bluuebunny/crossref_metadata_2025 huggingface dataset:
RAS/BRAF Circulating Tumor DNA Mutations as a Predictor of Response to First-Line Chemotherapy in Metastatic Colorectal Cancer Patients
Authors: Yao Jiannan , Zang Wanchun , Ge Yang , Weygant Nathaniel , Yu Pan , Li Lei , Rao Guanhua , Jiang Zhi , Yan Rui , He Linjia , Yu Yang , Jin Mulan , Cheng Gang , An Guangyu
Published: March 2018

Background. Since circulating tumor DNA (ctDNA) offers clear advantages as a minimally invasive method for tumor monitoring compared with tumor tissue, we aimed to evaluate genotyping ctDNA using a next-generation sequencing- (NGS-) based panel to identify the prognostic value of mutation status in metastatic colorectal cancer (mCRC) patients with primary tumor resected and with subsequent lines of treatment in this study. Methods. 76 mCRC patients treated in Beijing Chao-Yang Hospital from 2011 to 2017 were enrolled. Genotyping of RAS/BRAF in tumor tissue and ctDNA was determined by ARMS PCR and with a 40-gene panel using NGS, respectively. Patient clinicopathologic features and RAS/BRAF gene mutation status were evaluated by survival analysis for disease-free survival (DFS) and progression-free survival (PFS). Results. Among 76 patients, KRAS distributions were not significantly correlated with any clinicopathologic features. The concordance between tumor tissue and ctDNA KRAS mutation was 81.25%. Mutations of RAS/BRAF had no significant impact on DFS after surgery (hazard ratio (HR), 1.205; 95% CI, 0.618 to 2.349; P=0.5837) but prognosticated poorer PFS in subsequent first-line therapy (HR, 3.351; 95% CI, 1.172 to 9.576; P=0.024). Conclusion. ctDNA was comparable with tumor tissue for mutation detection. RAS/BRAF mutations detected in ctDNA predict a worse PFS in mCRC patients with first-line chemotherapy. Our results provide support for the prognostic value of RAS/BRAF ctDNA mutation detection in mCRC patients.
Coupling Fault Feature Extraction Method Based on Bivariate Empirical Mode Decomposition and Full Spectrum for Rotating Machinery
Authors: Jia Rong , Ma Fuqi , Wu Hua , Luo Xingqi , Ma Xiping
Published: March 2018

To accurately extract the fault characteristics of vibration signals of rotating machinery is of great significance to the unit online monitoring and evaluation. However, because the current feature extraction methods are mainly for single channel, the results of feature extraction are often inaccurate. To this end, a coupling fault feature extraction method based on bivariate empirical mode decomposition (BEMD) and full spectrum is proposed for rotating machinery. Firstly, the two-dimensional orthogonal signal obtained by orthogonal sampling technique is decomposed by bivariate empirical mode decomposition to obtain the intrinsic mode function with phase information. In order to obtain the sensitive modal components, the sensitivity coefficients are constructed on the basis of mutual information. Then, the sensitivity coefficient of each intrinsic mode function is calculated, and the intrinsic mode function with the larger sensitive coefficient is selected as the sensitive component. Finally, the full spectrum of the sensitive component is obtained using the full vector envelope technique, so as to get a comprehensive and accurate characteristic component. The results of simulations experiment and an application example show that this method can extract the fault characteristic component of the rotating machinery comprehensively and accurately. It is of great significance to realize the accurate diagnosis of coupling faults of rotating machinery.
Instrumental or Physical-Exercise Rehabilitation of Balance Improves Both Balance and Gait in Parkinson’s Disease
Authors: Giardini Marica , Nardone Antonio , Godi Marco , Guglielmetti Simone , Arcolin Ilaria , Pisano Fabrizio , Schieppati Marco
Published: March 2018

We hypothesised that rehabilitation specifically addressing balance in Parkinson’s disease patients might improve not only balance but locomotion as well. Two balance-training protocols (standing on a moving platform and traditional balance exercises) were assessed by assigning patients to two groups (Platform,n=15, and Exercises,n=17). The platform moved periodically in the anteroposterior, laterolateral, and oblique direction, with and without vision in different trials. Balance exercises were based on the Otago Exercise Program. Both platform and exercise sessions were administered from easy to difficult. Outcome measures were (a) balancing behaviour, assessed by both Index of Stability (IS) on platform and Mini-BESTest, and (b) gait, assessed by both baropodometry and Timed Up and Go (TUG) test. Falls Efficacy Scale-International (FES-I) and Parkinson’s Disease Questionnaire (PDQ-8) were administered. Both groups exhibited better balance control, as assessed both by IS and by Mini-BESTest. Gait speed at baropodometry also improved in both groups, while TUG was less sensitive to improvement. Scores of FES-I and PDQ-8 showed a marginal improvement. A four-week treatment featuring no gait training but focused on challenging balance tasks produces considerable gait enhancement in mildly to moderately affected patients. Walking problems in PD depend on postural instability and are successfully relieved by appropriate balance rehabilitation. This trial is registered with ClinicalTrials.govNCT03314597.
The Association between Serum Bilirubin Level and Electrochemical Skin Conductance in Chinese Patients with Type 2 Diabetes
Authors: Mao Fei , Zhu Xiaoming , Lu Bin , Li Yiming
Published: March 2018

Bilirubin is an antioxidant and plays a protective role against cardiovascular and microvascular disease. The aim of this study is to explore the possible protective effect of bilirubin on small nerve function. A total of 265 Chinese patients with type 2 diabetes mellitus (T2DM) were enrolled in the study. Both SUDOSCAN and other traditional diabetic neuropathy examinations including neuropathy symptom score (NSS), the neuropathy disability score (NDS) and Michigan Neuropathy Screening Instrument (MNSI) scores were performed in all patients with T2DM. Blood bilirubin levels were tested in the study. Spearman correlation analysis and multivariate regression analysis were performed to determine the relation between bilirubin level and hands and feet ESC values. Spearman correlation analysis demonstrated a correlation between total bilirubin and ESC levels including hands (r=0.165,P<0.05) and feet (r=0.122,P<0.05) as well as between UCBil and ESC levels including both hands (r=0.172,P<0.05) and feet (r=0.175,P<0.05). Multivariate regression linear analyses showed both total bilirubin and UCBil level were independently associated with hands and feet ESC levels. All these results suggested a positive association between bilirubin level and ESC level, indicating a possible protective role of bilirubin in peripheral small nerve dysfunction of type 2 diabetes mellitus.
Impact of Health Education on Knowledge and Behaviors toward Infectious Diseases among Students in Gansu Province, China
Authors: Wang Manli , Han Xuemei , Fang Haiqing , Xu Chang , Lin Xiaojun , Xia Shuxu , Yu Wenhan , He Jinlu , Jiang Shuai , Tao Hongbing
Published: March 2018

Objectives. Infectious disease knowledge and behaviors are key elements that ensure student health and safety. This study explores the impact of health education on student knowledge and behaviors toward infectious diseases and determines the factors affecting infectious diseases knowledge and behaviors among students in Gansu, China. Methods. A cross-sectional study and three sampling methods were used in two counties, 12 schools, and 32 classes in Gansu, China, from 2012 to 2013. Collected data included the following: (1) sociodemographic characteristics of 2002 students (1001 participants in the intervention group and 1001 in the control group); (2) accuracy of student knowledge and behaviors toward infectious diseases based on comparison of intervention and control groups through X2 test; and (3) mean scores on knowledge and behavior of students with different characteristics toward infectious diseases, as analyzed through analysis of variance (ANOVA). Multiple linear regression was conducted to analyze factors affecting student knowledge and behaviors toward infectious diseases. Results. Statistically significant differences were observed among eight items of infectious disease transmission and treatment knowledge between intervention and control groups (P<0.001). Average accuracies of knowledge and behaviors toward infectious diseases reached 72.23% and 60.03%. Significant differences were observed in six items on student behavior in rural and urban areas (P<0.001). Health education, household register, and county affected scores of student knowledge and behaviors toward infectious diseases (P<0.05). Gender and education level also affected scores of student behaviors toward infectious diseases (P<0.001). Conclusions. Health education contributes to student knowledge and behaviors toward infectious diseases. Students in the control group need intensified health education on infectious diseases. Health education needs to pay particular attention to rural students, all male students, and students at senior high school level living on campus.
Establishment of a Gene Detection System for Hotspot Mutations of Hearing Loss
Authors: Wang Chao , Wang Shengzhou , Chen Hongyan , Lu Daru
Published: March 2018

Hearing loss is an etiologically heterogeneous trait with a high incidence in China. Though conventional newborn hearing screening program has been widely adopted, gene detection can significantly improve the means of early discovering genetic risk factors. Thus, simple and efficient methods with higher sensitivity and lower cost for detecting hotspot mutations of hearing loss are urgently requested. Here we established a mutation detection system based on multiple fluorescent probe technique, which can detect and genotype nine hotspot mutations of four prominent hearing loss-related genes in two reactions on a four-channel real-time PCR instrument, includingGJB2(rs750188782, rs80338943, rs1110333204, and rs80338939),GJB3(rs74315319),SLC26A4(rs111033313 and rs121908362), andmtDNA 12S rRNA(rs267606617 and rs267606619). This system is with high sensitivity that enables detecting as low as 10 DNA copies samples per reaction. A comparison study in 268 clinical samples showed that the detection system had 100% concordance to Sanger sequencing. Besides, blood and saliva samples can be directly detected without DNA extraction process, which greatly simplifies the manipulation. The new system with high sensitivity, accuracy, and specimen type compatibility can be expectedly a reliable tool in clinical application.
Fetal Sirenomelia Associated with an Abdominal Cyst Originating from a Saccular Cloaca
Authors: Kinjo Yui , Masamoto Hitoshi , Nitta Hayase , Kinjo Tadatsugu , Tamaki Tomoko , Yoshimi Naoki , Aoki Yoichi
Published: March 2018

A 40-year-old pregnant woman presented with a fetal abdominal cyst and oligohydramnios. Color Doppler scan revealed a single blood vessel from the fetal aorta into a single umbilical artery. Severe oligohydramnios limited ultrasonographic evaluation of the fetal lower limbs, kidneys, or bladder. The pregnancy was terminated; the fetus showed fused lower limbs, bulging abdomen, and absent external genitalia and was diagnosed with type III sirenomelia. On autopsy, no normal bladder was observed, but duodenal atresia, anorectal atresia, and right renal agenesis were found. An intra-abdominal cyst, diagnosed histologically as a saccular cloaca, occupied the abdominal cavity. Ultrasonographic diagnosis of fetal sirenomelia is difficult due to poor depiction of the lower limbs. A vitelline artery leading to a single umbilical artery and a fetal abdominal cyst occupying most of the abdominal cavity are considered fetal sirenomelia associated with large defects of the gastrointestinal and genitourinary tracts.
A Novel Neural Network Model for Blood Pressure Estimation Using Photoplethesmography without Electrocardiogram
Authors: Wang Ludi , Zhou Wei , Xing Ying , Zhou Xiaoguang
Published: March 2018

The prevention, evaluation, and treatment of hypertension have attracted increasing attention in recent years. As photoplethysmography (PPG) technology has been widely applied to wearable sensors, the noninvasive estimation of blood pressure (BP) using the PPG method has received considerable interest. In this paper, a method for estimating systolic and diastolic BP based only on a PPG signal is developed. The multitaper method (MTM) is used for feature extraction, and an artificial neural network (ANN) is used for estimation. Compared with previous approaches, the proposed method obtains better accuracy; the mean absolute error is 4.02 ± 2.79 mmHg for systolic BP and 2.27 ± 1.82 mmHg for diastolic BP.
Experience and Expectations of Ovarian Cancer Patients in Australia
Authors: Holliday Catherine M. , Morte Maria , Byrne Josephine M. , Holliday Anne T.
Published: March 2018

Some of the most significant advances in ovarian cancer treatment have been those that result in improvements in progression-free survival (PFS); however there is little research to understand the value that patients place on accessing therapies that result in PFS as a clinical outcome related to survivorship. This study therefore aimed to understand the experience and expectations of women with ovarian cancer in Australia in relation to quality of life (QoL) and treatment options. An online survey collected demographic information and 13 investigator-derived structured interview questions were developed to understand the experience of women with ovarian cancer, their understanding of terminology associated with their condition, and expectations of future treatment. This study demonstrated that ovarian cancer patients equate PFS with being in remission and that patients expect QoL during that time to be good to excellent. Women in this study described excellent QoL as feeling positive and happy and not worrying about cancer, feeling fit and healthy without side effects, and being able to live life as they did before their diagnosis, including the absence of fear of progression or recurrence. It is therefore suggested that there is a positive relationship between PFS and QoL. While it is difficult to quantify QoL and further research is needed, the results of this study suggest that the minimum time that women with ovarian cancer expect in relation to treatments that result in PFS is approximately six months. In the absence of this information, decision-makers are left to make assumptions about the value women place on access to therapeutics that increase PFS, which for this type of cancer is an important aspect of survivorship.
Trajectory Specification Language for Air Traffic Control
Authors: Paielli Russell A.
Published: March 2018

Trajectory Specification is a method of specifying aircraft trajectories with tolerances such that the position at any given time in flight is constrained to a precisely defined bounding space. The bounding space is defined by tolerances relative to a reference trajectory that specifies position as a function of time. The tolerances are dynamic and are based on the aircraft navigation capabilities and the traffic situation. This paper proposes a standard Trajectory Specification Language (TSL) based on the Extensible Markup Language (XML) to represent these specifications and to communicate them by datalink. The language can be used to downlink trajectory requests from air to ground and to uplink trajectory assignments from ground to air. The XML format can be converted to binary for operational use, if necessary, using Efficient XML Interchange (EXI) or Abstract Syntax Notation (ASN.1).
Numerical Response Surfaces of Volume of Ablation and Retropulsion Amplitude by Settings of Ho:YAG Laser Lithotripter
Authors: Zhang Jian J. , Rutherford Jonathan , Solomon Metasebya , Cheng Brian , Xuan Jason R. , Gong Jason , Yu Honggang , Xia Michael L. D. , Yang Xirong , Hasenberg Thomas , Curran Sean
Published: March 2018

Objectives.Although laser lithotripsy is now the preferred treatment option for urolithiasis due to shorter operation time and a better stone-free rate, the optimal laser settings for URS (ureteroscopic lithotripsy) for less operation time remain unclear. The aim of this study was to look for quantitative responses of calculus ablation and retropulsion by performing operator-independent experiments to determine the best fit versus the pulse energy, pulse width, and the number of pulses.Methods.A lab-built Ho:YAG laser was used as the laser pulse source, with a pulse energy from 0.2 J up to 3.0 J and a pulse width of 150 μs up to 1000 μs. The retropulsion was monitored using a high-speed camera, and the laser-induced craters were evaluated with a 3-D digital microscope. The best fit to the experimental data is done by a design of experiment software.Results.The numerical formulas for the response surfaces of ablation speed and retropulsion amplitude are generated.Conclusions.The longer the pulse, the less the ablation or retropulsion, while the longer pulse makes the ablation decrease faster than the retropulsion. The best quadratic fit of the response surface for the volume of ablation varied nonlinearly with pulse duration and pulse number.
Analysis of Bacterial Community Structure of Activated Sludge from Wastewater Treatment Plants in Winter
Authors: Xu Shuang , Yao Junqin , Ainiwaer Meihaguli , Hong Ying , Zhang Yanjiang
Published: March 2018

Activated sludge bulking is easily caused in winter, resulting in adverse effects on effluent treatment and management of wastewater treatment plants. In this study, activated sludge samples were collected from different wastewater treatment plants in the northern Xinjiang Uygur Autonomous Region of China in winter. The bacterial community compositions and diversities of activated sludge were analyzed to identify the bacteria that cause bulking of activated sludge. The sequencing generated 30087–55170 effective reads representing 36 phyla, 293 families, and 579 genera in all samples. The dominant phyla present in all activated sludge were Proteobacteria (26.7–48.9%), Bacteroidetes (19.3–37.3%), Chloroflexi (2.9–17.1%), and Acidobacteria (1.5–13.8%). Fifty-five genera including unclassified_f_Comamonadaceae, norank_f_Saprospiraceae, Flavobacterium, norank_f_Hydrogenophilaceae, Dokdonella, Terrimonas, norank_f_Anaerolineaceae, Tetrasphaera, Simplicispira, norank_c_Ardenticatenia, and Nitrospira existed in all samples, accounting for 60.6–82.7% of total effective sequences in each sample. The relative abundances of Saprospiraceae, Flavobacterium, and Tetrasphaera with the respective averages of 12.0%, 8.3%, and 5.2% in bulking sludge samples were higher than those in normal samples. Filamentous Saprospiraceae, Flavobacterium, and Tetrasphaera multiplied were the main cause for the sludge bulking. Redundancy analysis (RDA) indicated that influent BOD5, DO, water temperature, and influent ammonia had a distinct effect on bacterial community structures.
Laser Acupuncture at Large Intestine 4 Compared with Oral Glucose Administration for Pain Prevention in Healthy Term Neonates Undergoing Routine Heel Lance: Study Protocol for an Observer‐Blinded, Randomised Controlled Clinical Trial
Authors: Stadler Jasmin , Avian Alexander , Posch Katrin , Urlesberger Berndt , Raith Wolfgang
Published: March 2018

Background. Nonpharmacological strategies have actually become more important in neonatal pain management during routinely applied minor painful procedures. However, commonly used nonpharmacological strategies are inferior to orally administered sweet solutions. Therefore, we will compare laser acupuncture, as a recent nonpharmacological method, with the standard care of oral glucose solution for pain prevention. Methods. Ninety‐five healthy term neonates will be allocated into one of two groups. Before routine heel lance for metabolic screening, one group will receive laser acupuncture at acupuncture point Large Intestine 4 (LI 4) bilaterally for 60 seconds per point (acupuncture group) and the other will receive the standard care with orally administered glucose solution (glucose group). The complete procedure of blood sampling will be recorded on video, excluding the intervention before heel lance. A paediatric nurse, blinded with respect to the allocation, will evaluate these video recordings and determine the Premature Infant Pain Profile (PIPP) for each neonate. Primary outcome will be the mean difference in PIPP scores between groups. Discussion. This observer‐blinded randomised controlled trial has been designed to explore potential advantages of laser acupuncture in the management of neonatal pain because more data are required to provide information about its efficacy and safety. Trial Registration. This trial is registered with DRKS00010122.
Treatment of Danhong Injection Combined with Naoxintong Capsule in Acute Coronary Syndrome Patients Undergoing PCI Operation: Study for a Randomized Controlled and Double‐Blind Trial
Authors: Zhao Shuai , Tang Yong , Cai Hairong , Liu Weifeng , Zhang Lieyuan , Chen Dongjie , Chen Bojun
Published: March 2018

Objective. This double‐blind and randomized placebo‐controlled trial evaluated the safety and efficacy of Danhong injection combined with Naoxintong capsule in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). Methods. ACS patients scheduled to undergo PCI (n = 130) were equally and randomly apportioned to either a treatment or control group. After PCI, the treatment group received Danhong injection combined with Naoxintong capsule for 12 weeks, while the control group was given placebo. Both groups were otherwise treated with conventional secondary prevention of coronary artery disease. The groups were primarily evaluated for clinical efficacy and cardiovascular events. Evaluative indicators of safety included adverse events, platelet count, and liver, renal, and blood coagulation functions. Result. No cardiovascular events or adverse reactions were observed in either group. The treatment group demonstrated better signs of clinical efficacy, including left ventricular ejection fraction, higher nitric oxide levels, and lower levels of endothelin‐1 (ET‐1) and von Willebrand factor (VWF). Conclusion. ACS patients treated with Danhong injection combined with Naoxintong capsule after PCI demonstrated better improvement with regard to markers associated with atherosclerosis and adverse cardiovascular events, without apparent adverse effects. Thus, Danhong injection combined with Naoxintong capsule was safe and effective for treating ACS patients after PCI.
Effect of Chlorogenic Acid Intake on Cognitive Function in the Elderly: A Pilot Study
Authors: Kato Morimasa , Ochiai Ryuji , Kozuma Kazuya , Sato Hirotaka , Katsuragi Yoshihisa
Published: March 2018

Objective. To evaluate the effect of chlorogenic acids (CGAs) intake on cognitive function. Methods. In this pilot study, the Cogstate and CNS Vital Signs test batteries were used to evaluate cognitive function in 8 healthy elderly men and women complaining of subjective memory loss after a 6‐month intake of a test beverage containing 330 mg of CGAs just before bedtime. Results. After a 6‐month CGA intake period, significant improvement was observed in the One Back Test of the Cogstate, the Shifting Attention Test, and Finger Tapping Test as well as in the composite memory, verbal memory, complex attention, cognitive flexibility, executive function, and motor speed domains of the CNS Vital Signs test battery. Conclusion. A 6‐month intake of CGAs may improve attentional, executive, and memory functions in the elderly with complaints of subjective memory loss.
Chronic Unpredictable Mild Stress Causing Cardiac and Thoracic Spinal Cord Electrophysiological Abnormalities May Be Associated with Increased Cardiac Expression of Serotonin and Growth-Associated Protein-43 in Rats
Authors: Liu Zhengjiang , Liu Hua , Zeng Zhi Huan
Published: March 2018

Background. The aim of this study was to investigate the potential mechanisms by which chronic unpredictable mild stress (CMS) might induce cardiovascular disease. Methods. Twenty male Sprague-Dawley rats (weighing 180–250 g) were divided into the CMS group (CMS for 3 weeks) and control group (n=10/group). Sucrose solution consumption, sucrose solution preference rate, and the open field test (horizontal and vertical movements) were used to confirm the establishment of the CMS model. Heart rate was determined in Langendorff-perfused hearts, and field action potential duration (FAPD) was measured in cardiac atrial tissue, cardiac ventricular tissue, and thoracic spinal cord segments 1–5. The expressions of serotonin (5-HT) and growth-associated protein-43 (GAP-43) in cardiac ventricular tissue were analyzed using immunohistochemistry and immunofluorescence. Results. Compared with the control group, sucrose solution consumption, sucrose solution preference rate, horizontal movement, and vertical movement were significantly lower in the CMS group (P<0.01). The CMS group exhibited significant decreases in atrial and ventricular FAPDs (P<0.05), as well as significant increases in heart rates (P<0.05) and T1–5 spinal cord FAPD (P<0.01), as compared with the control group. The expressions of 5-HT and GAP-43 in cardiac ventricular tissue were significantly higher in the CMS group than in controls (P<0.01). Conclusions. CMS causes cardiac and T1–5 spinal cord electrophysiological abnormalities as well as increased cardiac expression of 5-HT and GAP-43, indicating that CMS could potentially increase the risk of cardiovascular disease.
The Relationship between Diabetes-Related Complications and Obstructive Sleep Apnea in Type 2 Diabetes
Authors: Siwasaranond Nantaporn , Nimitphong Hataikarn , Manodpitipong Areesa , Saetung Sunee , Chirakalwasan Naricha , Thakkinstian Ammarin , Reutrakul Sirimon
Published: March 2018

This study explored the relationship between obstructive sleep apnea (OSA) and the presence of any diabetes-related complications in type 2 diabetes and whether this was mediated by hypertension. Secondly, the relationship between OSA severity and estimated glomerular filtration rate (eGFR) was investigated. A total of 131 patients participated. OSA was diagnosed using a home monitor, and severity was measured by apnea-hypopnea index (AHI) and oxygen desaturation index (ODI). OSA was found in 75.6% of the participants, 40.5% with moderate-to-severe degree. Any diabetes-related complications (retinopathy, neuropathy, nephropathy, or coronary artery disease) were present in 55.5%, and 70.2% of the participants had hypertension. Mediation analysis indicated that, compared to those with mild or no OSA, those with moderate-to-severe OSA were 3.05 times more likely to have any diabetes-related complications and that this relationship was mediated by the presence of hypertension. After adjusting for confounders, ODI (B = −0.036,p=0.041), but not AHI, was significantly associated with lower eGFR. In conclusion, moderate-to-severe OSA was related to the presence of any diabetes-related complications in type 2 diabetes, and the relationship was mediated by hypertension. The severity of intermittent hypoxia was associated with lower eGFR. Whether OSA treatment will delay or reduce diabetes-related complications should be investigated.
Aged Black-and-Gold Howler Monkey Female (Alouatta caraya): A Sign of Reproductive Senescence?
Authors: Raño Mariana , Valeggia Claudia R. , Kowalewski Martin M.
Published: March 2018

Reproductive senescence patterns have been scarcely studied in Neotropical primates. The few studies available on the hormonal profiles of aging female monkeys indicate that the decline of ovarian function in nonhuman primates may resemble the hormonal events associated with the perimenopause in women. In this study, we explore a reproductive hormone profile of an aged black-and-gold howler monkey female (Alouatta caraya) from a wild population in northeastern Argentina and compare this profile with that of a cycling female in the same population. As part of a larger study, we recorded sociosexual behaviors in adult and subadult females belonging to two groups, and we collected urine (n = 877) to determine the sex hormone profile of each female. These samples were analyzed using enzyme immunoassays for estrone conjugates and pregnanediol-3-glucuronide (PdG). We found differences in mean values of PdG between the younger (cycling) and the older female. These hormone values were lower in the older female, and she did not show any signs of cyclicity for either reproductive hormone. Our results show that the aging female in this wild population shows signs of ovarian senescence, indicated by low, acyclic levels of progesterone metabolites.
Differential Response of Dopamine Mediated by β-Adrenergic Receptors in Human Keratinocytes and Macrophages: Potential Implication in Wound Healing
Authors: Parrado Andrea Cecilia , Salaverry Luciana Soledad , Mangone Franco Mauricio , Apicella Carolina Eugenia , Gentile Teresa , Canellada Andrea , Rey-Roldán Estela Beatriz
Published: March 2018

Objective: Dopamine is an immunomodulatory neurotransmitter. In the skin, keratinocytes and macrophages produce proinflammatory cytokines and metalloproteinases (MMPs) which participate in wound healing. These cells have a catecholaminergic system that modulates skin pathophysiologic processes. We have demonstrated that dopamine modulates cytokine production in keratinocytes via dopaminergic and adrenergic receptors (ARs). The aim of this study was to evaluate the effect of dopamine and its interaction with β-ARs in human HaCaT keratinocytes and THP-1 macrophages. We evaluated the production of inflammatory mediators implicated in wound healing. Methods: Cells were stimulated with dopamine in the absence or presence of the β-adrenergic antagonist propranolol. Wound closure, MMP activity, and the production of IL-8, IL-1β, and IκB/NFκB pathway activation were determined in stimulated cells. Results: Dopamine did not affect the wound closure in human keratinocytes, but diminished the propranolol stimulatory effect, thus delaying cell migration. Similarly, dopamine significantly decreased MMP-9 activity and the propranolol-induced MMP activity. Dopamine significantly increased the p65-NFκB subunit levels in the nuclear extracts, which were reduced in the presence of propranolol in keratinocytes. On the other hand, dopamine significantly increased MMP-9 activity in THP-1 macrophages, but did not modify the propranolol-increased enzymatic activity. Dopamine significantly increased IL-8 production in human macrophages, an effect that was partially reduced by propranolol. Dopamine did not modify the p65-NFκB levels in the nuclear extracts in THP-1 macrophages. Conclusion: We suggest that the effect of dopamine via β-ARs depends on the physiological condition and the cell type involved, thus contributing to either improve or interfere with the healing process.
Economy of Standards: European Association of Urology Guideline Changes Influence Treatment Costs in Stage I Testicular Cancer Patients
Authors: John Axel , Baumgart André , Worst Thomas , Heinzelbecker Julia
Published: March 2018

Objective: The study aimed to calculate direct medical costs (DMC) during the first year of diagnosis and to evaluate the impact of guideline changes on treatment costs in clinical stage (CS) I testicular germ cell tumor (TGCT) patients in a German healthcare system. Materials and Methods: Healthcare expenditures as DMC during the first year of diagnosis for 307 TGCT patients in CS I treated at our institution from 1987 to 2013 were calculated from the statutory health insurance perspective using patient level data. Three periods were defined referring to the first European Association of Urology (EAU) guideline in 2001 as well as to subsequent major guideline changes in 2005 and 2010. Data source for cost calculations were the German Diagnosis Related Groups system for inpatient stays (version 2014) and the German system for reimbursement of outpatient care (EBM – Einheitlicher Bewertungsmaßstab, edition 2014). Results: During our 25 years of study period, mean DMC in the first year after diagnosis for the entire cohort of TGCT patients in CS I almost halved from EUR 13.000 to EUR 6.900 (p < 0.001). From 1987 to 2001, DMC for CS I seminomatous germ cell tumor (SGCT) patients were EUR 13.790 ± 4.700. From 2002 to 2010, mean costs were EUR 10.900 ± 5.990, and from 2011 to 2013, mean costs were EUR 5.190 ± 3.700. For CS I non-seminomatous germ cell tumor (NSGCT) patients, from 1987 to 2001, mean DMC were EUR 11.650 ± 5.690. From 2002 to 2010, mean costs were EUR 11.230 ± 5.990, and from 2011 to 2013, mean costs were EUR 11.170 ± 7.390. Follow-up examinations became less frequent over time, which caused a significant cost reduction for NSGCT (p = 0.042) while costs remained stable for SGCT. When adding costs of relapse treatment, active surveillance (AS) was the most cost-effective adjuvant treatment option in CS I NSGCT whereas one course carboplatin or AS caused similar expenditures in SGCT patients. Conclusion: The introduction of the EAU guidelines in 2001 caused a decrease in DMC in CS I seminoma patients. This cost reduction mainly took place due to the declining importance of radiation therapy. No substantial changes were seen in patients with CS I NSGCT. Costs for follow-up care also diminished, but to a lesser degree. Even when considering expenditures for relapse treatment, AS remained cost-effective in CS I TCGT patients. Our data show that evidence-based medicine in TGCT can reduce DMC in the first year after diagnosis.
Pain and Swelling after Percutaneous Endoscopic Gastrostomy Removal: An Unexpected Evolution
Authors: Queirós Patrícia , Sousa Diamantino , Antunes Artur , Sanchez Mercedez , França Ricardo , Casquilho José , Guerreiro Horácio
Published: March 2018

Gastrostomy site metastization is considered an uncommon complication of percutaneous endoscopic gastrostomy (PEG) placement in patients with head and neck tumours, but it is important to consider this possibility when evaluating gastrostomy-related symptoms. The authors present the case of a 40-year-old male with excessive alcohol consumption and active smoking, diagnosed with a stage IV oropharyngeal squamous cell carcinoma. The patient developed a paraneoplastic demyelinating motor polyneuropathy that, associated with tumour mass effect, caused dysphagia with need for nasogastric tube feeding. Treatment with radiotherapy and then chemoradiotherapy was administered and a PEG was placed with the pull method. Cancer remission and resolution of polyneuropathy was achieved, so PEG was removed. Two weeks later, the patient presented with pain and swelling at the gastrostomy site suggesting a local abscess, with improvement after drainage and antibiotic therapy. After 1 month, there was a tumour mass at the gastrostomy site and an oropharyngeal cancer metastasis was diagnosed. The patient underwent surgical excision of abdominal wall metastasis and abdominal disease was controlled. Nevertheless, there was subsequent oropharyngeal neoplasia recurrence and the patient died 6 months later. This case raises the discussion about gastrostomy placement methods that could avoid gastrostomy site metastization, the possible differential diagnosis, and diagnostic workout. Surgical resection may allow metastatic disease control, but by primary disease evolution greatly affects prognosis.
Ten-Year Survival of End-Stage Renal Disease Patients Treated with High-Efficiency Online Hemodiafiltration: A Cohort Study of a Center in South East Asia
Authors: Tiranathanagul Khajohn , Susantitaphong Paweena , Srisawat Nattachai , Mahatanan Nanta , Tungsanga Kriang , Praditpornsilpa Kearkiat , Eiam-Ong Somchai
Published: March 2018

Background: Recently, in the first hemodiafiltration (HDF) experience report from South East Asia (SEA), we reported a 3-year prospective study demonstrating the various short-term benefits of high-efficiency online HDF (OL-HDF) over high-flux hemodialysis (HD). Very few long-term survival reports of high-efficiency OL-HDF are available and the data are heterogeneous and incomplete. Objectives: The present historical cohort study was conducted to determine the long-term survival and outcome of high-efficiency OL-HDF-treated patients. Methods: Sixty-six high-efficiency OL-HDF treated patients at a center in SEA were included in the study. The prescription included blood and dialysis fluid flow rates of 400 and 800 mL/min, respectively. The post- or pre-dilution substitution fluid of 100 or 200 mL/min, respectively, was prescribed. Results: Of 66 HDF patients, whose age was 57.4 ± 14.0 years, there were 38 (58%) females. The majority of comorbidity was diabetes (36%). There were 33 (50%) incident HDF cases that were prescribed OL-HDF at the dialysis initiation and 33 (50%) prevalent HDF cases that were switched from HD to OL-HDF. The 1-, 3-, 5-, and 10-year survival rate were 95.1, 83.4, 77.7, and 61.8% respectively. The mean survival time was 8.99 ± 0.64 years. There were 15 transplantations and 15 deaths during this study periods. The 2 major causes of death were cardiovascular (33.3%) and infectious diseases (20%). Serum ferritin was the only parameter that correlated with mortality (HR 1.004, p = 0.005). There was comparable survival between incident and prevalent HDF cases. The survival after transplantation of a sub-group of patients who received kidney transplantation (KT) was not different from that of the overall HDF patients (p = 0.93). Conclusions: High-efficiency OL-HDF could provide an excellent long-term survival nearly comparable to the KT sub-group.
Arterial Spin Labeling Imaging of a Giant Aneurysm Leading to Subarachnoid Hemorrhage following Cerebral Infarction
Authors: Ueno Tatsuya , Sasaki Tatsuya , Iwamura Masatoshi , Kon Tomoya , Nunomura Jin-ichi , Midorikawa Hiroshi , Tomiyama Masahiko
Published: March 2018

An 83-year-old Japanese man was admitted with dysarthria and right hemiparesis. He had had a large intracranial aneurysm on the left internal carotid artery 5 years before admission and had been followed up under conservative treatment. On admission, diffusion-weighted imaging revealed a hyperintense signal on the left anterior choroidal artery territory. Time-of-flight magnetic resonance angiography demonstrated poor visibility of the middle and anterior cerebral arteries and the inferior giant aneurysm, suggesting distal emboli from aneurysm thrombosis or a reduction of blood outflow due to aneurysm thrombosis. Arterial spin labeling (ASL) signal increased in the giant aneurysm, suggesting blood stagnation within the aneurysmal sac, and decreased in the left hemisphere. We diagnosed cerebral infarction due to aneurysm thrombosis, and started antithrombotic therapy. On day 2, he suddenly died of subarachnoid hemorrhage due to rupturing of the giant aneurysm. When thrombosis occurs in a giant aneurysm, increasing ASL signal within the aneurysm and decreasing ASL signal with poor visibility on magnetic resonance angiography in the same arterial territory may indicate the danger of impending rupture of the giant aneurysm.
High Serum Thyrotropin Concentrations within the Reference Range: A Predictor of Malignancy in Nodular Thyroid Disease
Authors: Duccini Karla , de Souza Marcus Vinicius Leitão , Delfim Ricardo , Aguiar Ana Paula , Teixeira Patricia , Vaisman Mario
Published: March 2018

Objective: This study assessed whether or not a simple biochemical parameter, serum thyrotropin (TSH), within the reference range can predict the likelihood of thyroid malignancy in subjects undergoing fine-needle aspiration biopsy (FNAB) for thyroid nodules. Subjects and Methods: This cross-sectional study evaluated 236 patients without overt thyroid dysfunction who were not on levothyroxine therapy. They underwent FNAB of the thyroid nodules at the Clementino Fraga Filho University Hospital between 2011 and 2012. The reference range and serum TSH quartiles were determined according to age-specific values for serum TSH and then compared between the cases with benign thyroid nodular disease and differentiated thyroid carcinoma (DTC) based on surgical pathology reports. Results: Of the 236 patients, 201 (85.1%) underwent a surgical procedure (thyroidectomy) and 89/236 (44.3%) had DTC. The mean TSH concentrations were 2.09 ± 1.15 mU/L in benign patients versus 2.73 ± 1.33 mU/L in cases of DTC (p < 0.01). As TSH increased from quartiles 1 to 4, the frequency of a malignant diagnosis also increased progressively from 22% in quartile 1 to 65% in the last quartile (p ≤ 0.001). Conclusion: Thyrotropin levels were positively associated with the diagnosis of DTC in thyroid nodules.
ПРОБЛЕМА УТИЛІЗАЦІЇ МЕДИЧНИХ ВІДХОДІВ У ПОЛЬОВИХ УМОВАХ
Authors: Horishna O. V. , Deputat Yu. M. , Ivanko O. M. , Kozhokaru A. A. , Barkevych V. A. , Narozhov V. V.
Published: March 2018

Мета дослідження – визначити шляхи утилізації медичних відходів у польових умовах у відповідності з діючою нормативно-правовою базою.У польових умовах найбільш актуальною, чисельною і небезпечною групою відходів, яка потребує першочергового вирішення, є відходи групи В – інфіковані та потенційно інфіковані відходи, які мали контакт з біологічними середовищами інфікованого матеріалу. Висновки. Виходячи з положень, вимог і рекомендацій нормативно-правових актів, аналізу наукової літератури, рекомендуємо:1. У польових умовах при веденні бойових дій реально можливі лише етапи збирання, сортування та маркування медичних відходів у відповідні ємності та їх подальша евакуація за межі оперативної зони.2. При збиранні, сортуванні та маркуванні медичних відходів керуватися вимогами наказу МОЗ України від 08.06.2015 № 325 «Про затвердження Державних санітарно-протиепідемічних правил і норм щодо поводження з медичними відходами».3. У подальшому медичні відходи повинні транспортуватися до місць утилізації – мобільні та стаціонарні госпіталі, які мають бути обладнані пересувними або стаціонарними інсинераторами (за їх відсутності – укладати договори з установами, які мають відповідні технічні засоби для безпечного знищення медичних відходів). Зазначені рекомендації щодо утилізації медичних відходів у польових умовах при проведенні бойових дій відповідають вимогам міжнародного, вітчизняного законодавства та стандартам НАТО.
Case report and immunohistochemical study of a malignant peripheral nerve sheath tumor in a dog
Authors: Moreira Thaís de Almeida , Borges Leandro Willian , Serra Talita Lopes , Caetano Diego Petrocino , Costa Marcelo Carrijo da , Medeiros-Ronchi Alessandra Aparecida
Published: March 2018

Malignant peripheral nerve sheath tumor is rare and rarely reported in dogs. The term neurofibroma/sarcoma is classically used when the tumor is composed of Schawann and perineural cells. This work describes the clinical, histopathological, and immunohistochemical case of a subcutaneous malignant peripheral nerve sheath tumor, most likely a malignant neurofibroma located in the pelvic member of a Rottweiler dog. Histopathological features and immunohistochemical analysis corroborated the diagnosis, showing positivity for S-100 protein, vimentin, and CD57, and was useful to distinguish this type of neoplasm from other malignancies of similar morphologies.
Nutritional composition and evaluation of different methodologies for fat determination in wet feed for dogs and cats
Authors: Urrego Maria Isabel Gonzalez , Ernandes Mariane Ceschin , Matheus Laura Fantucci de Oliveira , Santos Karine de Melo , Oba Patricia Massae , Silva Cláudio Galeno Piantino , Vendramini Thiago Henrique Annibale , Pedrinelli Vivian , Brunetto Márcio Antonio
Published: March 2018

As a consequence of the increasing number of dog and cat owners, the pet food industry is expanding the range of pet food products in the market. In order to obtain more necessary information about the wet food segment for dogs and cats, the aim of this study was to determine the nutritional composition, to evaluate the information declared on the labels, and to compare the composition with the FEDIAF recommendations for protein and fat. Furthermore, three different methodologies of fat analysis were compared: crude fat (CFa), crude fat after acid hydrolysis (CFAH), and fat content obtained with Ankom XT15 (ANKOM) to determine the most adequate method for fat determination in wet foods. Twenty-five wet food products were evaluated, 13 wet foods for dogs and 12 for cats. Centesimal composition analyses obtained in this study were compared with guaranteed analysis declared on the label and with FEDIAF minimum recommended requirements for each species. The results of the nutritional composition and the values described on the label and the evaluation of the three fat determination methods were compared using the mixed model test with repeated measurements in the same samples, respectively (p < 0.05) in the SAS program, evaluation of protein adequacy and fat content were analyzed by mathematical calculations of difference and proportion. No difference was observed between nutritional composition of wet foods and the values declared on the labels for the majority of the diets analyzed, and there was a predominance of products that exceeded FEDIAF minimum recommendations of protein and fat for both species. No difference was observed between the three methods of fat content evaluation (p = 0.68). It was concluded that wet foods evaluated in this study match the label information and FEDIAF nutrient requirement recommendations, considering recommended calorie intake. All three fat determination methodologies evaluated were similar, justifying the choice of the easiest or cheapest method.
Progenitor Cells and Clinical Outcomes in Patients With Acute Coronary Syndromes
Authors: Samman Tahhan Ayman , Hammadah Muhammad , Raad Mohamad , Almwaqqat Zakaria , Alkhoder Ayman , Sandesara Pratik B. , Mohamed-Kelli Heval , Hayek Salim S. , Kim Jeong Hwan , O’Neal Wesley T. , Topel Matthew L. , Grant Aubrey J. , Sabbak Nabil , Heinl Robert E. , Gafeer Mohamad Mazen , Obideen Malik , Kaseer Belal , Abdelhadi Nasser , Ko Yi-An , Liu Chang , Hesaroieh Iraj , Mahar Ernestine A. , Vaccarino Viola , Waller Edmund K. , Quyyumi Arshed A.
Published: March 2018

Rationale:

Circulating progenitor cells (CPCs) mobilize in response to ischemic injury, but their predictive value remains unknown in acute coronary syndrome (ACS).

Objective:

We aimed to investigate the number of CPCs in ACS compared with those with stable coronary artery disease (CAD), relationship between bone marrow PCs and CPCs, and whether CPC counts predict mortality in patients with ACS.

Methods and Results:

In 2028 patients, 346 had unstable angina, 183 had an acute myocardial infarction (AMI), and the remaining 1499 patients had stable CAD. Patients with ACS were followed for the primary end point of all-cause death. CPCs were enumerated by flow cytometry as mononuclear cells expressing a combination of CD34+, CD133+, vascular endothelial growth factor receptor 2+, or chemokine (C-X-C motif) receptor 4+. CPC counts were higher in subjects with AMI compared those with stable CAD even after adjustment for age, sex, race, body mass index, renal function, hypertension, diabetes mellitus, hyperlipidemia, and smoking; CD34+, CD34+/CD133+, CD34+/CXCR4+, and CD34+/VEGFR2+ CPC counts were 19%, 25%, 28%, and 142% higher in those with AMI, respectively, compared with stable CAD. There were strong correlations between the concentrations of CPCs and the PC counts in bone marrow aspirates in 20 patients with AMI. During a 2 (interquartile range, 1.31–2.86)-year follow-up period of 529 patients with ACS, 12.4% died. In Cox regression models adjusted for age, sex, body mass index, heart failure history, estimated glomerular filtration rate, and AMI, subjects with low CD34+ cell counts had a 2.46-fold (95% confidence interval, 1.18–5.13) increase in all-cause mortality,
P
=0.01. CD34+/CD133+ and CD34+/CXCR4+, but not CD34+/VEGFR2+ PC counts, had similar associations with mortality. Results were validated in a separate cohort of 238 patients with ACS.

Conclusions:

CPC levels are significantly higher in patients after an AMI compared with those with stable CAD and reflect bone marrow PC content. Among patients with ACS, a lower number of hematopoietic-enriched CPCs are associated with a higher mortality.