bluuebunny/crossref_metadata_2025 huggingface dataset:
Kininogen deficiency or depletion reduces enhanced pause independent of pulmonary inflammation in a house dust mite-induced murine asthma model
Authors: Yang Jack , van ’t Veer Cornelis , Roelofs Joris J. T. H. , van Heijst Jeroen W. J. , de Vos Alex F. , McCrae Keith R. , Revenko Alexey S. , Crosby Jeff , van der Poll Tom
Published: October 2018

High-molecular-weight kininogen is an important substrate of the kallikrein-kinin system. Activation of this system has been associated with aggravation of hallmark features in asthma. We aimed to determine the role of kininogen in enhanced pause (Penh) measurements and lung inflammation in a house dust mite (HDM)-induced murine asthma model. Normal wild-type mice and mice with a genetic deficiency of kininogen were subjected to repeated HDM exposure (sensitization on days 0, 1, and 2; challenge on days 14, 15, 18, and 19) via the airways to induce allergic lung inflammation. Alternatively, kininogen was depleted after HDM sensitization by twice-weekly injections of a specific antisense oligonucleotide (kininogen ASO) starting at day 3. In kininogen-deficient mice HDM induced in Penh was completely prevented. Remarkably, kininogen deficiency did not modify HDM-induced eosinophil/neutrophil influx, T helper 2 responses, mucus production, or lung pathology. kininogen ASO treatment started after HDM sensitization reduced plasma kininogen levels by 75% and reproduced the phenotype of kininogen deficiency: kininogen ASO administration prevented the HDM-induced increase in Penh without influencing leukocyte influx, Th2 responses, mucus production, or lung pathology. This study suggests that kininogen could contribute to HDM-induced rise in Penh independently of allergic lung inflammation. Further research is warranted to confirm these data using invasive measurements of airway responsiveness.
MyD88 controls airway epithelial Muc5ac expression during TLR activation conditions from agricultural organic dust exposure
Authors: Dickinson John D. , Sweeter Jenea M. , Staab Elizabeth B. , Nelson Amy J. , Bailey Kristina L. , Warren Kristi J. , Jaramillo Ana Maria , Dickey Burton F. , Poole Jill A.
Published: October 2018

Inflammation from airborne microbes can overwhelm compensatory mucociliary clearance mechanisms, leading to mucous cell metaplasia. Toll-like receptor (TLR) activation via myeloid differentiation factor 88 (MyD88) signaling is central to pathogen responses. We have previously shown that agricultural organic dust extract (ODE), with abundant microbial component diversity, activates TLR-induced airway inflammation. With the use of an established model, C57BL/6J wild-type (WT) and global MyD88 knockout (KO) mice were treated with intranasal inhalation of ODE or saline, daily for 1 wk. ODE primarily increased mucin (Muc)5ac levels relative to Muc5b. Compared with ODE-challenged WT mice, ODE-challenged, MyD88-deficient mice demonstrated significantly increased Muc5ac immunostaining, protein levels by immunoblot, and expression by quantitative PCR. The enhanced Muc5ac levels in MyD88-deficient mice were not explained by differences in the differentiation program of airway secretory cells in naïve mice. Increased Muc5ac levels in MyD88-deficient mice were also not explained by augmented inflammation, IL-17A, or neutrophil elastase levels. Furthermore, the enhanced airway mucins in the MyD88-deficient mice were not due to defective secretion, as the mucin secretory capacity of MyD88-KO mice remained intact. Finally, ODE-induced Muc5ac levels were enhanced in MyD88-deficient airway epithelial cells in vitro. In conclusion, MyD88 deficiency enhances airway mucous cell metaplasia under environments with high TLR activation.
Divergent changes of p53 in pulmonary arterial endothelial and smooth muscle cells involved in the development of pulmonary hypertension
Authors: Wang Ziyi , Yang Kai , Zheng Qiuyu , Zhang Chenting , Tang Haiyang , Babicheva Aleksandra , Jiang Qian , Li Meichan , Chen Yuqin , Carr Shane G. , Wu Kang , Zhang Qian , Balistrieri Angela , Wang Christina , Song Shanshan , Ayon Ramon J. , Desai Ankit A. , Black Stephen M. , Garcia Joe G. N. , Makino Ayako , Yuan Jason X.-J. , Lu Wenju , Wang Jian
Published: October 2018

The tumor-suppressive role of p53, a transcription factor that regulates the expression of many genes, has been linked to cell cycle arrest, apoptosis, and senescence. The noncanonical function or the pathogenic role of p53 has more recently been implicated in pulmonary vascular disease. We previously reported that rapid nuclear accumulation of hypoxia-inducible factor (HIF)-1α in pulmonary arterial smooth muscle cells (PASMCs) upregulates transient receptor potential channels and enhances Ca2+entry to increase cytosolic Ca2+concentration ([Ca2+]cyt). Also, we observed differences in HIF-1α/2α expression in PASMCs and pulmonary arterial endothelial cells (PAECs). Here we report that p53 is increased in PAECs, but decreased in PASMCs, isolated from mice with hypoxia-induced pulmonary hypertension (PH) and rats with monocrotaline (MCT)-induced PH (MCT-PH). The increased p53 in PAECs from rats with MCT-PH is associated with an increased ratio of Bax/Bcl-2, while the decreased p53 in PASMCs is associated with an increased HIF-1α. Furthermore, p53 is downregulated in PASMCs isolated from patients with idiopathic pulmonary arterial hypertension compared with PASMCs from normal subjects. Overexpression of p53 in normal PASMCs inhibits store-operated Ca2+entry (SOCE) induced by passive depletion of intracellularly stored Ca2+in the sarcoplasmic reticulum, while downregulation of p53 enhances SOCE. These data indicate that differentially regulated expression of p53 and HIF-1α/2α in PASMCs and PAECs and the cross talk between p53 and HIF-1α/2α in PASMCs and PAECs may play an important role in the development of PH via, at least in part, induction of PAEC apoptosis and PASMC proliferation.
Aortic stiffness, pressure and flow pulsatility, and target organ damage
Authors: Mitchell Gary F.
Published: October 2018

Measures of aortic stiffness and pressure and flow pulsatility have emerged as correlates of and potential contributors to cardiovascular disease, dementia, and kidney disease. Higher aortic stiffness and greater pressure and flow pulsatility are associated with excessive pulsatile load on the heart, which increases mass and reduces global longitudinal strain of the left ventricle. Excessive stiffness and pulsatility are also associated with microvascular lesions in high-flow organs, such as the brain and kidney, suggesting that small vessels in these organs are damaged by pulsatility. This brief review will summarize evidence relating aortic stiffness to cardiovascular, brain, and kidney disease.
Long-term effects of NO3– on the relationship between oxygen uptake and power after three weeks of supplemented HIHVT
Authors: Finkel Armin , Röhrich Magdalena Aleksandra , Maassen Norbert , Lützow Moritz , Blau Larissa Sarah , Hanff Erik , Tsikas Dimitrios , Maassen Mirja
Published: October 2018

The aim of this study was to investigate the later effects of daily [Formula: see text] supplementation over 3 wk of training on the relationship between O2 uptake and power at different intensities with an incremental test (IT), a double-wingate test (WT), and an endurance capacity test at 80% Wmax (ECT) before and after the supplementation period. Seventeen male recreational athletes participated in this double-blind placebo (PL)-controlled study. Subjects participated in a 3-wk intermittent high-intensity, high-volume training period with 45 intervals of Wmax − 10 W and an active recovery period of 10 W in between with dietary [Formula: see text] (NaNO3) or placebo supplementation (NaCl) (both 8.5 mg·kg−1·day−1) on a cycle ergometer. During a training session, plasma [[Formula: see text]] ( P < 0.001) and plasma [[Formula: see text]] ( P < 0.01) were higher in nitrate (N), whereas in pre- and posttests mean plasma [[Formula: see text]] and [[Formula: see text]] were not different between groups. In the WT [48 h after cessation of supplementation (C)], the ratio between V̇o2 and power decreased in N ( P < 0.01) with no changes in PL. Endurance capacity (4–5 days after C) similarly increased in both groups ( P < 0.01). However, the total oxygen consumption decreased by 5% ( P < 0.01) in N, with no change in PL. The slope of V̇o2·W−1 in IT (5–7 days after C) decreased in N ( P < 0.01), whereas no changes were found in PL. During low- and moderate-intensity workloads, no changes and differences in V̇o2 could be detected. We conclude that nitrate supplementation causes a sustaining reduction of the oxygen cost per watt during exercise with a large recruitment of type II muscle fibers without affecting endurance capacity.

NEW & NOTEWORTHY Because most studies focused on the acute effects of [Formula: see text] supplementation on exercise performance during a supplementation period, the sustainability of the effects of the [Formula: see text] supplementation remain unknown. We followed the development of V̇o2/W at different intensities during the first week after cessation of daily [Formula: see text] supplementation over 3 wk. The results indicate that [Formula: see text] supplementation has a long-term effect for at least 7 days after cessation during heavy all-out workloads without affecting endurance capacity.
Spinal Endoscopy for Delayed-Onset Lumbar Radiculopathy Resulting from Foraminal Stenosis after Osteoporotic Vertebral Fracture: A Case Report of a New Surgical Strategy
Authors: Ishimoto Yuyu , Yamada Hiroshi , Curtis Elizabeth , Cooper Cyrus , Hashizume Hiroshi , Minamide Akihito , Nakagawa Yukihiro , Yoshida Munehito
Published: October 2018

There is little evidence regarding the optimal approach to treatment for delayed-onset lumbar radiculopathy due to foraminal stenosis after osteoporotic vertebral fracture. Here, we describe the use of spinal endoscopy for the treatment of this disabling condition, in an 80-year-old woman presenting with severe radicular pain following an osteoporotic lumbar compression fracture. Radiographic findings showed the compression of the L2 root within the foramen, and computed tomography identified a fragment of the posterior wall of the vertebral body under the pedicle. Since the patient had little back pain and was relatively frail, we decided to perform foraminal decompression via a lateral approach using spinal endoscopy. Intraoperative findings demonstrated degenerative changes as well as a fragment of the posterior wall of the fractured vertebral body in the foramen, covered in a fibrous film. The nerve was decompressed on removal of the fragment. After surgery, the patient experienced immediate pain relief. The preoperative Japanese Orthopedic Association (JOA) and visual analogue scale (VAS) scores were 9 and 82, respectively, and at 36-month follow-up, scores were reduced to 19 and 34, respectively.
Municipal Cross-Disciplinary Rehabilitation following Stroke in Denmark and Norway: A Qualitative Study
Authors: Aadal Lena , Pallesen Hanne , Arntzen Cathrine , Moe Siri
Published: October 2018

Aim. To explore and compare the content of rehabilitation practices in, respectively, a Danish and a Norwegian region, focusing on how the citizens’ rehabilitation needs are met during rehabilitation in the municipalities. Method. Six Danish and five Norwegian cases were followed 12 months after the onset of stroke. Field work and focus group interviews with multidisciplinary teams in the municipalities were conducted. The conceptual frame of the International Classification of Functioning was used to outline general patterns and local variation in the rehabilitation services. Findings. Each of the settings faces different challenges and opportunities in the provision of everyday life-supportive rehabilitation services. Rehabilitation after stroke in both settings basically follows the same guidelines, but the organization of rehabilitation programmes is more specialized in Denmark than in Norway. Team organization, multidisciplinarity, and collaboration to assess and target the patients’ needs characterized the Danish rehabilitation services. Decentralized coordination and monodisciplinary contributions with scarce or unsystematic collaboration were common in the Norwegian cases. Seamless holistic rehabilitation was challenged in both countries, but more notably in Norway. The municipal services emphasized physical functioning, which could conflict with the patients’ needs. Cognitive disturbances to and aspects of activity or participation were systematically addressed by the interdisciplinary teams in Denmark, while practitioners in Norway found that these disturbances were scarcely addressed. Discussion. The study showed major differences in municipal stroke rehabilitation services in the Northern Norway and Central Denmark Regions—in their ability to conduct everyday life—supportive rehabilitation services. Despite the fact that biopsychosocial conceptions of disease and illness, as recommended in the ICF, have been generally accepted, they seemed scarcely implemented in the political and health managerial arenas, especially in Norway. These national diversities can partly be explained by the size of the municipalities and the available health profiles in delivering patient and family-centred rehabilitation services.
Seismic Performance and Failure Mechanism of Megabraced Frame‐Core Tube Structures with Different Brace Patterns
Authors: Li Zuohua , Liu Pengyuan , Teng Jun , Wang Ying
Published: October 2018

The effect of mega braces on structural stiffness has been comprehensively discussed for various megabraced frame‐core tube structures. However, few studies have considered how mega braces affect the failure mechanism of mega structures exposed to seismic action, which is a nonlinear process. To address this issue, we present a study on the effects of different brace patterns on the failure mechanism and seismic performance of megabraced frame‐core tube structures. Specifically, the yield order of components, the distribution of plasticity, the distribution of internal forces, the degradation of structural nonlinear stiffness, and the behavior factor have been investigated. This study reveals that the yield of mega braces will change the deformation mode of adjacent mega columns and thus affect the plasticity distribution of adjacent substructures. The enhancement of mega braces improves the exterior tubes (thereby increasing their capacity to serve as the second line of seismic defence), mitigates the rate at which system stiffness degrades, and improves the overstrength of the structural systems. In addition, after the yield of mega braces, the maintenance of a higher‐amplitude axial force changes the proportion of internal force components in mega columns, reducing their ductility and further affecting the overall ductility of the structural system.
Thermodynamic Prescription of Cosmological Constant in the Randall-Sundrum II Brane
Authors: Bandyopadhyay Tanwi
Published: October 2018

In this work, we apply the quantum corrected entropy function derived from the Generalized Uncertainty Principle (GUP) to the holographic equipartition law to study the cosmological scenario in the Randall-Sundrum (RS) II brane. An extra driving term has come up in the effective Friedmann equation for a homogeneous, isotropic, and spatially flat universe. Further, thermodynamic prescription of the universe constraints this term eventually with an order equivalent to that of the cosmological constant.
Maternal Nutrition Education Provided by Midwives: A Qualitative Study in an Antenatal Clinic, Uganda
Authors: Nankumbi Joyce , Ngabirano Tom Dennis , Nalwadda Gorrette
Published: October 2018

Maternalnutrition during pregnancy affects the health of the mother and baby. The objective of this paper is to describe the maternal nutrition education offered by midwives to women attending an antenatal clinic. The study also examined the resources, support, and the needs of the midwives in offering the nutrition education. Six in-depth interviews with the midwives, six direct structured observations of the group education, and 12 one-on-one interactions of midwife and pregnant women observations were completed. The interviews and field observation notes were typed and analyzed using the latent content analysis. The emerging themes were the maternal nutrition education and the education needs of the midwives. The content and presentation of maternal nutrition were inadequate in scope and depth. The maternal nutrition education was offered to only pregnant women attending the first antenatal care visit. The routine antenatal education session lasted 45 minutes to 1 hour, covering a variety of topics, but the nutritional component was allotted minimal time (5–15 minutes). The organization, mode of delivery, guidelines, resources, and service environment were extremely deficient. The relevance of appropriate weight gain during pregnancy, guidelines for healthy habits, avoidance of substance abuse, and nutrition precautions in special circumstances was missing in the nutrition presentation. Information, maternal nutrition education resources, infrastructure, and health system gaps were identified. There was an inefficient nutrition education offered to the pregnant women attending the antenatal clinic. As means of promoting effective nutrition education, appropriate in-service training, mentorship, and support for the midwives are needed, as well as infrastructural and resource provision.
Testing the Explosion Resistance and Energy Absorption of a Polyurethane‐Foamed Aluminum Composite Structure
Authors: Yong Zhang , Zheng-yu Xue , Zhen-rong Lin , Yu-song Lu , Xiao-hui Wang
Published: October 2018

Concrete structures can suffer damage from the shock waves caused by explosions. However, the damage can be mitigated in practice by increasing the size of the energy‐absorbing interlayers to improve the antiknock performance of the concrete. The aim of this paper is to investigate the energy‐absorbing capability of a composite structure of polyurethane‐foamed aluminum and concrete. The composite structure consisted of C60 concrete with foamed aluminum or polyurethane‐foamed aluminum as a sandwich material. The thickness of the interlayers and the relative amounts of the different materials in the structure were the variables that were adjusted from test to test. To capture data related to the explosion, the structure was instrumented with pressure, acceleration, strain gauge, and displacement sensors. The efficacy of this structure was validated by way of surface contact explosions using 0.5 kg of TNT. By appropriately positioning the explosives in each test, the related parameters in the explosions, including the stress, displacement, acceleration, and strain, were recorded. The results of the tests indicated that the energy‐absorbing capability of the polyurethane‐foamed aluminum was significantly higher than that of the foamed aluminum, and the thickness of the energy‐absorbing layer had a great impact on the energy absorption effect.
Joint Method of Interference Suppression and Super-Resolution for Chinese Characters Image with Interference
Authors: Jiang Bo , Hu Wei , Liang Jian , Zhang Shouxu , Ma Xiaolei , Zhou Yan , Niu Jinping , Chen Xiaoxuan
Published: October 2018

As Chinese characters image often has insufficient photography illumination, or underlines under characters, or low resolution, a joint method of interference suppression and super-resolution for Chinese characters image with interference is proposed. In the stage of interference suppression preprocessing, the technology of image layer separation is used to decompose Chinese characters image into the illumination layer and reflectance layer at first, and reflectance layer that contains the essential property of input image is retained consequently. Then the reflectance layer is decomposed into four coefficient subimages by wavelet transform, and image smoothing via L0 gradient minimization with different scale factors is adopted to these different coefficient subimages. Subsequently, by a simple background processing and image filtering, the image preprocessing for Chinese characters image with interference is ultimately completed. In the stage of image super-resolution, due to acquisition limitation of a large number of high-resolution Chinese characters images, we adopt neighbor embedding super-resolution method for its advantage of greatly reducing the scale of training set. In the key feature vector of Chinese characters image, the weights of horizontal and vertical stroke features are strengthened; meanwhile, the other stroke features of Chinese characters are also considered. Ultimately, a super-resolution method more suitable for Chinese characters image is proposed. Experimental results show that our method of interference suppression has the superiority for Chinese characters images with aforementioned interference, and our optimized super-resolution method has better performance for test Chinese characters images than bicubic interpolation method and three classical super-resolution methods.
Experimental Study on the Transport of Light Gas Molecules through Low-Density Polyethylene Films
Authors: Checchetto Riccardo
Published: October 2018

An original experimental procedure for the study of gas permeation process through thin polymer films is presented. Employing mass spectroscopy techniques, this procedure allows the detection of the permeation flux with a signal-to-noise ratio large enough to obtain accurate measurements of the gas diffusivity also in processes with transient transport conditions lasting for short-interval times (~few seconds). The procedure is validated using as test material a thin low-density polyethylene (LDPE) film: the transport of four test gases with different molecular sizes and condensation properties (CO2, N2, D2, and He) is studied in the 295 to 350 K temperature interval. The CO2 diffusivity values well compare with values previously obtained studying the same LDPE film samples by integral permeation technique measuring the time lag value. Original data on the diffusivity of the He and D2 penetrant molecules are reported: in the examined temperature range, the diffusivity values of these small-size penetrants are in the 10−6 cm2/s range and follow an Arrhenius behavior with temperature. The activation energy values for diffusion are 18.8 ± 0.4 and 10.0 ± 0.4 kJ/mol for D2 and He, respectively.
Study on the Influence of Government Intervention on the Occupational Health and Safety (OHS) Services of Small- and Medium-Sized Enterprises (SMEs)
Authors: Zhang Jingjing , Mei Qiang , Liu Suxia , Wang Qiwei
Published: October 2018

The OHS services of SMEs are still in their start-up stage in China. As such, there is an absence of mature market norms, which in turn makes it difficult to guarantee the quality of OHS services. The government, as the “night watchman” of the market, is supposed to not only involve itself in the regulation of OHS service quality, but also introduce and implement proper regulatory strategies. This paper employs a computational experiment approach to construct an experimental platform based on multiagent interactions. By simulating the OHS service transaction activities of SMEs, this paper takes the perspective of dynamic evolution. From this perspective, we probe into the optimal regulatory strategy covering the positive influence of government punishment, policy supports, and service quality ratings of the OHS services of SMEs. These strategies should be built on the foundation of proper punishment standard and intensity, proper support standard and intensity, and quality rating information disclosure.
Applicability of Artificial Neural Networks to Predict Mechanical and Permeability Properties of Volcanic Scoria‐Based Concrete
Authors: al-Swaidani Aref M. , Khwies Waed T.
Published: October 2018

Numerous volcanic scoria (VS) cones are found in many places worldwide. Many of them have not yet been investigated, although few of which have been used as a supplementary cementitious material (SCM) for a long time. The use of natural pozzolans as cement replacement could be considered as a common practice in the construction industry due to the related economic, ecologic, and performance benefits. In the current paper, the effect of VS on the properties of concrete was investigated. Twenty‐one concrete mixes with three w/b ratios (0.5, 0.6, and 0.7) and seven replacement levels of VS (0%, 10%, 15%, 20%, 25%, 30%, and 35%) were produced. The investigated concrete properties were the compressive strength, the water permeability, and the concrete porosity. Artificial neural networks (ANNs) were used for prediction of the investigated properties. Feed‐forward backpropagation neural networks have been used. The ANN models have been established by incorporation of the laboratory experimental data and by properly choosing the network architecture and training processes. This study shows that the use of ANN models provided a more accurate tool to capture the effects of five parameters (cement content, volcanic scoria content, water content, superplasticizer content, and curing time) on the investigated properties. This prediction makes it possible to design VS‐based concretes for a desired strength, water impermeability, and porosity at any given age and replacement level. Some correlations between the investigated properties were derived from the analysed data. Furthermore, the sensitivity analysis showed that all studied parameters have a strong effect on the investigated properties. The modification of the microstructure of VS‐based cement paste has been observed, as well.
Combined Volumetric and Density Analyses of Contrast-Enhanced CT Imaging to Assess Drug Therapy Response in Gastroenteropancreatic Neuroendocrine Diffuse Liver Metastasis
Authors: Wang Yi , Huang Kun , Chen Jie , Luo Yanji , Zhang Yu , Jia Yingmei , Xu Ling , Chen Minhu , Huang Bingsheng , Ni Dong , Li Zi-Ping , Feng Shi-Ting
Published: October 2018

Objective. We propose a computer-aided method to assess response to drug treatment, using CT imaging-based volumetric and density measures in patients with gastroenteropancreatic neuroendocrine tumors (GEP-NETs) and diffuse liver metastases. Methods. Twenty-five patients with GEP-NETs with diffuse liver metastases were enrolled. Pre- and posttreatment CT examinations were retrospectively analyzed. Total tumor volume (volume) and mean volumetric tumor density (density) were calculated based on tumor segmentation on CT images. The maximum axial diameter (tumor size) for each target tumor was measured on pre- and posttreatment CT images according to Response Evaluation Criteria In Solid Tumors (RECIST). Progression-free survival (PFS) for each patient was measured and recorded. Results. Correlation analysis showed inverse correlation between change of volume and density (Δ(V + D)), change of volume (ΔV), and change of tumor size (ΔS) with PFS (r = −0.653, P=0.001; r = −0.617, P=0.003; r = −0.548, P=0.01, respectively). There was no linear correlation between ΔD and PFS (r = −0.226, P=0.325). Conclusion. The changes of volume and density derived from CT images of all lesions showed a good correlation with PFS and may help assess treatment response.
Seabed Dynamic Response of Offshore Wind Turbine Foundation under Vertical Harmonic Loading: An Analytic Solution
Authors: Pavlou Dimitrios G. , Li Yuzhu
Published: October 2018

Wave-induced dynamic loads yield displacement and stress propagation on the seabed beneath the offshore wind turbine foundation. Existing attempts to calculate the displacement/stress propagation based on commercial software packages or numerical solvers usually ignore the inertial effects and provide quasi-static solution for the dynamic problem or ignore the damping effect of the soil. Since real time displacement measurements on the seabed are difficult to be carried out, the existing results are not able to be validated and the conclusions are rather arbitrary. Analytic solutions can provide accurate results and are less time-consuming and more computationally efficient than the numerical approaches but difficult to be achieved. In the present study an exact solution of the wave propagation in the seabed under harmonic excitation of the wind turbine foundation is achieved. The solution is based on integral transforms and stress functions. Verification of the solution is provided and a representative example is solved and commended.
A 66-Year-Old Female with Apical Hypertrophic Cardiomyopathy Presenting with Hypertensive Crises and Type 2 Myocardial Infarction and a Normal Coronary Angiogram
Authors: Meghrajani Vineet , Wats Karan , Saxena Abhinav , Malik Bilal
Published: October 2018

A 66-year-old female presented to the emergency room with an episode of chest pain that lasted for a few minutes before resolving spontaneously. Electrocardiogram showed a left bundle branch block, left ventricular hypertrophy, and T wave inversions in the lateral leads. Initial cardiac troponin level was 0.15 ng/ml, with levels of 4 ng/ml and 9 ng/ml obtained 6 and 12 hours later, respectively. The peak blood pressure recorded was 195/43 mmHg. Echocardiogram with DEFINITY showed a small left ventricular cavity with apical hypertrophy, and coronary angiogram showed no stenotic or occluding lesions in the coronary arteries. The patient was admitted for a type 2 myocardial infarction with hypertensive crises. She was diagnosed with having apical hypertrophic cardiomyopathy, which is a variant of hypertrophic cardiomyopathy (HCM) in which the hypertrophy predominantly involves the apex of the left ventricle resulting in midventricular obstruction, as opposed to the left ventricular outflow tract obstruction seen in HCM. Patients with apical HCM may present with angina, heart failure, myocardial infarction, syncope, or arrhythmias and are typically managed with medications like verapamil and beta-blockers for those who have symptoms and antiarrhythmic agents like amiodarone and procainamide for treatment of atrial fibrillation and ventricular arrhythmias. An implantable cardioverter defibrillator (ICD) is recommended for high-risk HCM patients with a history of previous cardiac arrest or sustained episodes of ventricular tachycardia, syncope, and a family history of sudden death.
Estimation of Changes in Mechanical and Color Properties from the Weight Loss Data of “Shine Muscat” Fruit during Storage
Authors: Watanabe Takashi , Nakamura Nobutaka , Ota Nobuyoshi , Shiina Takeo
Published: October 2018

“Shine Muscat” fruit is a table grape commonly consumed cultivar in Japan; however, the storage characteristics have not been investigated, especially physical properties. The objective of this study was to clarify changes in weight loss, mechanical, and color properties of Shine Muscat fruit during storage and the relationships between them. The storage tests were performed at 15°C under two relative humidity (RH) conditions, i.e., RH 95% and RH 40%. The weight loss of fruit was calculated from the mass changes during storage. The mechanical properties—stress, strain, and elasticity—at the break point were examined by compression tests. The color properties, color differences (ΔE), and chroma (C) were calculated from L∗a∗b∗ scale parameters. The breaking stress did not reflect changes in the mechanical characteristics of samples during storage. Weight loss was highly correlated with the breaking strain and elasticity, ΔE, and C. In addition, the physical properties could be estimated from weight loss data (R2 = 0.81–0.94). We showed the changes in weight loss and other physical properties and proposed equations to estimate the physical properties based on weight loss data. The equations indicated the importance of inhibiting the weight loss to maintain the quality and could be used as a nondestructive and easy method for assessment of storage characteristics of Shine Muscat fruit.
Bacteriological Assessment of Bottled Drinking Water Available at Major Transit Places in Mangalore City of South India
Authors: Joseph Nitin , Bhat Sevitha , Mahapatra Subhani , Singh Ayush , Jain Sajal , Unissa Ahamed , Janardhanan Namritha
Published: October 2018

Introduction. Safe drinking water is essential for human life. It is generally considered that bottled water is safe for usage by people. For long-distance travelers, it serves as the only source of reliable drinking water. But, several studies have reported that bottled water does not always meet the acceptability standards. Objectives. To assess the bacteriological and physical quality of bottled water marketed in major transit areas and to check its compliance with national standards. Methods. The investigating team visited retail shops at three main transit sites for long-distance travelers in Mangalore city. A total of 24 water bottles of 12 brands were randomly selected. The analysis of total viable count (TVC) was done to assess the bacteriological quality of samples. Results. In 3(12.5%) samples, all of which were of local brands, batch number, the period of manufacture, and the period of expiry were not mentioned. Odor and floating bodies were present in one sample each. Five (20.8%) water bottles had been enriched with minerals. Ozone treatment was the most commonly 22(91.7%) used method for disinfection of water. In only 15(62.5%) samples, the bacterial contamination was within acceptable limits certified for drinking purposes. Water samples manufactured by multinational companies (p=0.018), those with batch number mentioned (p=0.042), the best period of manufacture (p=0.036), and long expiry dates (p=0.028) were acceptable for usage. Conclusion. Surveillance of bottled water manufacturing industries in the settings on a regular basis needs to be done by regulatory agencies. These measures will ensure safe and wholesome bottled water for public usage.
A Review of Native Wild Bee Nutritional Health
Authors: Leach Megan E. , Drummond Frank
Published: October 2018

Declines in wild and managed bee species richness and abundances have been observed throughout Europe and North America in recent decades. These declines have led to questions regarding pollination of wild and cultivated plants. In response to these concerns, efforts towards the conservation of pollinators have been initiated. Part of this conservation effort should be to provide the basic nutritional needs for bees. Nutrition plays one of the most important roles in bee growth, development, and reproduction. There is a large body of information regarding honey bee nutrition, whereas we lack nutritional information on native wild bees. Our knowledge of bumble bee nutritional needs has increased since the introduction of commercial rearing and sale of certain bumble bee species; however, there is still a lack of basic nutritional guidelines such as minimum dietary needs of proteins, amino acids, lipids, and sterols. The large difference in physiology and life history between honey bees and North American wild bees suggests that their nutritional requirements could be quite different.
Fournier’s Gangrene of the Penis following a Human Bite Wound
Authors: Overholt Tyler , Hajiran Ali , Ueno Cristiane , Zaslau Stanley
Published: October 2018

Fournier’s gangrene isolated to the penis is exceedingly rare. It is an urologic emergency that requires emergent parenteral antibiotics as well as aggressive irrigation and debridement. While human bite wounds can be overlooked as a serious cause of injury and infection, they can result in highly dangerous, polymicrobial infections in affected patients. Here, we report a case of penile Fournier’s gangrene caused by a human bite wound managed with broad spectrum antibiotics, irrigation and debridement, penile reconstruction, and skin grafting with successful preservation of a normal penile structure and function.
Homophilic CD44 Interactions Mediate Tumor Cell Aggregation and Polyclonal Metastasis in Patient-Derived Breast Cancer Models
Authors: Liu Xia , Taftaf Rokana , Kawaguchi Madoka , Chang Ya-Fang , Chen Wenjing , Entenberg David , Zhang Youbin , Gerratana Lorenzo , Huang Simo , Patel Dhwani B. , Tsui Elizabeth , Adorno-Cruz Valery , Chirieleison Steven M. , Cao Yue , Harney Allison S. , Patel Shivani , Patsialou Antonia , Shen Yang , Avril Stefanie , Gilmore Hannah L. , Lathia Justin D. , Abbott Derek W. , Cristofanilli Massimo , Condeelis John S. , Liu Huiping
Published: October 2018

Circulating tumor cells (CTC) seed cancer metastases; however, the underlying cellular and molecular mechanisms remain unclear. CTC clusters were less frequently detected but more metastatic than single CTCs of patients with triple-negative breast cancer and representative patient-derived xenograft models. Using intravital multiphoton microscopic imaging, we found that clustered tumor cells in migration and circulation resulted from aggregation of individual tumor cells rather than collective migration and cohesive shedding. Aggregated tumor cells exhibited enriched expression of the breast cancer stem cell marker CD44 and promoted tumorigenesis and polyclonal metastasis. Depletion of CD44 effectively prevented tumor cell aggregation and decreased PAK2 levels. The intercellular CD44–CD44 homophilic interactions directed multicellular aggregation, requiring its N-terminal domain, and initiated CD44–PAK2 interactions for further activation of FAK signaling. Our studies highlight that CD44+ CTC clusters, whose presence is correlated with a poor prognosis of patients with breast cancer, can serve as novel therapeutic targets of polyclonal metastasis.

Significance:

CTCs not only serve as important biomarkers for liquid biopsies, but also mediate devastating metastases. CD44 homophilic interactions and subsequent CD44–PAK2 interactions mediate tumor cluster aggregation. This will lead to innovative biomarker applications to predict prognosis, facilitate development of new targeting strategies to block polyclonal metastasis, and improve clinical outcomes.

See related commentary by Rodrigues and Vanharanta, p. 22.

This article is highlighted in the In This Issue feature, p. 1
Factors Associated with Acceptability, Consideration and Intention of Uptake of Direct-To-Consumer Genetic Testing: A Survey Study
Authors: Stewart Kelly F.J. , Kokole Daša , Wesselius Anke , Schols Annemie M.W.J. , Zeegers Maurice P. , de Vries Hein , van Osch Liesbeth A.D.M.
Published: October 2018

Background: With interest in personalised health care growing, so is interest in personal genetic testing. This is now offered direct-to-consumer, thereby referred to as direct-to-consumer genetic testing (DTC-GT). Criticisms have been expressed on whether a truly informed decision to undergo testing is made with regard to these services. In order to provide relevant information to achieve this, knowing the characteristics of the expected user population is helpful. Therefore, the aim of this study is to identify characteristics of individuals who (1) find the concept of DTC-GT acceptable and (2) consider undergoing DTC-GT in the distant or near future. Methods: This cross-sectional study investigated factors associated with acceptability, consideration and intention in the Dutch general population. Studied variables included awareness, principles and how-to knowledge, attitude, innovativeness, and multiple demographic characteristics. Generalised linear models were applied to identify associated variables. Results: Full data was obtained for 836 respondents. Of those, 18.3% found DTC-GT somewhat or totally acceptable, whereas 12.6% considered and 5.5% intended to undergo DTC-GT in the distant or near future. Acceptability was greater with lower principles knowledge, and consideration and intention with lower how-to knowledge. A more positive attitude and greater innovativeness were associated with an increase in all 3 outcomes. Conclusion: Informed decision making may be hampered as individuals with lower how-to knowledge were found to be more interested in pursuing testing. The identified characteristics can be used in development and distribution of public and personalized information, in order to help consumers make a truly informed decision.
Diet and Psychosis: A Scoping Review
Authors: Aucoin Monique , LaChance Laura , Cooley Kieran , Kidd Sean
Published: October 2018

Introduction: Schizophrenia spectrum disorders (SSD) represent a cluster of severe mental illnesses. Diet has been identified as a modifiable risk factor and opportunity for intervention in many physical illnesses and more recently in mental illnesses such as unipolar depression; however, no dietary guidelines exist for patients with SSD. Objective: This review sought to systematically scope the existing literature in order to identify nutritional interventions for the prevention or treatment of mental health symptoms in SSD as well as gaps and opportunities for further research. Methods: This review followed established methodological approaches for scoping reviews including an extensive a priori search strategy and duplicate screening. Because of the large volume of results, an online program (Abstrackr) was used for screening and tagging. Data were extracted based on the dietary constituents and analyzed. Results: Of 55,330 results identified by the search, 822 studies met the criteria for inclusion. Observational evidence shows a connection between the presence of psychotic disorders and poorer quality dietary patterns, higher intake of refined carbohydrates and total fat, and lower intake or levels of fibre, ω-3 and ω-6 fatty acids, vegetables, fruit, and certain vitamins and minerals (vitamin B12 and B6, folate, vitamin C, zinc, and selenium). Evidence illustrates a role of food allergy and sensitivity as well as microbiome composition and specific phytonutrients (such as L-theanine, sulforaphane, and resveratrol). Experimental studies have demonstrated benefit using healthy diet patterns and specific vitamins and minerals (vitamin B12 and B6, folate, and zinc) and amino acids (serine, lysine, glycine, and tryptophan). Discussion: Overall, these findings were consistent with many other bodies of knowledge about healthy dietary patterns. Many limitations exist related to the design of the individual studies and the ability to extrapolate the results of studies using dietary supplements to dietary interventions (food). Dietary recommendations are presented as well as recommendations for further research including more prospective observational studies and intervention studies that modify diet constituents or entire dietary patterns with statistical power to detect mental health outcomes.
Blood Pressure Assessment with Differential Pulse Transit Time and Deep Learning: A Proof of Concept
Authors: Ribas Ripoll Vicent , Vellido Alfredo
Published: October 2018

Background: Modern clinical environments are laden with technology devices continuously gathering physiological data from patients. This is especially true in critical care environments, where life-saving decisions may have to be made on the basis of signals from monitoring devices. Hemodynamic monitoring is essential in dialysis, surgery, and in critically ill patients. For the most severe patients, blood pressure is normally assessed through a catheter, which is an invasive procedure that may result in adverse effects. Blood pressure can also be monitored noninvasively through different methods and these data can be used for the continuous assessment of pressure using machine learning methods. Previous studies have found pulse transit time to be related to blood pressure. In this short paper, we propose to study the feasibility of implementing a data-driven model based on restricted Boltzmann machine artificial neural networks, delivering a first proof of concept for the validity and viability of a method for blood pressure prediction based on these models. Summary and Key Messages: For the most severe patients (e.g., dialysis, surgery, and the critically ill), blood pressure is normally assessed through invasive catheters. Alternatively, noninvasive methods have also been developed for its monitorization. Data obtained from noninvasive measurements can be used for the continuous assessment of pressure using machine learning methods. In this study, a restricted Boltzmann machine artificial neural network is used to present a first proof of concept for the validity and viability of a method for blood pressure prediction.
Early and Severe Polycystic Kidney Disease and Related Ciliopathies: An Emerging Field of Interest
Authors: Bergmann Carsten
Published: October 2018

Early and severe forms of polycystic kidney disease (PKD) do already manifest during childhood or adolescence. They are characterized by enlarged kidneys and diminished renal function that prenatally may result in Potter’s oligohydramnios sequence. Genetically, various defects can mimic this phenotype. Most common are PKHD1 mutations that lead to autosomal recessive PKD (ARPKD). About the same number of children do carry mutations in the dominant autosomal dominant polycystic kidney disease (ADPKD) genes, PKD1 and less frequent PKD2, often arise de novo or may affect both disease alleles in a recessive mode. Mutations in DZIP1L have been recently described to result in an ARPKD-like phenotype. Likewise, mutations in several other cystogenes can phenocopy early and severe PKD. Early and reliable prenatal diagnosis for which there is a strong demand in ARPKD and related diseases is feasible only by genetics. A comprehensive knowledge of disease-causing genes is essential for the correct diagnosis and parental counselling. The increasing number of genes that need to be considered benefits from the advances of next generation sequencing and allows the simultaneous analysis of all genes of interest in a single test, which is now the mainstay for genetic diagnosis. Interpretation of data is challenging and requires expert knowledge in data handling, bioinformatics and clinical genetics.
Extranodal Rosai-Dorfman of the Pancreas Presents with Bilateral Granulomatous Anterior Uveitis
Authors: Brown A’sha , Branson Sara V. , Datoo O’Keefe Ghazala A.
Published: October 2018

Background/Aims: To report a case of a 65-year-old female who presented with bilateral anterior granulomatous uveitis, which led to the diagnosis of Rosai-Dorfman Disease (RDD) and the discovery of an associated pancreatic mass. Methods: This is a retrospective case report of a single patient. Results: A 65-year-old African American Female received a full workup for bilateral anterior granulomatous uveitis and was found to have a pancreatic mass on imaging. Biopsy of this mass was diagnostic for RDD, a rare proliferative histiocytic disorder, which classically presents with painless cervical lymphadenopathy, leukocytosis, and hypergammaglobulinemia. Conclusion: Although rare, ocular involvement, including eyelid and orbital masses, and anterior uveitis, can herald the development of other systemic manifestations or RDD and can aid in the diagnosis of this systemic disease.
Incidence and Characteristics of de novo Renal Cryoglobulinemia After Direct-Acting Antivirals Treatment in an Egyptian Hepatitis C Cohort
Authors: Fayed Ahmed , El Nokeety Mahmoud M. , Samy Abdelaziz Tarek , Samir Hussien H. , Hamza Wael M. , El Shabony Tarek
Published: October 2018

Introduction: The side effects profile of the new direct-­acting antivirals for the treatment of hepatitis C virus (HCV) is not fully elucidated. Objective: In this cross-sectional study, we aim to describe the incidence and characteristics of a novel observation of de novo renal cryoglobulinemic glomerulonephritis after successful treatment with DAA. Methodology: A total of 12,985 Hepatitis C Patients (genotype IV) received the new DAA. After successful treatment, patients with deranged renal functions or proteinuria were referred to the nephrology department for assessment. The clinical manifestations ranged from lower limb edema to the development of purpura skin lesions. Cryoglobulins were tested in the serum using the PCR detection. Results: Fifty patients had detectable de novo cryoglobulins in the serum. The most common type in renal biopsies was membranoproliferative glomerulonephritis (52%) and chronic kidney disease (CKD) developed in 46% of cases. Conclusion: De novo cryoglobulinemic glomerulonephritis and progression to CKD may rarely complicate successful treatment of HCV using direct-acting antivirals.