bluuebunny/crossref_metadata_2025 huggingface dataset:
A large drawing of a nephron for teaching medical students renal physiology, histology, and pharmacology
Authors: Robinson Philip G. , Newman David , Reitz Cara L. , Vaynberg Lena Z. , Bahga Dalbir K. , Levitt Morton H.
Published: April 2018

The purpose of this study is to see whether a large drawing of a nephron helped medical students in self-directed learning groups learn renal physiology, histology, and pharmacology before discussing clinical cases. The end points were the grades on the renal examination and a student survey. The classes in the fall of 2014 and 2015 used the drawing, but not those of 2012 and 2013. The Charles E. Schmidt College of Medicine at Florida Atlantic University is a newly formed Florida medical school, which enrolled its first class in the fall of 2011. The school relies on self-directed problem-based learning in year 1 and changes over to a case inquiry method in the latter part of year 1 and throughout year 2. At the start of the renal course, each student group received a poster of a nephron with the objective of learning the cell functions of the different nephron parts. During the first year of using the drawing, there was no improvement in grades. After a student suggested adjustment to the drawing, there was a statistically significant difference in the total test score in the second year ( P < 0.001). An unexpected finding was lower grades in all 4 yr in the area of acid-base balance and electrolytes compared with the other four areas tested. In the survey, the students found the drawing useful.
Who perceives they are smarter? Exploring the influence of student characteristics on student academic self-concept in physiology
Authors: Cooper Katelyn M. , Krieg Anna , Brownell Sara E.
Published: April 2018

Academic self-concept is one’s perception of his or her ability in an academic domain and is formed by comparing oneself to other students. As college biology classrooms transition from lecturing to active learning, students interact more with each other and are likely comparing themselves more to other students in the class. Student characteristics can impact students’ academic self-concept; however, this has been unexplored in the context of undergraduate biology. In this study, we explored whether student characteristics can affect academic self-concept in the context of an active learning college physiology course. Using a survey, students self-reported how smart they perceived themselves to be in the context of physiology relative to the whole class and relative to their groupmate, the student with whom they worked most closely in class. Using linear regression, we found that men and native English speakers had significantly higher academic self-concept relative to the whole class compared with women and nonnative English speakers. Using logistic regression, we found that men had significantly higher academic self-concept relative to their groupmate compared with women. Using constant comparison methods, we identified nine factors that students reported influenced how they determined whether they were more or less smart than their groupmate. Finally, we found that students were more likely to report participating more than their groupmate if they had a higher academic self-concept. These findings suggest that student characteristics can influence students’ academic self-concept, which in turn may influence their participation in small-group discussion and their academic achievement in active learning classes.
Social media interruption affects the acquisition of visually, not aurally, acquired information during a pathophysiology lecture
Authors: Marone Jane R. , Thakkar Shivam C. , Suliman Neveen , O’Neill Shannon I. , Doubleday Alison F.
Published: April 2018

Poor academic performance from extensive social media usage appears to be due to students’ inability to multitask between distractions and academic work. However, the degree to which visually distracted students can acquire lecture information presented aurally is unknown. This study examined the ability of students visually distracted by social media to acquire information presented during a voice-over PowerPoint lecture, and to compare performance on examination questions derived from information presented aurally vs. that presented visually. Students ( n = 20) listened to a 42-min cardiovascular pathophysiology lecture containing embedded cartoons while taking notes. The experimental group ( n = 10) was visually, but not aurally, distracted by social media during times when cartoon information was presented, ~40% of total lecture time. Overall performance among distracted students on a follow-up, open-note quiz was 30% poorer than that for controls ( P < 0.001). When the modality of presentation (visual vs. aural) was compared, performance decreased on examination questions from information presented visually. However, performance on questions from information presented aurally was similar to that of controls. Our findings suggest the ability to acquire information during lecture may vary, depending on the degree of competition between the modalities of the distraction and the lecture presentation. Within the context of current literature, our findings also suggest that timing of the distraction relative to delivery of material examined affects performance more than total distraction time. Therefore, when delivering lectures, instructors should incorporate organizational cues and active learning strategies that assist students in maintaining focus and acquiring relevant information.
Science reflects history as society influences science: brief history of “race,” “race correction,” and the spirometer
Authors: Lujan Heidi L. , DiCarlo Stephen E.
Published: April 2018

Spirometers are used globally to diagnose respiratory diseases, and most commercially available spirometers “correct” for race. “Race correction” is built into the software of spirometers. To evaluate pulmonary function and to make recordings, the operator must enter the subject's race. In fact, the Joint Working Party of the American Thoracic Society/European Respiratory Society recommends the use of race- and ethnic-specific reference values. In the United States, spirometers apply correction factors of 10–15% for individuals labeled “Black” and 4–6% for people labeled “Asian.” Thus race is purported to be a biologically important and scientifically valid category. However, history suggests that race corrections may represent an implicit bias, discrimination, and racism. Furthermore, this practice masks economic and environmental factors. The flawed logic of innate, racial difference is also considered with disability estimates, preemployment physicals, and clinical diagnoses that rely on the spirometer. Thomas Jefferson’s Notes on the State of Virginia (1832) may have initiated this mistaken belief by noting deficiencies of the “pulmonary apparatus” of blacks. Plantation physicians used Jefferson’s statement to support slavery, believing that forced labor was a way to “vitalize the blood” of deficient black slaves. Samuel Cartwright, a Southern physician and slave holder, was the first to use spirometry to record deficiencies in pulmonary function of blacks. A massive study by Benjamin Apthorp Gould (1869) during the Civil War validated his results. The history of slavery created an environment where racial difference in lung capacity become so widely accepted that race correction became a scientifically valid procedure.
Vimentin expression is required for the development of EMT-related renal fibrosis following unilateral ureteral obstruction in mice
Authors: Wang Zheng , Divanyan Alex , Jourd’heuil Frances L. , Goldman Robert D. , Ridge Karen M. , Jourd’heuil David , Lopez-Soler Reynold I.
Published: April 2018

Most renal transplants ultimately fail secondary to chronic allograft nephropathy (CAN). Vimentin (vim) is a member of the intermediate filament family of proteins and has been shown to be important in the development of CAN. One of the pathways leading to chronic renal fibrosis after transplant is thought to be epithelial to mesenchymal transition (EMT). Even though vim expression is one of the main steps of EMT, it is unknown whether vim expression is required for EMT leading to renal fibrosis and allograft loss. To this end, the role of vim in renal fibrosis was determined via unilateral ureteral obstruction (UUO) in vim knockout mice (129 svs6 vim −/−). Following UUO, kidneys were recovered and analyzed via Western blotting, immunofluorescence, and transcriptomics. Cultured human proximal renal tubular (HK-2) cells were subjected to lentiviral-driven inhibition of vim expression and then treated with transforming growth factor (TGF)-β to undergo EMT. Immunoblotting as well as wound healing assays were used to determine development of EMT. Western blotting analyses of mice undergoing UUO reveal increased levels of vim soon after UUO. As expected, interstitial collagen deposition increased in control mice following UUO but decreased in vim −/− kidneys. Immunofluorescence analyses also revealed altered localization of β-catenin in vim −/− mice undergoing UUO without significant changes in mRNA levels. However, RNA sequencing revealed a decrease in β-catenin-dependent genes in vim −/− kidneys. Finally, vim-silenced HK-2 cell lines undergoing EMT were shown to have decreased cellular migration during wound healing. We conclude that vim inhibition decreases fibrosis following UUO by possibly altering β-catenin localization and downstream signaling.
Effect of standing posture on inhibitory postsynaptic potentials in gastrocnemius motoneurons
Authors: Garland S. J. , Gallina A. , Pollock C. L. , Ivanova T. D.
Published: April 2018

This study examined the task dependence of sensory inputs on motoneuron excitability by comparing the inhibitory postsynaptic potential (IPSP) evoked by stimulation of the sural nerve between a standing postural task (Free Standing) and a comparable voluntary isometric contraction performed in a supine position (Lying Supine). We hypothesized that there would be a smaller IPSP in standing than in the supine position, based on the task dependence of the ankle plantarflexor activity on the standing task. Ten healthy participants participated in a total of 15 experiments. Single motor unit (MU) firings were recorded with both intramuscular fine-wire electrodes and high-density surface electromyography. Participants maintained the MU discharge at 6–8 Hz in Free Standing or Lying Supine while the right sural nerve was stimulated at random intervals between 1 and 3 s. To evaluate the reflex response, the firing times of the discriminated MUs were used to construct peristimulus time histograms and peristimulus frequencygrams. The sural nerve stimulation resulted in weaker inhibition in Free Standing than in Lying Supine. This finding is discussed in relation to the putative activation of persistent inward currents in standing posture and the task-dependent advantages of overriding inhibitory synaptic inputs to the plantarflexors to maintain the standing posture.

NEW & NOTEWORTHY The task-dependent modulation of sensory inputs on motoneuron excitability in standing is not well understood. Evoking an inhibitory postsynaptic potential (IPSP) resulted in a smaller IPSP in gastrocnemius motoneurons in standing than in the supine position. Mildly painful sensory inputs produced weaker motoneuron inhibition in standing, suggesting an imperative to maintain ankle plantarflexion activity for the task of upright stance.
Computational model of brain-stem circuit for state-dependent control of hypoglossal motoneurons
Authors: Naji Mohsen , Komarov Maxim , Krishnan Giri P. , Malhotra Atul , Powell Frank L. , Rukhadze Irma , Fenik Victor B. , Bazhenov Maxim
Published: April 2018

In patients with obstructive sleep apnea (OSA), the pharyngeal muscles become relaxed during sleep, which leads to a partial or complete closure of upper airway. Experimental studies suggest that withdrawal of noradrenergic and serotonergic drives importantly contributes to depression of hypoglossal motoneurons and, therefore, may contribute to OSA pathophysiology; however, specific cellular and synaptic mechanisms remain unknown. In this new study, we developed a biophysical network model to test the hypothesis that, to explain experimental observations, the neuronal network for monoaminergic control of excitability of hypoglossal motoneurons needs to include excitatory and inhibitory perihypoglossal interneurons that mediate noradrenergic and serotonergic drives to hypoglossal motoneurons. In the model, the state-dependent activation of the hypoglossal motoneurons was in qualitative agreement with in vivo data during simulated rapid eye movement (REM) and non-REM sleep. The model was applied to test the mechanisms of action of noradrenergic and serotonergic drugs during REM sleep as observed in vivo. We conclude that the proposed minimal neuronal circuit is sufficient to explain in vivo data and supports the hypothesis that perihypoglossal interneurons may mediate state-dependent monoaminergic drive to hypoglossal motoneurons. The population of the hypothesized perihypoglossal interneurons may serve as novel targets for pharmacological treatment of OSA.

NEW & NOTEWORTHY In vivo studies suggest that during rapid eye movement sleep, withdrawal of noradrenergic and serotonergic drives critically contributes to depression of hypoglossal motoneurons (HMs), which innervate the tongue muscles. By means of a biophysical model, which is consistent with a broad range of empirical data, we demonstrate that the neuronal network controlling the excitability of HMs needs to include excitatory and inhibitory interneurons that mediate noradrenergic and serotonergic drives to HMs.
Phrenic long-term depression evoked by intermittent hypercapnia is modulated by serotonergic and adrenergic receptors in raphe nuclei
Authors: Stipica Safic Ivona , Pecotic Renata , Pavlinac Dodig Ivana , Dogas Zoran , Valic Zoran , Valic Maja
Published: April 2018

Intermittent hypercapnia evokes prolonged depression of phrenic nerve activity (phrenic long-term depression, pLTD). This study was undertaken to investigate the role of 5-HT and α2-adrenergic receptors in the initiation of pLTD. Adult male urethane-anesthetized, vagotomized, paralyzed, and mechanically ventilated Sprague-Dawley rats were exposed to a protocol of acute intermittent hypercapnia (AIHc; 5 episodes of 15% CO2in air, each episode lasting 3 min). The experimental group received microinjection of the selective 5-HT1Areceptor agonist 8-hydroxy-2-(dipropylamino)tetralin hydrobromide (8-OH-DPAT), the broad-spectrum 5-HT antagonist methysergide, or the α2-adrenergic antagonist yohimbine, whereas the control group received microinjection of 0.9% saline into the caudal raphe region. Peak phrenic nerve activity (pPNA) and burst frequency ( f) were analyzed during baseline (T0), during 5 hypercapnic episodes (THc1–THc5), and at 15, 30, and 60 min after the end of the last hypercapnic episode. In the control group, pPNA decreased 60 min after the end of the last hypercapnic episode compared with baseline values, i.e., pLTD developed ( P = 0.023). In the 8-OH-DPAT group, pPNA significantly decreased at T15, T30, and T60 compared with baseline values, i.e., pLTD developed ( P = 0.01). In the methysergide and yohimbine groups, AIHc did not evoke significant changes of the pPNA at T15, T30, and T60 compared with baseline values. In conclusion, activation of 5-HT1Areceptors accentuated induction of pLTD, whereas blockade of α2-adrenergic receptors prevented development of pLTD following AIHc in anesthetized rats. These results suggest that chemical modulation of 5-HT and α2-adrenergic receptors in raphe nuclei affects hypercapnia-induced pLTD, offering important insights in understanding the mechanisms involved in development of respiratory plasticity.

NEW & NOTEWORTHY Hypercapnia is a concomitant feature of many breathing disorders, including obstructive sleep apnea. In this study, acute intermittent hypercapnia evoked development of phrenic long-term depression (pLTD) 60 min after the last hypercapnic episode that was preserved if the selective 5-HT1Areceptor agonist 8-hydroxy-2-(dipropylamino)tetralin hydrobromide was microinjected in the caudal raphe region before the hypercapnic stimulus. This study highlights that both 5-HT and adrenergic receptor activation is needed for induction of pLTD in urethane-anesthetized rats following intermittent hypercapnia exposure.
Understanding the Compositional Variability of the Major Components of Hydrothermal Plumes in the Okinawa Trough
Authors: Zeng Zhigang , Wang Xiaoyuan , Chen Chen-Tung Arthur , Qi Haiyan
Published: April 2018

Studies of the major components of hydrothermal plumes in seafloor hydrothermal fields are critical for an improved understanding of biogeochemical cycles and the large-scale distribution of elements in the submarine environment. The composition of major components in hydrothermal plume water column samples from 25 stations has been investigated in the middle and southern Okinawa Trough. The physical and chemical properties of hydrothermal plume water in the Okinawa Trough have been affected by input of the Kuroshio current, and its influence on hydrothermal plume water from the southern Okinawa Trough to the middle Okinawa Trough is reduced. The anomalous layers of seawater in the hydrothermal plume water columns have higher K+, Ca2+, Mn2+, B3+, Ca2+/SO42-, and Mn2+/Mg2+ ratios and higher optical anomalies than other layers. The Mg2+, SO42-, Mg2+/Ca2+, and SO42-/Mn2+ ratios of the anomalous layers are lower than other layers in the hydrothermal plume water columns and are consistent with concentrations in hydrothermal vent fluids in the Okinawa Trough. This suggests that the chemical variations of hydrothermal plumes in the Tangyin hydrothermal field, like other hydrothermal fields, result in the discharge of high K+, Ca2+, and B3+ and low Mg2+ and SO42- fluid. Furthermore, element ratios (e.g., Sr2+/Ca2+, Ca2+/Cl−) in hydrothermal plume water columns were found to be similar to those in average seawater, indicating that Sr2+/Ca2+ and Ca2+/Cl− ratios of hydrothermal plumes might be useful proxies for chemical properties of seawater. The hydrothermal K+, Ca2+, Mn2+, and B3+ flux to seawater in the Okinawa Trough is about 2.62–873, 1.04–326, 1.30–76.4, and 0.293–34.7 × 106 kg per year, respectively. The heat flux is about 0.159–1,973 × 105 W, which means that roughly 0.0006% of ocean heat is supplied by seafloor hydrothermal plumes in the Okinawa Trough.
The Effects of Ammonium Polyacrylate and Diammonium Citrate as Base and Acid Dispersion Agents on Yttria‐Stabilized Zirconia (3Y‐TZP) Dispersion Properties
Authors: Sinaga Pestaria , Bae Sung-Hwan
Published: April 2018

Stable slurries in dispersions of 3Y‐TZP in aqueous suspension with the addition of different concentrations of dispersants such as ammonium polyacrylate (APA) and diammonium citrate (DAC) were investigated. The dispersion properties were investigated by measuring the particle size, zeta potential, sedimentation, and viscosity as a function of the wt.% of the dispersant. Both dispersant agents were attached to the 3Y‐TZP surface by the carboxylic group, as shown by the FTIR results. The addition of dispersants was found to produce more dispersed and stabilized aqueous suspension. As shown the viscosity result, that there is no being viscosity peak has been occurring and viscosity going decrease as the shear rates increasing which mean that the suspension has shear thinning behavior and there is no agglomeration as the shear rate is increased. It was determined that 3.5 wt.% of DAC and APA produced the best and most stable slurry; when 3.5 wt.% of DAC and APA was added, the zeta potential showed the largest value in the monodisperse condition. The low pH value of DAC has obtained the higher zeta potential value than APA, which was assumed due to low pH of DAC suspension. At low pH, the adsorption of the adsorbate will occur in a flat adsorbed, while at higher pH the polyelectrolyte will dangle into solution, thus reducing electrostatic repulsion as it is found in the case of APA addition. In this condition, the particle size was decreased to the lower value and the slurry’s stability was obtained with the lowest sedimentation height after the sedimentation test for 30 days. The sample was milled in an attrition mill at 1,000 rpm for four hours.
Appropriateness in Dentistry: A Survey Discovers Improper Procedures in Oral Medicine and Surgery
Authors: Oteri Giacomo , Panzarella Vera , Marcianò Antonia , Di Fede Olga , Maniscalco Laura , Peditto Matteo , Campisi Giuseppina
Published: April 2018

Objectives. The aim of this study was to assess appropriateness of diagnostic exams, treatments, and procedures among Italian dental practitioners.Materials and Methods. A questionnaire with multiple responses on topics of dentistry and oral medicine was administered to a sample of 198 Italian dental practitioners. Information on characteristics of the respondents was also collected. Descriptive statistics and multiple correspondence analysis (MCA) were applied. Data were analyzed using R software (version 3.3.2).Results. The survey respondents included Doctors of Medicine (MD) (54/198 = 27%) with or without specialty in dentistry (33% versus 67%), Doctors of Dental Surgery (DDS) (144/198 = 73%), DDS with specialty in orthodontics (7%), and DDS with specialty in oral surgery (4%). Mandatory procedures in dental and oral medicine education and training include (a) prescription of antibiotics before/after oral surgery procedures; (b) prevention strategies for oral cancer, and (c) prescription of dental X-ray examinations (41%, 52%, and 48%, resp.).Conclusion. On examining the results of the survey, it is evident that information and implementation of the above mentioned procedures are crucially needed. Our results confirm the necessity to reduce inappropriate practices in dentistry, implementing formation and information, leading to correct prescriptions, and optimizing patients’ oral health. This coincides with the Italian Slow Medicine program entitled “Fare di più non significa fare meglio–Choosing Wisely Italy,” which has also motivated this study.
The Renin-Angiotensin-Aldosterone System as a Therapeutic Target in Late Injury Caused by Ischemia-Reperfusion
Authors: Rodríguez-Lara Simón Quetzalcóatl , García-Benavides Leonel , Miranda-Díaz Alejandra Guillermina
Published: April 2018

Ischemia-reperfusion (I/R) injury is a well-known phenomenon that involves different pathophysiological processes. Connection in diverse systems of survival brings about cellular dysfunction or even apoptosis. One of the survival systems of the cells, to the assault caused by ischemia, is the activation of the renin-angiotensin-aldosterone system (also known as an axis), which is focused on activating diverse signaling pathways to favor adaptation to the decrease in metabolic supports caused by the hypoxia. In trying to adapt to the I/R event, great changes occur that unchain cellular dysfunction with the capacity to lead to cell death, which translates into a poor prognosis due to the progression of dysfunction of the cellular activity. The search for the understanding of the diverse therapeutic alternatives in molecular coupling could favor the prognosis and evolution of patients who are subject to the I/R process.
A Five-Level H-Bridge STATCOM for an Off-Grid PV Solar Farm under Two Controllers PI and PIλ-MPC Hybrid
Authors: Mengi Onur Ozdal
Published: April 2018

Investigations were presented in order to eliminate the reactive power on microgrid loads fed by an off-grid and mid-power photovoltaic solar energy system (PVSES) with a static synchronous compensator (STATCOM) device. The electric network is specifically characterized by P-Q loads, ambient temperature, and widely variable solar radiation levels. Two main innovations are developed. Firstly, the STATCOM apparatus is a 5-level H-bridge inverter with capacitances as load and must totally compensates the reactive power in the network load. Secondly, this compensation is controlled by a set of fractional PI (PIλ) and model predictive control (MPC) hybrid. The efficiencies of these controllers were compared with classical PI controllers. Large simulations, without and with reactive power compensation, in steady and transient states, are carried out to underline the merits of the presented works, by performing in the MATLAB-Simulink environment.
GNQ-209P Mutation in Metastatic Uveal Melanoma and Treatment Outcome
Authors: Abdel Karim Nagla , Eldessouki Ihab , Taftaf Ahmad , Ayham Deeb , Gaber Ola , Makramalla Abouelmagd , Correa Zelia M.
Published: April 2018

Metastatic prognosis in uveal melanoma is assessed by gene expression profiling (GEP) testing of the tumor cells, usually obtained by fine needle aspiration (FNA). GEP has demonstrated high accuracy in distinguishing class I and II tumors, both having different metastatic potential. Transcriptomic studies identified distinct mutations including somatic mutations in GNAQ and GNA11, detected in more than 80%, and contribute to the upregulation of the mitogen-activated protein kinase (MAPK) pathway and the development of uveal melanoma (UM). The role of these mutations in treatment selection and possible benefit from targeted therapy are somewhat unclear. However, until the discovery of novel agents, local versus systemic therapies remain options for treatment that can still be considered for disease control in certain cases. We report a series of patients with metastatic UM with distinct mutational profiles. One had significant liver metastases with proven GNQ-209P mutation on tissue biopsy while peripheral blood molecular profiling did not show these mutations. The other three cases had no GNQ-209P mutation. All cases received nab-paclitaxel (Abraxane) as a treatment drug, and we record their responses to treatment and their molecular-profiling results.
Primary Pleuropulmonary Synovial Sarcoma: A Case
Authors: Mrabet Fatima Zahra , El Ouazzani Hafsa , El Akkari Leila , Hammi Sanaa , Bourkadi Jamal Eddine , Zouaidia Fouad
Published: April 2018

Primary pleuropulmonary synovial sarcoma is extremely rare. The diagnosis can only be made after having eliminated an extrapleuropulmonary localization in the past and at the time of diagnosis. Our presentation is about a 40-year-old woman having a cough and dyspnea since three weeks ago; imaging had showed a left pleurisy with pleuropulmonary process. Histological study of the biopsy confirmed the diagnosis of pleuropulmonary synovial sarcoma. PET-SCAN had not identified any extrathoracic localization. This tumor is known for its aggressive nature and high risk of metastasis. Its primitive character is retained following a diagnostic procedure of exclusion. Surgical treatment remains the best therapeutic tool when it is technically feasible; otherwise the prognosis is often unfortunate. In this paper, we report a case of primary pleuropulmonary synovial sarcoma. Through this case, we present a rare disease that is often difficult to diagnose.
Epidemiology of Adult Soft-Tissue Sarcomas in Germany
Authors: Saltus Catherine W. , Calingaert Brian , Candrilli Sean , Lorenzo Maria , D’yachkova Yulia , Otto Thorsten , Wagner Uwe , Kaye James A.
Published: April 2018

We conducted a retrospective cohort study using data compiled from the regional German cancer registries by the Centre for Cancer Registry Data (ZfKD) at the Robert Koch Institut (RKI) to describe the epidemiology of adult soft-tissue sarcomas (STS) in Germany in 2003–2012, focusing on advanced STS. We identified 33,803 incident adult cases of STS (other than the Kaposi sarcoma and gastrointestinal stromal tumors). The incidence of STS was 6.05 (95% confidence interval (CI), 5.82–6.29) per 100,000 in 2012 (4,079 cases). During 2003–2012, the most common histologic categories were leiomyosarcoma (19%), liposarcoma (16%), and STS not otherwise specified (14%). The overall STS-specific mortality rate in 2012 was 2.31 (95% CI, 2.06–2.57) per 100,000, and the median overall survival from initial diagnosis was 5.83 (95% CI, 5.50–6.08) years. Using STS mortality rates as a proxy for incidence of advanced STS in Germany and applying the age- and sex-specific rates to the corresponding German population, we estimated that 1,581 incident adult advanced STS cases occurred in Germany in 2012. Our findings contribute to a refined understanding of the population burden of STS in Germany, including the number of patients with advanced STS who may be candidates for systemic treatment.
Impetigo Herpetiformis: Review of Pathogenesis, Complication, and Treatment
Authors: Namazi Nastaran , Dadkhahfar Sahar
Published: April 2018

Impetigo herpetiformis (IH) is among rare dermatosis of pregnancy, which is currently considered as a form of generalized pustular psoriasis. It is diagnosed by characteristic lesions of erythematous patches and grouped pustules mostly in the third trimester of pregnancy and may have systemic associations. A variety of complications have been reported in the course of IH. Treatment of IH can be quite challenging, and a number of treatment options have been reported to be effective for the management.
Risk Factors for Soil-Transmitted Helminthiasis in Preschool Children Living in Farmland, North Sumatera, Indonesia
Authors: Novianty Sri , Dimyati Yazid , Pasaribu Syahril , Pasaribu Ayodhia Pitaloka
Published: April 2018

Background. Disease burden from soil-transmitted helminthiasis (STH) is mainly attributed to its chronic and insidious impact on health and quality of life. Strategy recommended by World Health Organization (WHO) to control it was previously focused on school-aged children, but now preschool-aged children are involved. This study was intended to determine STH infection risk factors in preschool children.Methods. A cross-sectional study was conducted in Suka Village, North Sumatera, Indonesia, from October to December 2016. Subjects were children aged 1 to 5 years without history of taking antihelminthic. Subjects were obtained by consecutive sampling. Demographic data and risk factors for helminthiasis were collected using questionnaire-based interview. Subjects were divided into two groups, positive and negative STH infection, based on Kato Katz method. Analysis was done using chi-square and logistic regression test.pvalue < 0.05 was considered significant.Results. We enrolled 90 subjects in this study, with the mean age being 31.7 months. STH infection prevalence was 34.4%. Statistical analysis revealed that mother/caregiver hand washing habit (p=0.007), mother/caregiver nail trimming habit (p=0.018), and children nail trimming habit (p=0.022) were significant risk factors for STH infection.Conclusion. Mother/caregiver hand washing habit is the most influential risk factor for STH infection in preschool children.
Serum Metabolomics Study Based on LC‐MS and Antihypertensive Effect of Uncaria on Spontaneously Hypertensive Rats
Authors: Liu Ana , Chu Yan-Jun , Wang Xiaoming , Yu Ruixue , Jiang Haiqiang , Li Yunlun , Zhou Honglei , Gong Li-Li , Yang Wen-Qing , Ju Jianqing
Published: April 2018

Our previous studies have shown that Uncaria has an important role in lowering blood pressure, but its intervention mechanism has not been clarified completely in the metabolic level. Therefore, in this study, a combination method of HPLC‐TOF/MS‐based metabolomics and multivariate statistical analyses was employed to explore the mechanism and evaluate the antihypertensive effect of Uncaria. Serum samples were analyzed and identified by HPLC‐TOF/MS, while the acquired data was further processed by partial least squares discriminant analysis (PLS‐DA) and orthogonal partial least squares discriminant analysis (OPLS‐DA) to discover the perturbed metabolites. A clear cluster among the different groups was obtained, and 7 significantly changed potential biomarkers were screened out. These biomarkers were mainly associated with lipid metabolism (dihydroceramide, ceramide, PC, LysoPC, and TXA2) and vitamin and amino acids metabolism (nicotinamide riboside, 5‐HTP). The result indicated that Uncaria could decrease the blood pressure effectively, partially by regulating the above biomarkers and metabolic pathways. Analyzing and verifying the specific biomarkers, further understanding of the therapeutic mechanism and antihypertensive effect of Uncaria was acquired. Metabolomics provided a new insight into estimate of the therapeutic effect and dissection of the potential mechanisms of traditional Chinese medicine (TCM) in treating hypertension.
Numerical Computation for a Kind of Time Optimal Control Problem for the Tubular Reactor System
Authors: Zeng Detang , Yu Xin , Huang Jingfang , Tan Chunqing
Published: April 2018

This paper is devoted to the study of numerical computation for a kind of time optimal control problem for the tubular reactor system. This kind of time optimal control problem is aimed at delaying the initiation time τ of the active control as late as possible, such that the state governed by this controlled system can reach the target set at a given ending time T. To compute the time optimal control problem, we firstly approximate the original problem by finite element method and get a new approximation time optimal control problem governed by ordinary differential equations. Then, through the control parameterization method and time-scaling transformation, the approximation problem becomes an optimal parameter selection problem. Finally, we use Sequential Quadratic Program algorithm to solve the optimal parameter selection problem. A numerical simulation is given for illustration.
Lessons from the Crypt: HMGA1—Amping up Wnt for Stem Cells and Tumor Progression
Authors: Resar Linda , Chia Lionel , Xian Lingling
Published: April 2018

High mobility group A1 (HMGA1) chromatin remodeling proteins are enriched in aggressive cancers and stem cells, although their common function in these settings has remained elusive until now. Recent work in murine intestinal stem cells (ISC) revealed a novel role for Hmga1 in enhancing self-renewal by amplifying Wnt signaling, both by inducing genes expressing Wnt agonist receptors and Wnt effectors. Surprisingly, Hmga1 also “builds” a stem cell niche by upregulating Sox9, a factor required for differentiation to Paneth cells; these cells constitute an epithelial niche by secreting Wnt and other factors to support ISCs. HMGA1 is also highly upregulated in colon cancer compared with nonmalignant epithelium and SOX9 becomes overexpressed during colon carcinogenesis. Intriguingly, HMGA1 is overexpressed in diverse cancers with poor outcomes, where it regulates developmental genes. Similarly, HMGA1 induces genes responsible for pluripotency and self-renewal in embryonic stem cells. These findings demonstrate that HMGA1 maintains Wnt and other developmental transcriptional networks and suggest that HMGA1 overexpression fosters carcinogenesis and tumor progression through dysregulation of these pathways. Studies are now needed to determine more precisely how HMGA1 modulates chromatin structure to amplify developmental genes and how to disrupt this process in cancer therapy. Cancer Res; 78(8); 1890–7. ©2018 AACR.
Inositol Trisphosphate Receptor Type 3-mediated Enhancement of EGFR and MET Cotargeting Efficacy in Non–Small Cell Lung Cancer Detected by 18F-fluorothymidine
Authors: Iommelli Francesca , De Rosa Viviana , Terlizzi Cristina , Monti Marcello , Panico Mariarosaria , Fonti Rosa , Del Vecchio Silvana
Published: April 2018

Purpose: Our aim was to test whether imaging with 18F-fluorothymidine (18F-FLT) PET/CT was able to detect the combined effects of EGFR and MET inhibitors in oncogene-driven non–small cell lung cancer (NSCLC) and to elucidate the mechanisms underlying the enhanced efficacy of drug combination.

Experimental Design: NSCLC cells bearing MET amplification (H1993 and H820) were treated with EGFR and MET inhibitors either alone or in combination and then tested for cell viability and inhibition of signaling. Nude mice bearing H1993 tumors underwent 18F-FLT PET/CT scan before and after treatment with erlotinib and crizotinib alone or in combination (1:1 ratio) and posttreatment changes of 18F-FLT uptake in tumors were determined. The role of inositol trisphosphate receptor type 3 (IP3R3) in mediating the combined action of EGFR and MET inhibitors was tested by transfecting NSCLC cells with IP3R3-targeted siRNA.

Results: Imaging studies showed a significant reduction of 18F-FLT uptake in response to combined treatment with EGFR and MET inhibitors that was higher than that obtained with single agents (ANOVA, F-ratio = 6.215, P = 0.001). Imaging findings were confirmed by analysis of surgically excised tumors. Levels of IP3R3 were significantly reduced in both cells and tumors after treatment with crizotinib, whereas EGFR inhibitors caused a reduction of IP3R3 interaction with K-Ras mainly through dephosphorylation of serine residues of K-Ras.

Conclusions: Our findings indicate that 18F-FLT PET/CT is able to detect the enhanced efficacy of EGFR and MET inhibitors in oncogene-driven NSCLC and that such enhancement is mediated by IP3R3 through its interaction with K-Ras. Clin Cancer Res; 24(13); 3126–36. ©2018 AACR.
Incidence of Antibiotic-Related Rash in Children with Epstein-Barr Virus Infection and Evaluation of the Frequency of Confirmed Antibiotic Hypersensitivity
Authors: Dibek Misirlioglu Emine , Guvenir Hakan , Ozkaya Parlakay Aslinur , Toyran Muge , Tezer Hasan , Catak Arif Ismet , Kocabas Can Naci
Published: April 2018

Background: The incidence of rash after aminopenicillin treatment in children with Epstein-Barr Virus (EBV) infection was reported to be 80–100%. A few recent studies suggested that the incidence may be much lower during EBV infection. There are no clear data on the incidence of true drug hypersensitivity among these patients. The aim of this study is to determine the incidence of rash and antibiotic allergy after antibiotic treatment in children with EBV infection. Methods: Drug hypersensitivity was investigated in antibiotic-treated patients with a positive EBV IgM who developed a rash between 2013 and 2016. Results: During the study period, 221 children were diagnosed with EBV infection, and 120 (54.3%) patients were treated with antibiotics during disease. Rash developed in 41 (41/221, 18.6%) patients, and 20 of them (total 120; 16.6%) were treated with antibiotics (most frequently aminopenicillins: 72.5%), and 21 of them (total 101, 20.8%) were not treated with antibiotics (p = 0.43). For 10 of the 20 antibiotic-treated patients with a rash, parents did not consent to an allergy workup. Three of the 10 patients who were tested for drug allergy were proven to have amoxicillin-clavulanate hypersensitivity (30%). Five of the patients without workup reacted after reuse of the suspected drug for infection treatment. Conclusion: In this study, the incidence of drug hyper­sensitivity was much lower than previously reported. Some of the reactions that occur during infectious mononucleosis are transient, and some are true drug hypersensitivity reactions. Thus, these patients should be evaluated with allergy tests before these drugs are used again after EBV infection.
Big Data for Public Health Policy-Making: Policy Empowerment
Authors: Mählmann Laura , Reumann Matthias , Evangelatos Nikolaos , Brand Angela
Published: April 2018

Digitization is considered to radically transform healthcare. As such, with seemingly unlimited opportunities to collect data, it will play an important role in the public health policy-making process. In this context, health data cooperatives (HDC) are a key component and core element for public health policy-making and for exploiting the potential of all the existing and rapidly emerging data sources. Being able to leverage all the data requires overcoming the computational, algorithmic, and technological challenges that characterize today’s highly heterogeneous data landscape, as well as a host of diverse regulatory, normative, governance, and policy constraints. The full potential of big data can only be realized if data are being made accessible and shared. Treating research data as a public good, creating HDC to empower citizens through citizen-owned health data, and allowing data access for research and the development of new diagnostics, therapies, and public health policies will yield the transformative impact of digital health. The HDC model for data governance is an arrangement, based on moral codes, that encourages citizens to participate in the improvement of their own health. This then enables public health institutions and policymakers to monitor policy changes and evaluate their impact and risk on a population level.
Hyperpigmented Upper Eyelid: A Clue to the Diagnosis of Facial Lichen Planus Pigmentosus in a Patient with Frontal Fibrosing Alopecia
Authors: Gavazzoni Dias Maria Fernanda Reis , Rezende Hudson Dutra , Lofeu Cury Amanda , Trüeb Ralph M. , Vilar Enoï
Published: April 2018

Facial lichen planus pigmentosus (LPPig), a rare variant of classic lichen planus, was first described in patients with frontal fibrosing alopecia (FFA) by Dlova [Br J Dermatol 2013; 168: 439–442] in 2013. The diagnosis of facial LPPig is sometimes not easy, since clinical signs and histopathological features may frequently be confused with melasma or postinflammatory hyperpigmentation. We describe a case of a postmenopausal black woman diagnosed with FFA who presented with an identical brown-grayish pigmentation of the face and upper eyelids and typical dermoscopy analysis on both regions. We suggest that the hyperpigmentation of the upper eyelid with typical LLPig dermoscopy (upper eyelid sign) may be a clue for the diagnosis of LPPig and may avoid a scar-causing face biopsy.
Preeclampsia as a Form of Type 5 Cardiorenal Syndrome: An Underrecognized Entity in Women’s Cardiovascular Health
Authors: Rangaswami Janani , Naranjo Mario , McCullough Peter A.
Published: April 2018

Background: Preeclampsia is a multisystem vascular disorder of pregnancy that remains a leading cause of maternal and fetal morbidity and mortality. Preeclampsia remains an underrecognized risk factor for future cardiovascular and kidney disease in women and represents the confluence of preexisting vascular risk factors with superimposed endothelial injury from placental mediated anti-angiogenic factors. Summary: This review highlights the close relationship between preeclampsia and future cardiovascular and kidney disease. It describes the pathophysiology and current understanding of biomarkers that form the molecular signature for long-term endothelial dysfunction in preeclamptic women. Finally, it describes strategies for early identification and management of women with preeclampsia with elevated risk for cardiovascular and kidney disease. Key Messages: Future rigorous studies on cardiovascular risk modification in this phenotype of disease are essential to reduce the burden of cardiovascular and kidney disease, in women with preeclampsia.
MiR-140 Expression Regulates Cell Proliferation and Targets PD-L1 in NSCLC
Authors: Xie Wei-Bin , Liang Li-Hui , Wu Kai-Ge , Wang Le-Xing , He Xin , Song Cheng , Wang Yun-Qi , Li Yun-Hui
Published: April 2018

Background/Aims: Programmed death ligand1(PD-L1) plays a role in the development and progression of non-small cell lung cancer (NSCLC). This study aimed to identify miRNA(s) that are responsible for regulation of expression of PD-L1 in NSCLC, and to investigate the role of PD-L1 in regulation of the cell cycle in NSCLC. Methods: We predicted the target miRNA of PD-L1, which was miR-140, using the online tools TargetScan and miBase. In NSCLC cells obtained from clinical specimens, in addition to A549 and NCI-H1650 cell cultures, western blots were used to detect the level of expression of proteins, while real-time PCR was used to determine the level of expression of PD-L1, miR-140, cyclin E, and β-actin. Transfection with miR-140 mimics, miR-140 inhibitors, and PD-L1 siRNA were conducted using commercial kits. To determine whether miR-140 directly binds PD-L1, a luciferase reporter gene with wild type or mutated PD-L1 was used. Cell viability was measured with the MTT assay, and PI staining was used for cell cycle analysis. Results: We found low expression of miR-140 and high expression of PD-L1 and cyclin E in NSCLC cells. Over-expression of miR-140 suppressed the expression of PD-L1 by directly binding its 3’ UTR, and was also associated with decreased expression of cyclin E and inhibition of cellular proliferation in A549 and NCI-H1650 cells. Inhibition of PD-L1, in the absence of manipulations to miR-140, also decreased the expression of cyclin E. Conclusion: We conclude that miR-140 directly suppresses PD-L1 and inhibits the miR-140/PD-L1/cyclin E pathway in NSCLC.
Physics behind the implants used for high strain fractures: literature review
Authors: Macedo Aline Schafrum , Marinho Paulo Vinicius Tertuliano , Dal-Bó Ísis dos Santos , Bregadioli Thales , Diamante Gabriel , Fiuza Bianca , De Zoppa André Luis do Valle , Ferrigno Cassio Ricardo Auada
Published: April 2018

Whenever bone fractures occur, external forces produce continuous interfragmentary motion and a stabilization method is necessary. It is known that the mechanical conditions at the fracture site influence bone callus formation during healing process. To achieve primary (direct) bone healing, absolute stability at the fracture site is necessary. Perren’s concept of strain determines that relative deformation at the fracture gap depends on the original gap’s conformation. Simple fractures (without comminution) are considered high strain fractures since a small force applied to the fracture site results in great movement with deleterious effects on the healing process. The purpose of this study is to review the available literature regarding factors that influence the mechanics of high strain fractures in veterinary medicine, its treatment methods and implants available. Each fracture configuration requires special attention and critical care in choosing the osteosynthesis method and the type of stability required for consolidation to occur within the expected time. One must know the strain theory to become an orthopedic surgeon.