bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-term effects of increased protein intake after weight loss on intrahepatic lipid content and implications for insulin sensitivity: a PREVIEW study
Authors: Drummen M. , Dorenbos E. , Vreugdenhil A. C. E. , Raben A. , Fogelholm M. , Westerterp-Plantenga M. S. , Adam T. C.
Published: August 2018

The aim of this study was to assess the effects of a weight maintenance period comprising two diets differing in protein intake, after weight loss, on intrahepatic lipid content and implications for insulin sensitivity. A total of 25 participants [body mass index (BMI): 31.1 (3.5 kg/m2; intrahepatic lipid (IHL): 8.7 (8.3%; fasting glucose: 6.4 (0.6 mmol/l; homeostatic model assessment for insulin resistance (HOMA-IR): 3.7 (1.6; Matsuda index: 3.4 (2.9] started an 8-wk low-energy diet followed by a 2-yr weight maintenance period with either high protein or medium protein dietary guidelines. At baseline, after 6 mo, and after 2 yr, IHL, visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) were determined by magnetic resonance spectroscopy/imaging. Glucose and insulin concentrations, determined during an oral glucose challenge, were used to assess the HOMA-IR and Matsuda insulin sensitivity index (ISI). Protein intake was measured with 24-h urinary nitrogen excretion. Protein intake, BMI, IHL, VAT, SAT, HOMA-IR, and ISI did not change differently between the groups during the intervention. In the whole group, BMI, IHL, VAT, SAT, HOMA-IR, and ISI were favorably changed at 6 mo and 2 yr compared with baseline ( P < 0.05). Mixed-model analysis showed that independent of BMI, protein intake (g/d) at 6 mo was inversely related to IHL (coefficient: −0.04; P < 0.05) and VAT (coefficient: −0.01; P < 0.05). Overall, IHL was positively related to HOMA-IR (coefficient: 0.10; P < 0.01) and inversely related to ISI (coefficient: −0.17; P < 0.01), independent of BMI. A 2-yr medium- to high-protein energy-restricted diet reduced IHL and VAT. Independently of changes in BMI, IHL was inversely related to insulin sensitivity.
Whole Genome Sequencing in an Acrodermatitis Enteropathica Family from the Middle East
Authors: Abu-Duhier Faisel , Pooranachandran Vivetha , McDonagh Andrew J. G. , Messenger Andrew G. , Cooper-Knock Johnathan , Bakri Youssef , Heath Paul R. , Tazi-Ahnini Rachid
Published: August 2018

We report a family from Tabuk, Saudi Arabia, previously screened for Acrodermatitis Enteropathica (AE), in which two siblings presented with typical features of acral dermatitis and a pustular eruption but differing severity. Affected members of our family carry a rare genetic variant, p.Gly512Trp in the SLC39A4 gene which encodes a zinc transporter; disease is thought to result from zinc deficiency. Similar mutations have been reported previously; however, the variable severity within cases carrying the p.Gly512Trp variant and in AE overall led us to hypothesise that additional genetic modifiers may be contributing to the disease phenotype. Therefore whole genome sequencing was carried out in five family members, for whom material was available to search for additional modifiers of AE; this included one individual with clinically diagnosed AE. We confirmed that the p.Gly512Trp change in SLC39A4 was the only candidate homozygous change which was sufficiently rare (ExAC allele frequency 1.178e-05) and predicted deleterious (CADD score 35) to be attributable as a fully penetrant cause of AE. To identify other genes which may carry relevant genetic variation, we reviewed the relevant literature and databases including Gene Ontology Consortium, GeneMANIA, GeneCards, and MalaCards to identify zinc transporter genes and possible interacting partners. The affected individual carried variants in RECQL4 and GPAA1 genes with ExAC allele frequency <0.01 and CADD score >10. p.Gly512Trp is highly likely to be the pathogenic variant in this family. This variant was previously detected in a Tunisian proband with perfect genotype-phenotype segregation suggestive of pathogenicity. Further research is required in this area due to small sample size, but attention should be given to RECQL4 and GPAA1 to understand their role in the skin disease.
Stefan-Boltzmann Law and Casimir Effect for the Scalar Field in Phase Space at Finite Temperature
Authors: Amorim R. G. G. , da Cruz Filho J. S. , Santos A. F. , Ulhoa S. C.
Published: August 2018

We use the scalar field constructed in phase space to analyze the analogous Stefan-Boltzmann law and Casimir effect, both of them at finite temperature. The temperature is introduced by Thermo Field Dynamics (TFD) formalism and the quantities are analyzed once projected in the space of coordinates. We show that using the framework of phase space it is possible to introduce a thermal energy which is related to temperature as it vanishes when the temperature tends to zero. In fact given such a correlation the formalism of TFD is equivalent when project is in momenta space when compared to coordinates space.
Buprenorphine versus Morphine in Paediatric Acute Pain: A Systematic Review and Meta-Analysis
Authors: Murray Nathan , Malla Utsav , Vlok Ruan , Scott Alice , Chua Olivia , Melhuish Thomas , White Leigh
Published: August 2018

Introduction. In lab-based studies, buprenorphine appears to have a ceiling effect on respiratory depression but not on analgesia. There is increasing evidence in adult patients that buprenorphine has no ceiling effect on analgesia or side effects. The aim of this study was to investigate the efficacy and adverse effects of buprenorphine versus morphine in paediatric acute pain. Methods. A systematic review of five databases was performed until May 2018. Only randomised controlled trials were eligible for inclusion. The outcomes of interest included pain, respiratory depression, nausea, sedation, dizziness, and pruritus. Results. Four randomised controlled trials (n=195) were included. The only outcome measuring analgesic efficacy was time to breakthrough analgesia. Buprenorphine had a significant increase in time to breakthrough analgesia by 114.98 minutes compared to morphine (95% CI = 42.94 to 187.01; I2 = 0; p=0.002). There was no significant difference in the rates of adverse effects. Conclusions. Buprenorphine provided a longer duration of analgesia than morphine. This in combination with its unique sublingual preparation could prove particularly advantageous in the paediatric population. The studies included are likely underpowered to detect differences in the incidence of adverse effects; therefore, the same precautions should be taken as with any other opioid.
The Expanding Role of Systemic Therapy in the Management of Hepatocellular Carcinoma
Authors: Abdel-Rahman Omar , Cheung Winson Y.
Published: August 2018

Hepatocellular carcinoma (HCC) represents a global health problem, with the majority of patients presenting at an advanced or incurable stage. The development of effective systemic therapy options for this disease has been challenging because many HCC patients suffer from underlying liver cirrhosis that precludes the safe delivery of systemic therapy. The current review seeks to provide an overview of the current systemic therapeutic approaches for advanced HCC as well as some of the novel management strategies that are currently being evaluated.
Serum Lipidomics Profiling to Identify Biomarkers for Non-Small Cell Lung Cancer
Authors: Chen Yingrong , Ma Zhihong , Shen Xiongrong , Li Liqin , Zhong Jing , Min Li Shan , Xu Limin , Li Hongwei , Zhang Jianbin , Dai Licheng
Published: August 2018

Non-small cell lung cancer (NSCLC) is the leading cause of cancer death worldwide, which ranks top in both incidence and mortality. To broaden our understanding of the lipid metabolic alterations in NSCLC and to identify potential biomarkers for early diagnosis, we performed nontargeted lipidomics analysis in serum from 66 early-stage NSCLC, 40 lung benign disease patients (LBD), and 40 healthy controls (HC) using Ultrahigh Performance Liquid Chromatography-Quadrupole Time-of-Flight Mass Spectrometry (UHPLC-Q-TOF/MS). The identified biomarker candidates of phosphatidylcholines (PCs) and phosphatidylethanolamines (PEs) were further externally validated in a cohort including 30 early-stage NSCLC, 30 LBD, and 30 HC by a targeted lipidomic analysis. We observed a significantly altered lipid metabolic profile in early-stage NSCLC and identified panels of PCs and PEs to distinguish NSCLC patients and HC. The levels of PCs and PEs were found to be dysregulated in glycerophospholipid metabolism, which was the top altered pathway in early-stage NSCLC. Receiver operating characteristic (ROC) curve analysis revealed that panels of PCs and PEs exhibited good performance in differentiating early-stage NSCLC and HC. The levels of PE(16:0/16:1), PE(16:0/18:3), PE(16:0/18:2), PE(18:0/16:0), PE(17:0/18:2), PE(18:0/17:1), PE(17:0/18:1), PE(20:5/16:0), PE(18:0/18:1), PE(18:1/20:4), PE(18:0/20:3), PC(15:0/18:1), PC(16:1/20:5), and PC(18:0/20:1) in early-stage NSCLC were significantly increased compared with HC (p<0.05). Overall, our study has thus highlighted the power of using comprehensive lipidomic approaches to identify biomarkers and underlying mechanisms in NSCLC.
Determination of Combustion Process Model Parameters in Diesel Engine with Variable Compression Ratio
Authors: Milojević Saša , Pešić Radivoje
Published: August 2018

Compression ratio has very important influence on fuel economy, emission, and other performances of internal combustion engines. Application of variable compression ratio in diesel engines has a number of benefits, such as limiting maximal in cylinder pressure and extended field of the optimal operating regime to the prime requirements: consumption, power, emission, noise, and multifuel capability. The manuscript presents also the patented mechanism for automatic change engine compression ratio with two-piece connecting rod. Beside experimental research, modeling of combustion process of diesel engine with direct injection has been performed. The basic problem, selection of the parameters in double Vibe function used for modeling the diesel engine combustion process, also performed for different compression ratio values. The optimal compression ratio value was defined regarding minimal fuel consumption and exhaust emission. For this purpose the test bench in the Laboratory for Engines of the Faculty of Engineering, University of Kragujevac, is brought into operation.
Prediction of Attendance Demand in European Football Games: Comparison of ANFIS, Fuzzy Logic, and ANN
Authors: Şahin Mehmet , Erol Rızvan
Published: August 2018

An artificial neural network (ANN), adaptive neurofuzzy inference system (ANFIS) models, and fuzzy rule-based system (FRBS) models are developed to predict the attendance demand in European football games, in this paper. To determine the most successful method, each of the methods is analyzed under different situations. The Elman backpropagation, feed-forward backpropagation, and cascade-forward backpropagation network types are developed to determine the outperforming ANN model. The backpropagation and hybrid optimization methods are used for training fuzzy inference system (FIS) to determine the outperforming ANFIS model. The fuzzy logic model is developed after experimenting different forms of membership functions. To this end, the data of 236 soccer games are used to train the ANN and ANFIS models, and 2017/2018 season’s data of these clubs are used to test all of the models. The results of all models are compared with each other and real past data. To assess the performance of each model, two error measures that are Mean Absolute Percent Error (MAPE) and Mean Absolute Deviation (MAD) are implemented. These measures reveal that the ANN model that has Elman network type outperforms the other models. Finally, the results emphasize that the proposed ANN model can be effectively used for prediction purposes.
Pharmacological Evaluation of Mentha spicata L. and Plantago major L., Medicinal Plants Used to Treat Anxiety and Insomnia in Colombian Caribbean Coast
Authors: Caro Daneiva C. , Rivera David E. , Ocampo Yanet , Franco Luis A. , Salas Rubén D.
Published: August 2018

Anxiety disorders are highly prevalent, chronic, and disabling conditions that impose enormous health and economic costs both on individuals and on society. Medicinal plants are an invaluable source of bioactive metabolites that can be useful as new pharmacological treatment. Teas from Mentha spicata and Plantago major are employed by Colombian populations to treat stress and insomnia. This work was conducted to evaluate their anxiolytic and hypnotic properties. For this, we employed the Elevated Plus‐Maze test and the sodium pentobarbital‐induced hypnosis method using Wistar rats. Oral administration of M. spicata extract (1000 mg/Kg) significantly increased the exploration and time spent in the open arms, which indicates its anxiolytic activity. On the other hand, both M. spicata and P. major extracts (1000 mg/Kg) remarkably augmented the sleeping time induced by pentobarbital, suggesting a sedative and hypnotic effect of the plants extracts. In addition, the acute toxicological study demonstrated that the doses used did not induce mortality or toxicity effects at hepatic or renal level. The bioactivity seems to be related to several kinds of constituents, mainly phenolic compounds such as flavonoids and tannins. In conclusion, these results reinforce the potential use of these species in the therapy of anxiety.
Duodenal Diverticular Perforation after Small Bowel Obstruction: A Case Report
Authors: Khan Khuram , Saeed Saqib , Maria Haytham , Sbeih Mohammed , Iqbal Farhana , Ramcharan Alexius , Donaldson Brian
Published: August 2018

Introduction. Duodenal diverticulum is a rare disease that can be easily missed. The incidence of duodenal diverticulum diagnosed by upper GI study is approximately 5%. Autopsy results show that 22% of the population have duodenum diverticulum. Most patients with duodenal diverticulum are asymptomatic. However, complications like inflammation, perforation with retroperitoneal abscess, sepsis, pancreatitis, bile duct obstruction, and bleeding can occur. Approximately 162 cases of perforated duodenal diverticulum have been reported in the literature. Case Presentation. We present a rare case of an 82-year-old female with perforation of a duodenal diverticulum caused by small bowel obstruction; in addition to this, there was a synchronous colonic tumor. Conclusion. Diagnosis and management of this rare disorder are controversial. Nonoperative management is advocated in some cases. Some of the cases require early aggressive surgical intervention. The mortality rate remains approximately 45% in all these patients.
The Effect of Volatile Oil from Vernonia anthelmintica Seeds on Melanin Synthesis in B16 Cells and Its Chemical Analysis by GC‐QTOF‐MS
Authors: Aobuli Abulikemu , Maitusong Jumai , Bakri Mahinur , Lu Xueying , Maiwulanjiang Maitinuer , Aisa Haji Akber
Published: August 2018

Vernonia anthelmintica Willd. seeds have been used in folk medicine for the treatment of leukoderma in Xinjiang, China, for more than 300 years. The promoting activities of its volatile oil (AVO) in melanogenesis and its chemical composition were investigated in this paper. The bioactivities of AVO were examined by melanin synthesis and tyrosinase activity assay in B16 cells. Using GC‐QTOF‐MS technology, each compound of AVO contains a single separated peak in GC and the retention indices of every GC peak were calculated by the retention times of C7~C30 n‐alkanes that were injected at the same chromatographic conditions. Then each individual peak was identified by comparing its mass spectrum with the MS library (NIST 14). As a result, AVO increased the melanin content and tyrosinase activity in a dose‐dependent manner at concentrations of 10‐30μg·mL−1. The 64 compounds were identified in AVO which occupied 95.15% of total peak area in GC. They mainly contained caryophyllene (23.73%), sabinene (18.15%), α‐thujene (6.57%), thymol (5.29%), 4‐epi‐α‐acoradiene (4.98%), limonene (4.92%), anethole (3.44%), etc. According to the results the AVO can promote melanogenesis and upregulate tyrosinase activity in B16 cells.
An Improved 3D Shape Recognition Method Based on Panoramic View
Authors: Zheng Qiang , Sun Jian , Zhang Le , Chen Wei , Fan Huanhuan
Published: August 2018

Recognition of three-dimensional (3D) shape is a remarkable subject in computer vision systems, because of the lack of excellent shape representations. With the development of 2.5D depth sensors, shape recognition is becoming more important in practical applications. Many methods have been proposed to preprocess 3D shapes, in order to get available input data. A common approach employs convolutional neural networks (CNNs), which have become a powerful tool to solve many problems in the field of computer vision. DeepPano, a variant of CNN, converts each 3D shape into a panoramic view and shows excellent performance. It is worth paying attention to the fact that both serious information loss and redundancy exist in the processing of DeepPano, which limits further improvement of its performance. In this work, we propose a more effective method to preprocess 3D shapes also based on a panoramic view, similar to DeepPano. We introduce a novel method to expand the training set and optimize the architecture of the network. The experimental results show that our approach outperforms DeepPano and can deal with more complex 3D shape recognition problems with a higher diversity of target orientation.
Serum Homocysteine Levels in Men with and without Erectile Dysfunction: A Systematic Review and Meta-Analysis
Authors: Sansone Andrea , Cignarelli Angelo , Sansone Massimiliano , Romanelli Francesco , Corona Giovanni , Gianfrilli Daniele , Isidori Andrea , Giorgino Francesco , Lenzi Andrea
Published: August 2018

Objectives. Elevated levels of serum homocysteine (Hcy) have been associated with cardiovascular diseases and endothelial dysfunction, conditions closely associated with erectile dysfunction (ED). This meta-analysis was aimed to assess serum Hcy levels in subjects with ED compared to controls in order to clarify the role of Hcy in the pathogenesis of ED. Methods. Medline, Embase, and the Cochrane Library were searched for publications investigating the possible association between ED and Hcy. Results were restricted by language, but no time restriction was applied. Standardized mean difference (SMD) was obtained by random effect models. Results. A total of 9 studies were included in the analysis with a total of 1320 subjects (489 subjects with ED; 831 subjects without ED). Pooled estimate was in favor of increased Hcy in subjects with ED with a SMD of 1.00, 95% CI 0.65–1.35, p<0.0001. Subgroup analysis based on prevalence of diabetes showed significantly higher SMD in subjects without diabetes (1.34 (95% CI 1.08–1.60)) compared to subjects with diabetes (0.68 (95% CI 0.39–0.97), p<0.0025 versus subgroup w/o diabetes). Conclusions. Results from our meta-analysis suggest that increased levels of serum Hcy are more often observed in subjects with ED; however, increase in Hcy is less evident in diabetic compared to nondiabetic subjects. This study is registered with Prospero registration number CRD42018087558.
Lane Detection Based on Connection of Various Feature Extraction Methods
Authors: Li Mingfa , Li Yuanyuan , Jiang Min
Published: August 2018

Lane detection is a challenging problem. It has attracted the attention of the computer vision community for several decades. Essentially, lane detection is a multifeature detection problem that has become a real challenge for computer vision and machine learning techniques. Although many machine learning methods are used for lane detection, they are mainly used for classification rather than feature design. But modern machine learning methods can be used to identify the features that are rich in recognition and have achieved success in feature detection tests. However, these methods have not been fully implemented in the efficiency and accuracy of lane detection. In this paper, we propose a new method to solve it. We introduce a new method of preprocessing and ROI selection. The main goal is to use the HSV colour transformation to extract the white features and add preliminary edge feature detection in the preprocessing stage and then select ROI on the basis of the proposed preprocessing. This new preprocessing method is used to detect the lane. By using the standard KITTI road database to evaluate the proposed method, the results obtained are superior to the existing preprocessing and ROI selection techniques.
E. coli Bacteriostatic Action Using TiO2 Photocatalytic Reactions
Authors: Rojviroon Thammasak , Sirivithayapakorn Sanya
Published: August 2018

This experimental research comparatively investigates the Escherichia coli (E. coli) bacterial inactivation of the TiO2 photocatalytic thin films fabricated by the sol–gel dip-coating (SG) and low-temperature spray-coating (SP) techniques, with low-intensity (12 μW·cm−2) UVA-light-emitting diodes (UVA-LED) as the light source. The bacteriostatic experiments were undertaken using the nutrient broth (NB) and 0.85% NaCl with the initial E. coli concentrations of 102, 104, 106, and 108 CFU·mL−1. Moreover, the essential physical characteristics of the SG-TiO2 and SP-TiO2 photocatalytic thin films were determined prior to the experimental bacterial inactivation. The findings showed that both photocatalytic thin films possessed the ideal physical characteristics, especially the SP-TiO2 thin film. In addition, the viable cell counts, the cell morphology, and the bioluminescence-based adenosine triphosphate (ATP) indicated that both SG-TiO2 and SP-TiO2 thin films under UVA could effectively inhibit the proliferation of the E. coli cells in both NB and 0.85% NaCl.
Mathematical Modeling and Modal Switching Control of a Novel Tiltrotor UAV
Authors: Kong Zhiwei , Lu Qiang
Published: August 2018

This paper concentrates on the flight control of a novel tiltrotor aircraft with fixed wings. This kind of aircraft has two flight modes and a transition mode. In the phase of vertical take off and landing (VTOL), the aircraft can operate as a quadrotor helicopter. And in the phase of horizontal flight, the aircraft is in the normal airplane mode. The transition mode is between these two flight modes. In this part of work, a novel tiltrotor aircraft was presented since transition mode is achieved by tilting the front dual tiltrotor (DTR) and the mathematical model was established. The classical PID method was used during the phase of VTOL and the numerical results were given and the simulation shows good control effect. A nonlinear control law based on backstepping was proposed to achieve a stable transition from vertical flight to horizontal flight. And the numerical results show that the flight mode could transit stably which shows the effectiveness of the control approach. Finally, the vertical flight experiment has been carried out on DTR aircraft and the attitude was stable.
Variation Overtime among Patients of the Six Methadone Maintenance Treatment Clinics in Thai Nguyen from 2011 to 2015
Authors: Dao An Thi Minh , Nguyen Huong Thi Thu , Nguyen Long Hoang
Published: August 2018

Background. Methadone Maintenance Treatment (MMT) program’s success depends on the likelihood of reducing drop-out rate and keeping patients remaining in the program. There have been neither comprehensive studies about variation among patients who have been experiencing MMT for long period nor prediction of MMT period in which the risk of drop-out would be the highest in Thai Nguyen, a northern mountainous province where the MMT was established in 2011.Objectives. To analyze variation of the MMT population through indicators of drop-out and death, re-enrolment, and retention rate in the six Thai Nguyen MMT clinics.Methods. A retrospective study by reviewing daily treatment notebooks of the six MMT clinics in Thai Nguyen to identify events of drop-out, death, reenrolment among 2,567 patients registered from 12 May 2011 to 6 September 2015.Results. Cumulative hazard of drop-out over period from the first to the fourth year of MMT treatment has an increasing trend at 0.15; 0.31; 0.46; and 0.61, respectively. The cumulative probability of re-enrolment among 740 patients who have already quit the MMT program and then returned slightly increased from 0.07 to 0.16 between the first years and the fourth year in which the highest returning rate occurred within the first 2 years after drop-out. The cumulative retention rate decreased annually and stayed at 71.7% after 4 years of running the MMT.Conclusions. MMT patients and their families should be informed and consulted about the highest risk period of drop-out and also about period when drop-out patients are most likely to reenter the MMT. Counseling adherence for patients should be conducted not only at the beginning but also during the ongoing MMT and play an extremely important role in reducing drop-out of the program while special counseling should also be reenforced for the re-enrolment patients of MMT.
Personal Oral Infection Control, Low Birthweight, and Preterm Births in Appalachia West Virginia: A Cross-Sectional Study
Authors: Wiener R. Constance , Waters Christopher
Published: August 2018

Introduction. Appalachia West Virginia has a higher prevalence of preterm and low birthweight babies than the US national prevalence. Many factors have been studied which are known to influence preterm births and low birthweight babies. There are limited interventions that are available to decrease the likelihood of preterm and low birthweight babies; however oral health and personal oral infection control may be helpful. The purpose of this study was to evaluate the association of limited personal oral infection control among pregnant West Virginia Appalachian women and poor birth outcomes (preterm and low birthweight babies). Methods. A secondary data analysis of data from the West Virginia Healthy Start Helping Appalachian Parents and Infants (HAPI) Project from 2005 to 2016 was conducted. The researchers determined the odds ratio of personal oral infection control with a powered toothbrush (use of the brush fewer than 13 times per week versus use of the brush 13 or more times per week) on poor birth outcomes. Results. There were 845 women who completed the oral health program within the HAPI project. In unadjusted logistic regression, women who used the powered toothbrush and brushed less frequently had greater odds of poor birth outcomes than women who brushed more frequently (odds ratio of 2.07 [1.18, 3.62] P = 0.011 for low birthweight babies; and an odds ratio of 1.78 [1.04, 3.02] P = 0.034 for preterm birth). The results remained positive but were no longer significant in adjusted analysis. Conclusion. There is a need to identify interventions that will benefit pregnant women so that their pregnancies result in healthy pregnancy outcomes.
Morphology and Electrochemical Characterization of Electrodeposited Nanocrystalline Ni-Co Electrodes for Methanol Fuel Cells
Authors: Abdel-Karim R. , Ramadan M. , El-Raghy S. M.
Published: August 2018

An electrocatalytic electrode surface was developed for alcoholic fuel cell by electrodeposition of Ni-Co alloy on a 301 stainless steel substrate. Material characterization by EDX and XRD confirmed deposition of Ni-Co alloy on stainless steel surfaces with a cobalt content of 15–35%. SEM showed nodular and/or angular particles with some subparticles embedded within the coarse nodules. Increasing the deposition current density as well as deposition time leads to deposition of Ni-Co alloys characterized by coarse angular morphology with lower cobalt content. The electrocatalytic activity of the coated electrodes was characterized by potentiodynamic polarization test, electrochemical impedance spectroscopy (EIS), and cyclic voltammetry (CV) tests in anodic solution for electrochemical oxidation of methanol. Polarization study showed very much higher current density for the coated electrode compared to bare stainless steel. According to the EIS test in 1 M methyl alcohol acidic solution, it was found that polarization resistance of the coated sample was much lower compared to the bare substrate. The electrical equivalent circuit at the metal solution interface was found to be matching Randle with Warburg resistance. The results of the CV test showed higher peaks for alcohol oxidation and oxygen reduction compared to the bare substrate. The alloy coating with increased effective surface area leads to enhancement in the electrocatalytic activity of the electrodes. The alloys deposited at current densities of 50 and 80 mA/cm2 for 30 minutes (15–16% Co) had higher catalytic activity of the Ni-Co nanocrystalline deposits for methanol oxidation for direct methanol fuel cells, than those under other deposition conditions.
Comparison of Multiple Treatment Planning Techniques for High-Grade Glioma Tumors Near to Critical Organs
Authors: Bas Ayata Hande , Ceylan Cemile , Kılıç Ayhan , Güden Metin , Engin Kayıhan
Published: August 2018

Aim: The purpose of this study was to compare 6 treatment planning methods (5-beam coplanar intensity-modulated radiotherapy (IMRT), 7-beam coplanar IMRT, 7-beam noncoplanar IMRT, 2 full arc coplanar volumetric modulated arc therapy (VMAT), 2 half partial arc coplanar VMAT, and 2 half partial arc noncoplanar VMAT) for high-grade gliomas with planning target volumes (PTVs) overlapping the optic pathway and/or brainstem. Patients and Methods: 27 previously-treated patients with high-grade gliomas were replanned for treatment with IMRT5, IMRT7, IMRT7-non, VMAT2f, VMAT2h, and VMAT2h-non. In order to perform a comparative study of the treatment outcomes, 3 tumor localizations (right-sided, left-sided, and central tumors) were selected. Patients were administered a PTV dose of 60 Gy in 30 fractions with a maximum permitted dose of 110%. Results: Comparison of the 3 IMRT plans and 3 VMAT plans was performed for all 27 patients. The median conformity index was significantly higher (p < 0.05) in all IMRT plans compared to all VMAT plans in the case of right sided tumors. Significant differences were also observed between coplanar and noncoplanar plans in IMRT and VMAT in right-sided tumors (p < 0.05). Differences in brainstem mean doses were only found to be significant between coplanar and noncoplanar plans in centrally-located tumors. In right- and left-sided tumors, the VMAT2f plans demonstrated higher values than all IMRT plans in their mean values for radiation doses to the ipsilateral optic nerves, contralateral optic nerves, ipsilateral lens, ipsilateral eye, contralateral lens, contralateral eye, and contralateral optic nerves, as well in the maximums for the optic chiasm and contralateral optic nerves. Significantly faster treatment times were achieved with all VMAT plans compared to IMRT plans. Conclusion: IMRT techniques provided better target coverage than VMAT plans. However, VMAT techniques reduced treatment delivery time more than IMRT techniques. Technique selection for tumors located in 3 different localizations should be individualized in accordance with patients' specific parameters.
R-ICE Chemotherapy with or without Autologous Transplantation for Elderly Patients with Relapsed or Refractory Aggressive B-Cell Lymphomas
Authors: Turki Amin T. , Lamm Wolfgang , Liebregts Tobias , Dührsen Ulrich
Published: August 2018

For patients aged 60 years or older, the treatment of relapsed aggressive B-cell lymphomas remains challenging. The purpose of this retrospective analysis was to evaluate the results of the R-ICE (rituximab, ifosfamide, carboplatin, etoposide) protocol alone as compared to R-ICE followed by high-dose chemotherapy with autologous transplantation. The 3-year progression-free survival (PFS) and overall survival (OS) rates in 17 patients receiving R-ICE without transplantation were 32% (95% confidence interval (CI): 8.48-55.52) and 35% (95% CI: 11.48-58.52), respectively. Median PFS and OS times were 9 months (95% CI: 2-22) and 12 months (95% CI: 5-19), respectively. In 17 age-matched transplanted patients the respective survival rates were 18% (95% CI: 0.36-35.64) and 24% (95% CI: 4.4-43.6). Median PFS and OS times were 11 months (95% CI: 6-16) and 16 months (95% CI: 13-19), respectively. Thus, R-ICE alone is a reasonable treatment option for elderly patients with relapsed or refractory aggressive B-cell lymphomas.
Frailty and Associated Factors among Centenarians in the 5-COOP Countries
Authors: Herr Marie , Jeune Bernard , Fors Stefan , Andersen-Ranberg Karen , Ankri Joël , Arai Yasu , Cubaynes Sarah , Santos-Eggimann Brigitte , Zekry Dina , Parker Marti , Saito Yasuhiko , Herrmann François , Robine Jean-Marie ,   5-COOP group
Published: August 2018

Background: The global number of centenarians is still strongly growing and information about the health and healthcare needs of this segment of the population is needed. This study aimed to estimate the prevalence of frailty among centenarians included in a multinational study and to investigate associated factors. Methods: The 5-COOP study is a cross-sectional survey including 1,253 centenarians in 5 countries (Japan, France, Switzerland, Denmark, and Sweden). Data were collected using a standardized questionnaire during a face-to-face interview (73.3%), telephone interview (14.5%), or by postal questionnaire (12.2%). The 5 dimensions of the frailty phenotype (weight loss, fatigue, weakness, slow walking speed, and low level of physical activity) were assessed by using self-reported data. Factors associated with frailty criteria were investigated by using multivariate regression models. Results: Almost 95% of the participants had at least 1 frailty criterion. The overall prevalence of frailty (3 criteria or more) was 64.7% (from 51.5% in Sweden to 77.6% in Switzerland), and 32.2% of the participants had 4 or 5 criteria. The most frequent criteria were weakness (84.2%), slow walking speed (77.6%), and low level of physical activity (72.5%), followed by fatigue (43.8%) and weight loss (23.8%). Factors associated with frailty included data collection modes, country of residence, gender, living in institution, depression, dementia, disability, falls, and sensory impairments. Conclusions: This study shows that reaching 100 years of age rarely goes without frailty and sheds light on factors associated with frailty at a very old age.
Differences in Rate of Complete Excision of Basal Cell Carcinoma by Dermatologists, Plastic Surgeons and General Practitioners: A Large Cross-Sectional Study
Authors: Ramdas Kirtie , van Lee Charlotte , Beck Samuel , Bindels Patrick , Noordhoek Hegt Vincent , Pardo Luba , Versnel Sarah , Nijsten Tamar , van den Bos Renate
Published: August 2018

Background: Due to the increasing incidence of basal cell carcinoma (BCC) and rising health care costs, health care insurance companies seek ways to shift skin surgery for BCC from secondary to primary care. Objectives: To study the differences in complete excision of BCC by general practitioners (GPs), dermatologists, and plastic surgeons. Methods: A retrospective cross-sectional study of pathology records of 2,986 standard excisions of primary BCCs performed by a GP, dermatologist, or plastic surgeon in the area of Southwest Netherlands between 2008 and 2014. To compare the risk of an incomplete BCC excision between the specialties, the odds ratio (OR) was used adjusted for patient age, sex, tumor site, size, and histological subtype. Results: BCCs were completely excised by GPs in 70%, which was lower than the 93% by dermatologists and 83% by plastic surgeons (p < 0.001). Compared to the dermatologist, BCCs which were excised by a GP were 6 times higher at risk of an incomplete excision (adjusted OR 6, 95% CI 5–8) and 2 times higher at risk when excised by a plastic surgeon (adjusted OR 2, 95% CI 2–3). Conclusion: BCCs were more often completely excised by dermatologists than by GPs and plastic surgeons. Dermatologists probably perform better because of their extensive training and high experience in BCC care. To minimize incomplete BCC excision, GPs should receive specific training before the shift of BCC care from secondary to primary care is justifiable.
The Better Assessment of Illness Study for Delirium Severity: Study Design, Procedures, and Cohort Description
Authors: Hshieh Tammy T. , Fong Tamara G. , Schmitt Eva M. , Marcantonio Edward R.  , D'Aquila Madeline L. , Gallagher Jacqueline , Xu Guoquan , Guo Yun R. , Abrantes Tatiana F. , Bertrand Sylvie E. , Jones Richard N. , Inouye Sharon K. ,   for the BASIL Study Group
Published: August 2018

Background/Objectives: To describe the design, procedures, and cohort for the Better ASsessment of ILlness ­(BASIL) study, which is conducted to develop and test new delirium severity measures, compare them with existing measures, and examine related clinical outcomes. Methods: Prospective cohort study with 1 year follow-up of study participants at a large teaching hospital in Boston, Massachusetts. After brief cognitive testing and the Delirium Symptom Interview, delirium and delirium severity were rated daily in the hospital using the Confusion Assessment Method (CAM) and CAM-Severity score, the Delirium Rating Scale-Revised-98 (DRS-R-98), and the Memorial Delirium Assessment Scale (MDAS). Other key study variables included comorbidity, physical function (basic and instrumental activities of daily living [ADL]), ratings of subjective health and well-being, and clinical outcomes (length of stay, 30 day rehospitalization, nursing home admission, healthcare utilization). Follow-up interviews occurred at 1- and 12-month with patients and families. In 42 patient interviews, inter-rater reliability for key variables was assessed. Results: Of 768 eligible patients approached, 469 were screened and 352 enrolled, yielding an overall study response rate of 67% for potentially eligible participants. The mean participant was 80.3 years old (SD 6.8) and 203 (58%) were female. The majority of patients were medically complex with Charlson Comorbidity Scores ≥2 (192 patients, 55%), and 102 (29%) met criteria for dementia. Inter-rater reliability assessments (n = 42 pairs) were high for overall ratings of presence or absence of delirium by CAM (κ = 1.0), delirium severity by DRS-R-98 and MDAS (weighted kappa, κ = 1.0 for each) and for ADL impairment (κ = 1.0). For eligible participants at each time point, 278 out of 308 (90%) completed the 1-month follow-up and 132 out of 256 (53%) have completed the 12-month follow-up to date, which is still in progress. Among those who completed interviews, there was only 1–3% missing data on most major outcomes (delirium, basic ADL, and readmission). Conclusion: The BASIL study presents an innovative effort to advance the conceptualization and measurement of delirium severity. Unique strengths include the diverse cohort with complete high quality data and longitudinal follow-up, along with detailed collection of multiple delirium measures daily during hospitalization.
Examining the Cascade of Participant Attrition in a Genomic Medicine Research Study: Barriers and Facilitators to Achieving Diversity
Authors: Moore Elizabeth G. , Roche Myra , Rini Christine , Corty Edward W. , Girnary Zahra , O’Daniel Julianne M. , Lin Feng-Chang , Corbie-Smith Giselle , Evans James P. , Henderson Gail E. , Berg Jonathan S.
Published: August 2018

Background/Aims: Recent genomic medicine initiatives underscore the importance of including diverse participants in research. Considerable literature has identified barriers to and facilitators of increasing diversity, yet disparities in recruiting and retaining adequate numbers of participants from diverse groups continue to limit the generalizability of clinical genomic research. Methods: The North Carolina Clinical Genomic Evaluation by Next-gen Exome Sequencing study employed evidence-based strategies to enhance the participation of under-represented minority patients. In this study, we evaluate the impact of our efforts by systematically analyzing the “cascade” of attrition of participants throughout study interactions. Results: Although successful in recruiting a cohort that included ~30% non-Caucasian patients overall, the study still enrolled and retained a lower proportion of minorities compared to the pool of eligible patients who were nominated. We evaluated sociodemographic characteristics and related variables as potential factors associated with attrition throughout these phases of the study. Conclusions: These results suggest that varied approaches will be needed to increase participation in genomic medicine research. Our findings highlight factors to consider when developing strategies to address this critical need. Failing to include a broad range of populations in research studies will exacerbate existing disparities in the translation of genomic sequencing to medical care.
The Joint ORCA-EADPH Symposium on Sugar: The Oral Health Perspective – A Commentary
Authors: Schulte Andreas G. , Tsakos Georgios
Published: August 2018

Caries is the most prevalent chronic condition worldwide and the association between high-level intake of sugars and dental decay is strong and well established. Interestingly, to combat caries, dental practitioners and public health dentists in many countries have focused mainly on the application of different kinds of fluorides and fissure sealants but not on the reduction of sugar intake. Furthermore, for many years, sugars have not been the focus of dental research activities presented at the annual conferences of the European Organisation for Caries Research (ORCA) and the European Association of Dental Public Health (EADPH). In 2015, following the publication of the new WHO guidelines on the intake of sugars, the boards of ORCA and EADPH agreed to organize a common symposium entitled “Joint ORCA-ADPH Symposium on Sugar: The Oral Health Perspective”. This symposium was organized by a scientific committee and took place on July 6, 2016, in association with the 63rd ORCA Congress in Athens, Greece. It included 9 lectures highlighting different aspects of sugar consumption, contribution of sugar to dental caries, measuring sugar consumption, and fighting against sugar on a patient and public health basis. The purpose of this commentary is to give background information about the rationale of the above-mentioned symposium.
Radical Resection of Locally Recurrent Colorectal Cancer Significantly Improves Overall Survival: A Single-Center Cohort Study
Authors: Braun Rüdiger , Bruch Hans-Peter , Keck Tobias , Benecke Claudia , Hoffmann Martin
Published: August 2018

Background: Despite multimodal treatment strategies, locoregional recurrence rates are still significant in colorectal carcinoma (CRC). Methods: Clinical, pathological, perioperative, and survival data of 203 patients with recurrent CRC enlisted in a prospective database from 1990 to 2011 were analyzed. Results: Median disease-free survival in our cohort of 203 patients was 23 months after resection of the primary tumor. In total, 113 of these patients had surgical therapy with resection of the recurrent tumor. The primary tumor was localized in the rectum in 63 (56%) patients and in the colon in 50 (44%) patients. A complete resection of the recurrent tumor (R0) was achieved in 69 (61%) patients. Postoperative complications occurred in 42 (37%) patients. Postoperative mortality was 2.7%. The median overall survival for R0-resected patients without distant metastasis was 91 months. Those patients had better overall survival compared to patients in whom no complete resection of the recurrent tumor was possible (p < 0.001). There was no statistically significant difference (overall survival) between patients that had R0-resection with systemic metastasis and R1 (p = 0.794) or R2 (p = 0.422) resection. Conclusion: Surgical resection of a locally recurrent CRC leads to a substantial long-term survival rate for R0-resected patients.
Intragenic Microdeletion of ULK4 and Partial Microduplication of BRWD3 in Siblings with Neuropsychiatric Features and Obesity
Authors: Tassano Elisa , Uccella Sara , Giacomini Thea , Striano Pasquale , Severino Mariasavina , Porta Simona , Gimelli Giorgio , Ronchetto Patrizia
Published: August 2018

ULK4 and BRWD3 deletions have been identified in patients with developmental/language delay and intellectual disability. Both genes play pivotal roles in brain development. In particular, ULK4 encodes serine/threonine kinases that are critical for the development and function of the nervous system, while BRWD3 plays a crucial role in ubiquitination, as part of the ubiquitin/proteasome system. We report on 2 brothers, aged 7.6 and 20 years, presenting with cognitive impairment, epilepsy, autistic features, hearing loss, and obesity. Array-CGH analysis demonstrated 2 rare CNVs in both siblings: a paternally inherited microdeletion of ∼145 kb at 3p22.1, disrupting the ULK4 gene, and a maternally inherited microduplication of ∼117 kb at Xq21.1 including only the BRWD3 gene. As already described for other recurrent syndromes with variable phenotype, these findings are challenging in genetic counseling because of an evident variable penetrance. We discuss the possible correlations between the clinical phenotype of our patients and the function of the genes involved in these microrearrangements.
The Burden of Diverticular Disease and Its Complications: West versus East
Authors: Imaeda Hiroyuki , Hibi Toshifumi
Published: August 2018

Background: Colonic diverticulosis is prevalent and increasing not only in Western but also in Asian countries. Diverticulosis can be complicated by diverticulitis and diverticular bleeding. Diverticular disease is a burdensome digestive disease, because it is a major cause of hospital admissions and is associated with significant health-care costs. Summary: The incidence of diverticulosis increases with age. Most cases of diverticulosis in Western countries involve the left side of the colon, while diverticulosis is predominantly present on the right side of the colon in Asian countries. The incidence of diverticulitis also increases with age. Diverticulitis is predominantly located on the left side of the colon in Western countries, while it is predominantly located on the right side of the colon in Asian countries. The overall complication rate is higher in left-sided than in right-sided diverticulitis. The incidence of diverticular bleeding also increases with age. The right colon is the source of diverticular bleeding in more than 50% of patients in Western countries. In Asian countries, age greater than 70 years and both-sided diverticulosis increase the bleeding risk. Key Messages: In Western countries, diverticulosis and diverticulitis are predominantly located on the left side of the colon, whereas they are predominantly present on the right side of the colon in Asian countries. Diverticular bleeding is predominantly located on the right side in Western countries, and both-sided diverticulosis increases the risk of bleeding in Asian countries. Diverticular disease with complications requires admission and operation; moreover, it recurs frequently. Therefore, diverticular disease is associated with a significant economic burden in terms of health-care costs and resource utilization.