bluuebunny/crossref_metadata_2025 huggingface dataset:
Hydrolysis Activity of Virgin Coconut Oil Using Lipase from Different Sources
Authors: Nguyen T. A. V. , Le Truong D. , Phan Hoa N. , Tran Lam B.
Published: January 2018

Two types of lipase, Candida rugosa lipase (CRL) and porcine pancreas lipase (PPL), were used to hydrolyze virgin coconut oil (VCO). The hydrolysis process was carried out under four parameters, VCO to buffer ratio, lipase concentration, pH, and temperature, which have a significant effect on hydrolysis of lipase. CRL obtained the best hydrolysis condition at 1 : 5 of VCO to buffer ratio, 1.5% of CRL concentration, pH 7, and temperature of 40°C. Meanwhile, PPL gave different results at 1 : 4 of VCO to buffer ratio, 2% of lipase concentration, pH 7.5, and 40°C. The highest hydrolysis degree of CRL and PPL was obtained after 16 hours and 26 hours, reaching 79.64% and 27.94%, respectively. Besides, the hydrolysis process was controlled at different time course (every half an hour) at the first 4 hours of reaction to compare the initial hydrolysis degree of these two lipase types. FFAs from hydrolyzed products were isolated and determined the percentage of each fatty acid which contributes to the FFAs mixture. As a result, medium chain fatty acids (MCFAs) made up the main contribution in composition of FFAs and lauric acid (C12) was the largest segment (47.23% for CRL and 44.23% for PPL).
Design of a Conceptual Bumper Energy Absorber Coupling Pedestrian Safety and Low-Speed Impact Requirements
Authors: Mo Fuhao , Zhao Siqi , Yu Chuanhui , Xiao Zhi , Duan Shuyong
Published: January 2018

The car front bumper system needs to meet the requirements of both pedestrian safety and low-speed impact which are somewhat contradicting. This study aims to design a new kind of modular self-adaptive energy absorber of the front bumper system which can balance the two performances. The X-shaped energy-absorbing structure was proposed which can enhance the energy absorption capacity during impact by changing its deformation mode based on the amount of external collision energy. Then, finite element simulations with a realistic vehicle bumper system are performed to demonstrate its crashworthiness in comparison with the traditional foam energy absorber, which presents a significant improvement of the two performances. Furthermore, the structural parameters of the X-shaped energy-absorbing structure including thickness (tu), side arc radius (R), and clamping boost beam thickness (tb) are analyzed using a full factorial method, and a multiobjective optimization is implemented regarding evaluation indexes of both pedestrian safety and low-speed impact. The optimal parameters are then verified, and the feasibility of the optimal results is confirmed. In conclusion, the new X-shaped energy absorber can meet both pedestrian safety and low-speed impact requirements well by altering the main deformation modes according to different impact energy levels.
Interval-Valued Intuitionistic Fuzzy Einstein Geometric Choquet Integral Operator and Its Application to Multiattribute Group Decision-Making
Authors: Wang Qifeng , Sun Haining
Published: January 2018

With respect to the multiattribute decision-making (MADM) problem in which the attributes have interdependent or interactive phenomena under the interval-valued intuitionistic fuzzy environment, we propose a group decision-making approach based on the interval-valued intuitionistic fuzzy Einstein geometric Choquet integral operator (IVIFEGC). Firstly, the Einstein operational laws and some basic principle on interval-valued intuitionistic fuzzy sets are introduced. Then, the IVIFEGC is developed and some desirable properties of the operator are studied. Further, an approach to multiattribute group decision-making with interval-valued intuitionistic fuzzy information is developed, where the attributes have interdependent phenomena. Finally, an illustrative example is used to illustrate the developed approach.
Radical Gastrectomy: Still the Cornerstone of Curative Treatment for Gastric Cancer in the Perioperative Chemotherapy Era—A Single Institute Experience over a Decade
Authors: Kanhere Harsh , Goel Raghav , Finlay Ben , Trochsler Markus , Maddern Guy
Published: January 2018

Background and Objectives. Most gastric cancer patients now undergo perioperative chemotherapy (POCT) based on the MAGIC trial results. POCT consists of neoadjuvant chemotherapy (NACT) as well as postoperative adjuvant chemotherapy. This study assessed the applicability of perioperative chemotherapy and the impact of radical gastrectomy encompassing a detailed lymph-node resection on outcomes of gastric cancer. Methods. Medical and pathology records of all gastric carcinoma resections were reviewed from 2006 onwards. Pathological details, number of lymph-nodes resected, and proportion of involved nodes, reasons for nonadministration of NACT, complications, recurrence, and survival data were analysed. Results. Only twenty-eight (37.8%) out of 74 patients underwent NACT and only nine completed POCT. NACT was declined due to comorbidities/patient refusal n=24, early stage n=14, and emergency presentation n=8. Patients receiving NACT were much younger. Anastomotic leaks, hospital-mortality, lymph-node yield, and proportion of involved lymph-nodes were similar in both groups. Thirty-two patients died due to recurrence with lymph-node involvement heralding higher recurrence risk and much poorer survival (HR 2.66; p=0.013). Conclusion. More than 60% patients with resectable gastric carcinoma did not undergo NACT. Radical gastrectomy with lymphadenectomy remained the cornerstone of treatment in this period.
Molecular Detection ofBrucellaspp. from Milk of Seronegative Cows from Some Selected Area in Bangladesh
Authors: Islam Md. Sadequl , Islam Md. Ariful , Khatun Mst. Minara , Saha Sukumar , Basir Md. Samiul , Hasan Md- Mahmodul
Published: January 2018

Brucellosis is endemic in Bangladesh both in humans and in animals. A number of reasons complicate the diagnosis, as bovine brucellosis can be diagnosed by various serological tests. But the tests have a limitation; when the organism remains intracellular, the disease goes into chronic stage and the antibody titres may decline. The present study was conducted for isolation and detection ofBrucellaspp. by polymerase chain reaction (PCR) from seronegative cows. A total of 360 dairy cows from three geographical regions were screened serologically by Rose Bengal Plate Test (RBPT) where 24 samples were serologically positive and the rest of the samples were serologically negative. Among the 24 seropositive individuals, 11 were culture positive and 6 were culture positive from serologically negative dairy cows. The overall seroprevalence of brucellosis in cattle was 6.6% and in disease condition a higher prevalence was recorded in abortion (28.07%) followed by infertility (13.33%). To confirm theBrucellaspp. in seronegative dairy cattle, the isolates were extracted and PCR was conducted, which produced 905 bp amplicon size of 6Brucellaspp. from milk sample. So, for the detection or eradication of brucellosis, a bacteriological test and a PCR technique should be performed with the serological test of milk.
Application of D-Amino Acids as Biofilm Dispersing Agent in Dental Unit Waterlines
Authors: Ampornaramveth Ruchanee Salingcarnboriboon , Akeatichod Nilada , Lertnukkhid Jesita , Songsang Nichakorn
Published: January 2018

Aim and Purpose. Biofilms in dental unit waterlines (DUWLs) are extremely difficult to eliminate. Aim of this study is to evaluate the efficacy of a mixture of four D-amino acids on biofilm dispersion in DUWLs.Materials and Methods. A mixture of four D-amino acids (D-methionine, D-tryptophan, D-leucine, and D-tyrosine, 10 mM each), distilled water (control), and 0.1 M hydrochloric acid (HCl) was used in the experiment. In laboratory, pieces of DUWLs covered with biofilms were submerged in different solutions for 5 days, flushed, and measured OD600of the dispersed biofilms. Remnants of biofilms on the DUWLs were evaluated by SEM. In clinic, fifteen DCUs were incubated with test and control solutions, flushed, and measured OD600of the dispersed biofilms. Microbial count of DUWL output water was enumerated twice a week for four weeks.Results. There was a slight, but not significant, increase in OD600of flushing water in D-amino acids group. D-amino acids effectively reduced bacterial plaque as demonstrated by SEM. Incubation with D-amino acids significantly reduced biofilms especially after the first day of flushing. Bacterial count in DUWL output water was significantly reduced after treatment with D-amino acids.Conclusion. D-amino acids are applicable as biofilm dispersing agents in DUWLs.
Congenital Bladder Diverticulum in Adults: A Case Report and Review of the Literature
Authors: Abou Zahr Rawad , Chalhoub Khalil , Ollaik Farah , Nohra Joe
Published: January 2018

A 37-year-old male patient presented to the emergency department with fever, gross hematuria, and irritative lower urinary tract symptoms. Investigations revealed the presence of a large left bladder diverticulum superior and lateral to the left ureteral orifice without bladder outlet obstruction. Bladder diverticula in adults almost always present in the setting of bladder outlet obstruction. The finding of a congenital bladder diverticulum in an adult represents a rare clinical entity.
Heparin-Based Nanoparticles: An Overview of Their Applications
Authors: Rodriguez-Torres Maria del Pilar , Acosta-Torres Laura Susana , Diaz-Torres Luis Armando
Published: January 2018

This review deals with nanoparticles synthesized using heparin. Such nanoparticles have been widely studied since a long time ago, obtaining satisfactory outcomes. An outstanding aspect of these nanoparticles is that they possess good biocompatible characteristics, and since heparin is produced in the human body within the mast cells, this makes these nanoparticles useful for future applications like imaging, disease and cancer treatment, and antibacterial activity. They can also be used for applications that are not oriented directly to the medical and biological areas such as in the case of analyte detection in aqueous solution, although such studies are very few. These nanoparticles synthesis is mainly through wet chemistry methods, using heparin that could have been modified or not.
Cardioprotective and Metabolomic Profiling of Selected Medicinal Plants against Oxidative Stress
Authors: Afsheen Nadia , Khalil-ur-Rehman  , Jahan Nazish , Ijaz Misbah , Manzoor Asad , Khan Khalid Mahmood , Hina Saman
Published: January 2018

In this research work, the antioxidant and metabolomic profiling of seven selected medicinally important herbs including Rauvolfia serpentina, Terminalia arjuna, Coriandrum sativum, Elettaria cardamom, Piper nigrum, Allium sativum, and Crataegus oxyacantha was performed. The in vivo cardioprotective potential of these medicinal plants was evaluated against surgically induced oxidative stress through left anterior descending coronary artery ligation (LADCA) in dogs. The antioxidant profiling of these plants was done through DPPH and DNA protection assay. The C. oxyacantha and T. arjuna showed maximum antioxidant potential, while the E. cardamom showed poor antioxidative strength even at its high concentration. Different concentrations of extracts of the said plants exhibited the protection of plasmid DNA against H2O2 damage as compared to the plasmid DNA merely treated with H2O2. The metabolomic profiling through LC‐MS analysis of these antioxidants revealed the presence of active secondary metabolites responsible for their antioxidant potential. During in vivo analysis, blood samples of all treatment groups were drawn at different time intervals to analyze the cardiac and hemodynamic parameters. The results depicted that the group pretreated with HC4 significantly sustained the level of CK‐MB, SGOT, and LDH as well as hemodynamic parameters near to normal. The histopathological examination also confirmed the cardioprotective potential of HC4. Thus, the HC4 being safe and inexpensive cardioprotective herbal combination could be considered as an alternate of synthetic drugs.
Efficient FIR Filter Implementations for Multichannel BCIs Using Xilinx System Generator
Authors: Ghani Usman , Wasim Muhammad , Khan Umar Shahbaz , Mubasher Saleem Muhammad , Hassan Ali , Rashid Nasir , Islam Tiwana Mohsin , Hamza Amir , Kashif Amir
Published: January 2018

Background. Brain computer interface (BCI) is a combination of software and hardware communication protocols that allow brain to control external devices. Main purpose of BCI controlled external devices is to provide communication medium for disabled persons. Now these devices are considered as a new way to rehabilitate patients with impunities. There are certain potentials present in electroencephalogram (EEG) that correspond to specific event. Main issue is to detect such event related potentials online in such a low signal to noise ratio (SNR). In this paper we propose a method that will facilitate the concept of online processing by providing an efficient filtering implementation in a hardware friendly environment by switching to finite impulse response (FIR). Main focus of this research is to minimize latency and computational delay of preprocessing related to any BCI application. Four different finite impulse response (FIR) implementations along with large Laplacian filter are implemented in Xilinx System Generator. Efficiency of 25% is achieved in terms of reduced number of coefficients and multiplications which in turn reduce computational delays accordingly.
Los Desafíos de la Salud Pública
Authors: Giaconi Gandolfo Juan
Published: January 2018

Sin resumen
El Sistema de Salud chileno
Authors: Giaconi Gandolfo Juan
Published: January 2018

Sin resume
Situación de la salud materno infantil en Chile
Authors: Romero Sepulveda María Inés , Bedregal García Paula , Bastias Silva Gabriel
Published: January 2018

Sin resumen
La salud del adolescente y del joven
Authors: Romero Sepulveda María Inés
Published: January 2018

Sin resumen
Aspectos de la situación de la salud del adulto y senescente en Chile.
Authors: Valdivia Cabrera Gonzalo
Published: January 2018

Sin resumen
Hacia una gestión cada vez más eficiente en salud
Authors: Bellolio Rodriguez Jaime
Published: January 2018

Sin resumen
Epidemiología de las enfermedades transmisibles
Authors: Romero Sepulveda María Inés
Published: January 2018

Sin resumen
Epidemiología de los accidentes y violencias
Authors: Bedregal Garcia Paula
Published: January 2018

Sin resumen
Magnitud de las enfermedad crónica en Chile
Authors: Valdivia Cabrera Gonzalo , Bastias Silva Gabriel , Marquez C. Patricio
Published: January 2018

Sin resumen
Enfermedades crónica de la infancia
Authors: Bedregal Garcia Paula
Published: January 2018

Sin resumen
Epidemiología del cáncer en Chile
Authors: Valdivia Cabrera Gonzalo , Bastias Silva Gabriel
Published: January 2018

Sin resumen
Epidemiología ambiental
Authors: Salinas Arriagada Manuel
Published: January 2018

Sin resumen
La prevención de las enfermedades crónicas no transmisibles del adulto. Conceptos básicos para implementar programas con la base comunitaria
Authors: Berrios Carrasola Ximena
Published: January 2018

Sin resumen
Estilos de vida de la mujer adulta de la Región Metropolitana
Authors: Jadue Hund Liliana , Berrios Carrasola Ximena
Published: January 2018

Sin resumen
Salud ocupacional en Chile
Authors: Szantho Pongracz Gyorgy , Morales Freire Alejandro
Published: January 2018

Sin resumen
Nuevas generaciones de vacunas. Hacia un aumento del espectro de las infecciones prevenibles por inmunización y una mayor seguridad de los productos utilizados
Authors: Vial Claro Pablo A. , Abarca Villaseca Katia
Published: January 2018

Sin resumen
Las enfermedades crónicas del adultoy sus factores de riesgo. Un ejemplo de la investigación epidemiológica
Authors: Berrios Carrasola Ximena
Published: January 2018

Sin resumen
Paciente con cirrosis hepática y otras complicaciones
Authors: Gazitua Harmsen Ricardo , Rollan Rodriguez Antonio , Gonzalez Bombardiere Sergio
Published: January 2018

Sin resumen
Casos radiológicos
Authors: García Bruce Cristian , Otero Fuentes Carmen Gloria
Published: January 2018

Sin resumen
Cirugía endoscópica.
Authors: Llanos López Osvaldo
Published: January 2018

Sin resumen
Cirugía endoscópica del tudo digestivo alto.
Authors: Ibañez Anrique Luis
Published: January 2018

Sin resumen
Cirugía endoscópica del tudo digestivo bajo.
Authors: Raddatz Echavarria Alejandro
Published: January 2018

Sin resumen
Cirugía endoscópica biliar y pancreática.
Authors: Pimentel Muller Fernando , Guzman Bondik Sergio
Published: January 2018

Sin resumen
Colecistectomía laparoscópica.
Authors: Ibañez Anrique Luis
Published: January 2018

Sin resumen
Apendicectomía, colectomía y otras operaciones laparoscópicas abdominales.
Authors: Zuñiga Diaz Alvaro , Caracci Lagos Mario
Published: January 2018

Sin resumen
Videotoracoscopia.
Authors: Aparicio Ramirez Rodrigo
Published: January 2018

Sin resumen
Cirugía artroscópica.
Authors: Paulos Arenas Jaime , Figueroa Poblete David
Published: January 2018

Sin resumen
Cirugía endoscópica urológica.
Authors: Del Campo Shulze Fernando
Published: January 2018

Sin resumen
Cirugía endoscópica ginecologica.
Authors: Duque Arredondo Gonzalo , Bianchi Poblete Marcelo
Published: January 2018

Sin resumen
Tratamiento de la coledolitiasis.
Authors: Llanos López Osvaldo
Published: January 2018

Sin resumen
Helicobacter pylori y ulcera peptica.
Authors: Rollan Rodriguez Antonio
Published: January 2018

Sin resumen
Caso anatomo-clínico
Authors: Gazitua Harmsen Ricardo , Grebe Barros Gonzalo , Rosenberg Gomez Helmar , Lira Vergara Pablo
Published: January 2018

Sin resumen
Casos radiológicos
Authors: García Bruce Cristian , Flores Gutierrez Paulo , Fava Peirano Mario
Published: January 2018

Sin resumen
Primer encuentro científico con el decano
Authors: Escuela de Medicina Boletín
Published: January 2018

Sin resumen
El dolor es un señor de la humanidad aun más terrible que la muerte misma
Authors: Dagnino Sepúlveda Jorge
Published: January 2018

Sin Resumen
Definiciones y clasificaciones del dolor.
Authors: Dagnino Sepúlveda Jorge
Published: January 2018

Sin resumen
Respuesta sistémica al dolor agudo.
Authors: Dagnino Sepúlveda Jorge
Published: January 2018

Sin resumen
Medición del dolor.
Authors: Torregrosa Zuñiga Samuel , Bugedo Tarraza Guillermo
Published: January 2018

Sin resumen
Analgesicos narcóticos.
Authors: Gonzalez Arellano Alejandro , Dagnino Sepulveda Jorge
Published: January 2018

Sin resumen
Analgesicos no narcóticos.
Authors: Gonzalez Sotomayor Julio , Dagnino Sepulveda Jorge
Published: January 2018

Sin resumen
Dolor Postoperatorio.
Authors: Bugedo Tarraza Guillermo , Torregrosa Zuñiga Samuel
Published: January 2018

Sin resumen
Dolor agudo en niños.
Authors: Gonzalez Arellano Alejandro , Concha Pinto Mario
Published: January 2018

Sin resumen
Dolor crónicos no oncológico: causalgias de desaferentación.
Authors: Guerrero Lira Mario
Published: January 2018

Sin resumen
Dolor lumbar.
Authors: Paulos Arenas Jaime
Published: January 2018

Sin resumen
Dolor en cáncer.
Authors: Guerrero Lira Mario
Published: January 2018

Sin Resumen
Aspectos neuroquirurgicos en el manejo del dolor.
Authors: Tagle Madrid Patricio
Published: January 2018

Sin resumen
Evaluación y tratamiento psiquiatrico del dolor crónico.
Authors: Seguel Lizama Mario
Published: January 2018

Sin resumen
Cuidados paliativos.
Authors: Guerrero Lira Mario
Published: January 2018

Sin resumen
Dolor agudo postoperatorio.
Authors: Bugedo Tarraza Guillermo , Dagnino Sepulveda Jorge , Torregrosa Zuñiga Samuel
Published: January 2018

Sin resumen
Mecanismos y vías del dolor.
Authors: Torregrosa Zuñiga Samuel
Published: January 2018

Sin resumen
Casos radiológicos
Authors: García Bruce Cristian
Published: January 2018

Sin resumen
Caso anatomo-clínico
Authors: Gazitua Harmsen Ricardo , Dougnac Labatu Alberto , Chuaqui Jahiatt Benedicto , Andresen Hernandez Max
Published: January 2018

Sin resumen
Crónica
Authors: Moreno Rodrigo , Velasco Nicolas
Published: January 2018

Sin resumen
Platelet Secretion Defects and Acquired von Willebrand Syndrome in Patients With Ventricular Assist Devices
Authors: Geisen Ulrich , Brehm Kerstin , Trummer Georg , Berchtold‐Herz Michael , Heilmann Claudia , Beyersdorf Friedhelm , Schelling Johannes , Schlagenhauf Axel , Zieger Barbara
Published: January 2018

Background

The number of implanted ventricular assist devices (
VAD
s) has increased significantly recently. Bleeding, the most frequent complication, cannot be solely attributed to anticoagulation therapy. Acquired von Willebrand syndrome (
AVWS
) caused by increased shear stress is frequent in
VAD
patients and can increase the bleeding risk. The HeartMate
III
(
HM III
) is a novel left
VAD
featuring potential improvements over the HeartMate
II
.

Methods and Results

In this study, we investigated the prevalence and onset of
AVWS
in 198
VAD
patients. To our knowledge, this is the largest cohort of
VAD
patients whose longitudinal data on
AVWS
have been collected. We also analyzed whether
AVWS
is less severe in
HM III
patients than in HeartMate II patients. Because platelet dysfunction can raise the bleeding risk, we investigated platelet function in a subset of patients. In total, 198
VAD
patients and 60 patients with heart transplants as controls were included in this study. The ratio of von Willebrand factor collagen binding capacity to von Willebrand factor:antigen, multimer analyses, and platelet function (especially secretion of α‐ and δ‐granules) were investigated. All 198
VAD
patients developed
AVWS
. As soon as the
VAD
was explanted, the
AVWS
disappeared within hours.
AVWS
was less severe in the
HM III
patients than in the HeartMate
II
patients. The
HM III
patients had fewer bleeding symptoms. In addition,
VAD
patients exhibited a platelet α‐ and δ‐granule secretion defect.

Conclusions

AVWS
develops in
VAD
patients and may increase the bleeding risk. The
HM III
device causes less severe
AVWS
. Platelet secretion defects should be investigated in
VAD
patients because they also raise the bleeding risk.

Clinical Trial Registration

https://www.drks.de/drks_web
. Unique identifier:
DRKS
00000649.
Adenosine Production by Biomaterial‐Supported Mesenchymal Stromal Cells Reduces the Innate Inflammatory Response in Myocardial Ischemia/Reperfusion Injury
Authors: Shin Eric Y. , Wang Lanfang , Zemskova Marina , Deppen Juline , Xu Kai , Strobel Frederick , García Andrés J. , Tirouvanziam Rabindra , Levit Rebecca D.
Published: January 2018

Background

During myocardial ischemia/reperfusion (
MI
/R) injury, there is extensive release of immunogenic metabolites that activate cells of the innate immune system. These include
ATP
and
AMP
, which upregulate chemotaxis, migration, and effector function of early infiltrating inflammatory cells. These cells subsequently drive further tissue devitalization. Mesenchymal stromal cells (
MSC
s) are a potential treatment modality for
MI
/R because of their powerful anti‐inflammatory capabilities; however, the manner in which they regulate the acute inflammatory milieu requires further elucidation.
CD
73, an ecto‐5′‐nucleotidase, may be critical in regulating inflammation by converting pro‐inflammatory
AMP
to anti‐inflammatory adenosine. We hypothesized that
MSC
‐mediated conversion of
AMP
into adenosine reduces inflammation in early
MI
/R, favoring a micro‐environment that attenuates excessive innate immune cell activation and facilitates earlier cardiac recovery.

Methods and Results

Adult rats were subjected to 30 minutes of
MI
/R injury.
MSC
s were encapsulated within a hydrogel vehicle and implanted onto the myocardium. A subset of
MSC
s were pretreated with the
CD
73 inhibitor, α,β‐methylene adenosine diphosphate, before implantation. Using liquid chromatography/mass spectrometry, we found that
MSC
s increase myocardial adenosine availability following injury via
CD
73 activity.
MSC
s also reduce innate immune cell infiltration as measured by flow cytometry, and hydrogen peroxide formation as measured by Amplex Red assay. These effects were dependent on
MSC
‐mediated
CD
73 activity. Finally, through echocardiography we found that
CD
73 activity on
MSC
s was critical to optimal protection of cardiac function following
MI
/R injury.

Conclusions

MSC
‐mediated conversion of
AMP
to adenosine by
CD
73 exerts a powerful anti‐inflammatory effect critical for cardiac recovery following
MI
/R injury.
Probenecid Improves Cardiac Function in Patients With Heart Failure With Reduced Ejection Fraction In Vivo and Cardiomyocyte Calcium Sensitivity In Vitro
Authors: Robbins Nathan , Gilbert Mark , Kumar Mohit , McNamara James W. , Daly Patrick , Koch Sheryl E. , Conway Ginger , Effat Mohamed , Woo Jessica G. , Sadayappan Sakthivel , Rubinstein Jack
Published: January 2018

Background

Transient receptor potential vanilloid 2 is a calcium channel activated by probenecid. Probenecid is a Food and Drug Administration–approved uricosuric drug that has recently been shown to induce positive lusitropic and inotropic effects in animal models through cardiomyocyte transient receptor potential vanilloid 2 activation. The aim of this study was to test the hypothesis that oral probenecid can improve cardiac function and symptomatology in patients with heart failure with reduced ejection fraction and to further elucidate its calcium‐dependent effects on myocyte contractility.

Methods and Results

The clinical trial recruited stable outpatients with heart failure with reduced ejection fraction randomized in a single‐center, double‐blind, crossover design. Clinical data were collected including a dyspnea assessment, physical examination, ECG, echocardiogram to assess systolic and diastolic function, a 6‐minute walk test, and laboratory studies. In vitro force generation studies were performed on cardiomyocytes isolated from murine tissue exposed to probenecid or control treatments. The clinical trial recruited 20 subjects (mean age 57 years, mean baseline fractional shortening of 13.6±1.0%). Probenecid therapy increased fractional shortening by 2.1±1.0% compared with placebo −1.7±1.0% (
P
=0.007). Additionally, probenecid improved diastolic function compared with placebo by decreasing the E/E′ by −2.95±1.21 versus 1.32±1.21 in comparison to placebo (
P
=0.03). In vitro probenecid increased myofilament force generation (92.36 versus 80.82 mN/mm
2
,
P
<0.05) and calcium sensitivity (pCa 5.67 versus 5.60,
P
<0.01) compared with control.

Conclusions

Probenecid improves cardiac function with minimal effects on symptomatology and no significant adverse effects after 1 week in patients with heart failure with reduced ejection fraction and increases force development and calcium sensitivity at the cardiomyocyte level.

Clinical Trial Registration

URL
:
https://www.clinicaltrials.gov
. Unique identifier:
NCT
01814319.
Mitral Valve Anatomic Predictors of Hemodynamic Success With Transcatheter Mitral Valve Repair
Authors: Thaden Jeremy J. , Malouf Joseph F. , Nkomo Vuyisile T. , Pislaru Sorin V. , Holmes David R. , Reeder Guy S. , Rihal Charanjit S. , Eleid Mackram F.
Published: January 2018

Background

Mitral regurgitation is a heterogeneous disease. Determining which patients derive optimal outcomes from transcatheter edge‐to‐edge mitral valve repair (TMVR) remains challenging. We sought to determine whether baseline mitral valve anatomic characteristics are predictive of left atrial pressure (LAP) changes during TMVR with MitraClip.

Methods and Results

Consecutive patients with severe mitral regurgitation undergoing TMVR (n=112) underwent continuous intraprocedural LAP monitoring and retrospective echocardiographic analysis for specific mitral anatomic characteristics. Procedural success (optimal LAP reduction) was defined as ≥40% reduction in left atrial V‐wave pressure compared with baseline. Echocardiographic predictors of optimal LAP reduction and increased postprocedure mean diastolic gradient were evaluated. Mean age was 79±14 years, and 36 patients (32%) were women. Primary, mixed, and secondary mitral regurgitation were present in 78 patients (70%), 22 patients (20%), and 12 patients (10%), respectively. Baseline mean LAP and V‐wave were 22±6 and 38±13 mm Hg; after TMVR, these decreased to 19±5 and 27±10 mm Hg, respectively (
P
<0.0001 for both). Independent predictors of optimal LAP reduction were the presence of a flail scallop, mitral regurgitation localized to a single scallop, and high‐quality 3‐dimensional echocardiographic imaging. Independent predictors of elevated postprocedure mean diastolic gradient were elevated preprocedure mean diastolic gradient, mitral annular calcification, and implantation of multiple clips.

Conclusions

Mitral valve pathoanatomic features, including a flail leaflet and single jet, are predictive of optimal LAP reduction with TMVR. High‐quality 3‐dimensional imaging may help select patients with the highest likelihood of optimal hemodynamic results with TMVR. These data expand current knowledge about patient selection for TMVR and deserve further study in larger cohorts.
Pregnancy Loss and Carotid Intima–Media Thickness in Mexican Women
Authors: Hartasanchez Sandra A. , Flores‐Torres Mario , Monge Adriana , Yunes Elsa , Rodriguez Beatriz , Cantu‐Brito Carlos , Colaci Daniela , Lamadrid‐Figueroa Hector , Lopez‐Ridaura Ruy , Lajous Martin
Published: January 2018

Background

Cardiovascular disease in women often develops without conventional risk factors. Prenatal loss is a common pregnancy outcome that may result in physiological changes can increase the potential future risk of cardiovascular disease. Insufficient information exists regarding the impact of pregnancy loss on early markers of cardiovascular disease risk.

Methods and Results

Cross‐sectional analysis of 1767 disease‐free women from the MTC (Mexican Teachers' Cohort) who had been pregnant was used to evaluate the relationship between pregnancy loss and carotid intima–media thickness (IMT). Participants responded to a questionnaire regarding their reproductive history, risk factors, and medical conditions. We defined pregnancy loss as history of miscarriage and/or stillbirth. Trained neurologists measured IMT using ultrasound. We log‐transformed IMT and defined subclinical carotid atherosclerosis (SCA) as IMT ≥0.8 mm and/or plaque. We used multivariable linear and logistic regression models to assess the relation of pregnancy loss, IMT, and SCA. The mean age of participants was 49.8±5.1 years. The prevalence of pregnancy loss was 22%, and we observed SCA in 23% of participants. Comparing participants who reported a pregnancy loss and those who did not, the multivariable‐adjusted odds ratio for SCA was 1.52 (95% confidence interval, 1.12–2.06). Women who experienced a stillbirth had 2.32 higher odds (95% confidence interval, 1.03–5.21) of SCA than those who did not. Mean IMT appeared to be higher in women who reported a pregnancy loss relative to those who did not; nevertheless, this was not statistically significant.

Conclusions

Pregnancy loss could be linked to cardiovascular disease later in life. The key findings of our study await confirmation and further investigation of the potential underlying mechanisms for this association is required.
Lower Respiratory Tract Infection Therapy – the Role of Ciprofloxacin
Authors: Ball A P , Tillotson G S
Published: January 2018

Lower respiratory tract infections account for a large proportion of prescribed antibiotics and, with emerging resistance to standard agents, the introduction of the fluoroquinolones, in particular ciprofloxacin, has provided a further component in the armamentarium. This review encompasses 37 published clinical trials which featured ciprofloxacin; 3274 patients with lower respiratory tract infections were treated with this agent; in 94.1% of patients treatment was clinically successful and 90.9% of cases showed eradication of the causative pathogen. When these data were supplemented with previously unpublished Information from the clinical trial database, specific organism eradication rates of 86.1%, 96.2% and 94.6% for Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis, respectively, were observed. These findings suggest that the high respiratory tissue penetration of ciprofloxacin and the achievable minimum inhibitory concentrations lead to acceptable clinical outcomes in lower respiratory tract infections.
Sensitivity of Staphylococcus Aureus, Isolated from Skin Infections in 1994, to 19 Antimicrobial Agents
Authors: Nishijima S , Nakagawa M , Sugiyama T , Akamatsu H , Horio T , Kawabata S , Fujita M
Published: January 2018

The most common pathogen causing skin infections is Staphylococcus aureus and the incidence of multiply resistant strains of S. aureus has been increasing. The in vitro susceptibility of 130 isolates of S. aureus to 19 antimicrobial agents: ampicillin (ABPC), methicillin, cefaclor, cefpodoxime proxetil, gentamicin, erythromycin, clindamycin, minocycline, vancomycin, fusidic acid, norfloxacin, ofloxacin, enoxacin, ciprofloxacin, lomefloxacin, tosufloxacin, sparfloxacin, nadifloxacin and grepafloxacin, was evaluated by agar dilution tests. The S. aureus isolates were isolated from 130 patients with skin infections in 1994. The proportion of methicillin-resistant S. aureus isolates among the strains isolated was 19.2%. The concentration needed to inhibit 50% of the isolates was 3.13 mg/ml or less for all of the drugs, but the concentration needed to inhibit 90% of isolates was over 12.5 μg/ml, except in the cases of minocycline, vancomycin, fusidic acid, tosufloxacin and nadifloxacin. Tosufloxacin and nadifloxacin had the lowest minimum inhibitory concentrations. None of the S. aureus strains was resistant to nadifloxacin.
Loperamide Oxide for the Treatment of Chronic Diarrhoea in Crohn's Disease
Authors: van Outryve M , Toussaint J
Published: January 2018

Loperamide oxide was compared with placebo for the treatment of chronic diarrhoea in patients with Crohn's disease. After initially receiving 2 mg loperamide oxide or placebo, hospital out-patients with Crohn's disease were instructed to take one tablet of loperamide oxide (1 mg) or placebo after passage of each unformed stool in a 1-week double-blind investigation. Patients who responded to this treatment by passing less than three unformed stools per 24 h continued to receive the drug, twice daily, for a further week. At the end of the initial 1-week treatment phase both the investigator's and the patients' global evaluations of efficacy were significantly in favour of the active treatment ( P = 0.025 and P = 0.020, respectively). The investigator's assessment of the change in abdominal pain was significant for loperamide oxide ( P = 0.020) but not for placebo. Improvements in patient-rated severity of diarrhoea were significantly greater for loperamide oxide than for placebo ( P = 0.046). The mean daily dose of loperamide oxide was 2.7 mg. During the second week, both the investigator's and the patients' assessments of global efficacy and symptom improvement continued to favour loperamide oxide though the differences were not significant. Adverse events were rare. The results suggest that loperamide oxide (3 mg/per day) provides a safe and effective treatment for the chronic diarrhoea associated with Crohn's disease.
Effects on Health of Dietary Supplementation with 100 mg d-α-Tocopheryl Acetate, Daily for 6 Years
Authors: Takamatsu S , Takamatsu M , Satoh K , Imaizumi T , Yoshida H , Hiramoto M , Koyama M , Ohgushi Y , Mizuno S
Published: January 2018

To evaluate the clinical antioxidant effects of vitamin E, 161 healthy volunteers aged 39 to 56 years, were given 100 or 3 mg of d-α-tocopheryl acetate orally daily for 6 years using a randomized, double-blind design. Among the 147 volunteers who qualified for the analysis, seven of the 73 volunteers receiving 3 mg d-α-tocopheryl acetate daily and none of the 74 volunteers receiving 100 mg had coronary disorders including myocardial damage ( P < 0.02). ST or T wave abnormalities on electrocardiograms were considered to indicate coronary disorders (four volunteers). The mean serum total tocopherol (TOC) concentration in the 100-mg group was significantly higher than that in the 3-mg group 6 months after the start of the study, and this raised value was maintained throughout the study; the level in the 3-mg group did not change significantly from the baseline value. The low-density lipoprotein cholesterol/total TOC ratio, a parameter of the inhibition of peroxidation of low-density lipoprotein cholesterol, was the only serum lipid parameter that was significantly different, at baseline, in the volunteers with coronary disorders compared with the others. These findings indicate that long-term supplementation with 100 mg tocopheryl acetate daily may prevent the early stages of coronary atherosclerosis by decreasing peroxidation of low-density lipoprotein cholesterol.
Comparative Incidence of Allergy in the Presence or Absence of Cancer
Authors: Petroianu A , Chaves D N B , De Oliveira O
Published: January 2018

Depression of the immune system may be related to cancer development. Allergic manifestations are due to enhanced immunological activity. Several authors have found lower rates of malignancy in atopic individuals. To elucidate the relationship between cancer and allergy, the prevalence of allergic manifestations was surveyed in 400 healthy Controls and 400 patients with cancer. The number of allergies was significantly higher ( P < 0.001) in the control group than in patients with cancer. Women were more atopic than men in both groups ( P < 0.001) but skin colour did not affect the prevalence of allergies. The type of cancer was not related to any specific allergic manifestation. The results suggest that allergies occur less frequently in men than in women and less frequently in patients with cancer than in healthy controls but these relationships are complex and depend on other factors that need further investigation.
Cardiosympathetic Neuropathy is Independent of Cardioparasympathetic Neuropathy in Patients with Non-Insulin-Dependent Diabetes Mellitus
Authors: Okada S , Tanokuchi S , Higuchi T , Ogino Y , Ichiki K , Ishii K , Hamada H , Ota Z , Shimizu M , Hiraki Y
Published: January 2018

The relationship between cardiosympathetic neuropathy and cardioparasympathetic neuropathy was investigated in 103 patients with non-insulin-dependent diabetes mellitus. Cardioparasympathetic nerve function was assessed by comparing electrocardiographically the expiratory and inspiratory R-R interval ratios, during a period of deep breathing, and the coefficients of variation of the R-R intervals. Cardiosympathetic nerve function was assessed by determining the uptake of [123I]metaiodobenzyl guanidine into the myocardium. The results indicate that there is no significant correlation between cardioparasympathetic and cardiosympathetic nerve function.
Open Randomized Study Comparing Doxycycline and Co-Amoxiclav in the Treatment of Acute Suppurative Tracheobronchitis in Adults
Authors: Sternon J ,   The Collaborative Group of the Centre Universitaire de Medécine Générale de l'Université Libre de Bruxelles (CUMG-ULB) Investigators
Published: January 2018

Doxycycline and co-amoxiclav were compared in a randomized clinical trial involving adult patients with acute suppurative tracheobronchitis. Patients were treated for 5 to 10 days with either antibiotic following three schemes: co-amoxiclav 500 mg three times daily, or doxycycline 200 mg on day 1 followed by 100 mg daily, or 200 mg daily. Assessment after 5 – 9 days was based only on clinical parameters. Patients with inadequate response to the initial treatment were crossed over to the alternative antibiotic. Of the 210 patients enrolled, 206 were available for evaluation of efficacy. Both antibiotic regimens proved equally efficacious, with rates of clinical response (cure or improvement) of 89% and 91% for doxycycline and co-amoxiclav, respectively. Patients who were crossed over to the alternative antibiotic had a significantly lower cure rate after their second course of antibiotics (22% compared with 70%). Adverse effects, most often of gastro-intestinal origin, were more common in the co-amoxiclav group than in the doxycycline-treated group, but rarely caused cessation of treatment.
How Blood Pressure in Patients with Non-Insulin-Dependent Diabetes Mellitus is Influenced by Stress
Authors: Okada S , Ichiki K , Tanokuchi S , Ishii K , Hamada H , Ota Z
Published: January 2018

The effects of reducing stress on blood pressure were investigated in 20 patients with non-insulin-dependent diabetes mellitus. An anxiolytic, fludiazepam, was administered to the patients for 12 weeks and their blood pressures and State Trait Anxiety Inventory scores at the beginning and end of treatment were compared. Systolic and diastolic blood pressures and trait and state anxiety scores were all significantly reduced during the treatment period. There was also a weak correlation between the extent of the improvement in the same anxiety score and the improvement in diastolic blood pressures.
Age at Diagnosis of Non-Insulin-Dependent Diabetes Mellitus in Southern Iran
Authors: Pishdad G R
Published: January 2018

To obtain an estimate of the age at onset of non-insulin-dependent diabetes mellitus in southern Iran, the medical records of the confirmed diabetic patients who attended the diabetes and endocrine clinics in southern Iran from March 1984 to February 1993 were reviewed. The case records of 2566 patients, in whom non-insulin-dependent diabetes mellitus was considered most probable, and who were resident in southern Iran at the time of diagnosis, were studied; they included 1176 (45.8%) men and 1390 (54.2%) women. The age at diagnosis of the disease in men ranged between 18 and 82 years with a mean of 45.6 ± 11.4 (± SD) years, and in women, between 15 and 83 with a mean of 44.3 ± 12.2 (± SD) years. There was no statistically significant sex-related difference in the mean age at diagnosis of non-insulin-dependent diabetes mellitus in these patients. Sex-specific rates showed a female to male ratio of 1.25 to 1. Age-specific rates indicated that non-insulin-dependent diabetes mellitus was most often diagnosed before age 55 and most commonly in the forties.
The Treatment of Non-Gonococcal Urethritis with Single Dose Oral Azithromycin
Authors: Erdog#x0342;ru T , Ag#x0342;açfidan A , Önel M , Badur S , Ang#x0342; Ö , Telallog#x0342;lu S
Published: January 2018

In an uncontrolled study, the efficacy of azithromycin in the treatment of non-gonococcal urethritis was assessed in 41 male patients aged between 20 and 40 years with a mean age of 27 ± 5 years. Clinical and microbiological diagnosis confirmed that 28 men were found positive for Chlamydia trachomatis, 10 for Ureaplasma urealyticum and three for both C. trachomatis and U. urealyticum. All patients received 1 g azithromcyin orally (four 250 mg capsules). The length of time between the treatment and following visits were 7 – 10 days and 14 – 21 days for second and third visits, respectively. Complete eradication was achieved in 27 out of 41 patients. Of the remaining 14, six were found positive for C. trachomatis and were excluded as they did not return for the follow-up visit, one patient did not achieve complete eradication, one patient infected with both C. trachomatis and U. urealyticum failed to achieve complete eradication, and six patients infected with U. urealyticum failed to be completely cured. No adverse effects were reported in any patient. Single dose administration of 1 g azithromycin appears to be an effective and well-tolerated treatment for chlamydial urethritis and an advantage in terms of patient compliance.
Memphis, 1991
Authors: Giddy Lisa , Jeffreys David
Published: January 2018

The Survey of Memphis continued in 1991 with three main objectives: (1) to explore the buried stratigraphy beyond the ruin field by means of drill cores and resistivity meter survey; (2) to study the material excavated from six seasons of excavation on Kom Rabi'a; (3) to complete the first stage of the Epigraphic Survey by copying the large Middle-Kingdom inscribed block found re-used as a support beneath the granite statue of Ramesses II at the west gate of the Ptah enclosure. As in previous seasons, work was also carried out at Memphis in collaboration with inspectors of the EAO, notably on Kom Qal'a and Kom Rabi'a, as well as with other colleagues at Saqqara.
Memphis, 1991: Epigraphy
Authors: Malek Jaromir , Quirke Stephen
Published: January 2018

A brief account, with facsimile, of the recording of two fragments of an exceptionally important inscription dating to the reign of Amenemhet II.
Preliminary Report of the First Season of Work at Gebel El-Haridi, 1991–92
Authors: Kirby Christopher J.
Published: January 2018

The preliminary survey of this site identified archaeological material ranging in date from the Old Kingdom to Coptic period. Three areas were assessed for their archaeological potential: a group of quarries apparently associated with an inscription of Ramesses III (north of El-Khazindariya), large quarry terraces (Nazlet el-Haridi), and a complex association of quarries, tombs and domestic dwellings (Abu el-Nasr). The main focus of work was at Abu el-Nasr, where tombs of Old (and possibly New) Kingdom date, situated in terraces at the top of the slope, were planned and photographed. Two large quarries, containing previously unrecorded Ptolemaic inscriptions, were also studied. Preliminary investigation was started on a area of mud-brick and occupation debris, located directly below the terraces, at the base of Abu el-Nasr.
Marl Clay Pottery Fabrics of the New Kingdom from Memphis, Saqqara and Amarna
Authors: Bourriau J. D. , Nicholson P. T.
Published: January 2018

This paper attempts to introduce a research tool essential for the study of production and trade and the way they were organized in ancient Egypt by examining marl clay pottery fabrics from the New Kingdom. Marl clay was the preferred raw material for the containers used in the transport of food within the Nile Valley and beyond. Sample sherds from Memphis, Saqqara and Amarna are described and illustrated macroscopically (20 × magnification) and microscopically (from thin sections). The results are used to create a concordance between the fabric classifications used at these sites, and with that used at Qantir and with the Vienna System. The data given will allow other archaeologists to link their own material to that described and so have access to the evidence this pottery provides on chronology and commodity exchange.
The Cenotaph of the Sekwaskhet Family from Saqqara
Authors: Abdalla Aly
Published: January 2018

The publication of a series of five limestone offering niches from the private cenotaph of the Sekwaskhet family of the early Middle Kingdom. The monument, excavated to the north of the Teti pyramid by Firth and Gunn in 1921–22, is now displayed in the Cairo Museum (JE 55618). The family was associated with the cult of the Teti pyramid.
The Psš-kf and the ‘Opening of the Mouth’ Ceremony: A Ritual of Birth and Rebirth
Authors: Roth Ann Macy
Published: January 2018

In archaeological and textual evidence alike, the psš-kf-knife consistently occurs as part of the same collection of objects. In the Pyramid Texts, these objects are presented in a sequence that is the earliest attested form of the ‘opening of the mouth’ ceremony. The speeches accompanying the presentations suggest that the psš-kf and the objects associated with it were the equipment for a ritual mimicking birth and childhood, and that the role of the psš-kf in this process was to cut the umbilical cord of a newborn baby. Further archaeological, textual, and iconographic evidence is adduced to support this interpretation.