bluuebunny/crossref_metadata_2025 huggingface dataset:
A Survey of Multilingual Neural Machine Translation
Authors: Dabre Raj , Chu Chenhui , Kunchukuttan Anoop
Published: September 2020

We present a survey on multilingual neural machine translation (MNMT), which has gained a lot of traction in recent years. MNMT has been useful in improving translation quality as a result of translation knowledge transfer (transfer learning). MNMT is more promising and interesting than its statistical machine translation counterpart, because end-to-end modeling and distributed representations open new avenues for research on machine translation. Many approaches have been proposed to exploit multilingual parallel corpora for improving translation quality. However, the lack of a comprehensive survey makes it difficult to determine which approaches are promising and, hence, deserve further exploration. In this article, we present an in-depth survey of existing literature on MNMT. We first categorize various approaches based on their central use-case and then further categorize them based on resource scenarios, underlying modeling principles, core-issues, and challenges. Wherever possible, we address the strengths and weaknesses of several techniques by comparing them with each other. We also discuss the future directions for MNMT. This article is aimed towards both beginners and experts in NMT. We hope this article will serve as a starting point as well as a source of new ideas for researchers and engineers interested in MNMT.
A Survey of Ontologies for Simultaneous Localization and Mapping in Mobile Robots
Authors: Cornejo-Lupa María A. , Ticona-Herrera Regina P. , Cardinale Yudith , Barrios-Aranibar Dennis
Published: September 2020

Autonomous robots are playing important roles in academic, technological, and scientific activities. Thus, their behavior is getting more complex, particularly, in tasks related to mapping an environment and localizing themselves. These tasks comprise the Simultaneous Localization and Mapping (SLAM) problem. Representation of knowledge related to the SLAM problem with a standard, flexible, and well-defined model, provides the base to develop efficient and interoperable solutions. As many existing works demonstrate, Semantic Web seems to be a clear approach, since they have formulated ontologies, as the base data model to represent such knowledge. In this article, we survey the most popular and recent SLAM ontologies with our aim being threefold: (i) propose a classification of SLAM ontologies according to the main knowledge needed to model the SLAM problem; (ii) identify existing ontologies for classifying, comparing, and contrasting them, in order to conceptualize SLAM domain for mobile robots; and (iii) pin-down lessons to learn from existing solutions in order to design better solutions and identify new research directions and further improvements. We compare the identified SLAM ontologies according to the proposed classification and, finally, we explore new data fields to enrich existing ontologies and highlight new possibilities in terms of performance and efficiency for SLAM solutions.
Comparative Analysis and Framework Evaluating Web Single Sign-on Systems
Authors: Alaca Furkan , Oorschot Paul C. Van
Published: September 2020

We perform a comprehensive analysis and comparison of 14 web single sign-on (SSO) systems proposed and/or deployed over the past decade, including federated identity and credential/password management schemes. We identify common design properties and use them to develop a taxonomy for SSO schemes, highlighting the associated tradeoffs in benefits (positive attributes) offered. We develop a framework to evaluate the schemes, in which we identify 14 security, usability, deployability, and privacy benefits. We also discuss how differences in priorities between users, service providers, and identity providers impact the design and deployment of SSO schemes.
How Mobile App Design Overhauls Can Be Disastrous in Terms of User Perception
Authors: Franzmann Daniel , Eichner Arvid , Holten Roland
Published: September 2020

Smartphone apps are regularly updated and enhanced. However, design overhauls—that change the whole look of an app—are not expected to impact a user's behavior and, more specifically, continuance intentions. We reevaluate this claim based on the overwhelmingly negative feedback the social multimedia messaging app Snapchat received following a design overhaul released in February 2018. Following a mixed-method approach, we first analyze Snapchat's app ratings and their significant drop after the release of the update, using a Chow-test. Second, we use text mining to analyze a data set of 737,182 text reviews from the Google Play Store. We thereby provide empirical evidence that a design overhaul led to a significant decrease in app store ratings and started a social media firestorm among its users. Third, to theoretically explain the causes of the decrease in ratings, we conducted interviews with 26 Snapchat users. We contribute to the current discussion in IS research debates concerning whether perceived ease of use does play an essential role in the post-adoption context: We find evidence that substantial changes in an app design triggers a new adoption process and impacts the perceived ease of use, and thus, in particular, we contribute to the theoretical understanding of how users perceive design overhauls.
Comparing the Efficacy and Safety of Glucagon-Like Peptide 1 Receptor Agonists with Sodium-Glucose Cotransporter 2 Inhibitors for Obese Type 2 Diabetes Patients Uncontrolled on Metformin: A Systematic Review and Meta-Analysis of Randomized Clinical Trials
Authors: Ding Lu , Sun Bang , Xiao Xinhua , Kin Tatsuya
Published: September 2020

Introduction. To conduct the first meta-analysis of randomized controlled trials (RCTs) comparing glucagon-like peptide 1 receptor agonists (GLP-1RAs) with sodium-glucose cotransporter 2 inhibitors (SGLT-2is) for obese type 2 diabetes (T2D) patients uncontrolled on metformin. Methods. We searched Pubmed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Ovid, and Web of Science from inception to May 14, 2020, without language restrictions for eligible RCTs. The primary outcome is the mean change from baseline in glycated haemoglobin (HbA1c). Results. Totally, 3 RCTs enrolled 2066 patients were identified. Compared with SGLT-2is, treatment with GLP-1RAs achieved significant reduced HbA1c by 0.40% (95% CI: −0.54, −0.25;

p
<
0.00001

), fasting blood glucose (FBG) by 0.17 mmol/L (95% CI: −0.31, −0.04;

p
=
0.01

), and postprandial blood glucose (PBG) by 0.32 mmol/L (95% CI: −0.49, −0.14;

p
=
0.0003

) for obese T2D patients uncontrolled on metformin. The significant benefit of weight loss was seen in semaglutide (MD: −0.75; 95% CI: −1.18, −0.31;

p
<
0.0007

). No significant difference was detected between GLP-1RAs and SGLT-2is in overall adverse events (RR: 1.03; 95% CI: 0.98, 1.09;

p
=
0.76

), but gastrointestinal events showed higher occurrence in GLP-1RAs groups compared with SGLT-2is (RR: 1.62; 95% CI: 1.37, 1.93;

p
<
0.00001

). Subgroup analyses revealed that follow-up time did not statistically influence glycemic control. Conclusion. GLP-1RAs are superior to SGLT-2is for obese T2D patients uncontrolled on metformin in glycemic control without an increase in adverse events except for a higher occurrence in gastrointestinal events. Future large longer-term follow-up clinical trials are needed to provide more evidence about the sustainable effects and safety of GLP-1RAs compared with SGLT-2is.
A Model for Evolution of Investors Behavior in Stock Market Based on Reinforcement Learning in Network
Authors: Liu Xiaqun , Zhuang Yaming , Li Jinsheng , Zhou Wei
Published: September 2020

This paper builds an evolution model of investors behavior based on the reinforcement learning in multiplex networks. Due to the heterogeneity of learning characteristics of bounded rational investors in investment decisions, we consider, respectively, the evolution mechanism of individual investors and institutional investors on the complex network theory and reinforcement learning theory. We perform mathematical analysis and simulation to further explain the evolution characteristics of investors behavior. The conclusions are drawn as follows: First, the intensity of returns competition among institutional investors and the forgetting effect both have an impact on the equilibrium of their evolution as to all institutional investors and individual investors. Second, the network topology significantly affects the behavioral evolution of individual investors compared with institutional investors.
The Gap between Urban and Rural Development Levels Narrowed
Authors: Wang Mou , Kang Wenmei , Zhang Ruiying , Xia Jianhong (Cecilia)
Published: September 2020

The difference between urban and rural development levels (URDL) and the deficiency of rural development level have become the weak points for China to achieve balanced and high-quality development. In order to reveal the changing trend of urban-rural differences in China over the years and provide a reference for the policy-making of the balanced development of urban and rural areas and high-quality economic development, this paper uses the United Nations Development Program-adjusted Human Development Index (HDI) calculation method to calculate the urban and rural areas, based on 1995–2017 national time series data and provincial panel data. On this basis, this paper uses the Logarithmic Mean Weight Divisia to decompose the dynamic changes of the difference of URDL and analyzes the spatial equilibrium of the change trend of the differences of URDL, supplementing the shortcomings of the existing literature which only focuses on income, education, and other local areas and lacks continuity and comparison. The research finds that 1. based on the time series analysis of the difference of URDL, this paper firstly proposes the “inverted U” curve for the difference of URDL in China, which shows that the difference of URDL in China has experienced a process from expansion (1995–2001) to high fluctuation (2001–2011) to continuous convergence (2011–2017). 2. From the factor decomposition effect of the difference of URDL, the difference expansion period is caused by the increase in the gap between the Health Index, the Education Index, and the Income Index. With the decline in the gap between education levels and life expectancy, the growth trend of China’s urban-rural gap has been suppressed, and it has entered a high platform period with relative small fluctuation. After 2011, benefiting from the large decline in income level gaps, China’s urban-rural difference has entered a period of convergence. 3. From the perspective of the spatial evolution characteristics of the gap of URDL, the overall coefficient of variation of the country has shown a downward trend. The degree of spatial equilibrium is gradually increasing, and the overall changes in the east, west, and northeast are the same as the overall trend of the country. The decline in the northeast is the largest, the west is the second, and the east is the least. The middle shows a slight upward trend, but the value of each year is always smaller compared with other regions. Generally speaking, the gap of URDL is relatively good in the middle and northeast, followed by the east, and there is still much room for improvement in the balance of the west.
Lightweight Ship Detection Methods Based on YOLOv3 and DenseNet
Authors: Li Zhelin , Zhao Lining , Han Xu , Pan Mingyang , Hwang Feng-Jang
Published: September 2020

Ship detection is one of the most important research contents of ship intelligent navigation and monitoring. As a supplement to classical navigational equipment such as radar and the Automatic Identification System (AIS), target detection based on computer vision and deep learning has become a new important method. A target detector called YOLOv3 has the advantages of detection speed and accuracy and meets the real-time requirements for ship detection. However, YOLOv3 has a large number of backbone network parameters and requires high hardware performance, which is not conducive to the popularization of applications. On the basis of YOLOv3, this paper proposes a lightweight ship detection model (LSDM) in which the backbone network is improved by using dense connection inspired from DenseNet, and the feature pyramid networks are improved by using spatial separation convolution to replace normal convolution. The two improvements reduce parameters and optimize the network structure greatly. The experimental results show that, with only one-third of parameters of YOLOv3, the LSDM has higher accuracy and speed for ship detection. In addition, the LSDM is simplified further by reducing the number of densely connected units to form a model called LSDM-tiny. The experimental results show that, LSDM-tiny has similar detection speed with YOLOv3-tiny, but has a lot higher accuracy.
A Deterministic Method for Solving the Sum of Linear Ratios Problem
Authors: Wang Zhenping , Zhang Yonghong , Manfredi Paolo
Published: September 2020

Since the sum of linear ratios problem (SLRP) has many applications in real life, for globally solving it, an efficient branch and bound algorithm is presented in this paper. By utilizing the characteristic of the problem (SLRP), we propose a convex separation technique and a two-part linearization technique, which can be used to generate a sequence of linear programming relaxation of the initial nonconvex programming problem. For improving the convergence speed of this algorithm, a deleting rule is presented. The convergence of this algorithm is established, and some experiments are reported to show the feasibility and efficiency of the proposed algorithm.
Radiographic and Clinical Findings of Single‐Visit Root Canal Treatments with Apical Enlargement in Necrotic Teeth: A Retrospective Cohort Study
Authors: Eyüboğlu Tan F. , Olcay Keziban , Erkan Erhan , Özcan Mutlu
Published: September 2020

This study evaluated the long‐term clinical outcomes of single‐visit root canal treatments with apical enlargement on patients with necrotic pulp tissue retrospectively. A total of 137 teeth with necrotic pulp tissue which underwent single‐visit root canal treatments were included. The root canals were shaped up until the apical constriction, which was determined by an apex locator. The outcomes were evaluated by two independent and calibrated endodontists clinically and radiographically. Teeth were dichotomized into healed (PAI ≤ 2, no signs or symptoms) and nonhealed (PAI > 2, with/without signs or symptoms) groups. Each patients’ preoperative PAI and lesion size were recorded to evaluate the preoperative periapical status as well as several other prognostic factors. Statistical analyses were performed (p = 0.05) on ninety teeth. The mean observation time was 60 months. Out of ninety teeth, 87 (96.7%) were healed and 3 (3.3%) were nonhealed. No correlations were found between the prognostic factors and the outcomes (p > 0.05). Cohen’s kappa and Gwet’s agreement coefficient scores between the preoperative PAI scores and preoperative lesion sizes showed good agreements, with values of 0.834 and 0.898, respectively. Apical enlargement is a viable treatment option for single‐visit root canal treatments.
Platelet‐Rich Plasma Combined with Alendronate Reduces Pain and Inflammation in Induced Osteoarthritis in Rats by Inhibiting the Nuclear Factor‐Kappa B Signaling Pathway
Authors: Xin Feng , Wang Haihong , Yuan Feng , Ding Yunzhi
Published: September 2020

Purpose. Osteoarthritis (OA) is one of the common degenerative diseases of the joint in the world. This study was designed to explore the effect of platelet‐rich plasma (PRP) combined with alendronate (ALN) on OA. Methods. We induced OA model by anterior cruciate ligament transection (ACLT) method in rats and treating chondrocytes by IL‐1β in vitro. PRP and/or ALN were used to treat induced rats and chondrocytes. Hematoxylin and eosin (H&E) and Safranin O staining were used to observe the structures of cartilage. The mRNA expression of Collagen II, MMP‐13, and inflammatory factors (IL‐18, IL‐1β, and TNF‐α) in the cartilage and chondrocytes of rats was determined by qRT‐PCR. The expression of NF‐κB pathway‐related proteins (p‐p65, p65, IκBα, and p‐IκBα) in the cartilage and chondrocytes of rats was determined by Western blot. The proliferation of chondrocytes was detected by MTT assay. Results. Treatment with PRP, ALN, or PRP combined with ALN decreased the degree of cartilage destruction, the mRNA expression of MMP‐13 and inflammatory factors (IL‐18, IL‐1β, and TNF‐α), and the protein expression of p‐IκBα/IκBα and p‐p65/p65, increased Collagen II expression, and the threshold of tender and thermal pain in OA rats. Meanwhile, ALN, PRP, or ALN combined with PRP reversed the inhibiting effect of phorbol myristate acetate (PMA, an NF‐κB agonist) on cell proliferation and cartilage matrix metabolism. Among them, the effects of ALN combined with PRP were most obvious. Conclusion. PRP combined with ALN delayed OA progression by inhibiting the NF‐κB signaling pathway.
A Rare Case of Urinary Tract Fungal Ball Leading to Fungemia and Bilateral Chorioretinitis
Authors: Ferari Christopher , Crigger Chad , Morley Chad , Duchene David
Published: September 2020

Background. Fungemia due to obstructive urinary tract fungal ball is exceedingly rare. These patients often have multiple predisposing conditions, including diabetes or antimicrobial exposure. While candiduria can be relatively common in this population, urinary tract fungal balls are a rare entity. Hospitalists should be aware of this rare complication in patients presenting with funguria. Case Presentation. We present a case of a 44-year-old male with type II diabetes, chronic hepatitis C secondary to injection drug use, and chronic kidney disease who developed a urinary tract fungal ball leading to fungemia and subsequent bilateral chorioretinitis, additionally complicated by emphysematous cystitis and pyelonephritis. Additional invasive treatment options beyond typical antifungals are often required in the case of urinary tract fungal ball, and in this case, bilateral nephrostomy tubes and micafungin were employed. Hospital course was complicated by C. tropicalis fungemia with subsequent bilateral fungal chorioretinitis on dilated fundus exam. This was effectively treated with cyclogyl and prednisolone drops along with bilateral voriconazole injections. Follow-up imaging and cultures showed resolution of fungemia, urinary tract masses, and chorioretinal infiltrates; however, recurrent polymicrobial UTIs continue to be an issue for this patient. Conclusions. Special multidisciplinary management is required in the treatment of urinary tract fungal balls with subsequent fungemia, including nephrostomy tubes, antifungal irrigation, ureterorenoscopy, and more powerful antifungals such as amphotericin B and 5-flucytosine. This management draws from a myriad of specialties, including urology, infectious disease, and interventional radiology. Additionally, the literature has demonstrated that only approximately half of patients with fungemia receive an ophthalmologic evaluation. Ophthalmologic and urologic cooperation is essential in the case of obstructive uropathy leading to fungemia as the obstructive uropathy must be relieved and these patients should receive a dilated fundus exam.
A Novel Efficient Passive Spatial Orientation Detection Method of UMT Enabled by ISB
Authors: Xiong Zhengqiang , Sun Tao , Wang Zhengxing , Wu Yuhao , Yin Jie , Duan Chaoqun
Published: September 2020

The passive detection and direction-of-arrival (DOA) estimation problem is of great importance in many underwater applications such as target reconnaissance and data collection. In this paper, an Efficient Correlation-based Orientation Detection (ECOD) method is proposed to achieve high efficiency. Without high computational complexity in any Transform Domain, the time consumption of ECOD is largely reduced, which is especially critical for underwater intrusion detection, territorial waters protection, and many other real-time underwater applications. To achieve good invisibility, we design an intelligent submerged buoy (ISB) structure, which consists of six embedded hydrophones and an in situ electronic control unit (IECU). As a supplement to solutions against complex underwater environments, a hybrid ECOD method is also developed by involving the cooperation from underwater distributed sensor networks. To be specific, when high SNR signals are not recorded by a single ISB node, other distributed sensors are scheduled to assist in cooperative sensing. Simulation experiments demonstrate the efficiency of the ECOD method in passive 3D spatial orientation of underwater acoustic target and show that the ECOD method has a better performance in time consumption compared with general DOA algorithms.
An Energy-Aware Data Transmission Scheme under the Guarantee of Reliability for 3D WSNs
Authors: Zhang J. H. , Yi Z. X. , Peng C. Y. , Hussain Shahid
Published: September 2020

Three-dimensional wireless sensor networks (3D WSNs) play an important role to provide data collection services for Internet of things (IoT) in the real applications. However, many of the existing WSN data collection researches are based on a relatively simple linear or plane network model. The three-dimensional space problems are simplified to two-dimensional plane, which limits the applicability. In this paper, the data collection in 3D WSN is studied. In the three-dimensional space, we firstly analyze the data loads, energy consumption, and end-to-end (E2E) delay of each node when the network is following the shortest path routing. The mathematical analysis of data loads and E2E delay of each node are presented. Based on the analysis of data loads and energy consumption, an energy-ware data transmission scheme is proposed to achieve the trade-off optimization between the E2E delay and network lifetime under the guarantee of the transmission reliability. The key point of the proposed scheme is to make fully use of the unbalanced energy consumption of the 3D WSN. The performance of the proposed scheme is discussed, analyzed, and evaluated. The theoretical analysis and simulation results show that the E2E network delay and energy efficiency can be improved under the constraint of transmission reliability.
Enhanced Detection of Treatment Effects on Metastatic Colorectal Cancer with Volumetric CT Measurements for Tumor Burden Growth Rate Evaluation
Authors: Maitland Michael L. , Wilkerson Julia , Karovic Sanja , Zhao Binsheng , Flynn Jessica , Zhou Mengxi , Hilden Patrick , Ahmed Firas S. , Dercle Laurent , Moskowitz Chaya S. , Tang Ying , Connors Dana E. , Adam Stacey J. , Kelloff Gary , Gonen Mithat , Fojo Tito , Schwartz Lawrence H. , Oxnard Geoffrey R.
Published: September 2020

Purpose:

Mathematical models combined with new imaging technologies could improve clinical oncology studies. To improve detection of therapeutic effect in patients with cancer, we assessed volumetric measurement of target lesions to estimate the rates of exponential tumor growth and regression as treatment is administered.

Experimental Design:

Two completed phase III trials were studied (988 patients) of aflibercept or panitumumab added to standard chemotherapy for advanced colorectal cancer. Retrospectively, radiologists performed semiautomated measurements of all metastatic lesions on CT images. Using exponential growth modeling, tumor regression (d) and growth (g) rates were estimated for each patient's unidimensional and volumetric measurements.

Results:

Exponential growth modeling of volumetric measurements detected different empiric mechanisms of effect for each drug: panitumumab marginally augmented the decay rate [tumor half-life; d [IQR]: 36.5 days (56.3, 29.0)] of chemotherapy [d: 44.5 days (67.2, 32.1), two-sided Wilcoxon P = 0.016], whereas aflibercept more significantly slowed the growth rate [doubling time; g = 300.8 days (154.0, 572.3)] compared with chemotherapy alone [g = 155.9 days (82.2, 347.0), P ≤ 0.0001]. An association of g with overall survival (OS) was observed. Simulating clinical trials using volumetric or unidimensional tumor measurements, fewer patients were required to detect a treatment effect using a volumetric measurement-based strategy (32–60 patients) than for unidimensional measurement-based strategies (124–184 patients).

Conclusions:

Combined tumor volume measurement and estimation of tumor regression and growth rate has potential to enhance assessment of treatment effects in clinical studies of colorectal cancer that would not be achieved with conventional, RECIST-based unidimensional measurements.
Eltrombopag for the Treatment of Severe Inherited Thrombocytopenia
Authors: Abdelmoumen Karim , Fabre Marc , Ducastelle-Lepretre Sophie , Favier Remi , Ballerini Paola , Bordet Jean Claude , Dargaud Yesim
Published: September 2020

Inherited thrombocytopenias correspond to a group of hereditary disorders characterized by a reduced platelet count, platelet dysfunction, and a family history of thrombocytopenia. It is commonly associated with mucocutaneous bleeding. Thrombocytopenia results from mutations in genes involved in megakaryocyte differentiation, platelet formation, and clearance. Here we report on a patient presenting with severe syndromic inherited thrombocytopenia manifesting as spontaneous mucocutaneous bleeds, requiring frequent platelet transfusions. Thrombocytopenia was explained by the presence of 4 mutations in 3 hematopoietic transcription factor genes: FLI1, RUNX1, and ETV6. The patient was successfully treated with high-dose eltrombopag at 150 mg/day, an orally available non-peptide thrombopoietin receptor agonist. Since the start of treatment 23 months ago, the manifestations of bleeding have resolved, and no platelet transfusions or corticosteroids have been required. The patient has no clinical or laboratory evidence of myeloid malignancy so far.
Ogilvie Syndrome in a Refractory Germ Cell Tumor Treated with Vinblastine, Ifosfamide and Cisplatin Regimen
Authors: Varayathu Hrishi , Shah Mansi Sandip , Sarathy Vinu , Thomas Beulah Elsa , Munirathnam Vinayak , Shivalingappa Shivakumar Swamy , Naik Radheshyam
Published: September 2020

Ogilvie syndrome or intestinal pseudo-obstruction is a clinical syndrome characterized by autonomic imbalance affecting peristalsis of colon leading to obstructive signs and symptoms. The etiologies commonly implicated are drugs affecting the cholinergic system, narcotics, electrolyte imbalance, severe sepsis, cancer, major surgery, and renal and cardiac failure. Ogilvie syndrome secondary to chemotherapy is a very rare phenomenon with very few reports in the literature. Cisplatin-induced neuropathy has been reported to occur when the cumulative dose exceeds 360 mg/m2. It manifests predominantly as peripheral sensory neuropathy with autonomic neuropathy occurring very rarely in a subset of patients. All the reported cases to date who presented with autonomic dysfunction secondary to cisplatin also had peripheral sensory neuropathy. Herein, we report a case of metastatic nonseminomatous germ cell tumor treated with cisplatin based regimen, who presented with severe intestinal pseudo-obstruction when the cumulative dose exceeded 400 mg/m2 without any other manifestation of neuropathy. To our knowledge this is the first such case reported in the literature.
A Novel Variant in G6PD (c.1375C>G) Identified from a Hispanic Neonate with Extreme Hyperbilirubinemia and Low G6PD Enzymatic Activity
Authors: Bahr Timothy M. , Lozano-Chinga Michell , Agarwal Archana M. , Meznarich Jessica A. , Yost Christian C. , Li Peng , Reading N. Scott , Prchal Josef T. , Christensen Robert D.
Published: September 2020

We report a novel glucose-6-phosphate dehydrogenase (G6PD) variant (c.1375C>G) discovered in a 3-day-old Hispanic male child from Salt Lake City, UT, USA. This newborn presented with severe hyperbilirubinemia (29.8 mg/dL or 510 μmol/L) and marked hemolysis evidenced by elevated end-tidal carbon monoxide concentration (5.9 ppm, normal <1.7 ppm). Despite a very low prevalence of G6PD deficiency in Hispanic populations, we pursued testing for this condition and found he had low erythrocyte G6PD enzyme activity (2.8 U/g Hb, normal 9.9–16.6 U/g Hb) and a novel G6PD variant. His mother was heterozygous for this same variant, and she had a moderate decrease in G6PD enzyme activity (7.1 U/g Hb). On the basis of these findings, we propose this variant as a novel pathogenic mutation.
A Case of Peritoneal Dissemination and Splenic Metastasis after Gastric Cancer Surgery That Could Be Controlled with Multidisciplinary Treatment
Authors: Karakuchi Nozomi , Yanagawa Senichiro , Takei Daisuke , Kodama Shinya , Takeshima Yukio , Sumimoto Kazuo
Published: September 2020

Splenic metastasis is known to occur at the terminal stage of cancer. While peritoneal dissemination is the most frequent recurrence of gastric cancer, metastasis to the spleen from gastric cancer is very rare. Splenectomy is currently the most effective probable treatment for solitary splenic metastasis of gastric cancer; it provides a good patient prognosis. However, careful consideration of surgical indications is required, as splenic metastasis is typically accompanied by multi-organ metastasis and dissemination. One of the main cancer treatment methods is the “wait-and-see” approach using chemotherapy. In general, patients with gastric cancer are treated with systemic chemotherapy for distant metastases including peritoneal dissemination. Radiotherapy is not commonly used to prolong life in patients with gastric cancer as gastric cancer is predominantly adenocarcinoma. However, a recent report indicated that chemo-radiotherapy was performed successfully for unresectable gastric cancer, including peritoneal dissemination. Here, we present the case of a 67-year-old patient who was observed to have peritoneal dissemination and splenic metastasis after gastric cancer surgery. Once the peritoneal dissemination was localized, surgical excision and chemo-radiotherapy were performed. We treated the splenic metastasis with the “wait-and-see” strategy with chemotherapy. A complete response on imaging in accordance with the Response Evaluation Criteria in Solid Tumors was achieved using multidisciplinary treatment. Our strategy of intensive multidisciplinary therapy could be a treatment option for cases with peritoneal dissemination or splenic metastasis of gastric cancer.
Cardiac Troponin Is Elevated in Patients with Thyrotoxicosis and Decreases as Thyroid Function Improves and Brain Natriuretic Peptide Levels Decrease
Authors: Watanabe Natsuko , Yoshimura Noh Jaeduk , Hattori Naomi , Iwaku Kenji , Suzuki Nami , Yoshihara Ai , Ohye Hidemi , Suzuki Miho , Matsumoto Masako , Endo Kei , Kunii Yo , Takagi Gen , Sugino Kiminori , Ito Koichi
Published: September 2020

Introduction: High-sensitive cardiac troponin reflects micro-myocardial injury in the absence of overt myocardial infarction. Objective: This study aimed to clarify how thyrotoxicosis affects cardiac troponin. Methods: This was a prospective observational study in Japan. Untreated patients with thyrotoxicosis who visited Ito Hospital were enrolled, and medical treatment was initiated for hyperthyroidism. Thyroid function, high-sensitive troponin I (hsTnI), and brain natriuretic peptide (BNP) were measured at baseline and then every 3 months for 1 year. Results: Data from a total of 143 patients (median age, 42 years; 32 men and 111 women) were investigated. At baseline, median hsTnI was 1.9 pg/mL and ranged from 0 to 69.6 pg/mL. Five patients (3.5%) had a high hsTnI value that exceeded 26.2 pg/mL, which is used as the cutoff for diagnosis of myocardial infarction, and 22 patients (15.4%) had an intermediate value between 5.0 and 26.2 pg/mL. Multivariable regression analysis showed that significant predictors of the hsTnI value were age (β = 0.20, p = 0.01) and BNP (β = 0.43, p < 0.0001) (R2 = 0.27, F = 26.0, p < 0.0001), and significant predictors of the BNP value were age (β = 0.23, p = 0.001), hemoglobin (β = −0.43, p < 0.0001), free T4 (FT4) (β = 0.23, p = 0.001), and hsTnI (β = 0.27, p < 0.0001) (R2 = 0.49, F = 33.8, p < 0.0001). Correlations were found between a decrease in hsTnI and BNP in the first 3 months (ρ = 0.49, p < 0.0001). A decrease in FT4 in the first 3 months was weakly correlated with decreases in hsTnI (ρ = 0.32, p = 0.0004) and BNP (ρ = 0.32; p = 0.0003). Of the 27 patients with elevated hsTnI (≥5.0 pg/mL), the hsTnI level was normalized in 20 patients within a year. Conclusions: In thyrotoxicosis, the myocardial biomarker hsTnI is elevated in about 20% of patients; hsTnI levels decrease as thyroid function improves and BNP decreases.
Transtornos do humor, sintomas e tratamento na perspectiva dos familiares
Authors: Oliveira Jéssica Maria Vieira , Regne Giulia Ribeiro Schettino , Reinaldo Amanda Márcia dos Santos , Silveira Belisa Vieira da , Gomes Natalia de Magalhães Ribeiro
Published: September 2020

Objetivo: compreender a percepção de familiares de pacientes com diagnóstico de transtorno de humor emrelação à doença, sintomas e tratamento. Método: estudo de caso qualitativo realizado com familiares de pacientes com diagnóstico de transtorno de humor em tratamento em hospital psiquiátrico. A coleta de dados ocorreu por meio de entrevistas semiestruturadas e os dados foram submetidos à análise de conteúdo. Resultados: a desinformação e o estigma permeiam esse panorama, fragilizando relações, prejudicando o suporte familiar e o tratamento, que envolveu medicamentos, psicoterapia e eletroconvulsoterapia. Conclusão: os transtornos do humor, dadas sua complexidade e prevalência, necessitam ser compreendidos pela sociedade, família e profissionais. A família é afetada pelo sofrimento mental e necessita ser foco do cuidado.
Revisão sistemática qualitativa sobre avaliações de serviços em saúde mental na perspectiva dos usuários
Authors: Ricci Éllen Cristina , Pereira Mariana Barbosa , Erazo Leidy Janeth , Campos Rosana Teresa Onocko , Leal Erotildes Maria
Published: September 2020

Objetivo: identificar publicações nacionais brasileiras e internacionais na área de saúde mental sobre avaliação de serviços, destacando as formas de participação dos usuários. Método: trata-se de uma revisão sistemática qualitativa da literatura, que seguiu as orientações do PRISMA e utilizou duas plataformas internacionais que agregam um número significativo de bases de dados, com os descritores (saúde mental e avaliação) no período de 2004 a 2016. Resultados: levantou-se 4.735 artigos completos; tendo elegibilidadefinal de 137 artigos para leitura integral, sendo 44 incluídos na análise final. Percebe-se que há pesquisas sobre avaliação de serviços de saúde mental com a participação dos usuários no Brasil, mas ainda em número menor em comparação com Inglaterra, Austrália e EUA. Conclusão: a forma de participação dos usuários nas avaliações dos serviços, tanto no Brasil quanto em outros países, ainda é um desafio. Há pouco protagonismo dos usuários. No Brasil, coloca-se o desafio ainda de estruturar avaliações sistemáticas dos serviços públicos, com multiplicidade de métodos avaliativos e envolvendo todos os atores.
Experimental skin wound treatment with Copaifera langsdorffii Desf Kuntze (Leguminosae) extract and oil-resin in horses
Authors: Kauer Débora Perrone , Alonso Juliana de Moura , Gushiken Lucas  Fernando Sergio , Lemos Marivane , Padovani Carlos Roberto , Rodrigues Celso Antonio , Alves Ana Liz Garcia , Watanabe Marcos Jun , Bastos Jairo Kenupp , Pellizzon Cláudia Helena , Hussni Carlos Alberto
Published: September 2020

Copaifera langsdorffii is a Brazilian native plant that is used for wound healing or as an anti-inflammatory agent. Non-healing wounds are an important health problem, particularly in horses, because they can cause the animal invalidity or even lead to death. In addition, horses respond to skin wounds with chronic inflammatory response and intense wound granulation, thereby delaying the healing process. By this way, our aim was to evaluate the healing potential of Copaifera langsdorffii hydroalcoholic extract (HE) and oil-resin creams (OR) in horse skin wounds. Four wounds were performed bilaterally in the lumbar region of six horses with a 2 cm punch and treated daily with the respective treatments: saline solution, vehicle, 10% HE creams or 10% OR cream. Daily planimetry analyses were performed to measure the wound area and clinical parameters. In four different experimental periods (3, 7, 14 and 21 d), wound biopsies were removed and used for microscopic analyses. SS wounds presented a significant small area at day 3 and 7, OR wounds presented significant small area in comparison with HE at 14 d, and no significant difference was observed between treatments at 21 d. A better microscopic and clinical healing activity of HE and OR was identified in comparison with the controls. The OR group showed better healing quality, specifically after 7 d of treatment. Therefore, Copaifera langsdorffii formulations demonstrated their wound healing potential in horse skin lesions, exhibiting an improvement of the macro- and microscopic parameters.
Association of intraperitoneal ceftriaxone, intravenous gentamicin and oral metronidazole in the treatment of an abdominal abscess and peritonitis in a horse
Authors: Alonso Juliana De Moura , Ávila Alice Ribeiro , Apolonio Emanuel Vitor Pereira , Santos Bruna dos , Alves Ana Liz Garcia , Watanabe Marcos Jun , Rodrigues Celso Antonio , Hussni Carlos Alberto
Published: September 2020

Medical management of abdominal abscesses in horses requires prolonged antibiotic therapy and presents varied success rates. A 6-year-old male horse with a history of colic and multiple abdominal punctures to relieve gas was attended. At admission, tachycardia, tachypnea, hyperthermia, mucosal congestion, dehydration, and rigid gait were observed. The association of physical examination, laboratory and ultrasonographic findings allowed the diagnoses of peritonitis and abdominal abscess. Supporting treatment plus broad spectrum antibiotic therapy was performed: daily intraperitoneal ceftriaxone (25 mg/kg, 7 days); daily intravenous gentamicin (6.6 mg/kg, 7 days); per os metronidazole three times a day (15 mg/kg 12 days), followed by the same dose twice a day (15 mg/kg 33 days), totaling 45 days of treatment. Plasma fibrinogen and ultrasonographic examination were the most effective tools to evaluate abscess evolution. There was normalization of the physical examination 24 h after beginning the treatment, consecutive regression of the nucleated cell count in the peritoneal fluid, and regression of plasma fibrinogen and size of the abscess. On the 10th treatment day, the animal was discharged from the hospital, maintaining oral therapy with metronidazole every 12 h (15 mg / kg). When the animal returned on the 30th day, an abscess size regression was observed. However, there was no resolution, and therapy with metronidazole was maintained. On the 45th day of treatment, a new hospital evaluation was performed, where the abscess resolved, and metronidazole was suspended. It is highlighted that the therapeutic association used in the treatment of abdominal infection and abscess resulted in a rapid clinical response
Determination of acute median lethal concentration and sublethal effects on AChE activity of Gymnotus carapo (Teleostei: Gymnotidae) exposed to trichlorfon
Authors: Ferri Giovanni Henrique , Cardoso Israel Luz , Gil Juliana Augusta , Jonsson Claudio Martin , Rantin Francisco Tadeu , Ishikawa Márcia Mayumi
Published: September 2020

Trichlorfon (TRF) is a pesticide widely used in aquaculture to control fish ectoparasites. This pesticide is an inhibitor of acetylcholinesterase, an essential enzyme for termination of nerve impulses. High rates of TRF use generate risks to the environment and human health. In the environment, pesticides can affect the local fauna and generate an ecological breakdown. There are several studies performed with fish production; however, gaps are created for native fish with other commercial values. The tuvira (Gymnotus carapo) is a fish native to Brazilian fauna and has great commercial importance in sport fishing. The present study aimed to determine the lethal concentration of trichlorfon (Masoten) in Gymnotus carapo and its sublethal effects on the enzyme AChE. In this study, the acute toxicity (the concentrations to kill 50% of the fish LC50) of TRF in tuviras (Gymnotus carapo) and acetylcholinesterase inhibition in liver and muscle tissue of tuviras submitted to sublethal concentrations were evaluated. For the acute assay, concentrations of 0.0, 5.0, 7.5, 15, 22.5, 30, 37.5 and 45 mg L-1 were used for a period of 96 h. After the acute exposure period, a LC50 of 6.38 mg L-1 was determined. In the sublethal assay, concentrations of 0.0, 0.238, 0.438 and 0.638 mg L-1 were used, based on 10% of the LC50, over a period of 14 days. Two collections were performed: one at seven days and the other at the end (day 14). Inhibition of acetylcholinesterase in the liver was only shown (p < 0.05) for the treatment with 0.638 mg L-1 after 14 days of exposure. At seven days, muscle activity showed a significant difference only for the treatments 0.438 and 0.638 mg L-1, compared with the treatment 0.238 mg L-1 and control. At 14 days of exposure, only the treatment 0.638 mg L-1 showed significant differences in relation to the other groups, thus showing that enzyme recovery had occurred. The value found in the acute test allowed the conclusion that TRF presents moderately toxic characteristics to Gymnotus carapo. The toxicity parameter values calculated in the present study assisted in estimation of maximum allowable limits in bodies of water when combined with test data from other non-target organisms.
Minerais pesados de saprólitos de pegmatitos intrusivos no ortognaisse Resende Costa: caracterização e correlação com a Província Pegmatítica de São João del Rei, Minas Gerais, Brasil
Authors: Cidade Taís Proença , Ávila Ciro Alexandre , Neumann Reiner , Faulstich Fabiano Richard Leite , Silva Victor Hugo Riboura Menezes da , Sousa Sarah Siqueira da Cruz Guimarães
Published: September 2020

O estudo de minerais pesados representa uma importante ferramenta para a correlação entre pegmatitos, pois corpos espacialmente próximos e com mineralogia semelhante são normalmente interpretados como cogenéticos e provenientes de uma mesma fonte. Os minerais pesados dos pegmatitos intrusivos no ortognaisse Resende Costa foram descritos por estereomicroscopia, espectroscopia Raman, difratometria de raios X e a partir de imagens de elétrons retroespalhados em microscópio eletrônico de varredura. Esses se encontram mineralizados em minerais de Sn (cassiterita) e Nb-Ta (grupo da columbita-euxenita), semelhantemente aos pegmatitos intrusivos no metagranitoide Ritápolis, enquanto os corpos intrusivos no ortognaisse Cassiterita só exibem minerais do grupo da microlita e não apresentam cassiterita. Um intercrescimento entre fases de Nb-Ta-Ti se mostra determinante para caracterizar os pegmatitos intrusivos no ortognaisse Resende Costa e diferenciá-los dos corpos relacionados tanto ao metagranitoide quanto ao ortognaisse. Sugere-se a presença de pelo menos três gerações de corpos pegmatíticos na Província Pegmatítica de São João del Rei, sendo eles correlatos aos protólitos do ortognaisse Cassiterita, do ortognaisse Resende Costa e do metagranitoide Ritápolis.
Cardiorenal Protection With the Newer Antidiabetic Agents in Patients With Diabetes and Chronic Kidney Disease: A Scientific Statement From the American Heart Association
Authors: Rangaswami Janani , Bhalla Vivek , de Boer Ian H. , Staruschenko Alexander , Sharp Johanna A. , Singh Radhika Rajgopal , Lo Kevin Bryan , Tuttle Katherine , Vaduganathan Muthiah , Ventura Hector , McCullough Peter A. ,   On behalf of the American Heart Association Council on the Kidney in Cardiovascular Disease; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; and Council on Lifestyle and Cardiometabolic Health
Published: September 2020

Chronic kidney disease (CKD) with type 2 diabetes (T2D) is a major public health problem, resulting in significant cardiovascular and kidney adverse outcomes worldwide. Despite the widespread use of standard-of-care therapies for CKD with T2D over the past few decades, rates of progression to end-stage kidney disease remain high with no beneficial impact on its accompanying burden of cardiovascular disease. The advent of the newer classes of antihyperglycemic agents, including SGLT2 (sodium glucose cotransporter 2) inhibitors and GLP-1 (glucagon-like peptide-1) receptor agonists, has changed the landscape of therapeutic options for patients with CKD with T2D, with demonstration of significant reductions in cardiovascular adverse events and progression to end-stage kidney disease. Several potential mechanisms exist through which these beneficial effects are achieved in both drug classes, which may be independent of their antihyperglycemic effects. This scientific statement summarizes the current literature on the cardiorenal protective effects with SGLT2 inhibitors and GLP-1 receptor agonists in patients with CKD and T2D. It reviews potential mechanistic pathways that may drive these benefits and summarizes the literature on adverse effects in patients with CKD and T2D at risk for or with established cardiovascular disease. Last, it provides practical guidance on a proposed collaborative care model bridging cardiologists, nephrologists, endocrinologists, and primary care physicians to facilitate the prompt and appropriate integration of these therapeutic classes in the management of patients with T2D and CKD.
Origins of Primary Hypertension in Children
Authors: Litwin Mieczysław , Feber Janusz
Published: September 2020

Although relatively rare in childhood, primary hypertension (PH) is thought to have originated in childhood and may be even determined perinatally. PH prevalence increases in school-age children and affects 11% of 18-year-old adolescents. Associated with metabolic risk factors, elevated blood pressure in childhood is carried into adulthood. Analysis of the phenotype of hypertensive children has revealed that PH is a complex of anthropometric and neuro-immuno-metabolic abnormalities, typically found in hypertensive adults. Children with elevated blood pressure have shown signs of accelerated biological development, which are closely associated with further development of PH, metabolic syndrome, and cardiovascular disease in adulthood. At the time of diagnosis, hypertensive children were reported to have significant arterial remodelling expressed as significantly increased carotid intima-media thickness, increased stiffness of large arteries, lower area of microcirculation, and decreased endothelial function. These changes indicate that their biological age is 4 to 5 years older than their normotensive peers. All these abnormalities are typical features of early vascular aging described in adults with PH. However, as these early vascular changes in hypertensive children are closely associated with features of accelerated biological development and neuro-immuno-metabolic abnormalities observed in older subjects, it seems that PH in childhood is not only an early vascular aging event, but also an early biological maturation phenomenon.