bluuebunny/crossref_metadata_2025 huggingface dataset:
Disseminated histoplasmosis presenting as multiple oral ulcers
Authors: Hendren Nicholas , Yek Christina , Mull Jason , Cutrell James B
Published: July 2017

A 61-year-old female with a history of advanced HIV disease and chronic hepatitis B was presented with an 8-week history of painful oral ulcers. She appeared systemically well but examination revealed multiple well-demarcated clean-based ulcers on the tongue and hard palate. Biopsy of one of the lesions showed numerous histiocytes containing intracellular yeast forms consistent withHistoplasma capsulatum var. capsulatum. Fungal blood cultures subsequently grewH. capsulatum var. capsulatum, confirming a diagnosis of disseminated histoplasmosis. She was treated with intravenous amphotericin B for 2 weeks followed by a prolonged course of oral itraconazole, with which her ulcers resolved completely and have not recurred. This case exemplifies how oral ulcers may be a manifestation of an underlying systemic disease and demonstrates the utility of biopsy in establishing a diagnosis.
Thyrotoxicosis in patients with hypothyroidism is not just overtreatment
Authors: Kempegowda Punith , Nayak Ananth U
Published: July 2017

A 62-year-old Caucasian woman presented with hypothyroid symptoms and biochemical thyrotoxic picture. Previously, she underwent right-sided subtotal thyroidectomy and left partial thyroid lobectomy for thyroid lumps, and treated with thyroxine replacement for hypothyroidism. Although there were no significant findings on clinical examination, investigations confirmed thyrotoxicosis with positive autoimmunity against thyroid glandâ€”all in line with a diagnosis of Gravesâ€™ hyperthyroidism. We would like to highlight atypical presentations of thyroid dysfunction and conversion of underactive to overactive thyroid status with this case. Early recognition, diagnosis and intervention are essential to prevent and/or reduce associated morbidity and mortality. When encountered with such clinical conundrums, we recommend seeking opinion from an experienced endocrinologist while interpreting such situation.
Lupus miliaris disseminatus faciei: a distinctive facial granulomatous eruption
Authors: Dev Tanvi , Thami Tarkik , Longchar Moanaro , Sethuraman Gomathy
Published: July 2017

Facial granulomatous papules are important to recognise, as some of them are associated with significant systemic association, particularly sarcoidosis and certain infectious conditions. Lupus miliaris disseminatus faciei (LMDF) is a benign granulomatous disorder of unknown aetiology characterised by symmetrical, monomorphic, reddish-brown papules on the face. It is not associated with any underlying systemic involvement. We report a case of LMDF in a middle-aged man who presented to us with multiple asymptomatic and monomorphic reddish papules on the face for 3 months. Skin biopsy showed well-formed perifollicular epithelioid cell granulomas with focus of necrosis suggestive of LMDF. The lesions significantly responded to oral steroids.
Effectiveness of government anti-smoking policy on non-smoking youth in Korea: a 4-year trend analysis of national survey data
Authors: Kwak Jueun , Jeong Hyunsuk , Chun Sungha , Bahk Ji Hoon , Park Misun , Byun Youngseol , Lee Jina , Yim Hyeon Woo
Published: July 2017

Objectives

Since the Health Promotion Act was introduced in Korea in 1995, anti-smoking policies and regulations have undergone numerous revisions, and non-smoking areas have gradually been expanded. The purpose of this study was to examine the impact of a partial legislative ban on adolescent exposure to secondhand smoke using objective urinary cotinine levels in a nationwide representative sample.

Methods

Urine cotinine levels were measured in the Korea National Health and Nutrition Examination Survey from 2008 to 2011. This study was a trend analysis of 4 years of national survey data from 2197 Korean youth aged 10–18 years. Among non-smokers, the 75th percentile urinary cotinine level was estimated. We also considered the number of household smokers.

Results

The 75th percentile urine cotinine level of non-smokers showed a significant decreasing trend from 2008 to 2011, from 15.47 to 5.37 ng/mL, respectively. Urine cotinine did not decline significantly in non-smokers living with smokers during the study period. The results did not show a statistically significant reduction in smoking rate in adolescents from 2008 to 2011, although there was a trend towards a decrease (p=0.081).

Conclusions

Based on urine cotinine levels, government-initiated anti-smoking policies have only been effective among highly exposed non-smoking adolescents during the study period. Further study needs to evaluate whether or not the legislative ban affects domestic smoking exposure.
Efficacy of home-based non-pharmacological interventions for treating depression: a systematic review and network meta-analysis of randomised controlled trials
Authors: Sukhato Kanokporn , Lotrakul Manote , Dellow Alan , Ittasakul Pichai , Thakkinstian Ammarin , Anothaisintawee Thunyarat
Published: July 2017

Objectives

To systematically review and compare the efficacy of all available home-based non-pharmacological treatments of depression.

Design

Systematic review and network meta-analysis of randomised controlled trials.

Data sources

Medline, Scopus and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched since inceptions to 7 August 2016.

Eligibility criteria

Randomised controlled trials comparing the efficacy of home-based non-pharmacological interventions with usual care of patients with depression were included in the review.

Main outcomes

Depression symptom scores and disease remission rates at the end of treatment.

Results

Seventeen studies were included in the review. Home-based non-pharmacological interventions were categorised as (1) home-based psychological intervention, (2) home-based exercise intervention, (3) combined home-based psychological intervention with exercise intervention and (4) complementary medicine. Complementary medicine approaches were excluded from the meta-analysis due to heterogeneity. The standardised mean differences of post-treatment depression symptom scores between usual care groups and home-based psychological intervention, home-based exercise intervention and combined home-based psychological intervention with exercise intervention were âˆ’0.57 (95% CI âˆ’0.84 to âˆ’0.31), âˆ’1.03 (95% CI âˆ’2.89 to 0.82) and âˆ’0.78 (95% CI âˆ’1.09 to âˆ’0.47), respectively. These results suggest that only home-based psychological intervention and combined home-based psychological intervention with exercise intervention could significantly decrease depression scores. Compared with usual care groups, the disease remission rate was also significantly higher for home-based psychological intervention (pooled risk ratio=1.53; 95%â€‰CI 1.19 to 1.98) and combined home-based psychological intervention with exercise intervention (pooled risk ratio=3.47; 95%â€‰CI 2.11 to 5.70). Of all the studied interventions, combined home-based psychological intervention with exercise intervention had the highest probability of resulting in disease remission.

Conclusion

Our study confirms the efficacy of home-based psychological intervention and combined home-based psychological intervention with exercise intervention in the treatment of depression. Combined home-based psychological intervention and exercise intervention was the best treatment and should be considered for inclusion in clinical guidelines for managing depression.
Elucidating the information exchange during interfacility care transitions: Insights from a Qualitative Study
Authors: Jeffs Lianne , Saragosa Marianne , Law Madelyn , Kuluski Kerry , Espin Sherry , Merkley Jane , Bell Chaim M
Published: July 2017

Objective

To explore the perceptions of patients, their caregivers and healthcare professionals associated with the exchange of information during transitioning from two acute care hospitals to one rehabilitation hospital.

Design

An exploratory qualitative study using semi-structured interviews and observation.

Participants and setting

Patients over the age of 65 years admitted to an orthopaedic unit for a non-elective admission, their caregivers and healthcare professionals involved in their care. Participating sites included orthopaedic inpatient units from two acute care teaching hospitals and one orthopaedic unit at a rehabilitation hospital in an urban setting.

Findings

Three distinct themes emerged from participants’ narrative of their transitional care experience: (1) having no clue what the care plan is, (2) being told and notified about the plan and (3) experiencing challenges absorbing information. Participating patients and their caregivers reported not being engaged in an active discussion with healthcare professionals about their care transition plan. Several healthcare professionals described withholding information within the plan until they themselves were clear about the transition outcomes.

Conclusion

This study highlights the need to increase efforts to ensure that effective information exchanges occur during transition from acute care hospital to rehabilitation settings.
Vitamin D levels in critically ill patients with acute kidney injury: a protocol for a prospective cohort study (VID-AKI)
Authors: Cameron Lynda Katherine , Lei Katie , Smith Samantha , Doyle Nanci Leigh , Doyle James F , Flynn Kate , Purchase Nicola , Smith John , Chan Kathryn , Kamara Farida , Kidane Nardos Ghebremedhin , Forni Lui G , Harrington Dominic , Hampson Geeta , Ostermann Marlies
Published: July 2017

Introduction

Acute kidney injury (AKI) affects more than 50% of critically ill patients. The formation of calcitriol, the active vitamin D metabolite, from the main inactive circulating form, 25-hydroxyvitamin D (25(OH)D), occurs primarily in the proximal renal tubules. This results in a theoretical basis for reduction in levels of calcitriol over the course of an AKI. Vitamin D deficiency is highly prevalent in critically ill adults, and has been associated with increased rates of sepsis, longer hospital stays and increased mortality. The primary objective of this study is to perform serial measurements of 25(OH)D and calcitriol (1,25(OH)2D), as well as parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF23) levels, in critically ill adult patients with and without AKI, and to determine whether patients with AKI have significantly lower vitamin D metabolite concentrations. The secondary objectives are to describe dynamic changes in vitamin D metabolites, PTH and FGF23 during critical illness; to compare vitamin D metabolite concentrations in patients with AKI with and without renal replacement therapy; and to investigate whether there is an association between vitamin D status and outcomes.

Methods and analysis

230 general adult intensive care patients will be recruited. The AKI arm will include 115 critically ill patients with AKI Kidney Disease Improving Global Outcome stage II or stage III. The comparison group will include 115 patients who require cardiovascular or respiratory support, but who do not have AKI. Serial measurements of vitamin D metabolites and associated hormones will be taken on prespecified days. Patients will be recruited from two large teaching Trusts in England. Data will be analysed using standard statistical methods.

Ethics and dissemination

Ethical approval was obtained. Upon completion, the study team will submit the study report for publication in a peer-reviewed scientific journal and for conference presentation.

Trial registration number

NCT02869919; Pre-results.
Use of a mobile social networking intervention for weight management: a mixed-methods study protocol
Authors: Laranjo Liliana , Lau Annie Y S , Martin Paige , Tong Huong Ly , Coiera Enrico
Published: July 2017

Introduction

Obesity and physical inactivity are major societal challenges and significant contributors to the global burden of disease and healthcare costs. Information and communication technologies are increasingly being used in interventions to promote behaviour change in diet and physical activity. In particular, social networking platforms seem promising for the delivery of weight control interventions.

We intend to pilot test an intervention involving the use of a social networking mobile application and tracking devices (Fitbit Flex 2andFitbit Ariascale) to promote the social comparison of weight and physical activity, in order to evaluate whether mechanisms of social influence lead to changes in those outcomes over the course of the study.

Methods and analysis

Mixed-methods study involving semi-structured interviews and a pre–post quasi-experimental pilot with one arm, where healthy participants in different body mass index (BMI) categories, aged between 19 and 35 years old, will be subjected to a social networking intervention over a 6-month period. The primary outcome is the average difference in weight before and after the intervention. Secondary outcomes include BMI, number of steps per day, engagement with the intervention, social support and system usability. Semi-structured interviews will assess participants’ expectations and perceptions regarding the intervention.

Ethics and dissemination

Ethics approval was granted by Macquarie University’s Human Research Ethics Committee for Medical Sciences on 3 November 2016 (ethics reference number 5201600716).

The social network will be moderated by a researcher with clinical expertise, who will monitor and respond to concerns raised by participants. Monitoring will involve daily observation of measures collected by the fitness tracker and the wireless scale, as well as continuous supervision of forum interactions and posts. Additionally, a protocol is in place to monitor for participant misbehaviour and direct participants-in-need to appropriate sources of help.
Detailed assessment of benefits and risks of retrievable inferior vena cava filters on patients with complicated injuries: the da Vinci multicentre randomised controlled trial study protocol
Authors: Ho Kwok M , Rao Sudhakar , Honeybul Stephen , Zellweger Rene , Wibrow Bradley , Lipman Jeffrey , Holley Anthony , Kop Alan , Geelhoed Elizabeth , Corcoran Tomas
Published: July 2017

Introduction

Retrievable inferior vena cava (IVC) filters have been increasingly used in patients with major trauma who have contraindications to anticoagulant prophylaxis as a primary prophylactic measure against venous thromboembolism (VTE). The benefits, risks and cost-effectiveness of such strategy are uncertain.

Methods and analysis

Patients with major trauma, defined by an estimated Injury Severity Score >15, who have contraindications to anticoagulant VTE prophylaxis within 72 hours of hospitalisation to the study centre will be eligible for this randomised multicentre controlled trial. After obtaining consent from patients, or the persons responsible for the patients, study patients are randomly allocated to either control or IVC filter, within 72 hours of trauma admission, in a 1:1 ratio by permuted blocks stratified by study centre. The primary outcomes are (1) the composite endpoint of (A) pulmonary embolism (PE) as demonstrated by CT pulmonary angiography, high probability ventilation/perfusion scan, transoesophageal echocardiography (by showing clots within pulmonary arterial trunk), pulmonary angiography or postmortem examination during the same hospitalisation or 90-day after trauma whichever is earlier and (B) hospital mortality; and (2) the total cost of treatment including the costs of an IVC filter, total number of CT and ultrasound scans required, length of intensive care unit and hospital stay, procedures and drugs required to treat PE or complications related to the IVC filters. The study started in June 2015 and the final enrolment target is 240 patients. No interim analysis is planned; incidence of fatal PE is used as safety stopping rule for the trial.

Ethics and dissemination

Ethics approval was obtained in all four participating centres in Australia. Results of the main trial and each of the secondary endpoints will be submitted for publication in a peer-reviewed journal.

Trial registration number

ACTRN12614000963628; Pre-results.
Interventions that improve maternity care for immigrant women in the UK: protocol for a narrative synthesis systematic review
Authors: Higginbottom Gina Marie Awoko , Evans Catrin , Morgan Myfanwy , Bharj Kuldip Kaur , Eldridge Jeanette , Hussain Basharat
Published: July 2017

Introduction

A quarter of all births in the UK are to mothers born outside the UK. There is also evidence that immigrant women have higher maternal and infant death rates and of inequalities in the provision and uptake of maternity services/birth centres. The topic is of great significance to the National Health Service because of directives that address inequalities and the changing patterns of migration to the UK. Our main question for the systematic review is ‘what interventions exist that are specifically focused on improving maternity care for immigrant women in the UK?’ The primary objective of this synthesis is to generate new interpretations of research evidence. Second, the synthesis will provide substantive base to guide developments and implementation of maternity services/birth centres which are acceptable and effective for immigrant women in the UK.

Methods and analysis

We are using a narrative synthesis (NS) approach to identify, assess scientific quality and rigour, and synthesise empirical data focused on access and interventions that enhance quality of maternity care/birth centres for the UK immigrant women. The inclusion criteria include: publication date 1990 to present, English language, empirical research and findings are focused on women who live in the UK, participants of the study are immigrant women, is related to maternity care/birth centres access or interventions or experiences of maternity.

In order to ensure the robustness of the NS, the methodological quality of key evidence will be appraised using the Center for Evidence-Based Management tools and review confidence with CERQual (Confidence in the Evidence from Reviews of Qualitative Research). Two reviewers will independently screen studies and extract relevant evidence. We will synthesise evidence studying relationships between included studies using a range of tools.

Dissemination

Dissemination plan includes: an e-workshop for policymakers, collaborative practitioner workshops, YouTube video and APP, scientific papers and conference presentations.
Methotrexate and low-dose prednisolone downregulate osteoclast function by decreasing receptor activator of nuclear factor-κβ expression in monocytes from patients with early rheumatoid arthritis
Authors: Perpétuo Inês Pedro , Caetano-Lopes Joana , Rodrigues Ana Maria , Campanilho-Marques Raquel , Ponte Cristina , Canhão Helena , Ainola Mari , Fonseca João Eurico
Published: July 2017

Objective

Rheumatoid arthritis (RA) is a systemic, immune-mediated inflammatory disease that ultimately leads to bone erosions and joint destruction. Methotrexate (MTX) slows bone damage but the mechanism by which it acts is still unknown. In this study, we aimed to assess the effect of MTX and low-dose prednisolone (PDN) on circulating osteoclast (OC) precursors and OC differentiation in patients with RA.

Methods

Patients with RA before and at least 6 months after MTX therapy were analysed and compared with healthy donors. A blood sample was collected in order to assess receptor activator of NF-κβ (RANK) ligand surface expression on circulating leucocytes and frequency and phenotype of monocyte subpopulations. Quantification of serum levels of bone turnover markers and cytokines and OC differentiation assays were performed.

Results

Classical activation markers of monocytes and RANK increased in patients with RA at baseline, compared with control healthy donors, and after MTX and low-dose PDN (MTX+PDN) exposure they decreased to control levels. Although the number of OC was not different between groups, the percentage of resorbed area and the resorbed area per pit reduced after treatment. Serum soluble receptor activator of nuclear factor-kappa (RANKL) levels increased at baseline compared with healthy donors and normalised after therapy.

Conclusion

Our results suggest that MTX+PDN play an important role in downregulating OC function, which we believe occurs through the decrease in RANK surface expression in monocytes.
Compounds from Ilex paraguariensis extracts have antioxidant effects in the brains of rats subjected to chronic immobilization stress
Authors: Colpo Ana C. , de Lima Maria Eduarda , Maya-López Marisol , Rosa Hemerson , Márquez-Curiel Cristina , Galván-Arzate Sonia , Santamaría Abel , Folmer Vanderlei
Published: July 2017

Immobilization induces oxidative damage to the brain. Ilex paraguariensis extracts (Mate) and their major natural compound, chlorogenic acid (CGA), exert protective effects against reactive oxygen species formation. Here, the effects of Mate and CGA on oxidative damage induced by chronic immobilization stress (CIS) in the cortex, hippocampus, and striatum were investigated. For CIS, animals were immobilized for 6 h every day for 21 consecutive days. Rats received Mate or CGA by intragastric gavage 30 min before every restraint session. Endpoints of oxidative stress (levels of lipid peroxidation, protein carbonylation, and reduced (GSH) and oxidized (GSSG) forms of glutathione) were evaluated following CIS. While CIS increased oxidized lipid and carbonyl levels in all brain regions, CGA (and Mate to a lesser extent) attenuated lipid and protein oxidation as compared with control groups. GSH/GSSG balance showed a tendency to increase in all regions in response to stress and antioxidants. Taken together, our results support a protective role of dietary antioxidants against the neuronal consequences of stress.
Electronic modes in carbon nanotubes with single and double impurity sites
Authors: Komorowski P. G. , Cottam M. G.
Published: July 2017

A theoretical study of isolated and doubly-clustered impurities is presented for the electronic excitations in a carbon nanotube lattice. Using a matrix operator formalism and a tight-binding model where the interactions between atoms take place via nearest-neighbor hopping, the properties of the excitations are deduced. A geometry consisting of long, single-walled carbon nanotubes is assumed with the defects introduced in the form of substitutional impurity atoms, giving rise to the localized electronic modes of the nanotube as well as the propagating modes of the pure (host) material. The impurities are assumed to be in a low concentration, having the form of either a single, isolated defect or a small cluster of two defects close together. A tridiagonal matrix technique is employed within a Green’s function formalism to obtain the properties of the discrete modes of the system, including their frequencies and localization. The numerical examples show a dependence on the nanotube diameters and on the relative spatial configurations of the impurities. The results contrast with the previous studies of line impurities since there is no translational symmetry along the longitudinal axis of the nanotubes in the present case.
Phase transition and monopole densities in a nearest neighbor two-dimensional spin ice model
Authors: Morais C. W. , De Freitas D. N. , Mota A. L. , Bastone E. C.
Published: July 2017

In this work, we show that, due to the alternating orientation of the spins in the ground state of the artificial square spin ice, the influence of a set of spins at a certain distance of a reference spin decreases faster than the expected result for the long range dipolar interaction, justifying the use of the nearest neighbor two-dimensional square spin ice model as an effective model. Using an extension of the model presented in Y. L. Xie et al., Sci. Rep. 5, 15875 (2015), considering the influence of the eight nearest neighbors of each spin on the lattice, we analyze the thermodynamics of the model and study the dependence of monopoles and string densities as a function of the temperature.
Probabilistic Model Based Hybrid Classifier for Character Recognition
Authors: Sampath A. K. , Gomathi N.
Published: July 2017

Handwritten character recognition is most crucial one indulging in many of the applications like forensic search, searching historical manuscripts, mail sorting, bank check reading, tax form processing, book and handwritten notes transcription etc. The problem occurrence in the recognition is mainly because of the writing style variation, size variation (length and height), orientation angle etc. In this paper a probabilistic model based hybrid classifier is proposed for the character recognition combining the neural network and decision tree classifiers. In addition to the local gradient features i.e. histogram oriented feature and grid level feature, an additional feature called GLCM feature is extracted from the input image in the proposed recognition system and are concatenated for the image recognition procedure to encode color, shape, texture, local as well as the statistical information. These extracted features considered are given to the hybrid classifier which recognises the character. In the test set, recognition accuracy of 95% is achieved. The proposed probabilistic model based hybrid classifier tends to contribute more accurate character recognition rate compared to the existing character recognition system.
Interval Methods in Knowledge Representation
Authors: Kreinovich Vladik
Published: July 2017

Please send your abstracts (or copies of papers that you want to see reviewed here) to vladik@utep.edu, or by regular mail to Vladik Kreinovich, Department of Computer Science, University of Texas at El Paso, El Paso, TX 79968, USA.
Knowledge Management for Development: Rethinking the Trends of Knowledge Management Research in South Africa
Authors: Fombad Madeleine C. , Onyancha Omwoyo Bosire
Published: July 2017

In the knowledge-based economy, there is a growing realisation among policy makers that knowledge assets, besides the tangible assets of financial capital and local infrastructure, are the prime creators of wealth. Given the developmental challenges facing South Africa and contemporary global societies, it is clear that Knowledge Management (KM) should not only be seen as a tool for organisational effectiveness, but also as a developmental strategy for nations and societies. As South Africa is developing policies and strategies to overcome its developmental challenges and also to remain competitive in the new global knowledge-based economy, the question that ought to be answered is: To what extend does research on KM address developmental issues in South Africa? This paper adopts a quantitative approach using bibliometric analysis to investigate the extent of research on KM on developmental targets in South Africa. A bibliometric study was conducted using four EBSCO-hosted databases to extract relevant data. It was noted that there has been continued growth in the number of KM publications in South Africa focusing on a variety of subject areas; limited researcher attention has been paid to KM for development (KM4D) and most of the research on KM4D addresses quality education and infrastructure, unemployment and economic growth. The study advocates for the need for academic institutions and research organisations to devote considerable attention to research that enhances the application and integration of the effectiveness of KM in South Africa's development as the country strives to achieve its development goals.
Logarithmic uncertainty principle, convolution theorem related to continuous fractional wavelet transform and its properties on a generalized Sobolev space
Authors: Bahri Mawardi , Ashino Ryuichi
Published: July 2017

The continuous fractional wavelet transform (CFrWT) is a nontrivial generalization of the classical wavelet transform (WT) in the fractional Fourier transform (FrFT) domain. Firstly, the Riemann–Lebesgue lemma for the FrFT is derived, and secondly, the CFrWT in terms of the FrFT is introduced. Based on the CFrWT, a different proof of the inner product relation and the inversion formula of the CFrWT are provided. Thereafter, a logarithmic uncertainty relation for the CFrWT is investigated and the convolution theorem related to the CFrWT is established using the convolution of the FrFT. The CFrWT on a generalized Sobolev space is introduced and its important properties are presented.
Progress, Problems, and Improving Methods of Non-Engineering Countermeasures Against Urban Meteorological Disasters in China
Authors: XIN Yuan , JIANG Hairu , KONG Feng , LV Lili , PENG Yinghui
Published: July 2017

During China’s rapid urbanization, cities are threatened by ever more severe meteorological disasters. Urban meteorological disasters are characterized by massive destruction, high diffusion, and extensive social impact, which further complicate prevention and control. Therefore, non-engineering countermeasures are given a more prominent role in the process. China has primarily established a system of non-engineering countermeasures against urban meteorological disasters. However, this system does have its problems and flaws. The authors propose that disaster prevention should be technology-based and carried out in a scientific manner. A well-rounded disaster prevention institution should be established, and social participation must be raised. Urban meteorological monitoring, forecasting, and early warning abilities should be enhanced, prevention and control plans improved, relative legislation and administration completed, and social participation promoted so as to strengthen China’s non-engineering response to meteorological disasters.
Wearable brain imaging with multimodal physiological monitoring
Authors: Strangman Gary E. , Ivkovic Vladimir , Zhang Quan
Published: July 2017

The brain is a central component of cognitive and physical human performance. Measures, including functional brain activation, cerebral perfusion, cerebral oxygenation, evoked electrical responses, and resting hemodynamic and electrical activity are all related to, or can predict, health status or performance decrements. However, measuring brain physiology typically requires large, stationary machines that are not suitable for mobile or self-monitoring. Moreover, when individuals are ambulatory, systemic physiological fluctuations—e.g., in heart rate, blood pressure, skin perfusion, and more—can interfere with noninvasive brain measurements. In efforts to address the physiological monitoring and performance assessment needs for astronauts during spaceflight, we have developed easy-to-use, wearable prototypes, such as NINscan, for near-infrared scanning, which can collect synchronized multimodal physiology data, including hemodynamic deep-tissue imaging (including brain and muscles), electroencephalography, electrocardiography, electromyography, electrooculography, accelerometry, gyroscopy, pressure, respiration, and temperature measurements. Given their self-contained and portable nature, these devices can be deployed in a much broader range of settings—including austere environments—thereby, enabling a wider range of novel medical and research physiology applications. We review these, including high-altitude assessments, self-deployable multimodal e.g., (polysomnographic) recordings in remote or low-resource environments, fluid shifts in variable-gravity, or spaceflight analog environments, intracranial brain motion during high-impact sports, and long-duration monitoring for clinical symptom-capture in various clinical conditions. In addition to further enhancing sensitivity and miniaturization, advanced computational algorithms could help support real-time feedback and alerts regarding performance and health.
Increased IFNγ+ T Cells Are Responsible for the Clinical Responses of Low-Dose DNA-Demethylating Agent Decitabine Antitumor Therapy
Authors: Li Xiang , Zhang Yan , Chen Meixia , Mei Qian , Liu Yang , Feng Kaichao , Jia Hejin , Dong Liang , Shi Lu , Liu Lin , Nie Jing , Han Weidong
Published: July 2017

Purpose: Low-dose DNA-demethylating agent decitabine therapy is effective in a subgroup of cancer patients. It remains largely elusive for the biomarker to predict therapeutic response and the underlying antitumor mechanisms, especially the impact on host antitumor immunity.

Experimental Design: The influence of low-dose decitabine on T cells was detected both in vitro and in vivo. Moreover, a test cohort and a validation cohort of advanced solid tumor patients with low-dose decitabine-based treatment were involved. The activation, proliferation, polarization, and cytolysis capacity of CD3+ T cells were analyzed by FACS and CCK8 assay. Kaplan–Meier and Cox proportional hazard regression analysis were performed to investigate the prognostic value of enhanced T-cell activity following decitabine epigenetic therapy.

Results: Low-dose decitabine therapy enhanced the activation and proliferation of human IFNγ+ T cells, promoted Th1 polarization and activity of cytotoxic T cells both in vivo and in vitro, which in turn inhibited cancer progression and augmented the clinical effects of patients. In clinical trials, increased IFNγ+ T cells and increased T-cell cytotoxicity predicted improved therapeutic responses and survival in the test cohort and validation cohort.

Conclusions: We find that low-dose decitabine therapy promotes antitumor T-cell responses by promoting T-cell proliferation and the increased IFNγ+ T cells may act as a potential prognostic biomarker for the response to decitabine-based antitumor therapy. Clin Cancer Res; 23(20); 6031–43. ©2017 AACR.
ОТДАЛЕННЫЕ РЕЗУЛЬТАТЫ ОПЕРАТИВНОГО ЛЕЧЕНИЯ УЗЛОВЫХ ОБРАЗОВАНИЙ ЩИТОВИДНОЙ ЖЕЛЕЗЫ
Authors: Yusupov Sh. A. , Kurbaniyazov Z. B. , Davlatov S. S. , Rakhmanov K. E. , Daminov F. A.
Published: July 2017

Мета дослідження – покращення результатів хірургічного лікування хворих з вузловим зобом.Матеріал і методи. У дослідження був включений 281 пацієнт із захворюваннями щитоподібної залози, госпіталізований у відділення хірургії Самаркандського державного медичного інституту для проведення оперативного лікування протягом 2009–2016 рр.Результати. Рецидив вузлового зоба спостерігався у 9 випадках (4,7 % хворих) у часовому проміжку від 2 до 6 років. Наслідки оперативного втручання були благополучними, у 30 % пацієнтів були виявлені атипові клітини у протилежній частці щитоподібної залози, хоча клінічно вонавиглядала інтактною.Висновки. На основі вивчення віддалених результатів хірургічного лікування визначено оптимальний об’єм хірургічного втручання при різних морфологічних формах вузлового зоба. Адекватними об’ємами оперативного втручання визначено геміструмектомію, максимально субтотальну резекцію щитоподібної залози та тиреоїдектомію. При проведенні адекватної замісної терапії різко знижується число рецидивів після проведених оперативних втручань. Найбільший відсоток (4,7 %) рецидивів, не залежно від морфологічної форми вузлового зоба, зафіксовано при проведенні економної резекції та енуклеації вузла щитоподібної залози.
HOMEOSTATIC DISORDERS IN PATIENTS WITH COMBINATION OF HYPERTONIC DISEASE AND CHRONIC PANCREATITIS
Authors: Medvid I. I. , Babinets L. S. , Herasymets I. I. , Borovyk I. O.
Published: July 2017

Введення. Практично немає жодного захворювання, у розвитку і перебігу якого вегетативна нервова система не відігравала б ролі Це визначає актуальність дослідницьких процесів підтримки гомеостазу при поєднанні різних захворювань.Мета. Метою даного дослідження було вивчити і порівняти характер порушень вегетативної, антиоксидантної, калікреїн-кінінової системи та параметрів ендогенної інтоксикації у хворих з поєднанням гіпертонічної хвороби (ГХ) і хронічного панкреатиту (ХП).Матеріали та методи. У дослідженні взяли участь 40 пацієнтів з ГХ і супутнім ХП в фазі нестійкої ремісії, 15 практично здорових осіб. Середній вік був (47,7 ± 1,2) років. Дослідження вегетативної регуляції проводилось за допомогою визначення стандартних статистичних і спектральних показників варіабельності серцевого ритму (ВСР). Було проведено лабораторне визначення стандартних параметрів антиоксидантної, калікреїн-кінінової системи і тяжкості ендогенної інтоксикації.Результати. Зниження загальної потужності спектра, збільшення частки гуморально-метаболічних впливів на частоту серцевих скорочень, схильність до асимптоматичної вегетативної реактивності, зниження рівня супероксиддисмутази, глутатіону, прекалікреїну, ALPHA 2-макроглобуліну, кінази II, більш високі рівні каталази, середньомолекулярних пептидів, загальної протеолітичної активності калікреїну плазми спостерігались у хворих з поєднанням гіпертонічної хвороби і хронічного панкреатитом.Висновки. У пацієнтів із гіпертонічною хворобою при приєднанні хронічного панкреатиту виявлено ознаки порушення компенсаторних механізмів і підвищення дисбалансу вегетативної системи зі зменшенням пластичності адаптаційних процесів. Поєднання патологій також супроводжувалось проявами ендогенної інтоксикації, порушеннями антиоксидантної, калікреїн-кінінової системи.
ОЦІНКА ЯКОСТІ ЖИТТЯ У ПАЦІЄНТІВ З АРТЕРІАЛЬНОЮ ГІПЕРТЕНЗІЄЮ
Authors: Alifer O. O.
Published: July 2017

Резюме Артеріальна гіпертензія (АГ)- одна з найбільш значущих проблем охорони здоров’я в усьому світі. Причиною різного контролю артеріального тиску (АТ) можуть бути особливості поведінки, способу життя пацієнта, здатності сприймати поради щодо лікування АГ, різний соціальний статус.Метою дослідження було вивчення змін показників ЯЖ амбулаторних пацієнтів з АГ I, II та III ступенів згідно даних опитувальника SF-36.Матеріали і методи. В дослідження включено 126 хворих з верифікованим діагнозом первинної  АГ, з них - 86 жінок (68 %) і 40 чоловіків (32 %) у віці від 22 років до 81 років. Середній вік пацієнтів склав 53,3 ± 3,03 років. Для оцінки ЯЖ пацієнтів з АГ під час отримання лікування, використовували опитувальник SF-36, який дозволяє оцінити суб’єктивну задоволеність хворого своїм фізичним, психічним станом, соціальним функціонуванням.Висновки. Під час дослідження динаміки ЯЖ у пацієнтів з АГ виявлено, що при АГ I ступеня в порівнянні з АГ II ступеня були достовірно (Р < 0,05) більш високі показники ЯЖ по шкалі PF- на 6,34%  (р˃0,05) проти 24,2% відповідно (р < 0,05)), RE на 12,0% (р˃0,05) та GH  60,6% (р< 0,05). Порівняння ЯЖ у пацієнтів з АГ II та III ступеню встановило достовірні відмінності за шкалами PF, RE, SF, ВР і GH (р˃0,05).
Ефективність хірургічного лікування хворих з респіраторними проявами гастроезофагеальної рефлюксної хвороби
Authors: Paranyak M. R. , Grubnik V. V.
Published: July 2017

Мета роботи: порівняння ефективності консервативної терапії та хірургічного лікування пацієнтів з респіраторними проявами гастроезофагеальної рефлюксної хвороби та грижами стравохідного отвору діафрагми.Матеріали і методи. 41 пацієнту було виконано лапароскопічні фундоплікації за Ніссеном та 25 пацієнтам проведено консервативну терапію гастроезофагеальної рефлюксної хвороби. Результати лікування оцінено за допомогою цілодобового рН- моніторингу стравоходу та опитувальника якості життя GERD-HRQL. Також виконували визначення інтенсивності печії за шкалою Likert, інтенсивності нападу кашлю за даними 10-бальної візуальної аналогової шкали, кількісного показника нападів кашлю впродовж однієї доби, індексу симптому рефлюксного кашлю.Результати досліджень та їх обговорення. Встановлено достовірно кращий результат (р < 0,001) відносно зменшення частоти та інтенсивності кашлю у хворих, яким виконували лапароскопічні фундоплікації. Регрес типової симптоматики також був кращим (р < 0,001) у хворих, яким проводились хірургічні втручання.
Electrical and Structural Substrate of Arrhythmogenic Right Ventricular Cardiomyopathy Determined Using Noninvasive Electrocardiographic Imaging and Late Gadolinium Magnetic Resonance Imaging
Authors: Andrews Christopher M. , Srinivasan Neil T. , Rosmini Stefania , Bulluck Heerajnarain , Orini Michele , Jenkins Sharon , Pantazis Antonis , McKenna William J. , Moon James C. , Lambiase Pier D. , Rudy Yoram
Published: July 2017

Background—

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a significant cause of sudden cardiac death in the young. Improved noninvasive assessment of ARVC and better understanding of the disease substrate are important for improving patient outcomes.

Methods and Results—

We studied 20 genotyped ARVC patients with a broad spectrum of disease using electrocardiographic imaging (a method for noninvasive cardiac electrophysiology mapping) and advanced late gadolinium enhancement cardiac magnetic resonance scar imaging. Compared with 20 healthy controls, ARVC patients had longer ventricular activation duration (median, 52 versus 42 ms;
P
=0.007) and prolonged mean epicardial activation-recovery intervals (a surrogate for local action potential duration; median, 275 versus 241 ms;
P
=0.014). In these patients, we observed abnormal and varied epicardial activation breakthrough locations and regions of nonuniform conduction and fractionated electrograms. Nonuniform conduction and fractionated electrograms were present in the early concealed phase of ARVC. Electrophysiological abnormalities colocalized with late gadolinium enhancement scar, indicating a relationship with structural disease. Premature ventricular contractions were common in ARVC patients with variable initiation sites in both ventricles. Premature ventricular contraction rate increased with exercise, and within anatomic segments, it correlated with prolonged repolarization, electric markers of scar, and late gadolinium enhancement (all
P
<0.001).

Conclusions—

Electrocardiographic imaging reveals electrophysiological substrate properties that differ in ARVC patients compared with healthy controls. A novel mechanistic finding is the presence of repolarization abnormalities in regions where ventricular ectopy originates. The results suggest a potential role for electrocardiographic imaging and late gadolinium enhancement in early diagnosis and noninvasive follow-up of ARVC patients.
Age-Specific Sex Differences in Magnetic Resonance Imaging-Depicted Carotid Intraplaque Hemorrhage
Authors: Singh Navneet , Moody Alan R. , Zhang Bowen , Kaminski Isabella , Kapur Kush , Chiu Stephanie , Tyrrell Pascal N.
Published: July 2017

Background and Purpose—

Stroke rates are higher in men compared with women in the fourth through seventh decades of life, and higher rates may result from differences in carotid intraplaque hemorrhage (IPH), an unstable atherosclerotic plaque component. We report age-specific sex differences in the presence of magnetic resonance imaging-depicted carotid IPH.

Methods—

Patients (n=1115) underwent magnetic resonance imaging for carotid IPH between 2005 and 2014. Low-grade carotid stenosis patients (n=906) without prior endarterectomy were eligible for this cross-sectional study.

Results—

Of the 906 patients included (mean age±SD in years, 66.98±15.15), 63 (6.95%) had carotid IPH. In men and women, carotid IPH was present in 11.43% (48 of 420) and 3.09% (15 of 486), respectively (
P
<0.0001). Multivariable logistic regression analysis confirmed greater odds of carotid IPH in men for all ages: 45 to 54 (odds ratio=45.45; 95% confidence interval, 3.43–500), 55 to 64 years (odds ratio=21.74; 95% confidence interval, 3.21–142.86), 65 to 74 years (odds ratio=10.42; 95% confidence interval, 2.91–37.04), and ≥75 years (odds ratio=5.00; 95% confidence interval, 2.31–10.75). Male sex modified the effect of age on the presence of carotid IPH (β=0.074; SE=0.036;
P
=0.0411).

Conclusions—

Men have greater age-specific odds of magnetic resonance imaging-depicted carotid IPH compared with women. With increasing age post-menopause, the odds of carotid IPH in women becomes closer to that of men. Delayed onset of carotid IPH in women, an unstable plaque component, may partly explain differential stroke rates between sexes, and further studies are warranted.
Pit membranes and their evolution in the Oleinae of the Oleaceae
Authors: Nguyen Chieuda , Andrews Ashley , Baas Pieter , Bond Jason E. , Auad Maria , Dute Roland
Published: July 2017

Chionanthus retusus and most Osmanthus spp. possess torus-bearing intervascular pit membranes in their woods. Because the genera involved are thought to be closely related and are members of the subtribe Oleinae, we hypothesized that torus morphology should be similar across taxa. A study combining light, scanning electron, and atomic force microscopy indicates that tori in both genera comprise a bipartite thickening containing a central pustular region and an encircling corona. Removal of incrusting material from the torus exposes subtending sets of parallel microfibrils. We hypothesize that the torus structures of C. retusus and Osmanthus spp. (as represented by O. armatus) have the same morphology. Optimizing torus-bearing pits on published molecular phylogenies of the subtribe Oleinae indicates parallel evolution as an explanation for torus similarity between these two groups, although a robust and well-resolved phylogeny of the Oleaceae is still lacking. A brief study of the wood anatomy of Olea dioica was also undertaken. This species is a member of the subgenus Tetrapilus and thought to be closely related to torus-bearing genera of the Oleaceae. Despite the close relationship, no tori were observed in O. dioica.
Distributions of Tropical Precipitation Cluster Power and Their Changes under Global Warming. Part II: Long-Term Time Dependence in Coupled Model Intercomparison Project Phase 5 Models
Authors: Quinn Kevin M. , Neelin J. David
Published: July 2017

Distributions of precipitation cluster power (latent heat release rate integrated over contiguous precipitating pixels) are examined in 1°–2°-resolution members of phase 5 of the Coupled Model Intercomparison Project (CMIP5) climate model ensemble. These approximately reproduce the power-law range and large event cutoff seen in observations and the High Resolution Atmospheric Model (HiRAM) at 0.25°–0.5° in Part I. Under the representative concentration pathway 8.5 (RCP8.5) global warming scenario, the change in the probability of the most intense storm clusters appears in all models and is consistent with HiRAM output, increasing by up to an order of magnitude relative to historical climate. For the three models in the ensemble with continuous time series of high-resolution output, there is substantial variability on when these probability increases for the most powerful storm clusters become detectable, ranging from detectable within the observational period to statistically significant trends emerging only after 2050. A similar analysis of National Centers for Environmental Prediction (NCEP)–U.S. Department of Energy (DOE) AMIP-II reanalysis and Special Sensor Microwave Imager and Imager/Sounder (SSM/I and SSMIS) rain-rate retrievals in the recent observational record does not yield reliable evidence of trends in high power cluster probabilities at this time. However, the results suggest that maintaining a consistent set of overlapping satellite instrumentation with improvements to SSM/I–SSMIS rain-rate retrieval intercalibrations would be useful for detecting trends in this important tail behavior within the next couple of decades.