bluuebunny/crossref_metadata_2025 huggingface dataset:
Etiological Role and Repeated Infections of Sapovirus among Children Aged Less than 2 Years in a Cohort Study in a Peri-urban Community of Peru
Authors: Liu Xiaofang , Jahuira Helena , Gilman Robert H. , Alva Alicia , Cabrera Lilia , Okamoto Michiko , Xu Hang , Windle Henry J. , Kelleher Dermot , Varela Marco , Verastegui Manuela , Calderon Maritza , Sanchez Gerardo , Sarabia Vanessa , Ballard Sarah B. , Bern Caryn , Mayta Holger , Crabtree Jean E. , Cama Vitaliano , Saito Mayuko , Oshitani Hitoshi
Published: April 2016

Human sapovirus has been shown to be one of the most important etiologies in pediatric patients with acute diarrhea. However, very limited data are available about the causative roles and epidemiology of sapovirus in community settings. A nested matched case-control study within a birth cohort study of acute diarrhea in a peri-urban community in Peru from 2007 to 2010 was conducted to investigate the attributable fraction (AF) and genetic diversity of sapovirus. By quantitative reverse transcription–real-time PCR (qPCR) sapovirus was detected in 12.4% (37/299) of diarrheal and 5.7% (17/300) of nondiarrheal stools (
P
= 0.004). The sapovirus AF (7.1%) was higher in the second year (13.2%) than in the first year (1.4%) of life of children. Ten known genotypes and one novel cluster (
n
= 5) within four genogroups (GI, GII, GIV, and GV) were identified by phylogenetic analysis of a partial VP1 gene. Further sequence analysis of the full VP1 gene revealed a possible novel genotype, tentatively named GII.8. Notably, symptomatic reinfections with different genotypes within the same (
n
= 3) or different (
n
= 5) genogroups were observed in eight children. Sapovirus exhibited a high attributable burden for acute gastroenteritis, especially in the second year of life, of children in a Peruvian community. Further large-scale studies are needed to understand better the global burden, genetic diversity, and repeated infections of sapovirus.
Multiple Natural Substitutions in Avian Influenza A Virus PB2 Facilitate Efficient Replication in Human Cells
Authors: Mänz Benjamin , de Graaf Miranda , Mögling Ramona , Richard Mathilde , Bestebroer Theo M. , Rimmelzwaan Guus F. , Fouchier Ron A. M.
Published: April 2016

A strong restriction of the avian influenza A virus polymerase in mammalian cells generally limits viral host-range switching. Although substitutions like E627K in the PB2 polymerase subunit can facilitate polymerase activity to allow replication in mammals, many human H5N1 and H7N9 viruses lack this adaptive substitution. Here, several previously unknown, naturally occurring, adaptive substitutions in PB2 were identified by bioinformatics, and their enhancing activity was verified using
in vitro
assays. Adaptive substitutions enhanced polymerase activity and virus replication in mammalian cells for avian H5N1 and H7N9 viruses but not for a partially human-adapted H5N1 virus. Adaptive substitutions toward basic amino acids were frequent and were mostly clustered in a putative RNA exit channel in a polymerase crystal structure. Phylogenetic analysis demonstrated divergent dependency of influenza viruses on adaptive substitutions. The novel adaptive substitutions found in this study increase basic understanding of influenza virus host adaptation and will help in surveillance efforts.

IMPORTANCE
Influenza viruses from birds jump the species barrier into humans relatively frequently. Such influenza virus zoonoses may pose public health risks if the virus adapts to humans and becomes a pandemic threat. Relatively few amino acid substitutions—most notably in the receptor binding site of hemagglutinin and at positions 591 and 627 in the polymerase protein PB2—have been identified in pandemic influenza virus strains as determinants of host adaptation, to facilitate efficient virus replication and transmission in humans. Here, we show that substantial numbers of amino acid substitutions are functionally compensating for the lack of the above-mentioned mutations in PB2 and could facilitate influenza virus emergence in humans.
Herpes Simplex Virus 1 Serine Protease VP24 Blocks the DNA-Sensing Signal Pathway by Abrogating Activation of Interferon Regulatory Factor 3
Authors: Zhang Dandan , Su Chenhe , Zheng Chunfu
Published: April 2016

The interferon (IFN)-mediated antiviral response is a central aspect of host defense; however, viruses have evolved multiple strategies to counteract IFN-mediated responses in order to successfully infect the host. Herpes simplex virus 1 (HSV-1), a typical human-restricted DNA virus, is capable of counteracting host immune responses via several distinct viral proteins, thus establishing a lifelong latent infection. In this study, we demonstrate that the VP24 protein, a serine protease of HSV-1 essential for the formation and maturation of capsids, is a novel antagonist of the beta interferon (IFN-β) pathway. Here, VP24 was shown for the first time to dampen interferon stimulatory DNA (ISD)-triggered IFN-β production and inhibit IFN-β promoter activation induced by cyclic GMP-AMP synthase (cGAS) and stimulator of interferon genes (STING) and by STING, respectively. Further study demonstrated that ectopic expression of VP24 selectively blocked IFN regulatory factor 3 (IRF3) but not NF-κB promoter activation. In addition, VP24 was demonstrated to downregulate ISD-induced phosphorylation and dimerization of IRF3 during HSV-1 infection with a VP24 stable knockdown human foreskin fibroblast cell line. The underlying molecular mechanism is that VP24 abrogates the interaction between TANK-binding kinase 1 (TBK1) and IRF3, hence impairing IRF3 activation. These results illustrate that VP24 is able to block the production of IFN-β by inhibiting IRF3 activation, which may represent a critical adaptation to enable viral effective replication within the host.

IMPORTANCE
This study demonstrated that HSV-1 protein VP24 could inhibit IFN-β production and promoter activation triggered by ISD, cGAS and STING and by STING, respectively. VP24 selectively blocked IRF3 promoter activation and ISD-induced phosphorylation and dimerization of IRF3 without affecting the NF-κB promoter activation during viral infection. VP24 also inhibited IRF3 activation by impeding the interaction between TBK1 and IRF3 during viral infection. This study provides new insights into the immune evasion mediated by HSV-1 and identifies VP24 as a crucial effector for HSV-1 to evade the host DNA-sensing signal pathway.
A Single Amino Acid Substitution in Poliovirus Nonstructural Protein 2C
ATPase
Causes Conditional Defects in Encapsidation and Uncoating
Authors: Asare Emmanuel , Mugavero JoAnn , Jiang Ping , Wimmer Eckard , Paul Aniko V.
Published: April 2016

The specificity of encapsidation of C-cluster enteroviruses depends on an interaction between capsid proteins and nonstructural protein 2C
ATPase
. In particular, residue N
252
of poliovirus 2C
ATPase
interacts with VP3 of coxsackievirus A20, in the context of a chimeric virus. Poliovirus 2C
ATPase
has important roles both in RNA replication and encapsidation. In this study, we searched for additional sites in 2C
ATPase
, near N
252
, that are required for encapsidation. Accordingly, segments adjacent to N
252
were analyzed by combining triple and single alanine mutations to identify residues required for function. Two triple alanine mutants exhibited defects in RNA replication. The remaining two mutations, located in secondary structures in a predicted three-dimensional model of 2C
ATPase
, caused lethal growth phenotypes. Most single alanine mutants, derived from the lethal variants, were either quasi-infectious and yielded variants with wild-type (wt) or temperature-sensitive (
ts
) growth phenotypes or had a lethal growth phenotype due to defective RNA replication. The K
259
A mutation, mapping to an α helix in the predicted structure of 2C
ATPase
, resulted in a cold-sensitive virus.
In vivo
protein synthesis and virus production were strikingly delayed at 33°C relative to the wt, suggesting a defect in uncoating. Studies with a reporter virus indicated that this mutant is also defective in encapsidation at 33°C. Cell imaging confirmed a much-reduced production of K
259
A mature virus at 33°C relative to the wt. In conclusion, we have for the first time linked a cold-sensitive encapsidation defect in 2C
ATPase
(K
259
A) to a subsequent delay in uncoating of the virus particle at 33°C during the next cycle of infection.

IMPORTANCE
Enterovirus morphogenesis, which involves the encapsidation of newly made virion RNA, is a process still poorly understood. Elucidation of this process is important for future drug development for a large variety of diseases caused by these agents. We have previously shown that the specificity of encapsidation of poliovirus and of C-cluster coxsackieviruses, which are prototypes of enteroviruses, is dependent on an interaction of capsid proteins with the multifunctional nonstructural protein 2C
ATPase
. In this study, we have searched for residues in poliovirus 2C
ATPase
, near a presumed capsid-interacting site, important for encapsidation. An unusual cold-sensitive mutant of 2C
ATPase
possessed a defect in encapsidation at 37°C and subsequently in uncoating during the next cycle of infection at 33°C. These studies not only reveal a new site in 2C
ATPase
that is involved in encapsidation but also identify a link between encapsidation and uncoating.
Enhancing exercise tolerance and physical activity in COPD with combined pharmacological and non-pharmacological interventions: PHYSACTO randomised, placebo-controlled study design
Authors: Troosters Thierry , Bourbeau Jean , Maltais François , Leidy Nancy , Erzen Damijan , De Sousa Dorothy , Korducki Lawrence , Hamilton Alan
Published: April 2016

Introduction

Chronic obstructive pulmonary disease (COPD) is associated with exercise limitation and physical inactivity, which are believed to have significant long-term negative health consequences for patients. While a number of COPD treatments and exercise training programmes increase exercise capacity, there is limited evidence for their effects on physical activity levels, with no clear association between exercise capacity and physical activity in clinical trials. Physical activity depends on a number of behaviour, environmental and physiological factors. We describe the design of the PHYSACTO trial, which is investigating the effects of bronchodilators, either alone or with exercise training, in combination with a standardised behaviour-change self-management programme, on exercise capacity and physical activity in patients with COPD. It is hypothesised that bronchodilators in conjunction with a behaviour-change self-management programme will improve physical activity and that this effect will be amplified by the addition of exercise training.

Methods and analysis

Patients are being recruited from 34 sites in Australia, New Zealand, the USA, Canada and Europe. Patients receiving a multicomponent intervention designed to support behaviour change related to physical activity are randomised to four treatment arms: placebo, tiotropium, tiotropium+olodaterol, and tiotropium+olodaterol+exercise training. The primary outcome is improvement in exercise capacity after 8 weeks, measured by endurance time during a shuttle walk test. The secondary outcome is improvement in physical activity, including objective accelerometer assessment and patient-reported functioning using the Functional Performance Inventory—Short Form and the novel hybrid PROactive instrument. Additionally, the influence of moderating variables (ie, factors influencing a patient's choice to be physically active) on increases in physical activity is also explored.

Ethics and dissemination

The study has been approved by the relevant Institutional Review Boards, Independent Ethics Committee and Competent Authority according to national and international regulations. The findings of the trial will be disseminated through relevant peer-reviewed journals and international conference presentations.

Trial registration number

NCT02085161.
Diagnostic accuracy of the Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D) for detecting major depression: protocol for a systematic review and individual patient data meta-analyses
Authors: Thombs Brett D , Benedetti Andrea , Kloda Lorie A , Levis Brooke , Azar Marleine , Riehm Kira E , Saadat Nazanin , Cuijpers Pim , Gilbody Simon , Ioannidis John P A , McMillan Dean , Patten Scott B , Shrier Ian , Steele Russell J , Ziegelstein Roy C , Loiselle Carmen G , Henry Melissa , Ismail Zahinoor , Mitchell Nicholas , Tonelli Marcello
Published: April 2016

Introduction

The Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D) has been recommended for depression screening in medically ill patients. Many existing HADS-D studies have used exploratory methods to select optimal cut-offs. Often, these studies report results from a small range of cut-off thresholds; cut-offs with more favourable accuracy results are more likely to be reported than others with worse accuracy estimates. When published data are combined in meta-analyses, selective reporting may generate biased summary estimates. Individual patient data (IPD) meta-analyses can address this problem by estimating accuracy with data from all studies for all relevant cut-off scores. In addition, a predictive algorithm can be generated to estimate the probability that a patient has depression based on a HADS-D score and clinical characteristics rather than dichotomous screening classification alone. The primary objectives of our IPD meta-analyses are to determine the diagnostic accuracy of the HADS-D to detect major depression among adults across all potentially relevant cut-off scores and to generate a predictive algorithm for individual patients. We are already aware of over 100 eligible studies, and more may be identified with our comprehensive search.

Methods and analysis

Data sources will include MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, PsycINFO and Web of Science. Eligible studies will have datasets where patients are assessed for major depression based on a validated structured or semistructured clinical interview and complete the HADS-D within 2 weeks (before or after). Risk of bias will be assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Bivariate random-effects meta-analysis will be conducted for the full range of plausible cut-off values, and a predictive algorithm for individual patients will be generated.

Ethics and dissemination

The findings of this study will be of interest to stakeholders involved in research, clinical practice and policy.
Many people in Scotland now benefit from anticipatory care before they die: an after death analysis and interviews with general practitioners
Authors: Tapsfield Julia , Hall Charlie , Lunan Carey , McCutcheon Hazel , McLoughlin Peter , Rhee Joel , Leiva Alfonso , Spiller Juliet , Finucane Anne , Murray Scott A
Published: April 2016

Background

Key Information Summaries (KIS) were introduced throughout Scotland in 2013 so that anticipatory care plans written by general practitioners (GPs) could be routinely shared electronically and updated in real time, between GPs and providers of unscheduled and secondary care.

Aims

We aimed to describe the current reach of anticipatory and palliative care, and to explore GPs’ views on using KIS.

Methods

We studied the primary care records of all patients who died in 2014 in 9 diverse Lothian practices. We identified if anticipatory or palliative care had been started, and if so how many weeks before death and which aspects of care had been documented. We interviewed 10 GPs to understand barriers and facilitating factors.

Results

Overall, 60% of patients were identified for a KIS, a median of 18 weeks before death. The numbers identified were highest for patients with cancer, with 75% identified compared with 66% of those dying with dementia/frailty and only 41% dying from organ failure. Patients were more likely to die outside hospital if they had a KIS. GPs identified professional, patient and societal challenges in identifying patients for palliative care, especially those with non-cancer diagnoses.

Conclusions

GPs are identifying patients for anticipatory and palliative care more equitably across the different disease trajectories and earlier in the disease process than they were previously identifying patients specifically for palliative care. However, many patients still lack care planning, particularly those dying with organ failure.
Instability of unbounded transverse mixing layer in shallow waters
Authors: Karimpour Shooka , Chu Vincent H.
Published: April 2016

This paper examines the role of waves in the development of the instability of an unbounded transverse mixing layer in shallow waters. In supercritical state waves become significant. The matching of the wave-like asymptotic solution in the far field to the solutions near the inflection and the returning surfaces poses a difficult mathematical problem. We therefore conducted numerical simulations to find solutions directly from the shallow water equations. The simulations found that the growing waves in the unstable current had a consistent structure throughout the linear stage of the instability’s development. The excitation, reflection, and transmission of waves produced a modulating instability that maintained a consistent structure as the amplitude of the instability increased over many orders of magnitude. This role of the waves on the supercritical instability, as delineated by our numerical simulations, is not solely describable by the classical analytical method.
Accounting for Product Similarity in Software Project Duration Estimation
Authors: Tastekin Semra Yilmaz , Erten Yusuf Murat , Bilgen Semih
Published: April 2016

We extend an existing model proposed for estimating project duration for industrial projects in general, to software intensive systems projects. We show, through nine different cases studies from different sectors, that product similarity, measured in terms of requirements reuse, can be incorporated into that model to improve its applicability in software intensive systems projects.
Basic principles of hp virtual elements on quasiuniform meshes
Authors: Beir ao da Veiga L. , Chernov A. , Mascotto L. , Russo A.
Published: April 2016

In the present paper we initiate the study of [Formula: see text] Virtual Elements. We focus on the case with uniform polynomial degree across the mesh and derive theoretical convergence estimates that are explicit both in the mesh size [Formula: see text] and in the polynomial degree [Formula: see text] in the case of finite Sobolev regularity. Exponential convergence is proved in the case of analytic solutions. The theoretical convergence results are validated in numerical experiments. Finally, an initial study on the possible choice of local basis functions is included.
Simulation-Based Optical Spectra Analyses and Synthesis of Highly Monodispersed Mn-Doped ZnSe Nanocrystal
Authors: Abib Mukerem H. , Yao Xudong , Li Guopeng , Mi Longfei , Chang Yajing , Wang Hui , Yu Dabin , Jiang Yang
Published: April 2016

Geometrical structures of (ZnSe)n, [Formula: see text], ([Formula: see text] 1–4) and (MnxZn[Formula: see text]Se[Formula: see text], ([Formula: see text] clusters were calculated using density functional theory (DFT). Optical/absorption spectra, Raman spectra, HOMO–LUMO gap energy and binding energy of each cluster were calculated. The calculated results show the red shift of the optical/absorption spectra band caused by the manganese atoms doped in ZnSe clusters, and the highest occupied molecular orbital-lowest unoccupied molecular orbital (HOMO–LUMO) gap energy value is decreased. Furthermore, we realized highly monodispersed manganese-doped zinc selenide quantum dots (Mn:ZnSe d-dots) experimentally by using a convenient route. The as-synthesized Mn:ZnSe d-dots were characterized by UV-Vis absorption, photoluminescence (PL), X-ray diffraction (XRD), TEM and HRTEM. The experimental results revealed that the as-prepared Mn:ZnSe d-dots with zinc-blende structure have an average size of about 3.9 nm.
China’s Policy Shifts on Southeast Asia
Authors: Lina Wang , Kun Zhai
Published: April 2016

Since Xi Jinping was elected General Secretary of the Communist Party of China (CPC) in November 2012, the Chinese leadership has made a series of policy shifts on Southeast Asia, demonstrated both in its policy proclamation and in China’s increasing engagement with the region. On the policy level, the Chinese leadership has declared its commitment to transforming the China-ASEAN relationship from a strategic partnership into a “community of common destiny” based on the strengthened four pillars of China-ASEAN relations. In practice, China is devoting itself to building a positive image, offering more public goods, and participating more actively in the shaping of norms and rules concerning the South China Sea and in the management of major power competition in the region. With regard to the formal establishment of the ASEAN Community, China is taking new initiatives to promote relations with the ASEAN by fostering common values and strategic trust while enhancing regional economic development.
Transfer Learning to Infer Social Ties across Heterogeneous Networks
Authors: Tang Jie , Lou Tiancheng , Kleinberg Jon , Wu Sen
Published: April 2016

Interpersonal ties are responsible for the structure of social networks and the transmission of information through these networks. Different types of social ties have essentially different influences on people. Awareness of the types of social ties can benefit many applications, such as recommendation and community detection. For example, our close friends tend to move in the same circles that we do, while our classmates may be distributed into different communities. Though a bulk of research has focused on inferring particular types of relationships in a specific social network, few publications systematically study the generalization of the problem of predicting social ties across multiple heterogeneous networks.

In this work, we develop a framework referred to as TranFG for classifying the type of social relationships by learning across heterogeneous networks. The framework incorporates social theories into a factor graph model, which effectively improves the accuracy of predicting the types of social relationships in a target network by borrowing knowledge from a different source network. We also present several active learning strategies to further enhance the inferring performance. To scale up the model to handle really large networks, we design a distributed learning algorithm for the proposed model.

We evaluate the proposed framework (TranFG) on six different networks and compare with several existing methods. TranFG clearly outperforms the existing methods on multiple metrics. For example, by leveraging information from a coauthor network with labeled advisor-advisee relationships, TranFG is able to obtain an F1-score of 90% (8%--28% improvements over alternative methods) for predicting manager-subordinate relationships in an enterprise email network. The proposed model is efficient. It takes only a few minutes to train the proposed transfer model on large networks containing tens of thousands of nodes.
Colonic Carcinoma in Two Adult Cystic Fibrosis Patients
Authors: Chaun H , Paty B , Nakielna EM , Schmidt N , Holden Jk , Melosky B
Published: April 2016

Two adult women with cystic fibrosis (CF) who developed colonic carcinoma, both at age 31, are described. In both patients the carcinoma occurred in the midtransverse colon. The diagnosis had not been suspected, partly because of the patients’ relatively young age. In case 1, the symptoms also mimicked the distal intestinal obstruction syndrome. At diagnosis she was shown to have metastases to the regional lymph nodes. In case 2, despite a long history of chronic pulmonary and sinus disorders, CF was not diagnosed until the patient was 36 years old. The incidence of gastrointestinal malignancies has been shown to be significantly increased in patients with CF. As the life expectancy of the CF population increases, vigilance for gastrointestinal cancers in CF patients is important, as illustrated by these two cases.
Neoplastic Disorders in 100 Patients with Adult Celiac Disease
Authors: Freeman HUGH J
Published: April 2016

Previous reports have suggested that the incidence of some neoplastic disorders, particularly malignant lymphoma, is increased in patients with celiac disease. In this study, the type and number of neoplastic disorders detected in 100 consecutive celiac disease patients were explored. Sixty-five patients were initially diagnosed with celiac disease before, and 35 after, age 60 years. Ten elderly celiac patients had lymphoma or small intestinal adenocarcinoma. Although the overall incidence of malignant lymphoma was 8%, similar to that in other centres, the incidence in elderly celiac patients was 23% in this study. Celiac disease was detected before or after the diagnosis of lymphoma or small intestinal adenocarcinoma. In some patients, epithelial lymphocytosis was evident in the gastric, colonic or biliary tract epithelium. In addition, other immune-mediated disorders, dermatitis herpetiformis and autoimmune thyroiditis, were common. Finally, other malignant disorders of the esophagus, stomach and colon were not detected.
Endoscopic Diagnosis of Pyriform Fossa Lymphoma
Authors: Thomson A , Marlton P
Published: April 2016

Many endoscopists do not inspect the gastrointestinal tract superior to the cricopharyngeus, despite the fact that gastrointestinal symptoms (dysphagia, odynophagia and chest pain) can be produced by glottic and supraglottic lesions. A case of incoordinate swallowing secondary to a right-sided pyriform fossa lymphoma diagnosed at gastroscopy is presented.
Early Gastric Post-Transplant Lymphoproliferative Disorder andH pyloriDetection after Kidney Transplantation: A Case Report and Review of the Literature
Authors: Nash CL , Price LM , Stewart DA , Sepandj F , Yilmaz S , Barama A
Published: April 2016

The incidence of post-transplantation lymphoproliferative disorder (PTLD) in the adult renal transplant population ranges from 0.7% to 4%. The majority of cases involve a single site and arise, on average, seven months after transplantation. Histopathology usually reveals B-cell proliferative disease and has been standardized into its own classification. Treatment modalities consist of decreased immunosuppression, eradication of Epstein-Barr virus, surgical resection, systemic chemotherapy and monoclonal antibody therapy; however, mortality remains high, typically with a short survival time. In patients who have undergone renal transplantation, approximately 10% of those with PTLDs present with gastrointestinal symptomatology and disease. Reported sites include the stomach, and small and large bowel. Very few cases ofHelicobacter pylorior mucosal-associated lymphoid tissue have been described in association with PTLD. In the era of cyclosporine immunosuppression, the incidence of PTLD affecting the gastrointestinal tract may be increasing in comparison with the incidence seen with the use of older immunosuppression regimens. A case of antral PTLD andH pyloriinfection occurring three months after renal transplantation is presented, and the natural history and management of gastric PTLD are reviewed.
Gallstones in Elderly Patients: Impact of Laparoscopic Cholecystectomy
Authors: Montori A , Boscaini M , Gasparrini M , Miscusi G , Masoni L , Onorato M , Montori J
Published: April 2016

The use of laparoscopic cholecystectomy (LC) in elderly patients may pose problems because of their poor general condition, especially of cardiopulmonary function. Moreover, these patients present with acute cholecystitis and associated common bile duct stones more often than their younger counterparts. From 1990 to 1999, the authors performed 943 LCs; 31 (3.2%) were attempted on elderly patients, 11 (35%) of which were on an emergency basis because of acute cholecystitis, cholangitis or acute biliary pancreatitis. Ten per cent of LCs needed to be converted to an open cholecystectomy, most often because of an increase in the partial pressure of carbon dioxide in the blood produced by excessive operative time. A gasless procedure was used in the last three years of the study on eight cases; the overall rate of conversion from LC to open cholecystectomy in this group was 0%. Associated gallbladder and common bile duct stones were found in five (16%) patients (four preoperative LC endoscopic sphincterotomy and one transcystic approach). The success rate in both of these cases was 100%, overall morbidity was 29% and there was no mortality. These results show that LC is a feasible and safe procedure for use in elderly patients. Gasless LC should be preferred in patients classified as American Society of Anesthesiologists’ class III because an excessive duration of operation is the most common reason for converting to an open cholecystectomy.
Granulomatous Osteonecrosis in Crohn’s Disease
Authors: Freeman Hugh J , Owen David , Millan Mario
Published: April 2016

A 25‐year‐old white woman was diagnosed with Crohn’s disease involving the small and large intestines. She had a complex clinical course that required treatment with multiple pharmacological agents, including intravenous, oral and rectal corticosteroids. She also received parenteral nutrition with lipid emulsions. Finally, repeated intestinal resections and drainage of perianal abscesses were required. Her disease was complicated by gallstones, urolithiasis and hip pain. After osteonecrosis was diagnosed, joint replacements were performed. Review of the pathological sections from the resected hip, however, resulted in detection of granulomatous inflammation with multinucleated giant cells ‐ the histological ’footprint’ of Crohn’s disease in the gastrointestinal tract. Because prior specialized perfusion fixation pathological studies of the intestine in Crohn’s disease have shown that granulomas are located in the walls of blood vessels, a possible mechanism for the pathogenesis of osteonecrosis in Crohn’s disease is chronic microvascular ischemia of bone.
A Critical Approach to Clinical Practice Guidelines
Authors: Marshall John K
Published: April 2016

The rate of publication of clinical practice guidelines for the management of common medical illnesses continues to accelerate. The appropriate dissemination and uptake of high quality practice guidelines can synthesize evidence, improve patient outcomes and enhance the efficiency of health care delivery. However, the methodological rigour and relevance of the growing number of publications labelled ’clinical practice guidelines’ vary widely. Health care payers, providers and advocates must learn to appraise and interpret guideline recommendations critically. A simple and practical nine-question approach to evaluating the quality, relevance and effectiveness of clinical practice guidelines is presented.
Collagenous and Lymphocytic Colitis: A Clinical and Histopathological Review
Authors: Bohr Johan , Olesen Martin , Tysk Curt , Järnerot Gunnar
Published: April 2016

Collagenous colitis and lymphocytic colitis are newly described colitides that are only diagnosable microscopically; therefore, both are known under the umbrella term ’microscopic colitis’. This is a short review of the clinical findings, and epidemiological and basic observations of these relatively little described colitides belonging to the group of inflammatory bowel diseases.
Nonceliac Diaphragm Disease of the Duodenum
Authors: Freeman Hugh J
Published: April 2016

A 58-year-old, Indo-Canadian man presented with upper abdominal pain and the clinical features of a partial, gastric outlet obstruction. Subsequent studies, including endoscopic examination, revealed diaphragm-like strictures in the descending duodenum. Other reported causes such as celiac disease and drug-induced small bowel diaphragms were excluded. Possibly, the changes seen in this patient were related to ethnic food-induced, mucosal injury to the upper gastrointestinal tract. Further studies are needed to evaluate potential toxicity or protective effects of different ethnic diets and their relationship with the development of different intestinal diseases.
Measurement of Gallbladder Volume with Ultrasonography in Pregnant Women
Authors: Kapicioglu Sait , Gürbüz Sevgi , Danalioglu Ahmet , Sentürk Ömer , Uslu Mehmet
Published: April 2016

Fasting and postprandial gallbladder volumes were investigated using ultrasonography in three groups (10 subjects in each) of healthy women: third trimester pregnant women, postpartum women up to 10 days after giving birth and nonpregnant controls. The scans were performed at 09:00 after a 12 h fast. After the basal measurement was taken, gallbladder volumes were rescanned in 15 min intervals for 60 mins. At the end of this period, all volunteers received a standard liquid test meal, and scans were performed again for 1 h. The mean basal gallbladder volume was 22.2±4.2 mL in the nonpregnant (control) group. In the third trimester group, the basal volume was 37.8±10.5 mL – 70.5% higher than in the nonpregnant group (P<0.001). In the postpartum group, the mean basal volume was 37.9% lower (27.4±6.5 mL) than that of the third trimester group (P<0.02). This basal volume was 23.6% greater than that of the control group (P<0.05). After administration of a test meal, the postprandial gallbladder volumes decreased during the first few minutes compared with baseline values. The volumes decreased by 10.2% to 39.8% (23.5±7.3 to 34.0±10.2; P<0.01) in the third trimester group, by 14.9% to 43.2% (16.6±4.3 to 23.3±5.5; P<0.01, 0.001) in the postpartum group and by 19.2% to 51.6% (11.9±3.5 to 17.9±3.6; P<0.02, 0.05, 0.01, 0.001) in the control group. Postprandial mean gallbladder volumes of the third trimester (P<0.02) and postpartum groups (P<0.02 to 0.01) were significantly different from those of the control group. In conclusion, incomplete emptying of the gallbladder after eating during the third trimester of pregnancy may contribute to cholesterol-gallstone formation, and pregnancy may thus increase the risk of gallstones.
Achalasia: Dilation, Injection or Surgery?
Authors: Peracchia Alberto , Bonavina Luigi
Published: April 2016

Achalasia results from irreversible alterations of the esophageal myenteric plexus. The target of treatment in this setting is to reduce lower esophageal sphincter resistance to passage of the bolus. Definitive treatment of the disease requires pneumatic dilation or Heller myotomy. Although no controlled studies comparing modern endoscopic and surgical techniques are available, laparoscopic surgery is emerging as the initial intervention of choice.
Obscure Gastrointestinal Bleeding: An Approach to Management
Authors: Marshall JK , Lesi OA , Hunt RH
Published: April 2016

Obscure gastrointestinal bleeding provides an uncommon but frustrating and resource-intensive challenge for clinicians. Such patients hemorrhage recurrently from sites within the gastrointestinal tract that are not detected by routine endoscopy or radiography, and require a special diagnostic approach to localize or exclude less common bleeding sources such as small bowel angioectasia or neoplasia. The differential diagnosis of obscure gastrointestinal hemorrhage is discussed, and the performance of available endoscopic, radiological and surgical diagnostic tools including enteroscopy are examined critically. A stepwise management algorithm that progresses from the history and physical examination to surgical exploration is offered to facilitate early and efficient diagnosis.
Pure Oats as Part of the Canadian Gluten-Free Diet in Celiac Disease: The Need to Revisit the Issue
Authors: de Souza M. Cristina P. , Deschênes Marie-Eve , Laurencelle Suzanne , Godet Patrick , Roy Claude C. , Djilali-Saiah Idriss
Published: April 2016

The question about recommending pure, noncontaminated oats as part of the gluten-free diet of patients with celiac disease remains controversial. This might be due to gluten cross contamination and to the possible immunogenicity of some oat cultivars. In view of this controversy, a review of the scientific literature was conducted to highlight the latest findings published between 2008 and 2014 to examine the current knowledge on oats safety and celiac disease in Europe and North America. Results showed that regular oats consumed in Canada are largely contaminated. Overall, the consumption of pure oats has been generally considered to be safe for adults and children. However, it appears that some oat cultivars may trigger an immune response in sensitive individuals. Therefore, further long-term studies on the impact of consumption of oats identifying the cultivar(s) constitute an important step forward for drawing final recommendations. Furthermore, a closer and more accurate monitoring of the dietary intake of noncontaminated oats would be paramount to better determine what its actual contribution in the gluten-free diet of adults and children with celiac disease are in order to draw sound recommendations on the safety of pure oats as part of the gluten-free diet.
Modeling, Validation, and Control of Electronically Actuated Pitman Arm Steering for Armored Vehicle
Authors: Aparow Vimal Rau , Hudha Khisbullah , Kadir Zulkiffli Abd , Ahmad Megat Mohamad Hamdan Megat , Abdullah Shohaimi
Published: April 2016

In this study, 2 DOF mathematical models of Pitman arm steering system are derived using Newton’s law of motion and modeled in MATLAB/SIMULINK software. The developed steering model is included with a DC motor model which is directly attached to the steering column. The Pitman arm steering model is then validated with actual Pitman arm steering test rig using various lateral inputs such as double lane change, step steer, and slalom test. Meanwhile, a position tracking control method has been used in order to evaluate the effectiveness of the validated model to be implemented in active safety system of a heavy vehicle. The similar method has been used to test the actual Pitman arm steering mechanism using hardware-in-the-loop simulation (HILS) technique. Additional friction compensation is added in the HILS technique in order to minimize the frictional effects that occur in the mechanical configuration of the DC motor and Pitman arm steering. The performance of the electronically actuated Pitman arm steering system can be used to develop a firing-on-the-move actuator (FOMA) for an armored vehicle. The FOMA can be used as an active safety system to reject unwanted yaw motion due to the firing force.
Investigating Theoretical PV Energy Generation Patterns with Their Relation to the Power Load Curve in Poland
Authors: Jurasz Jakub , Mikulik Jerzy
Published: April 2016

Polish energy sector is (almost from its origin) dominated by fossil fuel feed power. This situation results from an abundance of relatively cheap coal (hard and lignite). Brown coal due to its nature is the cheapest energy source in Poland. However, hard coal which fuels 60% of polish power plants is picking up on prices and is susceptible to the coal imported from neighboring countries. Forced by the European Union (EU) regulations, Poland is struggling at achieving its goal of reaching 15% of energy consumption from renewable energy sources (RES) by 2020. Over the year 2015, RES covered 11.3% of gross energy consumption but this generation was dominated by solid biomass (over 80%). The aim of this paper was to answer the following research questions: What is the relation of irradiation values to the power load on a yearly and daily basis? and how should photovoltaics (PV) be integrated in the polish power system? Conducted analysis allowed us to state that there exists a negative correlation between power demand and irradiation values on a yearly basis, but this is likely to change in the future. Secondly, on average, daily values of irradiation tend to follow power load curve over the first hours of the day.
Ru-Based Thin Film Temperature Sensor for Space Environments: Microfabrication and Characterization under Total Ionizing Dose
Authors: Ravelo Arias S. I. , Ramírez Muñoz D. , Cardoso Susana , Freitas Paulo P.
Published: April 2016

The paper shows the microfabrication processes of a Ruthenium-based resistance temperature detector and its behavior in response to irradiation at ambient temperature. The radiation test was done in a public hospital facility and followed the procedures based on the ESA specification ESCC 22900. The instrumentation system used for the test is detailed in the work describing the sensors resistance evolution before, during, and after the exposure. A total irradiation dose of 43 krad with 36 krad/h dose rate was applied and a subsequent characterization was performed once the Ru sensors were submitted to an 80°C annealing process during a period of 168 h. The experimental measurements have shown the stability of this sensor against total ionizing dose (TID) tests, not only in their resistance absolute values during the irradiation phase but also in the relative deviation from their values before irradiation.
Performance Analysis of a Peak-Current Mode Control with Compensation Ramp for a Boost-Flyback Power Converter
Authors: Muñoz Juan-Guillermo , Gallo Guillermo , Osorio Gustavo , Angulo Fabiola
Published: April 2016

High voltage gain power converters are very important in photovoltaic applications mainly due to the low output voltage of photovoltaic arrays. This kind of power converters includes three or more semiconductor devices and four or more energy storage elements, making the dynamical analysis of the controlled system more difficult. In this paper, the boost-flyback power converter is controlled by peak-current mode with compensation ramp. The closed-loop analysis is performed to guarantee operation conditions such that a period-1 orbit is attained. The converter is considered as a piecewise linear system, and the closed-loop stability is determined by using the monodromy matrix, obtained by the composition of the saltation matrixes with the solutions of the dynamical equations in the linear intervals. The largest eigenvalue of the monodromy matrix gives the stability of the period-1 orbit, and a deep analysis using bifurcation diagrams let us reach a conclusion about the loss of the stability, which is experimentally verified. To avoid overcompensation effects, the minimum value required by the compensation ramp is obtained, and the minimum and maximum values of the load resistance are found too. The system has a good transient response under disturbances in the load and in the input voltage.
Ex Vivo Stromal Cell‐Derived Factor 1‐Mediated Differentiation of Mouse Bone Marrow Mesenchymal Stem Cells into Hepatocytes Is Enhanced by Chinese Medicine Yiguanjian Drug‐Containing Serum
Authors: Fu Linlin , Pang Bingyao , Zhu Ying , Wang Ling , Leng Aijing , Chen Hailong
Published: April 2016

Yiguanjian is administered in traditional Chinese medicine for liver diseases and has been demonstrated to reduce liver fibrosis. This study investigated the effect of Yiguanjian drug‐containing serum (YGJ) with Stromal Cell‐Derived Factor 1 (SDF‐1) and Hepatocyte Growth Factor (HGF) on the differentiation of murine bone‐marrow‐derived mesenchymal cells (BM‐MSCs) into hepatocytes in vitro. Adherent MSCs were isolated from murine bone marrow. Differentiation was induced by 20 ng/mL HGF, 50 ng/mL SDF‐1, and 20% Yiguanjian drug‐containing serum for 7 to 28 days, and mature hepatocytes’ marker albumin (ALB) and cholangiocytes’ marker cytokeratin‐18 (CK‐18) were assessed by immunocytochemistry and western blot. BM‐MSCs exhibited homogeneous spindle shape growth after subculture and stained positive for CD90 and negative for CD34. After induction with HGF + normal serum or YGJ for 14 days, HGF + SDF‐1 + normal serum for 7 days, or HGF + SDF‐1 + YGJ for 5 days, MSCs’ morphology changed gradually and begun to resemble hepatocyte‐like cells. Cultures supplemented with HGF + SDF‐1 + YGJ contained significantly higher proportions of ALB and CK‐18 positive cells than cultures supplemented with HGF + SDF‐1 + normal serum at day 7. These observations corroborated the results of western blot. In conclusion, Yiguanjian drug‐containing serum could facilitate the differentiation of murine BM‐MSCs into hepatocytes in vitro and has a synergistic effect with SDF‐1 and HGF.
A Centralized Energy Efficient Distance Based Routing Protocol for Wireless Sensor Networks
Authors: Gawade Rohit D. , Nalbalwar S. L.
Published: April 2016

Wireless sensor network (WSN) typically consists of a large number of low cost wireless sensor nodes which collect and send various messages to a base station (BS). WSN nodes are small battery powered devices having limited energy resources. Replacement of such energy resources is not easy for thousands of nodes as they are inaccessible to users after their deployment. This generates a requirement of energy efficient routing protocol for increasing network lifetime while minimizing energy consumption. Low Energy Adaptive Clustering Hierarchy (LEACH) is a widely used classic clustering algorithm in WSNs. In this paper, we propose a Centralized Energy Efficient Distance (CEED) based routing protocol to evenly distribute energy dissipation among all sensor nodes. We calculate optimum number of cluster heads based on LEACH’s energy dissipation model. We propose a distributed cluster head selection algorithm based on dissipated energy of a node and its distance to BS. Moreover, we extend our protocol by multihop routing scheme to reduce energy dissipated by nodes located far away from base station. The performance of CEED is compared with other protocols such as LEACH and LEACH with Distance Based Thresholds (LEACH-DT). Simulation results show that CEED is more energy efficient as compared to other protocols. Also it improves the network lifetime and stability period over the other protocols.
Sum-Power Minimization in Multiuser Single-DF-Relay Networks with Direct Links
Authors: Wang Shiguo , Peng Haixia , Liu Xianru
Published: April 2016

Forming cooperation through relay's assistance is a promising method to realize green communication by reducing transmission power. In this paper, for multiuser single-DF-relay wireless networks with direct links, the optimal power allocation strategy that minimizes system-sum-power consumption is investigated. Based on the principle that minimizing system-sum-power consumption is equivalent to maximizing system energy efficiency, users are classified into two parts after comparing the channel gains between source-destination link and relay-destination link. The optimal power allocation strategy of one part is determined directly, and minimizing the system-sum-power consumption of the other part is converted into minimizing source-sum-power consumption, which can be solved easily through Karush-Kuhn-Tucker (KKT) condition. Through numerical simulations, we further justified the effectiveness of our scheme compared to existing works.