bluuebunny/crossref_metadata_2025 huggingface dataset:
Hypertension Treatment in Patients with Metabolic Syndrome and/or Type 2 Diabetes Mellitus: Analysis of the Therapy Effectivity and the Therapeutic Inertia in Outpatient Study
Authors: Farský Štefan , Strišková Andrea , Borčin Marián
Published: April 2018

We have analysed the database of 1,595 consecutive patients visiting our department of cardiology and internal medicine clinic in 2005–2014. The analysis included 13,990 visit records, and the average number of visits per patient was 8.5 ± 7.0. Our goals were to evaluate the effectivity of hypertension treatment as for drug choice, decrease of sBP and dBP associated with a certain drug, a drug combination, and therapeutic inertia in patients with metabolic syndrome and/or diabetes mellitus. The final number of patients for analysis who fulfilled the inclusion criteria for interpenetration of both diagnostic circles was 570. Results. 15% of patients were treated using hypertension monotherapy, 70% of patients were treated using 2- to 4-drug combination therapy, and 15% of patients were treated using 5- to 6-drug combination. The drugs used most frequently were perindopril (perin), nitrendipine (nitre), amlodipine (amlo), telmisartan (telmi), hydrochlorothiazide (hydro), rilmenidine, and nebivolol (used in >100 patients). The most significant decrease of sBP was associated with treatment by nitre, hydro, telmi, and urapidil (>19 mmHg). The most significant decrease of dBP was associated with treatment by nitre, hydro, telmi, and verapamil (>10 mmHg). The most significant decrease of both sBP and dBP was associated with treatment using 3-drug combination of telmi + hydro + spironolactone (41 and 16 mmHg, resp.), telmi + hydro + nitre (34 and 15 mmHg, resp.), and telmi + hydro + urapidil (34 and 15 mmHg, resp.). At the last visit, 281 out of 413 patients at the first visit had sBP >140 mmHg (68%); that is, sBP control was 32%. At the last visit, 76 patients out of 217 at the first visit had dBP >90 mmHg (35%); that is, dBP control was 65%. Therapeutic inertia was calculated by evaluating the proportion of visits at which sBP was above the target for eligible visits minus the proportion of visits where the change was made in antihypertensive treatment (AHT), either medication type or dose, over the number of eligible visits, with the resultant value multiplied by the mean of the difference between the actual sBP and the target value at clinic visits. TIQ was counted at first 200 consecutive patients, and the average value was 57.30 ± 147.20. Conclusion. The study presents the real-life data concerning the difficulties in hypertension treatment in patients with concomitant metabolic syndrome and/or type 2 diabetes mellitus. sBP was controlled at 32% patients only. The study results allow evaluating the effectivity of hypertension treatment as for drug choice, decrease of sBP and dBP associated with a certain drug, a drug combination, and therapeutic inertia in these patients.
Treatment and Pathology of an Unusual Large Carcinoma of the Conjunctiva
Authors: Stahnke Thomas , Kilangalanga Ngoy , Knappe Steffi , Guthoff Rudolf F. , Erbersdobler Andreas
Published: April 2018

Carcinoma of the conjunctiva is a malignant tumor which is mostly detected and surgically treated at an early stage because of medical or cosmetic problems. Exceptions of this rule may occur in developing countries, where patients do not have access to standard medical care systems. We report the case of a conjunctival carcinoma in an African patient with an unusually late presentation. Because of local medical shortcomings, and considering the severe, transmural inflammation of anterior ocular structures, an exenteration was performed although the orbit was not deeply involved with the tumor. The strong nuclear expression of p53 indicates a major role of UV exposure in this case. A total of 16-month follow-up in this patient and larger published series suggest that the risk of metastasis is rather low under those circumstances, even with invasive tumors.
Performance Analysis of RF‐Powered Cognitive Radio Networks with Integrated Ambient Backscatter Communications
Authors: Xu Longteng , Zhu Kun , Wang Ran , Gong Shimin
Published: April 2018

Integrating ambient backscatter communications into RF‐powered cognitive radio networks has been shown to be a promising method for achieving energy and spectrum efficient communications, which is very attractive for low‐power or no‐power communications. In such scenarios, a secondary user (SU) can operate in either transmission mode or backscatter mode. Specifically, an SU can directly transmit data if sufficient energy has been harvested (i.e., transmission mode). Or an SU can backscatter ambient signals to transmit data (i.e., backscatter mode). In this paper, we investigate the performance of such systems. Specifically, channel inversion power control and an energy store‐and‐reuse mechanism for secondary users are adopted for efficient use of harvested energy. We apply stochastic geometry to analyze coverage probability and achievable rates for both primary and secondary users considering both communication modes. Analytical tractable expressions are obtained. Extensive simulations are performed and the numerical results show the validity of our analysis. Furthermore, the results indicate that the performance of secondary systems can be improved with the integration of both communication modes with only limited impact on the performance of primary systems.
Coprecipitation Method of Synthesis, Characterization, and Cytotoxicity of Pr3+:LaF3 (CPr = 3, 7, 12, 20, 30%) Nanoparticles
Authors: Pudovkin Maksim S. , Zelenikhin Pavel V. , Shtyreva Victoria , Morozov Oleg A. , Koryakovtseva Darya A. , Pavlov Vitaly V. , Osin Yury N. , Evtugyn Vladimir G. , Akhmadeev Albert A. , Nizamutdinov Alexey S. , Semashko Vadim V.
Published: April 2018

The Pr3+:LaF3 (CPr = 3, 7, 12, 20, 30%) nanoparticles were characterized by means of high-resolution transmission electron microscopy, X-ray diffraction, optical spectroscopy, energy dispersive X-ray spectroscopy, dynamic light scattering, and MTT assay. It was revealed that the average diameter of all the NPs is around 14–18 nm. The hydrodynamic radius of the Pr3+:LaF3 (CPr = 7%) nanoparticles strongly depends on the medium. It was revealed that hydrodynamic radii of the Pr3+:LaF3 (CPr = 7%) nanoparticles in water, DMEM, and RPMI-1640 biological mediums were 18 ± 5, 41 ± 6, and 186 ± 8 nm, respectively. The Pr3+:LaF3 (CPr = 7%) nanoparticles were nontoxic at micromolar concentrations toward COLO-320 cell line. The lifetime curves were fitted biexponentially, and for the Pr3+:LaF3 (CPr = 7%) NPs, the luminescence lifetimes of Pr3+ ions were 480 ± 2 and 53 ± 5 nanosec.
Adjuvant Therapy for Stage IB Germ Cell Tumors: One versus Two Cycles of BEP
Authors: Huddart Robert A. , Reid Alison M.
Published: April 2018

Testicular germ cell tumours are the commonest tumours of young men and are broadly managed either as pure seminomas or as ‘nonseminomas’. The management of Stage 1 nonseminomatous germ cell tumours (NSGCTs), beyond surgical removal of the primary tumour at orchidectomy, is somewhat controversial. Cancer-specific survival rates in these patients are in the order of 99% regardless of whether surveillance, retroperitoneal lymph node dissection, or adjuvant chemotherapy is employed. However, the toxicities of these treatment modalities differ. Undertreating those destined to relapse exposes them to the potentially significant toxicities of 3-4 cycles of bleomycin, etoposide, and cisplatin (BEP) chemotherapy. Conversely, giving adjuvant chemotherapy to all patients following orchidectomy results in overtreatment of a significant proportion. Therefore, the challenge lies in delineating the patient population who require adjuvant chemotherapy and in determining how much chemotherapy to give to adequately reduce relapse risk. This chapter reviews the factors to be considered when adopting a risk-adapted strategy for giving adjuvant chemotherapy in Stage 1B NSGCT sand discusses the data regarding the number of BEP cycles to administer.
Degradation Behavior of Electrospun PLA and PLA/CNT Nanofibres in Aqueous Environment
Authors: Magiera Anna , Markowski Jaroslaw , Pilch Jan , Blazewicz Stanislaw
Published: April 2018

The aim of the work was to compare the degradation behavior of electrospun nanofibres obtained from pure poly(lactic acid) (PLA) and modified with carbon nanotubes (CNTs) in aqueous environment. The nanofibres in the form of mats were manufactured using the electrospinning technique (ES) with potential biomedical application. To investigate the degradation behavior, one-component and composite (containing CNTs) nanofibres were compared using scanning electron microscopy (SEM), water contact angle measurements, differential scanning calorimetry (DSC), and mechanical testing. The changes in their morphology, structure, and selected physical and mechanical properties during incubation up to 14 days were analysed. Two types of CNTs differing in concentration of surface functional groups were used to modify the PLA nanofibres. PLA and composite nanofibres (PLA + CNT) during incubation underwent swelling and partial degradation due to the penetration of water into polymer matrix. Changes in the mechanical properties of composite mats were higher than those observed for pure PLA mats. After 14-day incubation, samples retained from 47 to 78% of their initial tensile strength, higher for PLA samples. Morphological changes in pure PLA nanofibres were more dynamic than in composite nanofibres. No significant changes in crystallinity, wettability, and porosity of the samples occurred.
Analytical Study on Deformation and Structural Safety of Parafoil
Authors: Wang Longfang , He Weiliang
Published: April 2018

This study focuses on the cell bump distortion and bearing capacity of parafoil structure. Based on the mechanical properties of the membrane structure, the spanwise model of parafoil inflation was established and verified by comparing with the fluid-structure interaction (FSI) results. Because the internal pressure is very low, the chordwise stiffness is mainly generated by suspending lines. The chordwise model of inflated parafoil was established in consideration of elastic force and aerodynamic force. The results show that the cell is slenderer; the canopy surface is smoother; the aerodynamic load has a light effect on the shrinkage and bump ratios; when the cell width is constant, the critical dynamic pressure reduces k times with the k times increasing in parafoil area; and the design parameters of the first-row line OA have significant effects on the structural stiffness of inflated parafoil. The analytical model is useful for the weakening deformation design and the safety discussion of large parafoil for rocket booster recovery.
Alpha-Fetoprotein and Hepatocellular Carcinoma Immunity
Authors: Wang Xiaoping , Wang Qiaoxia
Published: April 2018

Hepatocarcinoma is one of the most prevalent gastroenterological cancers in the world with less effective therapy. As an oncofetal antigen and diagnostic marker for liver cancer, alpha-fetoprotein (AFP) possesses a variety of biological functions. Except for its diagnosis in liver cancer, AFP has become a target for liver cancer immunotherapy. Although the immunogenicity of AFP is weak and it could induce the immune escapes through inhibiting the function of dendritic cells, natural killer cells, and T lymphocytes, AFP has attracted more attention in liver cancer immunotherapy. By in vitro modification, the immunogenicity and immune response of AFP could be enhanced. AFP-modified immune cell vaccine or peptide vaccine has displayed the specific antitumor immunity against AFP-positive tumor cells and laid a better foundation for the immunotherapy of liver cancer.
Effects of Late Evening Snack on Cirrhotic Patients: A Systematic Review and Meta-Analysis
Authors: Guo Ying-jie , Tian Zi-bin , Jiang Na , Ding Xue-li , Mao Tao , Jing Xue
Published: April 2018

Background. Energetic effects of late evening snack (LES) on cirrhotic patients were reported recently, but there was no quantitative analysis. In this meta-analysis, we reviewed and quantified the effects of LES on energy metabolism and substrate oxidation in the patients with cirrhosis, which will be of benefit for liver cirrhosis nutritional therapy. Methods. A systematic search was conducted in PubMed, Embase, Web of Science, Elsevier, China National Knowledge Infrastructure, and Wanfang Database for relevant trials published until July 2017. These studies statistically were combined and analyzed by RevMan 5.3. Results. Fourteen trials comprising 478 cases were eligible for analysis. The results showed that the respiratory quotient value (MD = 11.09) and carbohydrate oxidation value (MD = 0.05) significantly elevated with one week or with up to three weeks of LES treatment in cirrhotic patients (P<0.05). Meanwhile, the levels of serum albumin (MD = 2.98) and cholinesterase (SMD = 1.09) were increased with LES administration for three weeks or that lasting twelve weeks (P<0.05). However, there was no significant improvement for the levels of alanine aminotransferase (ALT) (P=0.53), aspartate aminotransferase (AST) (P=0.96), and total bilirubin (TB) (P=0.32). Conclusions. LES could improve the energy malnutrition state of cirrhotic patients. However, it may have little effect on reducing liver parenchymal injury indexes such as serum aminotransferase.
Spatial Microstructural Ordering of Expansive Clay Minerals
Authors: López-Lara T. , Hernández-Zaragoza J. B. , Carreón-Freyre D. , Cerca M. , Rojas-González E. , Minor Franco A. G. , Martínez-Barrera G. , Salgado-Delgado R.
Published: April 2018

The volumetric change within soils containing expanding clays depends upon their spatial ordering and their mineralogy. So this work studies the spatial microstructural ordering and mineralogy of different expanding clays in order to correlate them with some of their geotechnical properties (plasticity, classification, and expansion). The clay microstructure was obtained using X‐ray diffraction, and sweeping electronic microscopy. Physical characterization includes pH analysis. Clays with greater swelling (12.1–14.6% expansion) present greater agglomeration (gathering) (20–50 microns) in a flocculated structure that mainly contained sodic montmorillonite with 14–22 Å openings and 8.28 average pH, which indicates high electron concentrations with border‐face interactions. Clays with the least expansion (7.6%) present lower agglomerations (5–10 microns) with face‐to‐face contacts within a dispersed structure that mainly contained calcium montmorillonite with openings lower than 15 Å and pH 7.56, which indicates a low electron concentration and face‐to‐face interaction. Major clay expansion corresponds to a greater size agglomerates, greater opening between particles, and greater pH presenting border‐face and face‐to‐face interactions of a flocculent structure. Yet, the soils with lower expansion only present face‐to‐face interactions corresponding to a dispersed structure.
Behavior Intention Derivation of Android Malware Using Ontology Inference
Authors: Jiao Jian , Liu Qiyuan , Chen Xin , Cao Hongsheng
Published: April 2018

Previous researches on Android malware mainly focus on malware detection, and malware’s evolution makes the process face certain hysteresis. The information presented by these detected results (malice judgment, family classification, and behavior characterization) is limited for analysts. Therefore, a method is needed to restore the intention of malware, which reflects the relation between multiple behaviors of complex malware and its ultimate purpose. This paper proposes a novel description and derivation model of Android malware intention based on the theory of intention and malware reverse engineering. This approach creates ontology for malware intention to model the semantic relation between behaviors and its objects and automates the process of intention derivation by using SWRL rules transformed from intention model and Jess inference engine. Experiments on 75 typical samples show that the inference system can perform derivation of malware intention effectively, and 89.3% of the inference results are consistent with artificial analysis, which proves the feasibility and effectiveness of our theory and inference system.
Implant-Supported PMMA Monolithic Full-Arch Rehabilitation with Surgical Computer-Planned Guide and Immediate Provisional: A Case Report with One Year Follow-Up
Authors: Zizzari Vincenzo Luca , Tacconelli Gianmarco
Published: April 2018

The aim of this case report is to describe the surgical and prosthetic procedures to achieve maxillary and mandibular implant-supported PMMA monolithic full-arch rehabilitation (PMFR) with surgical computer-planned guide and immediate provisional. In such cases, the correct planning of dental implants’ position, length, and diameter and the prosthetic phases via computer-aided design are very important to achieve good aesthetic and functional long-lasting results.
Uncommon Infections in Children Suggest Underlying Immunodeficiency: A Case of Infective Endocarditis in a 3-Year-Old Male
Authors: Shakoor Aisha , El-Isa Ahmed , Kinsella Elizabeth , Halas Ryan , Leonov Andrey
Published: April 2018

Infective endocarditis (IE) results from bacterial or fungal infection and is associated with significant morbidity and mortality. Several known risk factors exist for endocarditis, and 90% of pediatric cases have an underlying structural or congenital heart disease or prosthetic heart valve. Literature on IE in previously healthy children is relatively sparse, and the pathogenesis and underlying risk factors remain mostly unknown. Our patient was a 3-year-old male with a unique presentation of IE. His lack of structural and congenital risk factors for endocarditis prompted further workup, and labs were consistent with insufficient immunoglobulin, suggesting a primary immunodeficiency (PAD). PAD presents as heightened susceptibility to infections, commonly seen as recurrent pneumonia, meningitis, septic arthritis, and otitis media. Pediatric patients commonly have infections, yet as many as in 1 in 2000 patients have PAD. Our case emphasizes the potential need for further investigation into PAD in a young patient with no known risk factors who develops an uncommon infection such as IE.
A Seven-Year Retrospective Study on the Surveillance of Hepatitis B in Laos
Authors: Paboriboune Phimpha , Vial Thomas , Chassagne François , Sitbounlang Philavanh , Soundala Sengaloun , Bertani Stéphane , Sengmanothong Davone , Babin Francois-Xavier , Steenkeste Nicolas , Dény Paul , Pineau Pascal , Deharo Eric
Published: April 2018

Objective. Lao PDR is one of the most highly endemic countries for hepatitis B in Asia and the second country for liver cancer incidence. Therefore, the follow-up of infected individuals through predictive serological markers is of utmost importance to monitor the progression of the pathology and take the decision on treatment. Methods. A retrospective-descriptive cohort study was conducted on 3,857 HBV-infected patients. Information about infection status (viral load, VL), liver function (aminotransferases), and treatments was recorded. Results. M/F sex ratio was 1.77 for a median age of 37. Patients under 37 displayed higher VL than older ones and men had higher VL than women. Initial VL ranged from <50 IU/mL to 2.5 1013 IU/mL. Median aminotransferase values were 45.5 U/L for ALAT and 44 U/L for ASAT, ranging from <8 to >2,000 U/L. Men had higher aminotransferase than women. Globally 20% of patients received treatment (mainly immunostimulant and reverse-transcriptase inhibitors); 11% had high levels of VL and liver enzymes, but only 2% of them were treated. Conclusion. Public health decisions should be taken urgently to rationalise vaccination and provide fair access to early diagnosis and treatment; otherwise the burden of HBV-associated diseases will be overwhelming for Laos in the near future.
Biosynthesis of Multicomponent Nanoparticles with Extract of Mortiño (Vaccinium floribundum Kunth) Berry: Application on Heavy Metals Removal from Water and Immobilization in Soils
Authors: Abril Mayra , Ruiz Hugo , Cumbal Luis H.
Published: April 2018

Through preparation of multicomponent nanoparticles (MCNPs) using ferric chloride (FeCl3), sodium sulfate (Na2SO4), and the extract of mortiño fruit (Vaccinium floribundum Kunth), we dramatically improved the removal/immobilization of heavy metals from water and in soils. As-prepared nanoparticles were spherical measuring approximately 12 nm in diameter and contained iron oxides and iron sulfides in the crystal structure. Removal of copper and zinc from water using MCNPs showed high efficiencies (>99%) at pH above 6 and a ratio of 0.5 mL of the extract:10 mL 0.5 M FeCl3·6H2O : 10 mL 0.035 M Na2SO4. The physisorption process followed by chemisorption was regarded as the removal mechanism of Cu and Zn from water. While, when MCNPs were used to treat soils contaminated with heavy metals, more than 95% of immobilization was accomplished for all metals. Nevertheless, the distribution of the metallic elements changed in the soil fractions after treatment. Results indicate that immobilization of metals after the injection of nanoparticles into soils was effective. Metals did not leach out when soils were drained with rain, drinking, and deionized water but fairly leached out under acidic water drainage.
The Efficacy and Safety of the Chinese Herbal Formula, JTTZ, for the Treatment of Type 2 Diabetes with Obesity and Hyperlipidemia: A Multicenter Randomized, Positive-Controlled, Open-Label Clinical Trial
Authors: Yu Xiaotong , Xu Lipeng , Zhou Qiang , Wu Shengping , Tian Jiaxing , Piao Chunli , Guo Hailong , Zhang Jun , Li Liping , Wu Shentao , Guo Meizhen , Hong Yuzhi , Pu Weirong , Zhao Xiyan , Liu Yang , Pang Bing , Peng Zhiping , Wang Song , Lian Fengmei , Tong Xiaolin
Published: April 2018

Background and Aim. Studies have shown an increasing number of type 2 diabetes (T2D) patients with concomitant obesity and hyperlipidemia syndromes, resulting from relevant metabolic disorders. However, there are few medications and therapies, which can thoroughly address these issues. Therefore, the current study evaluated the efficacy and safety of using JTTZ, a Chinese herbal formula, to treat T2D with obesity and hyperlipidemia. Methods. A total of 450 participants with T2D (HbA1c ≥ 7.0%; waist circumference ≥ 90 cm and 80 cm in males and females, resp.; and triglycerides (TG) ≥ 1.7 mmol/L) were randomly assigned, in equal proportions, to two groups in this multicenter randomized, positive-controlled, open-label trial. One group received JTTZ formula, and the other received metformin (MET) for 12 consecutive weeks. The primary efficacy outcomes were changes in HbA1c, TG, weight, and waist circumference. Adverse reactions and hypoglycemia were monitored. Results. HbA1c decreased by 0.75 ± 1.32% and 0.71 ± 1.2% in the JTTZ and MET groups, respectively, after 12 weeks of treatment. TG levels in the JTTZ and MET groups were reduced by 0.64 ± 2.37 mmol/L and 0.37 ± 2.18 mmol/L, respectively. Weight was decreased by 2.47 ± 2.71 kg in the JTTZ group and by 2.03 ± 2.36 kg in the MET group. JTTZ also appeared to alleviate insulin resistance and increase HOMA-β. In addition, symptoms were significantly relieved in participants in the JTTZ group compared to those in the MET group. One case of hypoglycemia was reported in the MET group. No severe adverse events were reported in either group. Conclusions. The JTTZ formula led to safe and significant improvements in the blood glucose, blood lipids, and weight levels; relieved symptoms; and enhanced β cell function for T2D patients with obesity and hyperlipidemia. The JTTZ formula has shown that it could potentially be developed as an alternative medicine for patients with T2D, particularly those who cannot tolerate metformin or other hypoglycemic drugs. This trial was registered with Clinicaltrials.gov NCT01471275.
Prevalence and Factors Associated with Hydatidiform Mole among Patients Undergoing Uterine Evacuation at Mbarara Regional Referral Hospital
Authors: Mulisya Olivier , Roberts Drucilla J. , Sengupta Elizabeth S. , Agaba Elly , Laffita Damaris , Tobias Tusabe , Mpiima Derrick Paul , Henry Lugobe , Augustine Ssemujju , Abraham Masinda , Hillary Twizerimana , Mugisha Julius
Published: April 2018

Objective. We sought to determine the prevalence of and factors associated with hydatidiform molar gestations amongst patients undergoing uterine evacuation at Mbarara Regional Referral Hospital (MRRH), Mbarara, Uganda. Methods. This was a cross-sectional study carried out from November 2016 to February 2017. All patients admitted for uterine evacuation for nonviable pregnancy were included. The study registered 181 patients. Data were collected on sociodemographics, medical conditions, obstetrics, and gynecological factors. The evacuated tissue received a full gross and histopathologic examination. Cases of pathologically suspected complete hydatidiform mole were confirmed by p57 immunohistochemistry. Data were analyzed using STATA 13. Results. The prevalence of hydatidiform mole was 6.1% (11/181). All detected moles were complete hydatidiform moles, and there were no diagnosed partial hydatidiform moles. Clinical diagnosis of molar pregnancy was suspected in 13 patients, but only 69.2% (9/13) were confirmed as molar pregnancies histologically. Two cases were clinically unsuspected. Factors that had a significant relationship with complete hydatidiform mole included maternal age of 35 years and above (aOR 13.5; CI: 1.46–125.31; p=0.00), gestational age beyond the first trimester at the time of uterine evacuation (aOR 6.2; CI: 1.07–36.14; p=0.04), and history of previous abortion (aOR 4.3; CI: 1.00–18.57; p=0.05). Conclusion. The prevalence of complete hydatidiform mole was high at 6.1%. Associated risk factors included advanced maternal age (35 years and above), history of previous abortions, and gestational age beyond the first trimester at the time of evacuations. Recommendations. We recommend putting in place capacity to do routine histopathological examination of all products of conception especially those at high risk for a molar gestation either by clinical suspicion or by risk factors including advanced maternal age, advanced gestational age, and history of previous abortion because of high prevalence of complete mole.
Successful Treatment of an Infant with Left Ventricular Noncompaction Presenting with Fatal Ventricular Arrhythmia Treated with Cardiac Resynchronization Therapy and an Implantable Cardioverter Defibrillator
Authors: Kimura Masato , Kawano Kengo , Yaoita Hisao , Kure Shigeo
Published: April 2018

We herein report the successful treatment of a 4-year-old girl with left ventricular noncompaction (LVNC) who presented with incessant ventricular fibrillation at 5 months of age. An implantable cardioverter defibrillator (ICD) was implanted, and dual chamber (DDD) pacing was initiated at 7 months of age. At her 10-month follow-up, her left ventricular ejection fraction (LVEF) had decreased from 45% to 20% with mechanical dyssynchrony. After upgrading to cardiac resynchronization therapy (CRT), the LVEF improved to 50%. The usefulness of CRT in pediatric LVNC has not been fully elucidated. However, our case suggests that CRT therapy may be an effective option for LVNC-induced cardiac dysfunction.
Petersen’s Space Internal Hernia after Laparoscopic One Anastomosis (Mini) Gastric Bypass
Authors: Kermansaravi Mohammad , Kazazi Mohammad , Pazouki Abdolreza
Published: April 2018

Background. One anastomosis gastric bypass (OAGB) is now considered as an appropriate alternative for Roux-en-Y gastric bypass (RYGB) with some advantages such as absence of risk for internal hernia (IH). But, is really the risk of IH equal zero after OAGB? Case Summary. A 37-year-old male was admitted due to severe abdominal crampy pain, nausea, vomiting, and obstipation. He had chronic and intermittent abdominal pain from 2 years after OAGB. With high suspicion of complete obstruction, the exploratory laparoscopy was performed. Intraoperative findings showed incarcerated bowel hernia from Petersen’s defect. The incarcerated bowel was reduced, and the defect was repaired. The patient was discharged 2 days after operation. Conclusion. The incidence of IH after OAGB is rare but not zero. In any suspicious signs and symptoms for IH, the early exploratory laparoscopy is mandatory to diagnose and treat.
Optimization of Solar Energy Harvesting: An Empirical Approach
Authors: Almusaied Zaid , Asiabanpour Bahram , Aslan Semih
Published: April 2018

Renewable energy is the path for a sustainable future. The development in this field is progressing rapidly and solar energy is at the heart of this development. The performance and efficiency limitations are the main obstacles preventing solar energy from fulfilling its potential. This research intends to improve the performance of solar panels by identifying and optimizing the affecting factors. For this purpose, a mechanical system was developed to hold and control the tilt and orientation of the photovoltaic panel. A data acquisition system and electrical system were built to measure and store performance data of the photovoltaic panels. A design of experiments and Response Surface Methodology were used to investigate the impact of these factors on the yield response as well as the output optimization. The findings of the experiment showed an optimum result with a tilt of 60° from the horizon, an azimuth angel of 45° from the south, and a clean panel condition. The wind factor showed insignificant impact within the specified range.
Daily Chronic Intermittent Hypobaric Hypoxia Does Not Induce Chronic Increase in Pulmonary Arterial Pressure Assessed by Echocardiography
Authors: Götschke Jeremias , Mertsch Pontus , Kneidinger Nikolaus , Kauffmann-Guerrero Diego , Behr Jürgen , Huber Rudolf Maria , Reichenberger Frank , Milger Katrin
Published: April 2018

Chronic hypoxia causes pulmonary vascular remodeling resulting in persistently increased pulmonary arterial pressures (PAP) even after return to normoxia. Recently, interest in chronic intermittent hypobaric hypoxia (CIHH) was raised because it occurs in subjects working at high altitude (HA) but living in lowland. However, effects of daily CIHH on PAP are unknown. In this pilot study, we included 8 healthy subjects working at (2650 m) each workday for 8-9 h while living and sleeping at LA and 8 matched control subjects living and working at LA. Cardiorespiratory measurements including echocardiography at rest and during exercise were performed at LA (Munich, 530 m) and HA (Zugspitze, 2650 m). Hemoglobin was higher in CIHH subjects. LA echocardiography showed normal right and left cardiac dimensions and function in all subjects. Systolic PAP (sPAP) and tricuspid annular plane systolic excursion (TAPSE) at rest were similar in both groups. Resting blood gas analysis (BGA) at HA revealed decreased pCO2 in CIHH compared to controls (HA: 28.4 versus 31.7 mmHg, p=0.01). During exercise, sPAP was lower in CIHH subjects compared to controls (LA: 28.7 versus 35.3 mmHg, p=0.02; HA: 26.3 versus 33.6 mmHg, p=0.04) and peripheral oxygen saturation (SpO2) was higher. In sum, subjects exposed to CIHH showed no signs of pulmonary vascular remodeling.
A Case of Familial Mediterranean Fever with Extensive Lymphadenopathy and Complex Heterozygous Genotype Presenting in the Fourth Decade
Authors: Al-Khafaji Jawad , Ganz-Lord Fran , Konjeti Venkata Rajesh , Viny Aaron D.
Published: April 2018

Familial Mediterranean fever (FMF) is an inherited disease caused by loss of function mutations in the MEFV gene encoding pyrin, a negative regulator of interleukin-1. The disease is characterized by recurrent fever and self-limited attacks of joint, chest, and abdominal pain but lymphadenopathy is an infrequent manifestation. While mesenteric lymphadenopathy has been described in several cases in the literature; hilar, paratracheal, axillary, pelvic, and retroperitoneal lymphadenopathy are extremely rare and have been reported separately in very few individuals. In this report, we present a patient with late-onset FMF with extensive lymphadenopathy in all of the aforementioned anatomic regions. Genetic analysis identified three heterozygous pyrin mutations in a patient with no affected family members. Genetic investigation of the patient’s mother identified a novel carrier haplotype E148Q/P369S. The proband also inherited the previously described and rare A744S mutation previously not thought to be a disease-defining lesion. This unique compound heterozygous genotype resulted in a novel genotype-phenotype association producing an atypical clinical presentation of FMF that fits within the pattern of several case reports of late-onset disease with respect to clinical course and therapeutic response.
A Review of Robotics in Neurorehabilitation: Towards an Automated Process for Upper Limb
Authors: Oña E. D. , Cano-de la Cuerda R. , Sánchez-Herrera P. , Balaguer C. , Jardón A.
Published: April 2018

Robot-mediated neurorehabilitation is a growing field that seeks to incorporate advances in robotics combined with neuroscience and rehabilitation to define new methods for treating problems related with neurological diseases. In this paper, a systematic literature review is conducted to identify the contribution of robotics for upper limb neurorehabilitation, highlighting its relation with the rehabilitation cycle, and to clarify the prospective research directions in the development of more autonomous rehabilitation processes. With this aim, first, a study and definition of a general rehabilitation process are made, and then, it is particularized for the case of neurorehabilitation, identifying the components involved in the cycle and their degree of interaction between them. Next, this generic process is compared with the current literature in robotics focused on upper limb treatment, analyzing which components of this rehabilitation cycle are being investigated. Finally, the challenges and opportunities to obtain more autonomous rehabilitation processes are discussed. In addition, based on this study, a series of technical requirements that should be taken into account when designing and implementing autonomous robotic systems for rehabilitation is presented and discussed.
R Inguinal/R Scrotum Extramammary Paget’s Disease with Diffuse Spine Metastasis Complicated by Microangiopathic Hemolytic Anemia
Authors: Mansurov Alay , Christenson Eric
Published: April 2018

A 47-year-old male presented with a groin lesion in 2011. Initial treatment with antifungals and vinegar was unsuccessful. In 2016, biopsy of this lesion was pursued with diagnosis of extramammary Paget’s disease (EMPD). Prior to the scheduled excision, he developed constant lower back pain with radiation to his lower extremities. MRI confirmed vertebral metastasis. Despite surgical and radiation therapy, his back pain progressed, and repeat imaging showed epidural spread of tumor in the thoracic spine. Later, the patient was admitted to the hospital due to severe anemia and thrombocytopenia. Further work-up confirmed the diagnosis of microangiopathic hemolytic anemia (MAHA). As we know, there are only few reports of spinal metastases in patients with EMPD. To the best of our knowledge, this is the first case report of EMPD complicated by MAHA.
Cryo-Imaging and Software Platform for Analysis of Molecular MR Imaging of Micrometastases
Authors: Qutaish Mohammed Q. , Zhou Zhuxian , Prabhu David , Liu Yiqiao , Busso Mallory R. , Izadnegahdar Donna , Gargesha Madhusudhana , Lu Hong , Lu Zheng-Rong , Wilson David L.
Published: April 2018

We created and evaluated a preclinical, multimodality imaging, and software platform to assess molecular imaging of small metastases. This included experimental methods (e.g., GFP-labeled tumor and high resolution multispectral cryo-imaging), nonrigid image registration, and interactive visualization of imaging agent targeting. We describe technological details earlier applied to GFP-labeled metastatic tumor targeting by molecular MR (CREKA-Gd) and red fluorescent (CREKA-Cy5) imaging agents. Optimized nonrigid cryo-MRI registration enabled nonambiguous association of MR signals to GFP tumors. Interactive visualization of out-of-RAM volumetric image data allowed one to zoom to a GFP-labeled micrometastasis, determine its anatomical location from color cryo-images, and establish the presence/absence of targeted CREKA-Gd and CREKA-Cy5. In a mouse with >160 GFP-labeled tumors, we determined that in the MR images every tumor in the lung >0.3 mm2 had visible signal and that some metastases as small as 0.1 mm2 were also visible. More tumors were visible in CREKA-Cy5 than in CREKA-Gd MRI. Tape transfer method and nonrigid registration allowed accurate (<11 μm error) registration of whole mouse histology to corresponding cryo-images. Histology showed inflammation and necrotic regions not labeled by imaging agents. This mouse-to-cells multiscale and multimodality platform should uniquely enable more informative and accurate studies of metastatic cancer imaging and therapy.
A Study on Dynamic Amplification Factor and Structure Parameter of Bridge Deck Pavement Based on Bridge Deck Pavement Roughness
Authors: Han Fei , Dan Dan-hui , Wang Hu
Published: April 2018

In order to study the coupled influence of deck pavement roughness and velocity on dynamic amplification factor, a 2‐DOF 1/4 vehicle model is employed to establish the vehicle‐bridge‐coupled vibration system. The random dynamic load of running vehicle simulated by software MATLAB is applied on bridge deck pavement (BDP) through ANSYS software. Besides, the influence of BDP parameters on control stress under static load and random vibration load is analyzed. The results show that if the surface of BDP is smooth, the dynamic magnification coefficient would first increase and then decrease with increasing of vehicle velocity and reach its maximum value when v = 20 m/s; if the surface of BDP is rough, the maximal and minimum values of the dynamic amplification coefficient (DAC) occur, respectively, when the velocity reaches 10 m/s and 15 m/s. For a composite bridge deck with the cushion layer, the thickness of asphalt pavement should be not too thick or thin and better to be controlled for about 10 cm; with the increasing of cushion layer thickness, the control stress of deck pavement is all decreased and show similar change regularity under effect of different loads. In view of self‐weight of structure, the thickness of the cushion layer is recommended to be controlled for about 4 cm.
Immunotherapy for Pancreatic Cancer: More Than Just a Gut Feeling
Authors: Riquelme Erick , Maitra Anirban , McAllister Florencia
Published: April 2018

Summary: Development of pancreatic cancer in spontaneous murine models is associated with enrichment of specific strains of gut and intratumoral bacteria that induce a tolerogenic immunosuppressive microenvironment favoring cancer progression and resistance to immunotherapies. Ablation of the microbiome with antibiotics reshapes the tumor microenvironment, inducing T-cell activation, improving immune surveillance, and increasing sensitivity to immunotherapy in established tumors. Cancer Discov; 8(4); 386–8. ©2018 AACR.

See related article by Pushalkar et al., p. 403.
Causative Effects of Genetically Determined High Maternal/Fetal Endothelin-1 on Preeclampsia-Like Conditions in Mice
Authors: Li Feng , Kakoki Masao , Smid Marcela , Boggess Kim , Wilder Jennifer , Hiller Sylvia , Bounajim Carol , Parnell Scott E. , Sulik Kathleen K. , Smithies Oliver , Maeda-Smithies Nobuyo
Published: April 2018

Endothelin-1 (ET-1) is implicated in the pathophysiology of preeclampsia. An association between an
EDN1
gene polymorphism with high ET-1 and preeclampsia was reported in humans, but their cause and effect relationships have not been defined. We examined the pregnancy effects in mice with a modified
Edn1
allele that increases mRNA stability and thus ET-1 production. Heterozygous
Edn1

H/
+

females showed no obvious abnormalities before pregnancy, but when mated with wild-type (WT) males developed a full spectrum of preeclampsia-like phenotypes, including increased systolic blood pressure, proteinuria, glomerular endotheliosis, and intrauterine fetal growth restriction. At 7.5 days post-coitus, the embryos from
Edn1

H/
+

dams, regardless of their
Edn1
genotype, lagged 12 hours in development compared with embryos from WT dams, had disoriented ectoplacental cones, and retained high E-cadherin expression. In contrast, WT females mated with
Edn1

H/
+

males, which also carried half of the fetuses with
Edn1

H/
+

genotype, showed a mild systolic blood pressure increase only. These WT dams had 2× higher plasma soluble fms-like tyrosine kinase-1 than WT dams mated with WT males. In human first trimester trophoblast cells, pharmacological doses of ET-1 increased the cellular
sFlt1
transcripts and protein secretion via both type A and B ET-1 receptors. Our data demonstrate that high maternal ET-1 production causes preeclampsia-like phenotypes during pregnancy, affecting both initial stage of trophoblast differentiation/invasion and maternal peripheral vasculature during late gestation. High fetal ET-1 production, however, could cause increased soluble fms-like tyrosine kinase-1 in the maternal circulation and contribute to blood pressure elevation.
An Inquiry into the Nature of Service: A Historical Overview (Part 1)
Authors: Kim Miso
Published: April 2018

Design academia and industry has increasingly recognized service as a perspective of design. However, there is still more to explore in design research regarding the assumption that sits beneath this success: What is service? In this paper I explore this question by collecting different perspectives on service that have existed throughout human history: objectified labor, mutual aid, communal sharing, and assistance by contract. By exploring these diverse historical understandings of service, I seek to draw attention to the nature of service as participation.
The Grape Remote Sensing Atmospheric Profile and Evapotranspiration Experiment
Authors: Kustas William P. , Anderson Martha C. , Alfieri Joseph G. , Knipper Kyle , Torres-Rua Alfonso , Parry Christopher K. , Nieto Hector , Agam Nurit , White William A. , Gao Feng , McKee Lynn , Prueger John H. , Hipps Lawrence E. , Los Sebastian , Alsina Maria Mar , Sanchez Luis , Sams Brent , Dokoozlian Nick , McKee Mac , Jones Scott , Yang Yun , Wilson Tiffany G. , Lei Fangni , McElrone Andrew , Heitman Josh L. , Howard Adam M. , Post Kirk , Melton Forrest , Hain Christopher
Published: April 2018

Particularly in light of California’s recent multiyear drought, there is a critical need for accurate and timely evapotranspiration (ET) and crop stress information to ensure long-term sustainability of high-value crops. Providing this information requires the development of tools applicable across the continuum from subfield scales to improve water management within individual fields up to watershed and regional scales to assess water resources at county and state levels. High-value perennial crops (vineyards and orchards) are major water users, and growers will need better tools to improve water-use efficiency to remain economically viable and sustainable during periods of prolonged drought. To develop these tools, government, university, and industry partners are evaluating a multiscale remote sensing–based modeling system for application over vineyards. During the 2013–17 growing seasons, the Grape Remote Sensing Atmospheric Profile and Evapotranspiration eXperiment (GRAPEX) project has collected micrometeorological and biophysical data within adjacent pinot noir vineyards in the Central Valley of California. Additionally, each year ground, airborne, and satellite remote sensing data were collected during intensive observation periods (IOPs) representing different vine phenological stages. An overview of the measurements and some initial results regarding the impact of vine canopy architecture on modeling ET and plant stress are presented here. Refinements to the ET modeling system based on GRAPEX are being implemented initially at the field scale for validation and then will be integrated into the regional modeling toolkit for large area assessment.
Dynamically Constrained Interpolation of the Sparsely Observed Suspended Sediment Concentrations in Both Space and Time: A Case Study in the Bohai Sea
Authors: Mao Xinyan , Wang Daosheng , Zhang Jicai , Bian Changwei , Lv Xianqing
Published: April 2018

The observed suspended sediment concentrations (SSCs) obtained from the water sampling are usually sparsely distributed in both space and time, which are traditionally applied just to calibrate other types of observations. In this study a dynamically constrained interpolation methodology (DCIM) is developed to interpolate these sparsely observed SSCs in the Bohai Sea. In this method the suspended sediment transport model is taken as dynamical constraints to interpolate the observations. Meanwhile, the interpolated results are optimized iteratively by adjusting the key model parameters using the adjoint method.

The DCIM is first verified using the synthetic observations produced by twin model runs. The modeling results reveal that this method is effective at interpolating the sparsely observed artificial SSCs, even when the observations are heavily contaminated by data noise. Then, the sparsely observed practical SSCs obtained from a large area survey in the Bohai Sea are interpolated using the DCIM. The interpolated results are verified by randomly selected independent observations. The discrepancies between the interpolated SSCs and the observations are significantly decreased. When all the observations are interpolated, the final interpolated SSCs captured a majority (96.88%) of observations with a factor of 2 and the correlation coefficient between the observed and interpolated SSCs is 0.98. Besides, the interpolated results have presented the reasonable dynamical variations of SSCs in the space and time domains. The modeling results indicate that the DCIM is an effective tool for interpolating the sparsely observed SSCs in both space and time.
The Brazilian Public Health in Contemporary Capitalism
Authors: Junqueira Virgínia , Mendes Áquilas N.
Published: April 2018

This article examines some political and economic facts that led to an intensification of austerity measures by the Brazilian government, including ones against the Unified Health System (SUS) and its progressive dismantling. In a country where fundamental human rights were never fully respected, nowadays social and labor rights are under severe attacks. The deepening of the capital crisis and the rise of interest-bearing capital dominance have been causing unemployment, social insecurity growth, and resulting public fund appropriation by the private capital. The Brazilian governments in the 1990s and 2000s have implemented deeper cuts in social policy expenditure, freezing security benefits, privatizing services, and prioritizing the payment of public debt interests. The right wing’s project involves the demoralization of not only the Workers’ Party but also the left as a whole, so that the adoption of austerity measures could be achieved without popular resistance. It is the duty of the Brazilian left wing to denounce such a project and to provoke firm initiatives to rebuild its bonds with the working class.