July 2015

Laser surface hardening process is a very promising hardening method for ferrous and nonferrous alloys where transformations occur during cooling after laser melting in the solid state. This study experimentally characterizes laser surface hardening of tool steel in both water and air. For the underwater operation, laser surface scanning is performed over the tool steel surface which is immersed in water. The laser surface hardening tests are performed with a maximum 200 W fiber laser with a Gaussian distribution of energy in the beam. For the surface hardening, single-track melting experiment which sequentially scans elongated path of single line has been performed. As the hardened depth depends on the thermal conductivity of the material, the surface temperature and the penetration depth may be varied by underwater laser processing. The feasibility of underwater laser surface hardening process is discussed on the basis of average hardness level and hardened bead shape.
Shear Capacity and Failure Behavior of Steel-Reinforced High Ductile Concrete Beams
Authors: Deng Mingke , Dai Jie , Lu Huasong , Liang Xingwen
Published: July 2015

The shear behavior of six high ductile fiber reinforced concrete (HDC) beams is studied to investigate the influence of shear-span ratio and HDC mechanical property on the improvement of the shear failure mode and shear capacity of short beams. Four steel-reinforced high ductile concrete beams (SHDC) beams with different shear span ratios are tested under concentrated load at midspan. To study the effect of stirrups and steel on the shear capacity of short beams, two additional specimens without steel but one including stirrups are investigated. The main aspects of SHDC beams are discussed in detail, such as failure mode, deformability, and shear capacity. Test results show that the SHDC short beams keep high residual bearing capacity and great integrity when suffering from large deformation. It is revealed that HDC increased the shear ductility and improved the shear failure mode of short beams. A comparison with the shear equations of Chinese YB9082-2006 shows that the Chinese Code equation provides conservative estimation for HDC beams. This study proposes modifications to the equation for predicting the shear capacity of HDC beams.
Association of DNA Repair Gene APE1 Asp148Glu Polymorphism with Breast Cancer Risk
Authors: AlMutairi Fatima , Ali Khan Pathan Akbar , Alanazi Mohammed , Shalaby Manal , Alabdulkarim Huda A. , Alamri Abdullah , Al Naeem Abdulrahman , Elrobh Moammad , Shaik Jilani P. , Khan Wajahatullah , Khan Zahid , Reddy Parine Narasimha
Published: July 2015

Objective. The aim of this study was to investigate the role of APE1 Asp148Glu polymorphism in breast cancer progression in Saudi population.Methods. We examined the genetic variations (rs1130409) in the DNA base excision repair gene APE1 at codon 148 (Asp148Glu) and its association with breast cancer risk using genotypic assays andin silicostructural as well as functional predictions.In silicostructural analysis was performed with Asp148Glu allele and compared with the predicted native protein structure. The wild and mutant 3D structures of APE1 were compared and analyzed using solvent accessibility models for protein stability confirmation.Results. Genotypic analysis of APE1 (rs1130409) showed statistically significant association of Asp148Glu with elevated susceptibility to breast cancer. Thein silicoanalysis results indicated that the nsSNP Asp148Glu may cause changes in the protein structure and is associated with breast cancer risk.Conclusion. Taken together, this is the first report that established that Asp148Glu variant has structural and functional effect on the APE1 and may play an important role in breast cancer progression in Saudi population.
Neural Rhythms of Change: Long-Term Improvement after Successful Treatment in Children with Disruptive Behavior Problems
Authors: Woltering Steven , Liao Victoria , Liu Zhong-Xu , Granic Isabela
Published: July 2015

Neural changes were investigated for children with disruptive behavior problems one year after a treatment program ended. Thirty-nine children and their parents visited the research lab before, after, and a year after treatment ended. During those lab visits, electroencephalography (EEG) was recorded during a challenging Go/No-go task. Treatment consisted of intensive 14-week combined cognitive behavioral therapy and parent management training sessions. For the analysis, participants were divided into long-term improvers (IMPs) and long-term nonimprovers (NIMPs) based on changes in their externalizing problem scores. The results showed early no-go theta power (4–8 Hz, 100–250 ms) decreased for long-term IMPs compared to NIMPs. When participants were divided based on changes in their comorbid internalizing symptoms, effects were stronger and reductions in theta power were found for early as well as later phases (250–650 ms). We provided preliminary evidence that theta power is a useful neural measure to trace behavioral change linked to improved self-regulation even up to a year after treatment ended. Results may have implications for the characterization of children with disruptive behavior problems and may lead to the development of novel markers of treatment success.
Adsorption Removal of Environmental Hormones of Dimethyl Phthalate Using Novel Magnetic Adsorbent
Authors: Chang Chia-Chi , Tseng Jyi-Yeong , Ji Dar-Ren , Chiu Chun-Yu , Lu De-Sheng , Chang Ching-Yuan , Yuan Min-Hao , Chang Chiung-Fen , Chiou Chyow-San , Chen Yi-Hung , Shie Je-Lueng
Published: July 2015

Magnetic polyvinyl alcohol adsorbent M‐PVAL was employed to remove and concentrate dimethyl phthalate DMP. The M‐PVAL was prepared after sequential syntheses of magnetic Fe3O4 (M) and polyvinyl acetate (M‐PVAC). The saturated magnetizations of M, M‐PVAC, and M‐PVAL are 57.2, 26.0, and 43.2 emu g−1 with superparamagnetism, respectively. The average size of M‐PVAL by number is 0.75 μm in micro size. Adsorption experiments include three cases: (1) adjustment of initial pH (pH0) of solution to 5, (2) no adjustment of pH0 with value in 6.04–6.64, and (3) adjusted pH0 = 7. The corresponding saturated amounts of adsorption of unimolecular layer of Langmuir isotherm are 4.01, 5.21, and 4.22 mg g−1, respectively. Values of heterogeneity factor of Freundlich isotherm are 2.59, 2.19, and 2.59 which are greater than 1, revealing the favorable adsorption of DMP/M‐PVAL system. Values of adsorption activation energy per mole of Dubinin‐Radushkevich isotherm are, respectively, of low values of 7.04, 6.48, and 7.19 kJ mol−1, indicating the natural occurring of the adsorption process studied. The tiny size of adsorbent makes the adsorption take place easily while its superparamagnetism is beneficial for the separation and recovery of micro adsorbent from liquid by applying magnetic field after completion of adsorption.
Longer-Term Postcure Measurement of Cuspal Deformation Induced by Dimensional Changes in Dental Materials
Authors: Falsafi A. , Oxman J. D. , Tse P.-H. , Ton T. T.
Published: July 2015

Aim. This paper presents a simple, versatile in vitro methodology that enables indirect quantification of shrinkage and expansion stresses under clinically relevant conditions without the need for a dedicated instrument.Methods. For shrinkage effects, resulting cusp deformation of aluminum blocks with MOD type cavity, filled with novel filling compositions and commercial cements, has been measured using a bench-top micrometer and a Linear Variable Differential Transformer (LVDT, a displacement transducer) based instrument.Results. The results demonstrated the validity of the proposed simple methodology. The technique was successfully used in longer-term measurements of shrinkage and expansion stress for several dental compositions.Conclusions. In contrast to in situ techniques where a measuring instrument is dedicated to the sample and its data collection, the proposed simple methodology allows for transfer of the samples to the environment of choice for storage and conditioning. The presented technique can be reliably used to quantify stress development of curing materials under clinically relevant (oral) conditions. This enables direct examination and comparison of structural properties corresponding to the final stage of formed networks. The proposed methodology is directly applicable to the study of self-curing systems as they require mouth-type conditions (temperature and humidity) to achieve their designed kinetics and reactions.
Characteristics of Three-Dimensional Power Doppler in Gestational Trophoblastic Disease
Authors: Wang Wei , Tian Xueye , Zhang Ting , Wang Yanyan , Han Zhen , An Ruifang
Published: July 2015

Purpose. In the present study, the three-dimensional power Doppler was used as a quantitative method to evaluate its reliability in detecting and assessing of gestational trophoblastic disease (GTD).Methods. 52 GTD patients who received diagnosis and treatment at the first affiliated hospitals of Xi’an Jiaotong University in China between 2011 and 2013 were evaluated using Voluson E8 (GE Medical System). Demographic information, pathological characteristics, clinical history, sonographic images, and related indices (resistance index, vascularization index, and flow and vascularization index) were evaluated.Result. Three-dimension power Doppler indicated that there were significant differences in the resistance index, vascularization index, flow index, and vascularization-flow index between the healthy individuals and each subgroup of patients (P<0.01). Further, in combining invasive hydatidiform mole and choriocarcinoma groups, there was a significant difference between hydatidiform mole and the combined malignant group (P<0.01). And the abnormal sonographic and power Doppler findings in GTD were resolved when chemotherapy was done successfully.Conclusion. Combined with the clinical features, sonography and three-dimension power Doppler imaging were helpful in diagnosing GTD as a noninvasive method, distinguishing the invasive nature of disease, detecting the recurrence of the disease, and assessing the effectiveness of the chemotherapy.
Fishery Landing Forecasting Using Wavelet-Based Autoregressive Integrated Moving Average Models
Authors: Shabri Ani , Samsudin Ruhaidah
Published: July 2015

The accuracy of the wavelet-ARIMA (WA) model in monthly fishery landing forecasting is investigated in the study. In the first part of the study, the discrete wallet transform (DWT) is used to decompose fishery landing time series data. Then ARIMA, as a powerful forecasting tool, is implemented to predict each wavelet transform subseries components independently. Finally, the prediction results of the modeled subseries components are summed to formulate an ensemble forecast for the original fishery landing series. To assess the effectiveness of this model, monthly fishery landing recorded data from East Johor and Pahang states of Peninsular Malaysia have been used as a case study. The result of the study shows that the proposed model was found to provide more accurate fishery landing series forecasts than the individual ARIMA model.
Maintaining Tumor Heterogeneity in Patient-Derived Tumor Xenografts
Authors: Cassidy John W. , Caldas Carlos , Bruna Alejandra
Published: July 2015

Preclinical models often fail to capture the diverse heterogeneity of human malignancies and as such lack clinical predictive power. Patient-derived tumor xenografts (PDX) have emerged as a powerful technology: capable of retaining the molecular heterogeneity of their originating sample. However, heterogeneity within a tumor is governed by both cell-autonomous (e.g., genetic and epigenetic heterogeneity) and non–cell-autonomous (e.g., stromal heterogeneity) drivers. Although PDXs can largely recapitulate the polygenomic architecture of human tumors, they do not fully account for heterogeneity in the tumor microenvironment. Hence, these models have substantial utility in basic and translational research in cancer biology; however, study of stromal or immune drivers of malignant progression may be limited. Similarly, PDX models offer the ability to conduct patient-specific in vivo and ex vivo drug screens, but stromal contributions to treatment responses may be under-represented. This review discusses the sources and consequences of intratumor heterogeneity and how these are recapitulated in the PDX model. Limitations of the current generation of PDXs are discussed and strategies to improve several aspects of the model with respect to preserving heterogeneity are proposed. Cancer Res; 75(15); 2963–68. ©2015 AACR.
Plasminogen Activator Inhibitor-1 in Cancer: Rationale and Insight for Future Therapeutic Testing
Authors: Placencio Veronica R. , DeClerck Yves A.
Published: July 2015

Despite its function as an inhibitor of urokinase and tissue-type plasminogen activator (PA), PA inhibitor-1 (PAI-1) has a paradoxical protumorigenic role in cancer, promoting angiogenesis and tumor cell survival. In this review, we summarize preclinical evidence in support of the protumorigenic function of PAI-1 that has led to the testing of small-molecule PAI-1 inhibitors, initially developed as antithrombotic agents, in animal models of cancer. The review discusses the challenges and the opportunities that lay ahead to the development of efficacious and nontoxic PAI-1 inhibitors as anticancer agents. Cancer Res; 75(15); 2969–74. ©2015 AACR.
HOXB7 Is an ERα Cofactor in the Activation of HER2 and Multiple ER Target Genes Leading to Endocrine Resistance
Authors: Jin Kideok , Park Sunju , Teo Wei Wen , Korangath Preethi , Cho Sean Soonweng , Yoshida Takahiro , Győrffy Balázs , Goswami Chirayu Pankaj , Nakshatri Harikrishna , Cruz Leigh-Ann , Zhou Weiqiang , Ji Hongkai , Su Ying , Ekram Muhammad , Wu Zhengsheng , Zhu Tao , Polyak Kornelia , Sukumar Saraswati
Published: July 2015

Why breast cancers become resistant to tamoxifen despite continued expression of the estrogen receptor-α (ERα) and what factors are responsible for high HER2 expression in these tumors remains an enigma. HOXB7 chromatin immunoprecipitation analysis followed by validation showed that HOXB7 physically interacts with ERα, and that the HOXB7–ERα complex enhances transcription of many ERα target genes, including HER2. Investigating strategies for controlling HOXB7, our studies revealed that MYC, stabilized via phosphorylation mediated by EGFR–HER2 signaling, inhibits transcription of miR-196a, a HOXB7 repressor. This leads to increased expression of HOXB7, ER target genes, and HER2. Repressing MYC using small-molecule inhibitors reverses these events and causes regression of breast cancer xenografts. The MYC–HOXB7–HER2 signaling pathway is eminently targetable in endocrine-resistant breast cancer.

Significance: HOXB7 acts as an ERα cofactor regulating a myriad of ER target genes, including HER2, in tamoxifen-resistant breast cancer. HOXB7 expression is controlled by MYC via transcriptional regulation of the HOXB7 repressor miR-196a; consequently, antagonists of MYC cause reversal of selective ER modulator resistance both in vitro and in vivo. Cancer Discov; 5(9); 944–59. ©2015 AACR.

See related commentary by Heideman et al., p. 909.

This article is highlighted in the In This Issue feature, p. 893
Prosodic Realization of Focus in Bilingual Production of Southern Min and Mandarin
Authors: Chen Ying , Xu Yi , Guion-Anderson Susan
Published: July 2015

Previously post-focus compression (PFC) - the lowering of fundamental frequency (F0) and intensity of post-focal words to below those of the same words in identical sentences with neutral focus - was found in Beijing Mandarin but not in Taiwan Southern Min and Taiwan Mandarin. This study investigated whether the presence of PFC would vary with age and language use of societal bilinguals of Southern Min and Mandarin. Three groups of bilingual speakers of Quanzhou Southern Min and Mandarin, age around 20, 40 and 60, were examined for their prosodic realization of focus. All the speakers acquired Southern Min first, followed by Mandarin in childhood, but the younger speakers used more Mandarin than the older speakers. Comparisons of duration, intensity and F0 in focused, prefocus and post-focus words indicated that all groups produced Taiwan-like focus, i.e., without PFC, in Southern Min, but the youngest group produced Beijing-like PFC in Mandarin. These findings reveal that increased language experience, such as greater amount of second language (L2) use, correlates with increased ability to produce native-like PFC in L2, suggesting that PFC can be used as an indicator in assessing L2 speech acquisition.
Fundamental Frequency Range in Japanese and English: The Case of Simultaneous Bilinguals
Authors: Graham Calbert
Published: July 2015

This article reports an experiment to test whether Japanese and English speakers vary their fundamental frequency (f0) range as a function of the language spoken. Speech samples of Japanese-(American) English simultaneous bilinguals (5 males, 5 females; all undergraduates at UC Berkeley) performing comparable reading tasks in their two native languages were analysed. The study builds on a relatively new approach to measuring f0 range that computes its high and low points from tonal targets in the intonational phonology. Unlike in most previous studies where f0 range is traditionally treated as a one-dimensional measure, f0 range in this study is measured along two quasi-independent dimensions: level and span. Findings revealed statistically significant crosslanguage differences between Japanese and English in both dimensions. This provides new insights into the relation between prosodic structure and f0 range in these two typologically different prosodic systems.
The Effect of cAMP-PKA Activation on TGF-β1-Induced Profibrotic Signaling
Authors: Weng Lin , Wang Weiling , Su Xiaohong , Huang Yong , Su Limin , Liu Ming , Sun Yi , Yang Baoxue , Zhou Hong
Published: July 2015

Background: The cAMP-PKA signaling pathway and TGF-β1-dependent fibrosis pathways are of particular importance in ADPKD progression, but the cross-talk between these pathways remains unclear. Therefore, we used an MDCK-cell model and embryonic kidney-cyst model to study the regulatory role of cAMP-PKA signaling in the TGF-β1 induced fibrotic process. Method and Results: Pkd1flox/flox; Ksp-Cre and Pkd1+/+; Ksp-Cre mice were used as an in vivo model. Increased kidney volume, renal cysts formation and up-regulation of the fibrosis-related proteins TGF-β1, connective tissue growth factor (CTGF), and fibronectin (FN) can be observed in Pkd1flox/flox; Ksp-Cre mice. In an embryonic kidneys-cyst model, TGF-β1, FN and collagen type I were highly expressed. Western blotting revealed the obviously up-regulation of TGF-β1, CTGF, FN and collagen type I expression following forskolin treatment in MDCK cells. Selective PKA inhibition with H89 may partially reversed the above effects. Pretreatment with the TGF-β RI kinase inhibitor VI SB431542 suppressed the increased expression of CTGF, FN and collagen type I caused by forskolin. Our data also indicate that forskolin inhibited TGF-β-induced ERK1/2 phosphorylation and FN up-regulation. ERK inhibition useing PD98059 significantly inhibited the expression of CTGF, FN and collagen type I caused by TGF-β1. Conclusions: The cAMP-PKA signaling pathway can directly promote the production of TGF-β1 and/or TGF-β1-dependent fibrogenetic molecules in MDCK cells and embryonic kidney cysts, but when TGF-β1 and its downstream pathways were highly expressed in MDCK cells, cAMP-PKA had a significantly negative effect on TGF-β1 induced p-ERK1/2 and FN expression.
Ultra Low Dose Delta 9-Tetrahydrocannabinol Protects Mouse Liver from Ischemia Reperfusion Injury
Authors: Hochhauser Edith , Lahat Eylon , Sultan Maya , Pappo Orit , Waldman Maayan , Sarne Yosef , Shainberg Asher , Gutman Mordechai , Safran Michal , Ari Ziv Ben
Published: July 2015

Background/Aims: Ischemia/reperfusion (I/R) injury is the main cause of both primary graft dysfunction and primary non-function of liver allografts. Cannabinoids has been reported to attenuate myocardial, cerebral and hepatic I/R oxidative injury. Delta-9-tetrahydrocannabinol (THC), a cannabinoid agonist, is the active components of marijuana. In this study we examined the role of ultralow dose THC (0.002mg/kg) in the protection of livers from I/R injury. This extremely low dose of THC was previously found by us to protect the mice brain and heart from a variety of insults. Methods: C57Bl Mice were studied in in vivo model of hepatic segmental (70%) ischemia for 60min followed by reperfusion for 6 hours. Results: THC administration 2h prior to the induction of hepatic I/R was associated with significant attenuated elevations of: serum liver transaminases ALT and AST, the hepatic oxidative stress (activation of the intracellular signaling CREB pathway), the acute proinflammatory response (TNF-α, IL-1α, IL-10 and c-FOS hepatic mRNA levels, and ERK signaling pathway activation). This was followed by cell death (the cleavage of the pro-apoptotic caspase 3, DNA fragmentation and TUNEL) after 6 hours of reperfusion. Significantly less hepatic injury was detected in the THC treated I/R mice and fewer apoptotic hepatocytes cells were identified by morphological criteria compared with untreated mice. Conclusion: A single ultralow dose THC can reduce the apoptotic, oxidative and inflammatory injury induced by hepatic I/R injury. THC may serve as a potential target for therapeutic intervention in hepatic I/R injury during liver transplantation, liver resection and trauma.
Inhibition of Notch Signaling Promotes the Adipogenic Differentiation of Mesenchymal Stem Cells Through Autophagy Activation and PTEN-PI3K/AKT/mTOR Pathway
Authors: Song Bao-quan , Chi Ying , Li Xue , Du Wen-jing , Han Zhi-Bo , Tian Jian-jian , Li Juan-juan , Chen Fang , Wu He-he , Han Li-xin , Lu Shi-hong , Zheng Yi-zhou , Han Zhong-chao
Published: July 2015

Background: The Notch signaling pathway is implicated in a broad range of developmental processes, including cell fate decisions. This study was designed to determine the role of Notch signaling in adipogenic differentiation of human bone marrow derived MSCs (BM-MSCs). Methods: The Notch signaling was inhibited by the γ-secretase inhibitor N-[N-(3,5-difluor- ophenacetyl-L-alanyl)]-S-phenylglycine t-butylester (DAPT). The markers involving adipogenic differentiation of MSCs, the relative pathway PTEN-PI3K/Akt/mTOR and autophagy activation were then analyzed. Furthermore, the autophagy inhibitor chloroquine (CQ) and 3-methyladenine (3-MA) were used to study the role of autophagy in the DAPT-induced the adipogenic differentiation of MSCs. Results: We first confirmed the down -regulation of Notch gene expression during MSCs adipocyte differentiation, and showed that the inhibition of Notch signaling significantly enhanced adipogenic differentiation of MSCs. Furthermore, Notch inhibitor DAPT induced early autophagy by acting on PTEN-PI3K/Akt/mTOR pathway. The autophagy inhibitor CQ and 3-MA dramatically abolished the effects of DAPT-induced autophagy and adipogenic differentiation of MSCs. Conclusion: Our results indicate that inhibition of Notch signaling could promote MSCs adipogenesis mediated by autophagy involving PTEN-PI3K/Akt/mTOR pathway. Notch signaling could be a novel target for regulating the adipogenic differentiation of MSCs.
Thrombopoietin Protects Cardiomyocytes from Iron-Overload Induced Oxidative Stress and Mitochondrial Injury
Authors: Chan Shing , Chan Godfrey Chifung , Ye Jieyu , Lian Qizhou , Chen Jianliang , Yang Mo
Published: July 2015

Background/Aims: Thalassaemia accompanied with iron-overload is common in Hong Kong. Iron-overload induced cardiomyopathy is the commonest cause of morbidity and mortality in patients with β-thalassaemia. Chronic iron-overload due to blood transfusion can cause cardiac failure. Decreased antioxidant defence and increased ROS production may lead to oxidative stress and cell injury. Iron-overload may lead to heart tissue damage through lipid peroxidation in response to oxidative stress, and a great diversity of toxic aldehydes are formed when lipid hydroperoxides break down in heart and plasma. Methods: Iron entry into embryonic heart H9C2 cells was determined by calcein assay using a fluorometer. Reactive oxygen species (ROS) production in cells treated with FeCl3 or thrombopoietin (TPO) was monitored by using the fluorescent probe H2DCFDA. Changes in mitochondrial membrane potential of H9C2 cells were quantified by using flow cytometry. Results: We demonstrated that iron induced oxidative stress and apoptosis in cardiomyocytes, and that iron increased ROS production and reduced cell viability in a dose-dependent manner. Iron treatment increased the proportion of cells with JC-1 monomers, indicating a trend of drop in the mitochondrial membrane potential. TPO exerted a cardio-protective effect on iron-induced apoptosis. Conclusions: These findings suggest that iron-overload leads to the generation of ROS and further induces apoptosis in cardiomyocytes via mitochondrial pathways. TPO might exert a protective effect on iron-overload induced apoptosis via inhibiting oxidative stress and suppressing the mitochondrial pathways in cardiomyocytes.
Does the Compliance to Intravesical BCG Differ between Common Clinical Practice and International Multicentric Trials?
Authors: Serretta Vincenzo , Scalici Gesolfo Cristina , Alonge Vincenza , Cicero Giuseppe , Moschini Marco , Colombo Renzo
Published: July 2015

Introduction: The aim of this study was to analyze the reasons for intravesical BCG interruption in clinical practice. BCG for at least one year is advocated as the best regimen to treat high-risk non-muscle invasive bladder cancer (NMIBC). However, almost 50% of patients don't complete it. Toxicity accounts for 10% of dropouts in international trials. Materials and Methods: Patients with T1HG NMIBC undergoing 1-year BCG were enrolled in this study. BCG was administered for one year. Toxicity and causes of treatment interruption were recorded. Results: A total of 411 patients were enrolled in the study. Out of these total number of patients, 380 (92.5%) completed the induction cycle and 215 (52.3%) completed one year. Toxicity requiring interruption or postponement was recorded in 25 (6.1%) and 60 (14.6%) patients. Ninety-three patients (30.2%) stopped BCG, 9 (9.7%) for recurrence and 14 (15.1%) for grade-3 toxicity. Intriguingly, 55 (59.1%) patients refused BCG due to mild discomfort and deterioration in quality of social life. Conclusions: Grades 2-3 toxicity causes BCG interruption in a few cases. Almost 60% of interruptions are attributable to persistent grade-1 toxicity, which is inadequately treated.
Emergency Cerclage: Improvement of Outcomes by Standardization of Management
Authors: Rius Mariona , Cobo Teresa , García-Posadas Raúl , Hernández Sandra , Teixidó Irene , Barrau Enrique , Abad Carmen , Palacio Montse
Published: July 2015

Introduction: Cervical dilatation followed by prolapse and ballooning of membranes into the vagina at mid-gestation is a critical situation. The aim of this study was to describe the outcome of emergency cerclage in a tertiary referral center during a 10-year period (2001-2010) in which a defined selection of women and standard protocol were introduced. Subjects and Methods: Thirty-nine cases of emergency cervical cerclage performed before 24 completed weeks were retrospectively reviewed. Data related to maternal history, diagnosis, procedure details, postoperative management and perinatal outcome were recorded. Maternal characteristics and perinatal outcomes are described. Results: Gestational age at cerclage (mean ± SD) was 22.1 ± 2.0 weeks with 61% (24/39) of women presenting bulging membranes. Gestational age at delivery and cerclage-to-delivery time (mean ± SD) were 28.6 ± 6.2 weeks and 49.1 ± 36.5 days, respectively. Only 38.5% (15/39) of the whole group and 44.1% (15/34) of those who reached 24.0 weeks delivered beyond 28 weeks of gestational age. Neonatal survival before discharge was 82.4% (28/34). Discussion: Perinatal outcomes after emergency cerclage are still poor with more than half of the cases delivering before 28 weeks. A standard protocol may help in the management of these rare cases.
Carriers of Autosomal Recessive Alport Syndrome with Thin Basement Membrane Nephropathy Presenting as Focal Segmental Glomerulosclerosis in Later Life
Authors: Deltas Constantinos , Savva Isavella , Voskarides Konstantinos , Papazachariou Louiza , Pierides Alkis
Published: July 2015

Collagen IV nephropathies (COL4Ns) comprise benign familial microscopic hematuria, thin basement membrane nephropathy (TBMN), X-linked Alport syndrome (AS) and also autosomal recessive and dominant AS. Apart from the X-linked form of AS, which is caused by hemizygous mutations in the COL4A5 gene, the other entities are caused by mutations in the COL4A3 or COL4A4 genes. The diagnosis of these conditions used to be based on clinical and/or histological findings of renal biopsies, but it is the new molecular genetics approach that revolutionised their investigation and proved particularly instrumental, especially, in many not so clear-cut cases. More recently, the spectrum of COL4N has expanded to include late onset focal segmental glomerulosclerosis (FSGS) that develops on top of TBMN in later life. Also, other reports showed that some patients with a primary diagnosis of familial FSGS proved to have variants in COL4 genes. In the presence of a renal biopsy picture of FSGS and in the absence of either electron microscopy studies or molecular genetic studies that point to TBMN and COL4N, the patient and his family may be mistakenly diagnosed with hereditary FSGS leading to unnecessary further investigations, erroneous family counselling and improper corticosteroid treatment. TBMN is a frequent finding in the general population, and according to several recent reports, it may be the underlying cause and the explanation for many familial and sporadic cases of late-onset FSGS with non-nephrotic proteinuria. This is an important new finding that needs widespread recognition. It is anticipated that the molecular genetic analysis with next generation sequencing will certainly offer timely correct diagnosis.
Inducing Persistent Flow Disturbances Accelerates Atherogenesis and Promotes Thin Cap Fibroatheroma Development in
D374Y
-PCSK9 Hypercholesterolemic Minipigs
Authors: Pedrigi Ryan M. , Poulsen Christian Bo , Mehta Vikram V. , Ramsing Holm Niels , Pareek Nilesh , Post Anouk L. , Kilic Ismail Dogu , Banya Winston A.S. , Dall’Ara Gianni , Mattesini Alessio , Bjørklund Martin M. , Andersen Niels P. , Grøndal Anna K. , Petretto Enrico , Foin Nicolas , Davies Justin E. , Di Mario Carlo , Fog Bentzon Jacob , Erik Bøtker Hans , Falk Erling , Krams Rob , de Silva Ranil
Published: July 2015

Background—

Although disturbed flow is thought to play a central role in the development of advanced coronary atherosclerotic plaques, no causal relationship has been established. We evaluated whether inducing disturbed flow would cause the development of advanced coronary plaques, including thin cap fibroatheroma.

Methods and Results—

D374Y
-PCSK9 hypercholesterolemic minipigs (n=5) were instrumented with an intracoronary shear-modifying stent (SMS). Frequency-domain optical coherence tomography was obtained at baseline, immediately poststent, 19 weeks, and 34 weeks, and used to compute shear stress metrics of disturbed flow. At 34 weeks, plaque type was assessed within serially collected histological sections and coregistered to the distribution of each shear metric. The SMS caused a flow-limiting stenosis, and blood flow exiting the SMS caused regions of increased shear stress on the outer curvature and large regions of low and multidirectional shear stress on the inner curvature of the vessel. As a result, plaque burden was ≈3-fold higher downstream of the SMS than both upstream of the SMS and in the control artery (
P
<0.001). Advanced plaques were also primarily observed downstream of the SMS, in locations initially exposed to both low (
P
<0.002) and multidirectional (
P
<0.002) shear stress. Thin cap fibroatheroma regions demonstrated significantly lower shear stress that persisted over the duration of the study in comparison with other plaque types (
P
<0.005).

Conclusions—

These data support a causal role for lowered and multidirectional shear stress in the initiation of advanced coronary atherosclerotic plaques. Persistently lowered shear stress appears to be the principal flow disturbance needed for the formation of thin cap fibroatheroma.
Impact of Fine Particulate Matter (PM
2.5
) Exposure During Wildfires on Cardiovascular Health Outcomes
Authors: Haikerwal Anjali , Akram Muhammad , Del Monaco Anthony , Smith Karen , Sim Malcolm R. , Meyer Mick , Tonkin Andrew M. , Abramson Michael J. , Dennekamp Martine
Published: July 2015

Background

Epidemiological studies investigating the role of fine particulate matter (
PM
2.5
; aerodynamic diameter <2.5 μm) in triggering acute coronary events, including out‐of‐hospital cardiac arrests and ischemic heart disease (
IHD
), during wildfires have been inconclusive.

Methods and Results

We examined the associations of out‐of‐hospital cardiac arrests,
IHD
, acute myocardial infarction, and angina (hospital admissions and emergency department attendance) with
PM
2.5
concentrations during the 2006–2007 wildfires in Victoria, Australia, using a time‐stratified case‐crossover study design. Health data were obtained from comprehensive health‐based administrative registries for the study period (December 2006 to January 2007). Modeled and validated air exposure data from wildfire smoke emissions (daily average
PM
2.5
, temperature, relative humidity) were also estimated for this period. There were 457 out‐of‐hospital cardiac arrests, 2106 emergency department visits, and 3274 hospital admissions for
IHD
. After adjusting for temperature and relative humidity, an increase in interquartile range of 9.04 μg/m
3
in
PM
2.5
over 2 days moving average (lag 0‐1) was associated with a 6.98% (95% CI 1.03% to 13.29%) increase in risk of out‐of‐hospital cardiac arrests, with strong association shown by men (9.05%,95%CI 1.63% to 17.02%) and by older adults (aged ≥65 years) (7.25%, 95%
CI
0.24% to 14.75%). Increase in risk was (2.07%, 95%
CI
0.09% to 4.09%) for
IHD
‐related emergency department attendance and (1.86%, 95%
CI
: 0.35% to 3.4%) for
IHD
‐related hospital admissions at lag 2 days, with strong associations shown by women (3.21%, 95%
CI
0.81% to 5.67%) and by older adults (2.41%, 95%
CI
0.82% to 5.67%).

Conclusion

PM
2.5
exposure was associated with increased risk of out‐of‐hospital cardiac arrests and
IHD
during the 2006–2007 wildfires in Victoria. This evidence indicates that
PM
2.5
may act as a triggering factor for acute coronary events during wildfire episodes.
Clusia heterocolorata (Clusiaceae), a new species from the Brazilian Atlantic Forest
Authors: Marinho Lucas Cardoso , Amorim André M. , Bittrich Volker
Published: July 2015

Clusia heterocolorata is described, illustrated, its diagnostic characteristics, morphological affinities, and conservation status are discussed, and a geographical distribution map is presented. This new species belongs to the section Phloianthera, characterized by a dome-shaped androecium with numerous resiniferous stamens and staminodes.
Idealized Numerical Experiments on Cyclone Development in the Tropical, Subtropical, and Extratropical Environments
Authors: Yanase Wataru , Niino Hiroshi
Published: July 2015

The development of cyclones, particularly in the Southern Hemisphere summer, is active in the tropics and extratropics but is inactive in the subtropics. To elucidate the influence of environmental fields on the cyclone development in the tropics, subtropics, and extratropics, idealized numerical experiments are conducted using a nonhydrostatic channel model. The experiments examine the development of a weak initial vortex within a zonally uniform environmental field that consists of five factors: the Coriolis parameter, zonal wind, potential temperature, relative humidity, and surface temperature difference between the ocean and atmosphere. The idealized experiments successfully reproduce the significant cyclone development in the tropical and extratropical environment as well as no cyclone development in the subtropical environment. This result confirms the dominant role of the environmental field in controlling the cyclone development. To clarify which environmental factor is responsible for the suppression of cyclone development in the subtropics, a series of sensitivity experiments is performed. A tropical cyclone cannot develop in the subtropics because of low temperature, strong stratification, and strong vertical shear compared to the tropics. On the other hand, an extratropical cyclone cannot develop in the subtropics because of the small Coriolis parameter and weak vertical shear compared to the extratropics. The relative humidity and surface temperature difference play only secondary roles. These results provide useful insights into the climatological distribution of various types of synoptic-scale cyclones.
Austral Spring Southern Hemisphere Circulation and Temperature Changes and Links to the SPCZ
Authors: Clem Kyle R. , Renwick James A.
Published: July 2015

Significant austral spring trends have previously been observed in West Antarctica and Antarctic Peninsula temperatures and in atmospheric circulation across the southern Pacific and Atlantic. Here, physical mechanisms for the observed trends are investigated through analysis of monthly circulation and temperatures from the ERA-Interim dataset and outgoing longwave radiation (OLR) data. The negative pressure trend over the South Pacific during spring is strongest in September, while the positive pressure trend over the South Atlantic is strongest in October. Pressure trends in November are generally nonsignificant. The authors demonstrate that a significant September trend toward increased convection (reduced OLR) in the poleward portion of the South Pacific convergence zone (SPCZ) is statistically related to Rossby wave–like circulation changes across the southern oceans. The wave response is strongest over the South Pacific in September and propagates eastward to the South Atlantic in October. OLR-related changes are linearly congruent with around half of the observed total changes in circulation during September and October and are consistent with observed trends in South Pacific sea ice concentration and surface temperature over western West Antarctica and the western Antarctic Peninsula. These results suggest SPCZ variability in early spring, especially on the poleward side of the SPCZ, is an important contributor to circulation and surface temperature trends across the South Pacific/Atlantic and West Antarctica.
Changes in Reflective Functioning during Psychoanalytic Psychotherapies
Authors: Hörz-Sagstetter Susanne , Mertens Wolfgang , Isphording Sybille , Buchheim Anna , Taubner Svenja
Published: July 2015

This study examines how reflective functioning (RF) can be assessed in analytic sessions and throughout psychoanalytic psychotherapy. The goals are to replicate in part a study by Josephs and colleagues (2004) by applying the RF Scale to analytic sessions and to study fluctuations of RF within each session. Additionally, RF based on sessions was compared with the RF ratings based on the Adult Attachment Interview (AAI) during the course of two psychoanalytic psychotherapies with a duration of 240 hours. RF changes based on 10 sessions per patient, assessed at baseline and after 80, 160, and 240 hours of therapy, and RF changes based on AAI ratings measured at baseline and after 240 hours of therapy, and in one case at follow-up, were related to changes of symptoms and attachment classifications over time. Results showed that in both cases RF fluctuated within sessions. The average RF rating per session increased over the course of treatment, while the AAI-based RF rating needed longer to increase. Rather good correspondence was found between session-based RF ratings and independent AAI-based RF ratings. In both cases, changes in RF over time were compared to changes in attachment classification based on the AAI and to symptomatic change. Better correspondence between symptomatic and attachment changes was found with the AAI-based RF rating. It was tentatively interpreted that session-based RF ratings may represent a state of RF that is strongly influenced by the therapist-patient interaction, whereas AAI-based RF can be considered to have more trait characteristics.
Institutional, Financial, Legal, and Cultural Factors in a Distance Learning Program
Authors: Blakeman Rachel , Haseley Dennis
Published: July 2015

As psychoanalytic institutes evolve, adapting to the contemporary financial and social environment, the integration of new technologies into psychoanalytic education presents opportunities for expansion to candidates residing beyond the usual geographic boundaries. While the teaching of analytic content through distance learning programs appears to be relatively straightforward, factors including legalities, traditional mind-sets, and cross-cultural issues need to be considered as complicating the situation, as illustrated by one U.S. institute’s distance learning initiative with a group in South Korea.
Medial and Superior Orbital Decompression
Authors: Poczos Pavel , Kurbanov Almaz , Keller Jeffrey T. , Zimmer Lee A.
Published: July 2015

Objective:

Visualization by Draf I-III endoscopic access to the frontal sinus via drainage pathways is sometimes inadequate. We compare lateral frontal sinus exposures by Draf approaches versus our modification of removing the medial-superior wall of the orbit while preserving the periorbita.

Methods:

Twenty cadaveric heads dissected using Draf IIB, III, and modified Draf III with medial and superior orbital decompression (MSOD) underwent thin-cut computed tomography (CT) scanning. Under image guidance, measurements extended from the midline crista gali to the most lateral point of the frontal sinus. A case report shows the modified Draf III improved frontal sinus access.

Results:

Comparing Draf IIB and III with Draf III with MSOD, respectively, distances between midline and most lateral point averaged 19.1 mm, 23.7 mm, and 30.4 mm (left) and 18.7 mm, 25.1 mm, and 32.2 mm (right). Differences between Draf III with/without MSOD were 6.65 mm (left) and 7.09 mm (right); 12 heads were excluded because of under-pneumatization of the sinuses.

Conclusions:

Draf III with MSOD extended surgical access to lateral regions of the frontal sinus. This extension achieved better visualization and instrumentation with minimal removal of the frontal bone’s orbital segment anterior and superior to the anterior ethmoidal artery while preserving the periorbita.
Inpatient Complications After Transsphenoidal Surgery in Cushing’s Versus Non-Cushing’s Disease Patients
Authors: Svider Peter F. , Raikundalia Milap D. , Pines Morgan J. , Baredes Soly , Folbe Adam J. , Liu James K. , Eloy Jean Anderson
Published: July 2015

Objective:

Transsphenoidal surgery (TSS) harbors a potential for hypopituitarism, cerebrospinal fluid (CSF) leaks, and other complications. We utilized the Nationwide Inpatient Sample Database (NIS) to compare inpatient complication rates between Cushing’s disease (CD) and non-Cushing’s disease (NCD) patients undergoing TSS.

Methods:

Inpatient hospitalization data for 960 CD and 12 110 NCD patients who underwent TSS between 2002 and 2010 were accessed. Demographic information, outcomes, and complication rates were evaluated.

Results:

Patients with CD had a female predilection (81.7%) and were younger (40.5 ± 14.4 years) than NCD patients (47.8% female; 52.1 ± 16.3 years) ( P < .001). Length of stay and total charges did not differ between groups. Patients with CD had significantly greater postoperative diabetes insipidus rates (14.0% vs 9.6%, P < .001) and urinary/renal complications (1.7% vs 0.9%, P = .027). After adjusting for possible confounders, the relationship between urinary/renal complications and CD status strengthened. There was no difference in rates of CSF leak and iatrogenic pituitary disorders overall.

Conclusion:

No differences were noted in the rate of early CSF leaks between postoperative TSS CD and NCD patients. Postoperative diabetes insipidus did not significantly differ between groups after adjusting for confounders. Only odds of urinary/renal complications in CD patients was significant after adjustment.
Presidential Risk Orientation and Force Employment Decisions
Authors: Macdonald Julia , Schneider Jacquelyn
Published: July 2015

In this article, we explore how presidential risk orientations affect force employment decisions through an analysis of the use of unmanned weaponry during the Bush and Obama administrations. We hypothesize that the conception of risk plays an integral part in this choice of weaponry. In order to examine our hypothesis, we utilize the verbs-in-context system of operational code analysis to quantify the risk propensities of President Bush and President Obama during the Afghanistan War from 2001 to 2013. At the aggregate level, we find that the two presidents exhibit unique interpretations of risk with respect to manned versus unmanned weaponry. We further disaggregate our data to examine whether these preferences are fixed or fluctuate with situational changes. We find that President Bush’s risk calculations are influenced by a number of situational variables, highlighting the importance of changing decision contexts in explaining risk behaviors. President Obama’s risk calculations, on the other hand, remain constant over time lending credence to the importance of overall risk propensity in determining risk-taking behaviors. Our findings indicate that risk is an important variable in explaining the means of force employed during conflict, and that the source of this behavior can vary by leader.