bluuebunny/crossref_metadata_2025 huggingface dataset:
A Systematic Approach to Identify Sources of Abnormal Interior Noise for a High‐Speed Train
Authors: Zhang Jie , Xiao Xinbiao , Sheng Xiaozhen , Li Zhihui , Jin Xuesong
Published: May 2018

A systematic approach to identify sources of abnormal interior noise occurring in a high‐speed train is presented and applied in this paper to resolve a particular noise issue. This approach is developed based on a number of previous dealings with similar noise problems. The particular noise issue occurs in a Chinese high‐speed train. It is measured that there is a difference of 7 dB(A) in overall Sound Pressure Level (SPL) between two nominally identical VIP cabins at 250 km/h. The systematic approach is applied to identify the root cause of the 7 dB(A) difference. Well planned measurements are performed in both the VIP cabins. Sound pressure contributions, either in terms of frequency band or in terms of facing area, are analyzed. Order analysis is also carried out. Based on these analyses, it is found that the problematic frequency is the sleeper passing frequency of the train, and an area on the roof contributes the most. In order to determine what causes that area to be the main contributor without disassembling the structure of the roof, measured noise and vibration data for different train speeds are further analyzed. It is then reasoned that roof is the main contributor caused by sound pressure behind the panel. Up to this point, panels of the roof are removed, revealing that a hole of 300 cm2 for running cables is presented behind the red area without proper sound insulation. This study can provide a basis for abnormal interior noise analysis and control of high‐speed trains.
MEGF10, a Glioma Survival-Associated Molecular Signature, Predicts IDH Mutation Status
Authors: Li Guanzhang , Wang Zhiliang , Zhang Chuanbao , Liu Xing , Yang Fuqiang , Sun Lihua , Liang Jingshan , Hu Huimin , Liu Yanwei , You Gan , Bao Zhaoshi , Zhang Wei , Wang Zheng , Jiang Tao
Published: May 2018

Glioma is the most common primary brain tumor with various genetic alterations; among which, IDH mutation is the most common mutation and plays an important role in glioma early development, especially in lower grade glioma (LGG, WHO II-III). Previous studies have found that IDH mutation is tightly associated with extensive methylation across whole genome in glioma. To further investigate the role of IDH, we obtained methylation data of 777 samples from CGGA (Chinese Glioma Genome Atlas) and TCGA (The Cancer Genome Atlas) with IDH mutation status available. A package compiled under R language called Tspair was used as the main analytic tool to find potential probes that were significantly affected by IDH mutation. As a result, we found one pair of probes, cg06940792 and cg26025891, which was capable of predicting IDH mutation status precisely. The hypermethylated probe was cg06940792, designed in the promoter region of MEGF10, while the hypomethylated probe was cg26025891, designed in the promoter region of PSTPIP1. Survival analysis proved that hypermethylation or low expression of MEGF10 indicated a favorable prognosis in 983 glioma samples. Moreover, gene ontology analysis demonstrated that MEGF10 was associated with cell migration, cell proliferation, and regulation of apoptosis in glioma. All findings above can be validated in three other independent cohorts. In a word, our results suggested that methylation level and mRNA expression of MEGF10 in glioma were not only correlated with IDH mutation but also associated with clinical outcome of patients, providing potential guide for future dissection of IDH role in glioma.
A Framework of Rebalancing Imbalanced Healthcare Data for Rare Events’ Classification: A Case of Look-Alike Sound-Alike Mix-Up Incident Detection
Authors: Zhao Yang , Wong Zoie Shui-Yee , Tsui Kwok Leung
Published: May 2018

Identifying rare but significant healthcare events in massive unstructured datasets has become a common task in healthcare data analytics. However, imbalanced class distribution in many practical datasets greatly hampers the detection of rare events, as most classification methods implicitly assume an equal occurrence of classes and are designed to maximize the overall classification accuracy. In this study, we develop a framework for learning healthcare data with imbalanced distribution via incorporating different rebalancing strategies. The evaluation results showed that the developed framework can significantly improve the detection accuracy of medical incidents due to look-alike sound-alike (LASA) mix-ups. Specifically, logistic regression combined with the synthetic minority oversampling technique (SMOTE) produces the best detection results, with a significant 45.3% increase in recall (recall=75.7%) compared with pure logistic regression (recall=52.1%).
Allograft Reconstruction of the Extensor Mechanism after Resection of Soft Tissue Sarcoma
Authors: Müller Daniel A. , Beltrami Giovanni , Scoccianti Guido , Cuomo Pierluigi , Totti Francesca , Capanna Rodolfo
Published: May 2018

Introduction. Soft tissue tumors around the knee joint still pose problems for the excision and subsequent reconstruction. Methods. In the 6 included patients the soft tissue sarcoma has its base on the anterior surface of the extensor mechanism and expands towards the skin. The entire extensor apparatus (quadriceps tendon, patella, and patellar tendon) was resected and replaced by a fresh-frozen allograft. Results. The mean follow-up was 6.7 years (range: 2–12.4 years). In two patients a local recurrence occurred, resulting in a 5-year local recurrence-free rate of 66.7% (95% CI: 19.5%–90.4%). Distant metastases were found in 4 patients resulting in a 5-year metastasis-free rate of 33.3% (95% CI: 4.6%–67.5%). Two patients underwent at least one revision surgery, including one patient in whom the allograft had to be removed. According to the ISOLS function score 24.7 points (range: 19–28 points) were achieved at the last follow-up. The mean active flexion of the knee joint was 82.5° (range: 25–120°) and a mean extension lag of 10° (range: 0–30°) was observed. Conclusions. The replacement of the extensor mechanism by an allograft is a reasonable option, allowing wide margins and restoration of active extension in most patients. Trial Registration. The presented study is listed on the ISRCTN registry with trial number ISRCTN63060594.
Aminophylline and Ephedrine, but Not Flumazenil, Inhibit the Activity of the Excitatory Amino Acid Transporter 3 Expressed inXenopusOocytes and Reverse the Increased Activity by Propofol
Authors: Moon Sohyeon , Baik Hee Jung
Published: May 2018

We investigated the effects of flumazenil, aminophylline, and ephedrine on the excitatory amino acid transporter type 3 (EAAT3) activity and the interaction with propofol. EAAT3 was expressed in theXenopusoocytes. L-Glutamate-induced membrane currents were measured using the two-electrode voltage clamp at various drug concentrations. Oocytes were preincubated with protein kinase C- (PKC-) activator, or inhibitor, and phosphatidylinositol 3-kinase (PI3K) inhibitor. To study the interaction with propofol, oocytes were exposed to propofol, propofol + aminophylline, or ephedrine. Aminophylline and ephedrine significantly decreased EAAT3 activity. Aminophylline (95 μM) and ephedrine (1.19 μM) significantly decreasedVmax, but not Km of EAAT3, for glutamate. The phorbol 12-myristate-13-acetate-induced increase in EAAT3 activity was abolished by aminophylline or ephedrine. The decreased EAAT3 activities by PKC inhibitors (staurosporine, chelerythrine) and PI3K inhibitor (wortmannin) were not significantly different from those by aminophylline or ephedrine, as well as those by PKC inhibitors or PI3K inhibitor + aminophylline or ephedrine. The enhanced EAAT3 activities induced by propofol were significantly abolished by aminophylline or ephedrine. Aminophylline and ephedrine inhibit EAAT3 activity via PKC and PI3K pathways and abolish the increased EAAT3 activity by propofol. Our results indicate a novel site of action for aminophylline and ephedrine.
Health-Related Effects of the Elderly Care Program
Authors: Kim Young-Eun , Hong Seok-Won
Published: May 2018

Objectives. This study aimed to determine the health-related effects of elderly care through the elderly program (ECEP) compared to those who were put on standby. Methods. Analysis was conducted concerning the demographic characteristics and chronic disease prevalence status of 108,803 ECEP participants from 2007 to 2013 and 33,932 recipients of elderly care by the elderly (ECE) in 2013. A survey was conducted to determine the effects of emotional support on 508 elders who received ECE in 2014. To determine the effect of elderly care by participation, a comparative analysis was performed using the propensity score method and a differences-in-differences model. Statistical tests were performed on these study subjects’ medical expenses and utilization of medical care, while they participated in the ECEP. Results. ECEP participants incurred a lower total medical expense increase by US$431.94, US$75.54 lower copayment, US$357.60 lower insurance payment, and US$403.04 lower hospitalization costs, compared to the elders who were on standby. Furthermore, a significant decrease was observed in the number of days of hospitalization, even in the case of medical care utilization. Those who were receiving elderly care scored an average of 7.70 points on the Short Geriatric Depression Scale. 51% of these individuals showed a significantly high level of depression, with a score of 8 points or higher, which is a criterion for screening for depression. Conclusions. The present study showed differences in medical expenses and the utilization of medical care associated with ECEP.
Effect of Camphorquinone Concentration in Physical-Mechanical Properties of Experimental Flowable Resin Composites
Authors: Maciel Dayany da Silva Alves , Caires-Filho Arnaldo Bonfim , Fernandez-Garcia Marta , Anauate-Netto Camillo , Alonso Roberta Caroline Bruschi
Published: May 2018

The aim of this study was to evaluate the effect of camphorquinone concentration in physical-mechanical properties of experimental flowable composites in order to find the concentration that results in maximum conversion, balanced mechanical strength, and minimum shrinkage stress. Model composites based on BISGMA/TEGDMA with 70% wt filler loading were prepared containing different concentrations of camphorquinone (CQ) on resin matrix (0.25%, 0.50%, 1%, 1.50%, and 2% by weight). Degree of conversion was determined by FTIR. Surface hardness was assessed before and after 24 h ethanol storage and softening rate was determined. Depth of cure was determined by Knoop hardness evaluation at different depths. Color was assessed by reflectance spectrophotometer, employing the CIE-Lab system. Flexural strength and elastic modulus were determined by a three-point bending test. Shrinkage stress was determined in a Universal Testing Machine in a high compliance system. Data were submitted to ANOVA and Tukey’s test (α = 0.05). The increase in CQ concentration caused a significant increase on flexural strength and luminosity of composites. Surface hardness was not affected by the concentration of CQ. Composite containing 0.25% wt CQ showed lower elastic modulus and shrinkage stress when compared to others. Depth of cure was 3 mm for composite containing 1% CQ and 2 mm for the other tested composites. Degree of conversion was inversely correlated with softening rate and directly correlated with elastic modulus and shrinkage stress. In conclusion, CQ concentration affects polymerization characteristics and mechanical strength of composites. The concentration of CQ in flowable composite for optimized polymerization and properties was 1% wt of the resin matrix, which allows adequate balance among degree of conversion, depth of cure, mechanical properties, and color characteristics of these materials.
Prevalence of Abnormal Glucose Regulation according to Different Diagnostic Criteria in Ischaemic Stroke without a History of Diabetes
Authors: Zhang Xinmiao , Shi Qiuyan , Zheng Huaguang , Jia Qian , Zhao Xingquan , Liu Liping , Wang Chunxue , Meng Xia , Jing Jing , Pan Yuesong , Wang Yilong , Wang Yongjun
Published: May 2018

We aimed to investigate the prevalence and distribution of abnormal glucose regulation, including prediabetes and newly diagnosed diabetes, according to different criteria in ischaemic stroke patients without a history of diabetes. Data were derived from a representative cohort across China. Prediabetes was defined as fasting plasma glucose (FPG) 5.6–6.9 mmol/L or 2-hour oral glucose tolerance test (OGTT) 7.8–11.0 mmol/L or haemoglobin A1c (HbA1c) 5.7–6.4%. Newly diagnosed diabetes was defined as FPG ≥ 7.0 mmol/L, 2 h OGTT ≥ 11.1 mmol/L or HbA1c ≥ 6.5%. Among 1251 ischaemic stroke patients, 471 (37.5%) were detected as prediabetes and 539 (43.1%) were detected as newly diagnosed diabetes. Prediabetes was present in 118 (9.4%), 290 (23.2%) and 314 (25.1%) stroke patients, and newly diagnosed diabetes was present in 138 (11.0%), 370 (29.6%), and 365 (29.2%) stroke patients, based on FPG, 2 h OGTT, and HbA1c criteria, respectively. Dependency on FPG alone would have missed 74.9% of patients in the prediabetes range and 74.4% of patients in the diabetes range. Our study demonstrated a high prevalence of prediabetes and diabetes in ischaemic stroke patients without a history of diabetes. OGTT and HbA1c helped detect the majority of prediabetes and newly diagnosed diabetes in ischaemic stroke patients.
Reduced-Complexity Receiver for Free-Space Optical Communication over Orbital Angular Momentum Partial-Pattern Modes
Authors: ElHelaly Alaa , Mehana Ahmed H. , Khairy Mohammad M.
Published: May 2018

This paper explores the effect of a partial-pattern receiver for transmitted orbital angular momentum (OAM) multimodes included in the Laguerre-Gaussian beam propagating under non-Kolomogorov weak-to-moderate turbulence on the achievable capacity and the error rates with introduced controlled parameters. We deduce the necessary conditions for reducing the receiver’s area to guarantee that the modes are decoupled when the area is reduced. Furthermore, we derive the conditions at which area reduction yields a performance gain over the complete-area reception. For that, some use cases are introduced and discussed and the basic building block for multibeam MIMO receivers with a reduced area is developed and analyzed.
Comparison of 3DVar and EnSRF Data Assimilation Using Radar Observations for the Analysis and Prediction of an MCS
Authors: Gao Shibo , Min Jinzhong
Published: May 2018

Using radar observations, the performances of the ensemble square root filter (EnSRF) and an indirect three-dimensional variational (3DVar) data assimilation method were compared for a mesoscale convective system (MCS) that occurred in the Front Range of the Rocky Mountains, Colorado (USA). The results showed that the root mean square innovations (RMSIs) of EnSRF were lower than 3DVar for radar reflectivity and radial velocity and that the spread of EnSRF was generally consistent with its RMSIs. EnSRF substantially improved the analysis of the MCS compared with an experiment without radar data assimilation, and it produced a slight but noticeable improvement over 3DVar in terms of both coverage and intensity. Forecast results initiated from the final analysis revealed that EnSRF generally produced the best prediction of the MCS, with improved quantitative reflectivity and precipitation forecast skills. EnSRF also demonstrated better performance than 3DVar in the prediction of neighborhood probability for reflectivity at thresholds of 20 and 35 dBZ, which better matched the observed radar reflectivity in terms of both shape and extension. Additionally, the humidity, temperature, and wind fields were also improved by EnSRF; the largest error reduction was found in the water vapor field near the surface and at upper levels.
Chronic Pulmonary Histoplasmosis Identified in a Young Patient with Selective Immunoglobulin M Deficiency
Authors: Preneta Ania , Nada Khaled M. , Raja Asima , Kasubhai Moiz
Published: May 2018

Chronic histoplasmosis is typically diagnosed in patients who are immunocompromised or severely debilitated and who either live in or who have travelled to endemic areas. We report the case of a young, otherwise immunocompetent male patient who presented to a New York hospital with lobar consolidation and was found to have chronic pulmonary histoplasmosis. He described no history of travel to an endemic area. Immunological workup later revealed selective immunoglobulin M (IgM) deficiency. The literature has suggested a link between IgM deficiency and fungal infections. Recent research has also proposed a link between autoimmunity and IgM deficiency. Our clinical vignette describes the case of a patient with selective IgM deficiency who was diagnosed with pulmonary histoplasmosis without any clinical evidence of autoimmune disease.
The Biological Activities of Vitamin D and Its Receptor in Relation to Calcium and Bone Homeostasis, Cancer, Immune and Cardiovascular Systems, Skin Biology, and Oral Health
Authors: Khammissa R. A. G. , Fourie J. , Motswaledi M. H. , Ballyram R. , Lemmer J. , Feller L.
Published: May 2018

Vitamin D plays an important role in calcium homeostasis and bone metabolism, with the capacity to modulate innate and adaptive immune function, cardiovascular function, and proliferation and differentiation of both normal and malignant keratinocytes. 1,25(OH)2D, the biologically active form of vitamin D, exerts most of its functions through the almost universally distributed nuclear vitamin D receptor (VDR). Upon stimulation by 1,25(OH)2D, VDR forms a heterodimer with the retinoid X receptor (RXR). In turn, VDR/RXR binds to DNA sequences termed vitamin D response elements in target genes, regulating gene transcription. In order to exert its biological effects, VDR signalling interacts with other intracellular signalling pathways. In some cases 1,25(OH)2D exerts its biological effects without regulating either gene expression or protein synthesis. Although the regulatory role of vitamin D in many biological processes is well documented, there is not enough evidence to support the therapeutic use of vitamin D supplementation in the prevention or treatment of infectious, immunoinflammatory, or hyperproliferative disorders. In this review we highlight the effects of 1,25(OH)2D on bone and calcium homeostasis, on cancer, and refer to its effects on the cardiovascular and immune systems.
On the Equivalence of Stochastic Fixed Point Iterations for Generalized φ-Contractive-Like Operators
Authors: Akewe Hudson , Eke Kanayo Stella , Olisama Victoria
Published: May 2018

We present the equivalence of some stochastic fixed point iterative algorithms by proving the equivalence between the convergence of random implicit Jungck-Kirk-multistep, random implicit Jungck-Kirk-Noor, random implicit Jungck-Kirk-Ishikawa, and random implicit Jungck-Kirk-Mann iterative algorithms for generalized φ-contractive-like random operators defined on separable Banach spaces.
Juxtacrine Signaling Inhibits Antitumor Immunity by Upregulating PD-L1 Expression
Authors: Yang Wen-Hao , Cha Jong-Ho , Xia Weiya , Lee Heng-Huan , Chan Li-Chuan , Wang Ying-Nai , Hsu Jennifer L. , Ren Guoxin , Hung Mien-Chie
Published: May 2018

Programmed death-ligand 1 (PD-L1) is a well-known immune checkpoint protein that helps cancer cells evade immune response. Anti–PD-L1 immune therapy has been approved for the treatment of several advanced human cancers. Therefore, further understanding of the regulatory mechanisms of PD-L1 is critical to improve PD-L1–targeting immunotherapy. Recent studies indicated that contact-dependent pathways may regulate anticancer immunity, highlighting the importance of cell contact–induced signaling in cancer immunity. Here, we show that tumor cell contact upregulates PD-L1 expression and reduces T-cell–mediated cell killing through the membrane receptor tyrosine kinase ephrin receptor A10 (EphA10), which is not expressed in normal tissues except testis and is known to mediate cell contact–dependent juxtacrine signaling. Knockout of EphA10 in tumor cells increased T-cell–mediated antitumor immunity in syngeneic mouse models. EphA10 expression also correlated positively with PD-L1 in human breast tumor tissues. Together, our data reveal that in addition to paracrine/autocrine signaling, cell contact–mediated juxtacrine signaling also promotes PD-L1 expression, implying that tumor cells may escape immune surveillance via this mechanism and that targeting EphA10 to boost antitumor immunity may be a new immune checkpoint blockade strategy for female patients with breast cancer.

Significance: Regulation of PD-L1 expression by cell contact–mediated signaling promotes immune escape in breast cancer and may lead to the development of an immunotherapy with less adverse effects in female patients. Cancer Res; 78(14); 3761–8. ©2018 AACR.
Hepatocellular Carcinoma Outcome Is Predicted by Expression of Neuronal Calcium Sensor 1
Authors: Schuette Daniel , Moore Lauren M. , Robert Marie E. , Taddei Tamar H. , Ehrlich Barbara E.
Published: May 2018

Background: Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related death worldwide. There is an urgent demand for prognostic biomarkers that facilitate early tumor detection, as the incidence of HCC has tripled in the United States in the last three decades. Biomarkers to identify populations at risk would have significant impact on survival. We recently found that expression of Neuronal Calcium Sensor 1 (NCS1), a Ca2+-dependent signaling molecule, predicted disease outcome in breast cancer, but its predictive value in other cancer types is unknown. This protein is potentially useful because increased NCS1 regulates Ca2+ signaling and increased Ca2+ signaling is a hallmark of metastatic cancers, conferring cellular motility and an increasingly aggressive phenotype to tumors.

Methods: We explored the relationship between NCS1 expression levels and patient survival in two publicly available liver cancer cohorts and a tumor microarray using data mining strategies.

Results: High NCS1 expression levels are significantly associated with worse disease outcome in Asian patients within these cohorts. In addition, a variety of Ca2+-dependent and tumor growth-promoting genes are transcriptionally coregulated with NCS1 and many of them are involved in cytoskeleton organization, suggesting that NCS1 induced dysregulated Ca2+ signaling facilitates cellular motility and metastasis.

Conclusions: We found NCS1 to be a novel biomarker in HCC. Furthermore, our study identified a pharmacologically targetable signaling complex that can influence tumor progression in HCC.

Impact: These results lay the foundation for using NCS1 as a prognostic biomarker in prospective cohorts of HCC patients and for further functional assessment of the characterized signaling axis. Cancer Epidemiol Biomarkers Prev; 27(9); 1091–100. ©2018 AACR.
Machine Learning–Based Radiomics for Molecular Subtyping of Gliomas
Authors: Lu Chia-Feng , Hsu Fei-Ting , Hsieh Kevin Li-Chun , Kao Yu-Chieh Jill , Cheng Sho-Jen , Hsu Justin Bo-Kai , Tsai Ping-Huei , Chen Ray-Jade , Huang Chao-Ching , Yen Yun , Chen Cheng-Yu
Published: May 2018

Purpose: The new classification announced by the World Health Organization in 2016 recognized five molecular subtypes of diffuse gliomas based on isocitrate dehydrogenase (IDH) and 1p/19q genotypes in addition to histologic phenotypes. We aim to determine whether clinical MRI can stratify these molecular subtypes to benefit the diagnosis and monitoring of gliomas.

Experimental Design: The data from 456 subjects with gliomas were obtained from The Cancer Imaging Archive. Overall, 214 subjects, including 106 cases of glioblastomas and 108 cases of lower grade gliomas with preoperative MRI, survival data, histology, IDH, and 1p/19q status were included. We proposed a three-level machine-learning model based on multimodal MR radiomics to classify glioma subtypes. An independent dataset with 70 glioma subjects was further collected to verify the model performance.

Results: The IDH and 1p/19q status of gliomas can be classified by radiomics and machine-learning approaches, with areas under ROC curves between 0.922 and 0.975 and accuracies between 87.7% and 96.1% estimated on the training dataset. The test on the validation dataset showed a comparable model performance with that on the training dataset, suggesting the efficacy of the trained classifiers. The classification of 5 molecular subtypes solely based on the MR phenotypes achieved an 81.8% accuracy, and a higher accuracy of 89.2% could be achieved if the histology diagnosis is available.

Conclusions: The MR radiomics-based method provides a reliable alternative to determine the histology and molecular subtypes of gliomas. Clin Cancer Res; 24(18); 4429–36. ©2018 AACR.
The Effect of Feeding Behavior on Hypothalamus in Obese Type 2 Diabetic Rats with Glucagon-like Peptide-1 Receptor Agonist Intervention
Authors: Lu Ke , Chen Xiaoyan , Yan Jianhua , Li Xinchun , Huang Chen , Wan Qi , Deng Xuelian , Zou Qiao
Published: May 2018

Objective: To investigate the utility of intravoxel incoherent motion-diffusion weighted imaging (IVIM-DWI) derived parameters in hypothalamus for monitoring the effect of Exendin-4 (Ex-4) intervention on the feeding behavior in obese diabetic rats within early feeding. Methods: 21 obese and 19 non-obese rats which were treated with streptozotocin injections were initially divided into an obese diabetes group (OD, n = 10), a non-obese diabetes group (D, n = 8), an obese group (O, n = 9) and a non-obese group (N, n = 9). Then, the rats in the 4 groups received subcutaneous injections of Ex-4, and feeding behavior was examined at 5, 35, 65, 95, and 125 min. The hypothalamic function was evaluated by IVIM-DWI. Finally, the relationship between the hypothalamic function and the amount of food intake was analyzed. Results: In comparison with the N group, the food intake significantly decreased in the O , OD, and D groups in response to Ex-4. Furthermore, a significant positive correlation was found between food intake and D values at different times from 5 to 125 min after Ex-4 intervention in all 4 groups. Conclusion: A direct correlation between the change of hypothalamic function and feeding behavior was detected in OD rats with Ex-4 intervention in the early feeding period. The hypothalamic D value derived from IVIM-DWI is promising to reflect the dynamic change of hypothalamic function due to intervention.
Benign Solitary Fibrous Histiocytoma of Xanthomatous Subtype of the Perilimbal Conjunctiva and Adjacent Sclera in a Youth
Authors: Ali-Ridha Andre , Brownstein Seymour , O’Connor Michael , Milman Tatyana , Tang Tina
Published: May 2018

Aims: To report the clinical and pathological features of a benign fibrous histiocytoma of the xanthomatous subtype in the perilimbal conjunctiva and adjacent sclera in a youth. Methods: An 11-year-old Caucasian boy presented with a yellowish dome-shaped conjunctival mass abutting the inferotemporal limbus of the left eye. The tumor measured 4 mm in its maximum diameter. The lesion was excised and was noted to extend into the sclera. Three years postoperatively, there was no evidence of recurrence. Results: Histopathological examination disclosed a highly cellular lesion composed predominantly of benign-appearing foamy histiocytes without multinucleated giant cells. The tumor contained sparse fibrous septa without a storiform configuration. Immunohistochemical analysis showed diffuse cytoplasmic positive staining with adipophilin, CD34, and CD163. Conclusion: A lesion comprised of numerous homogeneous foamy histiocytes without multinucleated giant cells in the perilimbal conjunctiva and adjacent sclera of a youth is presented as a unique case of a rare variant of fibrous histiocytoma of the xanthomatous subtype.
Weight Status of 7-Year-Old Hungarian Children between 2010 and 2016 Using Different Classifications (COSI Hungary)
Authors: Kovacs Viktoria Anna , Bakacs Marta , Kaposvari Csilla , Illes Eva , Erdei Gergo , Martos Eva , Breda Joao
Published: May 2018

Aims: To describe the prevalence of thinness, overweight, and obesity in Hungarian children (age 7.0-7.9 years) according to different classifications, to assess the progress between 2010 and 2016, and to investigate whether tendencies differ according to gender. Methods: A national representative sample was generated by two-stage cluster sampling, and a total of 2,651 children (50.9% boys; age 7.49 ± 0.3 years) were measured (weight and height) in October 2016. Population estimates were calculated using the WHO, IOTF, and national cut-offs. Results: Prevalence of thinness (including grade 1 and 2) was 12.6% based on the IOTF criteria and 15.6% based on the WHO definition. 22.5% of children were identified as overweight or obese according to the IOTF classification, compared with 28.4% according to the WHO definition. Between 2010 and 2016, each classiﬁcation indicated possible stability in overweight and obesity prevalence. In contrast, the prevalence of thinness grade 2 almost doubled in 6 years according to all definitions (p < 0.05). No significant gender difference was observed in the progress. Conclusion: Overweight and obesity appeared to be stable over 6 years, but we detected growing thinness rates. Routine collection of high-quality data that are based on standardized and comparable methods is essential to monitor the childhood obesity problem.
Autologous Neurosensory Retinal Transplantation for Unclosed and Large Macular Holes
Authors: Ding Chun  , Li Shengguo , Zeng Jun
Published: May 2018

Purpose: The aim of this study was to demonstrate the surgical technique and clinical outcome of autologous neurosensory retinal patch transplantation for recurrent large macular hole (MH)-induced retinal detachment after failed surgery with internal limiting membrane (ILM) removal or transplantation. Methods: We reviewed 5 patients with recurrent MH-induced retinal detachment after failed surgeries with ILM removal or transplantation who underwent vitrectomy combined with autologous neurosensory retinal patch transplantations and were followed up over 6 months. In the autologous neurosensory retinal patch transplantation procedure, a small piece of neurosensory retina was removed and transplanted inside the MH. The anatomic outcomes of MH-induced retinal detachment were evaluated by fundus examinations and optical coherence tomography. The pre­operative and postoperative best-corrected visual acuities (BCVAs) were compared and the MH closure rates were measured as the main outcomes. Results: A total of 5 patients (3 men and 2 women; average age 35.4 ± 18.72 years) were included in our study. Complete MH sealing was achieved in 5 eyes after autologous neurosensory retinal patch transplantations, and no complications were observed. The mean BCVA was 2.38 ± 0.57 (range 1.6–3) before surgery, and 1.46 ± 0.51 (range 1–2) at 6 postoperative months. There was a significant difference in BCVA before versus after the surgery (p < 0.05, paired t test). Conclusions: Autologous neurosensory retinal patch transplantation is an effective addition to the surgical options for large MH-induced retinal detachment after failed surgery with ILM removal or transplantation.
Juvenile Traumatic Brain Injury Results in Cognitive Deficits Associated with Impaired Endoplasmic Reticulum Stress and Early Tauopathy
Authors: Hylin Michael J. , Holden Ryan C. , Smith Aidan C. , Logsdon Aric F. , Qaiser Rabia , Lucke-Wold Brandon P.
Published: May 2018

The leading cause of death in the juvenile population is trauma, and in particular neurotrauma. The juvenile brain response to neurotrauma is not completely understood. Endoplasmic reticulum (ER) stress has been shown to contribute to injury expansion and behavioral deficits in adult rodents and furthermore has been seen in adult postmortem human brains diagnosed with chronic traumatic encephalopathy. Whether endoplasmic reticulum stress is increased in juveniles with traumatic brain injury (TBI) is poorly delineated. We investigated this important topic using a juvenile rat controlled cortical impact (CCI) model. We proposed that ER stress would be significantly increased in juvenile rats following TBI and that this would correlate with behavioral deficits using a juvenile rat model. A juvenile rat (postnatal day 28) CCI model was used. Binding immunoglobulin protein (BiP) and C/EBP homologous protein (CHOP) were measured at 4 h in the ipsilateral pericontusion cortex. Hypoxia-inducible factor (HIF)-1α was measured at 48 h and tau kinase measured at 1 week and 30 days. At 4 h following injury, BiP and CHOP (markers of ER stress) were significantly elevated in rats exposed to TBI. We also found that HIF-1α was significantly upregulated 48 h following TBI showing delayed hypoxia. The early ER stress activation was additionally asso­ciated with the activation of a known tau kinase, glycogen synthase kinase-3β (GSK-3β), by 1 week. Tau oligomers measured by R23 were significantly increased by 30 days following TBI. The biochemical changes following TBI were associated with increased impulsive-like or anti-anxiety behavior measured with the elevated plus maze, deficits in short-term memory measured with novel object recognition, and deficits in spatial memory measured with the Morris water maze in juvenile rats exposed to TBI. These results show that ER stress was increased early in juvenile rats exposed to TBI, that these rats developed tau oligomers over the course of 30 days, and that they had significant short-term and spatial memory deficits following injury.
Robotic Parathyroid Surgery: Current Perspectives and Future Considerations
Authors: Arora Asit , Garas George , Tolley Neil
Published: May 2018

Robotic parathyroidectomy represents a novel surgical approach in the treatment of primary hyperparathyroidism when the parathyroid adenoma has been pre-operatively localised. It represents the “fourth generation” in the evolution of parathyroid surgery following a process of surgical evolution from cervicotomy and 4-gland exploration to a variety of minimally invasive, open and endoscopic, targeted approaches. The existing evidence (levels 2–3) supports it as a feasible and safe technique with equivalent results to targeted open parathyroidectomy for primary hyperparathyroidism in carefully selected patients. However, it takes longer to perform and is more costly than conventional parathyroidectomy. It offers superior cosmesis by completely avoiding a neck scar making it a valid option for those patients who for biological and/or cultural reasons may wish to avoid a neck scar. Robotic parathyroidectomy is not for every patient, surgeon, or hospital. Its application should be confined to high-volume centres and experienced surgeons. Intensive training and proctorship are required for its safe implementation combined with careful patient selection. This particularly relates to the patient’s body habitus (BMI < 30 kg/m2) and concordance among the different imaging modalities used pre-operatively. With robotic market competition driving down costs, its role may change. For now, robotic parathyroidectomy occupies a niche role and can only be justified in a select subset of patients.
Knowledge about Stroke in Belo Horizonte, Brazil: A Community-Based Study Using an Innovative Video Approach
Authors: Meira Fidel , Magalhães Daiane , da Silva Luiz Sérgio , Mendonça e Silva Ana Clara , Silva Gisele Sampaio
Published: May 2018

Background and Purpose: Stroke is a leading cause of death in Brazil. Knowledge about the clinical manifestations of stroke as well as its risk factors and its management is still poor in the country. We intended to assess the stroke knowledge of an urban population in Belo Ho­rizonte, Brazil. Methods: Individuals assisted by a basic health unit were interviewed between February and August 2014. After demographic data collection, the participants were asked to watch a video that consisted of a person presenting stroke signals and they were asked to answer questions about the condition shown on the video. Afterwards, they answered a semi-structured questionnaire to evaluate their stroke knowledge. Results: A total of 703 people were interviewed (62.1% female, mean age 46.7 years). Recognition of a person having a stroke on the presented video was achieved by 56.1% of the subjects. Female sex (p = 0.029) and contact with someone who had had a stroke (family member [p < 0.01], neighbor [p < 0.05]) increased the odds of correctly identifying the condition showed on the video. The most commonly mentioned clinical manifestations of stroke were weakness (34.7%) and speech disturbance (31.6%). Stroke risk factors that were most named were “unbalanced diet” (42.3%) and hypertension (33.7%). Most participants (66.8%) said they would call the emergency medical services, while 17.8% would go directly to a hospital. Only 17 subjects knew thrombolytic therapy for acute stroke. Conclusion: Female sex and a family history of stroke increased the odds of recognizing the signs of stroke. Knowledge about the clinical manifestations, risk factors, and management of stroke was low in the studied population.
Exemplos de figuras retóricas no 1º Responsório das matinas e encomendação de defuntos, de José Maurício Nunes Garcia
Authors: Soares Eliel Almeida
Published: May 2018

O artigo expõe a utilização de figuras retóricas no 1º Responsório das matinas e encomendação de defuntos, de José Maurício Nunes Garcia, destacando que esses recursos eram aplicados com o propósito de elaborar um enunciado musical eloquente e persuasivo. A metodologia empregada é embasada em análises de elementos de retórica musical relacionados ao texto, harmonia e disposição do discurso musical, apresentados em alguns exemplos.
“Pelo bem ou pelo mal, até que eu ajudei bastante gente, né?”
Authors: Castro Marcos Câmara de , Toni Marcelo
Published: May 2018

Entrevista com o professor Marcelo Toni. Marcelo Toni é fagotista da Orquestra Sinfônica Municipal de São Paulo.
A ideologia do cânone e a morte da criatividade
Authors: Silva Alexandre Guilherme Montes
Published: May 2018

Nesta pequena comunicação são abordados alguns conceitos importantes sobre a natureza da ideia de cânone, em especial sobre a ideia de pertencimento e de legitimação de um cânone musical de grandes obras e grandes compositores. Também o novo conceito desenvolvido por Pascal Gielen sobre a criatividade a serviço do lucro (lu-criatividade) e as ideias de Lipovetsky e Serroy sobre o novo capitalismo artista são aqui apresentados de maneira breve. Na conclusão evidenciam-se os contrastes entre os dois conceitos principais aqui descritos: o cânone e a criatividade.
Piano performance: music communication and the performer-audience shared experience
Authors: James Barbara
Published: May 2018

A música é um poderoso mecanismo social, e uma apresentação musical é um atraente meio de comunicação que revela aspectos da personalidade e musicalidade do artista. A imaginação criativa de um pianista é essencial para dar apelo emocional à música, com a apresentação sendo construída a partir de sua interpretação, o que envolve um conceito flexível, para que cada artista possa oferecer uma interpretação distinta. A trilha sonora envolve interação contínua com a música, com os músicos avaliando a qualidade e o ajuste dos sons ao conceito dramático da partitura. Os sons gerados pelas ações realizadas enquanto a música é tocada comunicam suas características estruturais e emocionais, aumentando a amplitude dessas ações ao passo em que a habilidade e a conexão do pianista com a música aumentam. Embora o aspecto aural fora anteriormente considerado fundamental para o domínio da música, a informação visual também influencia a percepção dos observadores sobre as intenções expressivas da mesma, e isto é importante especialmente para públicos mais ingênuos. A presença de observadores durante uma performance é uma motivação para os músicos, afetando a amplitude e intensidade dos movimentos que, por sua vez, aumentam o engajamento do público com a apresentação. Neste nível de apresentação, músicos qualificados sentem uma gratidão intrínseca enquanto tocam, entrando em um estado de atenção sem qualquer esforço e grande excitação, o que gera um estado subjetivo de experiência ideal. Sentir a conexão do artista com a música envolve a atenção da plateia, forjando um laço que resulta na atividade neural nas mesmas regiões cerebrais de ambos e permitindo uma partilha da experiência afetiva. Comunicação do desempenho bem-sucedido implica na captura da imaginação da plateia pelo artista, e esta análise explora os diferentes elementos da apresentação, dando forma à comunicação e transportando a expressividade da música e as características que afetam os observadores e melhoram sua apreciação da performance. O estudo conclui com uma análise do processo de avaliação da apresentação.
Olivier Toni e a sorte de ter sido seu amigo
Authors: Squeff Enio
Published: May 2018

Crônica em que o ex-jornalista e atual artista plástico Enio Squeff narra suas experiências com o prof. Olivier Toni, recorrendo a lembranças que se passaram quando de sua primeira visita a Prados, no interior de Minas Gerais.
Depoimento exclusivo de Claudia Toni à RT
Authors: Toni Claudia
Published: May 2018

Um depoimento exclusivo de Claudia Toni à Revista da Tulha.
“Na minha profissão, eu divido com os outros, não faço nada sozinho”
Authors: Castro Marcos Câmara de , Toni Olivier
Published: May 2018

Entrevista inédita com Olivier Toni. Leia biografia do entrevistado nas pp. 137-139.
Prediction of Thrombotic and Bleeding Events After Percutaneous Coronary Intervention: CREDO‐Kyoto Thrombotic and Bleeding Risk Scores
Authors: Natsuaki Masahiro , Morimoto Takeshi , Yamaji Kyohei , Watanabe Hirotoshi , Yoshikawa Yusuke , Shiomi Hiroki , Nakagawa Yoshihisa , Furukawa Yutaka , Kadota Kazushige , Ando Kenji , Akasaka Takashi , Hanaoka Keiichi Igarashi , Kozuma Ken , Tanabe Kengo , Morino Yoshihiro , Muramatsu Toshiya , Kimura Takeshi ,   the CREDO‐Kyoto PCI/CABG Registry Cohort 2, RESET, and NEXT trial investigators
Published: May 2018

Background

Prediction of thrombotic and bleeding risk is important to optimize antithrombotic therapy after percutaneous coronary intervention.

Methods and Results

We developed the prediction rules for thrombotic and bleeding events separately in Japanese patients. Derivation and validation cohorts consisted of 4778 patients from
CREDO
‐Kyoto (Coronary Revascularization Demonstrating Outcome Study in Kyoto) registry cohort 2 and 4669 patients from RESET (Randomized Evaluation of Sirolimus‐Eluting Versus Everolimus‐Eluting Stent Trial) and NEXT (Nobori Biolimus‐Eluting Versus Xience/Promus Everolimus‐Eluting Stent Trial). Primary thrombotic and bleeding events were a composite of myocardial infarction, definite or probable stent thrombosis or ischemic stroke, and GUSTO (Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries) moderate or severe bleeding. The prediction rule for thrombosis assigned 2 points for severe chronic kidney disease, atrial fibrillation, peripheral vascular disease, and anemia and 1 point for age ≥75 years, heart failure, diabetes mellitus, and chronic total occlusion. The prediction rule for bleeding assigned 2 points for thrombocytopenia, severe chronic kidney disease, peripheral vascular disease, and heart failure and 1 point for prior myocardial infarction, malignancy, and atrial fibrillation. In derivation and validation cohorts, area under the curve was 0.68 and 0.64, respectively, for thrombosis and 0.66 and 0.66, respectively, for bleeding. In the validation cohort, a high thrombosis risk score (≥4, n=682) was associated with higher 3‐year incidence of thrombotic events than a score that was intermediate (2–3, n=1178) or low (0–1, n=2809) (7.6%, 3.7%, versus 2.4%, respectively;
P
<0.0001). A high bleeding risk score (≥3, n=666) was associated with higher incidence of bleeding than scores that were intermediate (1–2, n=1802) or low (0, n=2201) (8.8%, 4.1%, versus 2.3%, respectively;
P
<0.0001). Among 682 patients at high thrombotic risk, only 39 (5.7%) had low bleeding risk, whereas 401 (58.8%) had high bleeding risk with very high incidence of bleeding (11.6%).

Conclusions

CREDO
‐Kyoto thrombotic and bleeding risk scores demonstrated modest accuracy in stratifying thrombotic and bleeding risks; however, a large proportion of patients at high thrombotic risk also had high bleeding risk.
Illness Identity: A Novel Predictor for Healthcare Use in Adults With Congenital Heart Disease
Authors: Van Bulck Liesbet , Goossens Eva , Luyckx Koen , Oris Leen , Apers Silke , Moons Philip
Published: May 2018

Background

To optimize healthcare use of adults with congenital heart disease, all important predictors of healthcare utilization should be identified. Clinical and psychological characteristics (eg, age and depression) have been found to be associated with healthcare use. However, the concept of illness identity, which assesses the degree to which congenital heart disease is integrated into one's identity, has not yet been investigated in association with healthcare use. Hence, the purpose of the study is to examine the predictive value of illness identity for healthcare use.

Methods and Results

In this ambispective analytical observational cohort study, 216 adults with congenital heart disease were included. The self‐reported Illness Identity Questionnaire was used to assess illness identity states: engulfment, rejection, acceptance, and enrichment. After 1 year, self‐reported healthcare use for congenital heart disease or other reasons over the past 6 months was assessed including hospitalizations; visits to general practitioner; visits to medical specialists; and emergency room visits. Binary logistic and negative binomial regression analyses were conducted, adjusting for age, sex, disease complexity, and depressive and anxious symptoms. The more profoundly the heart defect dominated one's identity (ie, engulfment), the more likely this person was to be hospitalized (odds ratio=3.76; 95% confidence interval=1.43–9.86), to visit a medical specialist (odds ratio=2.32; 95% confidence interval=1.35–4.00) or a general practitioner (odds ratio=1.78; 95% confidence interval=1.01–3.17), because of their heart defect.

Conclusions

Illness identity, more specifically engulfment, has a unique predictive value for the occurrence of healthcare encounters. This association deserves further investigation, in which the directionality of effects and the contribution of illness identity in terms of preventing inappropriate healthcare use should be determined.