bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of Reinforcement Length on Singularity of Single‐Lap Joints
Authors: Wang Yuqi , Li Yanhui , Zhou Kaixuan
Published: July 2018

In order to enhance the strength of single‐lap joints, the single‐lap joints with reinforcements were proposed. The influence of reinforcement length on the singular behavior near to the interface point of single‐lap joints was investigated theoretically and numerically. The theoretical strength of singularity point was calculated by Bogy determinant. Stresses along the interface close to the singularity points were calculated with finite element analyses (FEAs). Results showed that the singular stress intensity factor of single‐lap joints can be decreased by the reinforcement. However, the singular stress intensity factor of single‐lap joints with reinforcements was decreased slightly with increasing reinforcement length.
Sociodemographic Characteristics, Dietary Practices, and Nutritional Status of Adults with Hypertension in a Semi-Rural Community in the Eastern Region of Ghana
Authors: Colecraft Esi K. , Asante Matilda , Christian Aaron K. , Adu-Afarwuah Seth
Published: July 2018

Introduction. Hypertension is a major contributor to the global disease burden and mortality. Evidence suggests increasing hypertension prevalence in Ghana but there is limited public awareness and information on the characteristics of those with the disease. Objective. To describe the baseline characteristics of adults with hypertension who were randomized to receive either hypertension related nutrition education plus hospital-based standard of care or only the standard of care (control group) in Asesewa, a semi-rural community in the Eastern Region of Ghana. Only baseline data were used in the present analysis. Methods. A cross-sectional baseline survey was completed for 63 adults with confirmed hypertension diagnosis. Data on sociodemographic characteristics and diet were obtained through interviews and participants’ body mass index (BMI) was computed. Pearson chi-square statistic was used to assess differences between those with both elevated diastolic blood pressure (DBP) and systolic blood pressure (SBP) and those with only elevated SBP. Results. Mean ± SD age of participants was 54.5±13.8 years. Approximately 71% of participants had both elevated SBP (>140 mmHg) and DBP (>90 mmHg) while the remaining 29% had only elevated SBP. The median number of times the food groups beneficial to hypertension management were consumed in the preceding week to the interview was 1 for green leafy vegetables, 1 for dairy products, 2 for fruits, and 4 for legumes. The median number of times for consuming harmful food groups was 3 for salted fish and 7 times for fats and oils. Signifcantly more participants in the age group above 50 than the younger participants had elevated SBP (83.3 vs. 16.7:P=0.027) and those with BMI equal to or greater than 25 were more likely to have both elevated SBP and DBP (P=0.047). Conclusions. Findings from this study have implications for the prevention and management of hypertension in this semi-rural population.
DPP-4 Inhibitor Sitagliptin Improves Cardiac Function and Glucose Homeostasis and Ameliorates β-Cell Dysfunction Together with Reducing S6K1 Activation and IRS-1 and IRS-2 Degradation in Obesity Female Mice
Authors: Qiao Shigang , Mao Guofang , Li Hua , Ma Zhimin , Hong Lei , Zhang Huiling , Wang Chen , An Jianzhong
Published: July 2018

Background. Chronic overnutrition leads to cardiac dysfunction and insulin (INS) resistance. Dipeptidyl peptidase-4 (DPP-4) improves glucose metabolism and insulin sensitivity in both human and animal models. In this study, we explored whether DPP-4 inhibitor sitagliptin (SIT) is involved in the protection of cardiac function and β-cell function using an obesity female mouse model. Methods. Six-week-old C57BL6/J mice were fed a high fat and fructose Western diet with DPP-4 inhibitor SIT for 12 weeks. Cardiac function was examined by echocardiography. Body weight, plasma glucose, and insulin concentrations were measured. The contents of total S6 kinase 1 (S6K1), phosphorylation of S6K1 activation, and INS docking proteins INS receptor substrates 1 and 2 (IRS-1, IRS-2) were assayed, and histology of heart tissue was performed. Results. Chronic Western diet consumption elevated plasma glucose and insulin and caused obesity, diastolic dysfunction, and β-cell dysfunction. DPP-4 inhibition with SIT resulted in reduction in body weight, fasting glucose, and plasma insulin, and improved cardiac diastolic dysfunction. SIT also decreased mTOR/S6K1 activation and prevented the degradation of IRS-1 and IRS-2. Conclusions. This study revealed pleiotropic protective effects of DPP-4 inhibitor SIT on cardiac function, glycemia, and β-cell function together with reducing S6K1 activation and IRS-1 and IRS-2 degradation in the obesity female mouse model.
Beijing Opera Synthesis Based on Straight Algorithm and Deep Learning
Authors: Wang XueTing , Jin Cong , Zhao Wei
Published: July 2018

Speech synthesis is an important research content in the field of human-computer interaction and has a wide range of applications. As one of its branches, singing synthesis plays an important role. Beijing Opera is a famous traditional Chinese opera, and it is called Chinese quintessence. The singing of Beijing Opera carries some features of speech but it has its own unique pronunciation rules and rhythms which differ from ordinary speech and singing. In this paper, we propose three models for the synthesis of Beijing Opera. Firstly, the speech signals of the source speaker and the target speaker are extracted by using the straight algorithm. And then through the training of GMM, we complete the voice control model to input the voice to be converted and output the voice after the voice conversion. Finally, by modeling the fundamental frequency, duration, and frequency separately, a melodic control model is constructed using GAN to realize the synthesis of the Beijing Opera fragment. We connect the fragments and superimpose the background music to achieve the synthesis of Beijing Opera. The experimental results show that the synthesized Beijing Opera has some audibility and can basically complete the composition of Beijing Opera. We also extend our models to human-AI cooperative music generation: given a target voice of human, we can generate a Beijing Opera which is sung by a new target voice.
Systematic Review with Network Meta-Analysis: Efficacy of Induction Therapy with a Second Biological Agent in Anti-TNF-Experienced Crohn’s Disease Patients
Authors: Pagnini Cristiano , Siakavellas Spyros I. , Bamias Giorgos
Published: July 2018

Background and Aim. Crohn’s disease (CD) is a chronic inflammatory condition of the gastrointestinal tract with the potential to progress to a severe debilitating state. Treatment with biological agents is highly efficient, improving both short-term outcomes and long-term prognosis. Nonetheless, up to 60% of patients receiving biological therapy will exhibit nonresponse at some point. The optimal management of such patients is not clearly defined. Besides traditional anti-TNF agents (infliximab, adalimumab, and certolizumab), alternative biological therapies (natalizumab, vedolizumab, and ustekinumab) are currently available for the treatment of CD. Our aim was to analyze all available evidence regarding efficacy of a second biological in “biological-treatment-experienced” patients. Methods. A systematic review of the literature was conducted using specific criteria for selecting relevant randomized clinical trials evaluating response to administration of secondary biological therapy in “anti-TNF-experienced” CD patients. Data from these studies was used to perform (a) traditional meta-analysis to ascertain the effect of secondary treatment versus placebo and (b) network meta-analysis to compare indirectly the efficacy of available biological agents. Results. Out of initially 977 studies, only eight were included for analysis, providing a total of 1281 treated and 733 placebo-receiving CD patients. Treatment with a second biological was found to be superior to placebo for both induction of remission (OR 2.2, 95% CI 1.7 to 3) and response (OR 1.9, 95% CI 1.5 to 2.5), with global rates of 24% and 42%, respectively (placebo rate: 11% and 27%, p<0.0001 for both). Indirect comparisons performed with network meta-analysis suggest no specific agent is clearly superior to others, with relatively better results observed for adalimumab in inducing disease remission. Conclusion. In anti-TNF-experienced CD patients, secondary biological administration may be efficient, while no specific agent seems to outperform the others. Further research is needed to identify optimal management strategies for this challenging subset of patients.
Positive Association between TGFB1 Gene and Susceptibility to Idiopathic Scoliosis in Bulgarian Population
Authors: Nikolova Svetla , Dikova Milka , Dikov Dobrin , Djerov Assen , Savov Alexey , Kremensky Ivo , Loukanov Alexandre
Published: July 2018

Idiopathic scoliosis (IS) is a common medical condition beginning in childhood and characterized by strong evidence for a genetic susceptibility to three-dimensional spinal deformity. The primary goal of the current case-control study is to examine the association between the TGFB1 (-509C/T) functional polymorphic variant and genetic predisposition to IS in the Bulgarian population and the genotype-phenotype correlations in distinct case-control subgroups based on age at onset, family history, and gender. A total of 127 patients with primary scoliosis and 254 gender-matched control subjects were recruited. The mean Cobb angle was 53.8 ± 21.2°. Genotyping of cases and controls was performed using the TaqMan real-time amplification technique. The results were processed statistically using Pearson’s Chi-squared test and Fisher’s exact test with a value of p less than 0.05 as statistically significant. The polymorphic T allele and TT genotype were associated with a greater incidence of IS and can be considered as predisposing factors with a moderate effect on deformity development. The current results suggested that there was a genetic predisposition in early and late onset IS and familial, sporadic, and female cases. Nevertheless, replication studies are needed to reveal the relationship between the TGFB1 locus and certain subtypes of IS in different populations.
Integrating Bus Holding Control Strategies and Schedule Recovery: Simulation-Based Comparison and Recommendation
Authors: Wu Weitiao , Liu Ronghui , Jin Wenzhou
Published: July 2018

In the absence of control strategies, headway fluctuation and bus bunching are commonly observed in transit operation due to the stochastic attributes such as travel time and passenger demand. Existing research on real-time control largely focused on developing operational tactics to maintain bus arrival regularity at stops without fully considering the effect of schedule recovery. This paper investigates the effect of bus driver behavior on bus holding control strategies and more specifically their effort in catching up with schedule in case of delay, i.e., schedule recovery. To this end, this paper first proposes a bus propagation model with capacity constraint to simulate the evolution of bus trajectories along a fixed route. It proceeds to explicitly incorporate both holding control actions and schedule recovery effect into the bus propagation model. Using simulation for a high-frequency bus line in Guangzhou, China, schedule- (SH) and headway-based holding (HH) control strategies are compared under various operational settings in the context of schedule recovery. These comparisons show that SH performs better under certain conditions, and SH generally benefits more from schedule recovery than HH. These results provide insights into the bus stop layout design and implementation of holding methods in the context of cruising guidance.
LMI Based Principles in Strictly Metzlerian Systems Control Design
Authors: Krokavec Dušan , Filasová Anna
Published: July 2018

The paper is concerned with the design requirements that relax the existing conditions reported in the previous literature for continuous-time linear positive systems, reformulating the linear programming approach by the linear matrix inequalities principle. Incorporating an associated structure of linear matrix inequalities, combined with the Lyapunov inequality guaranteeing asymptotic stability of positive system structures, the conditions are presented, with which the state-feedback controllers and the system state observers can be designed. A numerical example illustrates the proposed conditions.
Modified Droop Method Based on Master Current Control for Parallel-Connected DC-DC Boost Converters
Authors: Shebani Muamer M. , Iqbal Tariq , Quaicoe John E.
Published: July 2018

Load current sharing between parallel-connected DC-DC boost converters is very important for system reliability. This paper proposes a modified droop method based on master current control for parallel-connected DC-DC boost converters. The modified droop method uses an algorithm for parallel-connected DC-DC boost converters to adaptively adjust the reference voltage for each converter according to the load regulation characteristics of the droop method. Unlike the conventional droop method, the current feedback signal (master current) for one of the parallel-connected converters is used in the inner loop controller for all converters to avoid any differences in the time delay of the control loops for the parallel-connected converters. The algorithm ensures that the load current sharing is identical to the load regulation characteristics of the droop method. The proposed algorithm is tested with a mismatch in the parameters of the parallel converters. The effectiveness of the proposed algorithm is verified using Matlab/Simulink simulation.
Serum Sex Steroids as Prognostic Biomarkers in Patients Receiving Androgen Deprivation Therapy for Recurrent Prostate Cancer: A Post Hoc Analysis of the PR.7 Trial
Authors: Toren Paul , Hoffman Azik , Ding Keyue , Joncas France-Hélène , Turcotte Véronique , Caron Patrick , Pouliot Frédéric , Fradet Yves , Lévesque Éric , Guillemette Chantal , Klotz Laurence
Published: July 2018

Purpose: Phenotypic biomarkers are a high priority for patients receiving androgen deprivation therapy (ADT) for prostate cancer given the increasing number of treatment options. This study evaluates serum sex steroids as prognostic biomarkers in men receiving ADT for recurrent prostate cancer.

Experimental Design: Retrospective cohort study of Canadian patients in the PR.7 trial (accrual 1999–2005) who received continuous ADT for biochemical recurrence postradiotherapy. Patients were excluded with follow-up <2 years or who received estrogens or corticosteroids. Kaplan–Meier and multivariable Cox regression analyses adjusted for baseline prognostic factors assessed time to castration-resistant prostate cancer (CRPC), prostate cancer survival, and overall survival according to tertile of sex steroid measured by mass spectrometry.

Results: Post-ADT initiation, we measured samples in 219 patients as well as two subsequent annual samples in a subset of 101 patients. Testosterone levels correlated with androstenedione (AD) and DHT, while DHT, AD, androsterone (AST), dehydroepiandrosterone (DHEA), and androstenediol (A5diol) were highly correlated to each other and negatively associated with age. Higher tertiles of estrone (E1) and estradiol (E2) were significantly associated with sooner time to CRPC. In patients with longitudinal samples, increases in serum DHEA and AST were significantly associated with sooner time to CRPC. Limitations include the number of events for some groups.

Conclusions: Our data suggest the patient hormonal milieu has long-term prognostic value in men receiving ADT for recurrent prostate cancer, including increased levels of E1 and E2 and rising DHEA and AST levels, which predict a shorter time to CRPC. Clin Cancer Res; 24(21); 5305–12. ©2018 AACR.
Effekte einer suchtspezifischen Partnerschaftsintervention in einer stationären Entwöhnungsbehandlung
Authors: Schünemann Olivia , Lindenmeyer Johannes , Heinrichs Nina
Published: July 2018

Hintergrund: Die Wirksamkeit suchtspezifischer Partnerschaftsinterventionen wurde fast ausschließlich in randomisiert kontrollierten Studiendesigns überprüft. Daher wird hier untersucht, ob eine suchtspezifische kognitive Partnerschaftsintervention unter stationären Versorgungsbedingungen mit Veränderungen in der Partnerschaftszufriedenheit und der psychischen Belastung assoziiert ist und welche Patienten besonders von der Partnerschaftsintervention profitieren. Patienten und Methoden: Es wurden routinemäßig erhobene Daten von 1843 Patienten mit Alkoholabhängigkeit, die in einer Partnerschaft leben, genutzt (M = 47,1 Jahre; 68,4% männlich). Erfasst wurden Prä- und Post-Daten (Behandlungsdauer M = 10,2 Wochen) zur Partnerschaftszufriedenheit (Partnerschaftsfragebogen) bzw. zum sozialen Druck (Skala zur Erfassung des sozialen Drucks). Von einer Substichprobe (n = 621) waren auch Angaben zur psychischen Belastung (Symptom-Checkliste-90-R) verfügbar. Verglichen wurden Patienten mit bzw. ohne freiwillig genutzte zusätzliche Partnerschaftsintervention während einer stationären Entwöhnungsbehandlung. Die Patienten wurden gematcht, um trotz fehlender Randomisierung mögliche Konfundierungen zu kontrollieren. Behandlungseffekte wurden über eine 2-faktorielle Varianzanalyse mit Messwiederholung berechnet und Prädiktoren wurden anhand von Entscheidungsbäumen identifiziert. Ergebnisse: Beide Gruppen zeigten eine signifikante Prä-post-Verbesserung hinsichtlich ihrer selbstberichteten Partnerschaftszufriedenheit und psychischen Belastung. Es fanden sich keine Gruppenunterschiede. Ähnlich verhält es sich mit den Prädiktoren: In beiden Interventionsgruppen war die initiale Partnerschaftszufriedenheit ein Prädiktor für die Verbesserung der Partnerschaftszufriedenheit und das Geschlecht Prädiktor für die Reduktion der psychischen Belastung. Schlussfolgerung: Die Ergebnisse deuten darauf hin, dass Partnerschaftsinterventionen im subjektiven Erleben der Patienten unter Versorgungsbedingungen kurzfristig keinen zusätzlichen positiven Effekt haben.
Doctors’ Knowledge and Attitudes Regarding Enteral Feeding and Eating Problems in Advanced Dementia
Authors: Punchik Boris , Komissarov Elena , Zeldez Vladimir , Freud Tamar , Samson Tali , Press Yan
Published: July 2018

Background: The use of feeding tubes (FTs) in patients with advanced dementia does not yield positive health outcomes and can have a negative effect. Methods: A cross-sectional study assessed the knowledge and attitudes of physicians on the use of FTs for patients with advanced dementia. Results: 201 of 240 doctors (83.8%) participated in the study; 61.7% of the doctors claimed that FTs prevent aspiration, 51.7% that they prevent pneumonia, and 38.8% that they prevent weight gain. Almost one-third (32.3%) said that the decision to use FTs could be taken by a hospitalist or a primary physician (28.9%). Conclusion: We found large gaps in knowledge among doctors about the use of FTs and consequences in patients with advanced dementia.
Relationships between Clinical Presentation, Serology, Histology, and Duodenal Deposits of Tissue Transglutaminase Antibodies in Pediatric Celiac Disease
Authors: Loberman-Nachum Nurit , Schvimer Michael , Avivi Camila , Barshack Iris , Lahad Avishay , Fradkin Akiva , Bujanover Yoram , Weiss Batia
Published: July 2018

Background: The clinical, histological, and serological spectrum of celiac disease (CD) vary widely. We aimed to examine relationships between symptoms, serum anti-tissue transglutaminase antibodies (tTG) levels, mucosal damage, and mucosal anti-tTG deposits in pediatric CD. Methods: A retrospective single-center, cohort study of children referred for endoscopy with suspected CD during 2011–2014. We retrieved the clinical data, blindly reviewed duodenal biopsies, and performed immunohistochemical staining for anti-tTG deposits. Patients were classified as monosymptomatic or polysymptomatic. Mucosal anti-tTG deposits were classified according to the location of deposits, dominant intensity, maximal intensity, and percentage of stained area. Results: Of 252 patients with confirmed CD, complete data were available for 100: 37 males in the age range 1.3–16.7 with median 4.0 years. Monosymptomatic patients (n = 54) presented at an older age than polysymptomatic patients (1.3–15.5, median 8.1 vs. 1.3–16.7, median 6.3 years, p = 0.026). Marsh 2–3c was more prevalent in polysymptomatic patients (93 vs. 78%, p = 0.028). The intensity of mucosal anti-tTG deposits correlated with serum anti-tTG levels but not with the clinical presentation. Conclusions: Multiple symptoms and high serum anti-tTG antibody levels correlated with mucosal damage in children with CD. The role of immunohistochemical staining for intestinal anti-tTG mucosal deposits in the diagnosis of borderline CD is not yet established.
Long-Term Opioid Agonist Treatment Participation after First Treatment Entry is Similar across 4 European Regions but Lower in Non-Nationals
Authors: Nordt Carlos , Wiessing Lucas , Kuijpers Wil , Wisselink Jeroen , Espelt Albert , Brugal M. Teresa , Mravčik Viktor , Nechanská Blanka , Seifritz Erich , Herdener Marcus
Published: July 2018

Heroin users in opioid agonist treatment (OAT) show markedly reduced heroin consumption, less crime and a lower mortality rate. However, the extent of long-term OAT participation over subsequent treatment episodes remains unclear. We analysed the annual proportion of patients in treatment (at least 1 day) since the start of first OAT in 4 European regions: Barcelona (BA) 1996–2012: 8,602 patients; Czech ­Republic (CZ) 2000–2014: 4,377 patients; Netherlands (NL) 1994–2014: 33,235 patients, Zurich (ZU) 1992–2015: 11,795. We estimated the long-term decline of treatment need due to mortality or abstinence and also a “nuisance” short-term decline until the equilibrium level of cycling in and out of OAT is reached to obtain the adjusted treatment participation value. The adjusted treatment participation was around 50% (BA: 47.4–51.4%; CZ: 49.8–53.9%; NL: 52.3–54.0%; ZU: 46.4–49.3%), and the annual decline of treatment need was close to 4%. Non-nationals (NL patients with a migrant background) showed substantial lower adjusted treatment participation (rate ratio BA: 0.059–0.343; NL: 0.710–0.751; ZU: 0.681–0.797; CZ: n.a.). Our method may provide a policy-relevant indicator of long-term provision, quality and access to OAT following first treatment.
Role of 1α,25-Dihydroxyvitamin D3 in Adipogenesis of SGBS Cells: New Insights into Human Preadipocyte Proliferation
Authors: Felicidade Ingrid  , Sartori Daniele , Coort Susan L.M. , Semprebon Simone Cristine , Niwa Andressa Megumi , D’Epiro Gláucia Fernanda Rocha , Biazi Bruna Isabela , Marques Lilian Areal , Evelo Chris T. , Mantovani Mário Sérgio , Ribeiro Lúcia Regina
Published: July 2018

Background/Aims: Compared with non-obese individuals, obese individuals commonly store more vitamin D in adipose tissue. VDR expression in adipose tissue can influence adipogenesis and is therefore a target pathway deserving further study. This study aims to assess the role of 1,25(OH)2D3 in human preadipocyte proliferation and differentiation. Methods: RTCA, MTT, and trypan blue assays were used to assess the effects of 1,25(OH)2D3 on the viability, proliferation, and adipogenic differentiation of SGBS cells. Cell cycle and apoptosis analyses were performed with flow cytometry, triglycerides were quantified, and RT-qPCR was used to assess gene expression. Results: We confirmed that the SGBS cell model is suitable for studying adipogenesis and demonstrated that the differentiation protocol induces cell maturation, thereby increasing the lipid content of cells independently of treatment. 1,25(OH)2D3 treatment had different effects according to the cell stage, indicating different modes of action driving proliferation and differentiation. In preadipocytes, 1,25(OH)2D3 induced G1 growth arrest at both tested concentrations without altering CDKN1A gene expression. Treatment with 100 nM 1,25(OH)2D3 also decreased MTT absorbance and the lipid concentration. Moreover, increased normalized cell index values and decreased metabolic activity were not induced by proliferation or apoptosis. Exposure to 100 nM 1,25(OH)2D3 induced VDR, CEBPA, and CEBPB expression, even in the preadipocyte stage. During adipogenesis, 1,25(OH)2D3 had limited effects on processes such as VDR and PPARG gene expression, but it upregulated CEBPA expression. Conclusions: We demonstrated for the first time that 1,25(OH)2D3 induces changes in preadipocytes, including VDR expression and growth arrest, and increases the lipid content in adipocytes treated for 16 days. Preadipocytes are important cells in adipose tissue homeostasis, and understanding the role of 1,25(OH)2D3 in adipogenesis is a crucial step in ensuring adequate vitamin D supplementation, especially for obese individuals.
Non-Esterified Fatty Acids Over-Activate the TLR2/4-NF-Κb Signaling Pathway to Increase Inflammatory Cytokine Synthesis in Neutrophils from Ketotic Cows
Authors: Zhang Yuming , Li Xiaobing , Zhang Haolong , Zhao Zhibo , Peng Zhicheng , Wang Zhe , Liu Guowen , Li Xinwei
Published: July 2018

Background/Aims: Dairy cows with clinical ketosis display a negative energy balance and high blood concentrations of non-esterified fatty acids (NEFAs), the latter of which is an important pathological factor of ketosis in cows. The aims of this study were to investigate the inflammatory status of ketotic cows and to determine whether and through what underlying mechanism high levels of NEFAs induce an inflammatory response. Methods: Proinflammatory factors and the nuclear factor kappa B (NF-κB) signaling pathway were evaluated in neutrophils from clinical ketotic and control cows, using methods including western blotting, quantitative real-time polymerase chain reaction, and enzyme-linked immunosorbent assay. In vitro, the effects of NEFAs on the NF-κB signaling pathway in cow neutrophils were also evaluated using the above experimental techniques. Results: Ketotic cows displayed low blood concentrations of glucose and high blood NEFA and β-hydroxybutyrate concentrations. Importantly, Toll-like receptor 2 (TLR2) and TLR4 expression and IκBα and NF-κB p65 phosphorylation levels in neutrophils (PMNs) were significantly higher in ketotic cows than in control cows, indicating over-activation of the TLR2/4-induced NF-κB inflammatory pathway in PMNs in ketotic cows. The blood concentrations of the inflammatory cytokines interleukin-6 (IL-6), IL-1β, and tumor necrosis factor-α (TNF-α) were also significantly increased in ketotic cows. Interestingly, we found that NEFAs were positively correlated with proinflammatory cytokines. In vitro, after pharmacological inhibition of TLR2 and TLR4 expression in cow neutrophils, TLR2 and TLR4 expression was significantly decreased, and the phosphorylation level of NF-κB p65 was also reduced. Cow neutrophils were treated with different concentrations of NEFAs and pyrrolidine dithiocarbamate (PDTC; an NF-κB inhibitor). High concentrations of NEFAs (0.5 and 1 mM) significantly increased TLR2 and TLR4 expression, IκBα and NF-κB p65 phosphorylation levels, NF-κB p65 transcriptional activity, and IL-6, IL-1β, and TNF-α synthesis in cow neutrophils. The inhibition of NF-κB by PDTC suppressed the NEFA-induced synthesis of proinflammatory cytokines. Conclusions: High concentrations of NEFAs can over-activate the TLR2/4-mediated NF-κB signaling pathway to induce the over-production of proinflammatory cytokines, thereby increasing inflammation in cows with clinical ketosis.
Клінічнi спостереження автотрансплантації зубів як альтернативи імплантації
Authors: Hutor N. S. , Tverdokhlib N. O. , Avdeev O. V.
Published: July 2018

Summary. Study of the tooth range defect area, the post-extraction alveolar socket, the state of the transplanted tooth by using an X-ray examination is relevant nowadays.The aim of the study – to increase the efficiency of complex treatment of patients with defects in the tooth range by using dental autotransplantation for their restoration.Materilas and Methods. 10 patients without somatic diseases were examined: 7 women and 3 men, aged 23 to 30, residents of Ternopil town. Using clinical and radiological methods of examination, they had found by ones periodontitis tooth that was not subject to therapeutic treatment, the presence of intact third molars. Autotransplantation and clinical observations were performed on 2 patients.Results and Discussion. According to clinical and radiological examination data, autotransplantation in patients, as a surgical method of treatment, is sufficiently effective. Clinical observations have proven that one way to restore the integrity of the tooth range can be autotransplantation. For its conduct, indications for surgical treatment with the use of modern diagnostic methods should be determined, patients’ consent is required. Conclusions. To conduct autotransplantation one should begin with indications for its implementation: the presence of intact third molars; presence of the first molars not subject to conservative treatment; age of the patient; health status; good hygiene of the oral cavity; preliminary careful X-ray examination. Autotransplantation of the third molar as a surgical method of treatment is a sufficiently effective, accessible, cost-effective operation for patients in the absence of the first molar.
Використання наночасток гідроксилапатиту стронцію для профілактики та лікування підвищеної стертості зубів (лабораторні дослідження)
Authors: Tkachenko I. M. , Sidorova A. I. , Marchenko I. Y. , Nazarenko Z. Y.
Published: July 2018

Summary. The paper describes a method for strontium hydroxyapatite nanoparticles for the prevention and treatment of high abrasion of teeth with minimum size of the primary particles with a high degree of aggregation and the penetration of nanoparticles into the crystal lattice of the tooth enamel, which is provided by increasing the density of the enamel layer the effectiveness of treatment and prevention of high abrasion of teeth.The aim of the study – development of several derivatives of strontium salts having different structure of nanoparticles for the purpose of their further integration into the enamel layer to increase the enamel strength.Materials and Methods. On the basis of the proposed method we designed research protocol samples of teeth with increased abrasion to assess the penetration and fixation of nanoparticles on the surface of the tooth enamel. The use of the proposed method in a dental practice would improve the effectiveness of treatment and prevention of high abrasion of teeth due to inclusion in the complex treatment in the form of applications, ointments and gels.Results and Discussion. We obtained nanoparticles synthesized from strontium nitrate in the form of prisms measuring from 30 nm to 34 nm in size obtained by precipitation from strontium chloride.Conclusions. As a result of experimental research, strontium hydroxylapatite nanostructures from anion derivatives (chloride, nitrate, acetate) were discovered. Microscopic investigation showed that they consisted of plates, needles and equiaxed particles with dimensions from 19.4 to 35 nm, which is confirmed by X-ray, trace studies and microscopic studies.
Реінтервенції в пацієнтів з атрезією легеневої артерії та інтактною міжшлуночковою перегородкою після перфорації клапана легеневої артерії
Authors: Maksymenko A. V. , Shypov D. O. , Motrechko O. O. , Kuzmenko Yu. L. , Dovhaliuk A. A.
Published: July 2018

Мета роботи: визначити фактори, що впливають на частоту реінтервенцій у післяопераційному періоді після перфорації кла­пана легеневої артерії в пацієнтів з атрезією легеневої артерії та інтактною міжшлуночковою перегородкою (АЛАІМШП).Матеріали і методи. Проведено ретроспективний аналіз періопераційних даних, отриманих за допомогою ехокардіографії та рентген-хірургічного обстеження, та даних про післяопераційний перебіг хвороби з медичних карт 77 пацієнтів з АЛАІМШП, яким проведена перфорація та балонна вальвулопластика клапана легеневої артерії за період з вересня 2003 до 31 грудня 2014 р. у Центрі дитячої кардіології та кардіохірургії.Результати досліджень та їх обговорення. Перфорація та подальша балонна вальвулопластика клапана легеневої артерії у новонароджених пацієнтів з АЛАІМШП є ефективною та безпечною процедурою для відновлення антеградного легеневого кровотоку. В нашій групі пацієнтів ефективність склала 87 % (n = 41). Госпітальна летальність склала 4,8 % (n=2). Проте, незважаючи на переваги даної методики, значна частка пацієнтів потребує повторних втручань. Серед наших пацієнтів частота повторних втручань у ранньому післяопераційному періоді склала 34 % (n = 14) і, як правило, пов’язана з необхідністю створення додаткового джерела легеневого кровотоку. Серед факторів, що впливали на частоту реінтервенцій у ранньому післяопераційному періоді в пацієнтів з АЛАІМШП, були наступні показники: розмір кільця тристулкового клапана та його відповідний показник Z-score; співвідношення розмірів тристулкового до мітрального клапанів; розмір міжпередсердного сполучення.У віддаленому періоді повторних операцій потребували 11 пацієнтів (27 %). Всі проведені реінтервенції були спрямовані на пластику вихідного тракту правого шлуночка (ВТПШ). Єдиним показником, здатним прогнозувати необхідність повторного втручання на ВТПШ, був максимальний градієнт тиску на вихідному тракті.
Аналіз результатів лікування хворих із пошкодженнями стравоходу, ускладненими гострим гнійним медіастинітом
Authors: Shevchuk I. M. , Snizhko S. S.
Published: July 2018

Мета роботи: покращити результати лікування хворих із перфорацією стравоходу, ускладненою гострим гнійним медіастинітом.Матеріали і методи. Проаналізовані результати лікування 27 хворих із перфораціями стравоходу, ускладненими гострим гнійним медіастинітом.Результати досліджень та їх обговорення. Причинами перфорації стравоходу були сторонні тіла – у 9 (33,3 %) хворих, спонтанний розрив – у 8 (29,6 %) хворих, ятрогенія – у 5 (18,5 %) хворих, неспроможність швів після резекції стравоходу і стентування – у 5 (18,5 %) хворих. Післяопераційна летальність у хворих із пошкодженнями стравоходу, ускладненими гострим гнійним медіастинітом, склала 37,1 % (померли 10 із 27 хворих). При застосуванні бокової торакотомії післяопераційна летальність склала 50 % (померли 9 із 18 хворих), при відеоасистованій торакоскопії – 14,3 % (помер один із 7 хворих).Своєчасна діагностика перфорації стравоходу та гострого гнійного медіастиніту – один із вирішальних факторів у лікуванні даних хворих. Вибір хірургічної тактики індивідуальний в кожному окремому випадку. Основною метою хірургічного лікування є ліквідація гнійно-запального процесу в середостінні та стабілізація стану хворих. При перфорації стравоходу, ускладненій гострим гнійним медіастинітом, розширені операції на стравоході супроводжуються високими показниками післяопераційної летальності, що обмежує їх використання у хворих із сепсисом та поліорганною недостатністю. Зашивання перфорації стравоходу слід проводити для відмежування просвіту стравоходу від клітковини середостіння, локалізації гнійного процесу в середостінні і стабілізації загального стану хворого. Малоінвазивні операційні втручання за допомогою відеоасистованої торакоскопії можуть слугувати операціями вибору у хворих із перфорацією стравоходу при поширених формах гострого гнійного медіастиніту для санації і дренування гнійно-запального процесу в середостінні, стабілізації стану хворих та попередження розвитку септичних ускладнень.
Особливості хірургічного лікування варикозного розширення вен пахового каналу у вагітних
Authors: Antonyuk-Kisil V. M. , Dzubanovsky I. Ya. , Yenikeeva V. M. , Lichner S. I. , Lypnyi V. M. , Semeniuk M. V.
Published: July 2018

Мета роботи: розробка показань до операційного лікування пахового варикозу у вагітних та оцінка результатів лікування за умов короткочасного перебування в стаціонарі.Матеріали і методи. На базі комунального закладу “Обласний перинатальний центр” Рівненської обласної ради з початку 2013 р. до лютого 2018 р. включно діагноз первинного симптомного варикозного розширення вен пахового каналу (ПСВРВПК) встановлено у 265 жінок. Ізольовану форму ПСВРВПК діагностовано у 68 (25,66 %) вагітних, поєднані форми виявлено у 197 (74,34 %) вагітних із венами басейну сафенових вен, зовнішніх статевих органів, промежини. У плановому порядку прооперовано 48 (18,11 %) вагітних з симптомним ПСВРВПК у ІІ–ІІІ триместрах вагітності.Результати досліджень та їх обговорення. Розроблено і впроваджено тактику лікування даної патології залежно від форми та поширення. 48 (18,11 %) пацієнток дали згоду на проведення в плановому порядку хірургічного лікування даної патології в ІІ–ІІІ триместрах вагітності: 21 (43,75 %) жінка через неефективну консервативну терапію, коли захворювання клінічно прогресувало і поширювалось; 18 (37,5 %) вагітних з метою підготовки природного пологового шляху до пологів природним шляхом при вираженому варикозному розширенні вен зовнішніх статевих органів і промежини для зменшення ризиків кровотечі у випадку розриву варикозних вузлів та звуження показань до хірургічних пологів; 9 (18,75 %) вагітним на їх вимогу, для покращення косметичних проблем зовнішніх статевих органів і/або нижніх кінцівок, спричинених варикозним розширенням вен при відсутності протипоказань до втручання у вагітної з боку соматичного і акушерського статусів.
Вплив величини внутрішньочеревного тиску та ішемічно- реперфузійних порушень на прояви цитолітичного синдрому та його корекція тіоцетамом в експерименті
Authors: Melnyk O. I.
Published: July 2018

Мета роботи: з’ясувати вплив ішеміно-реперфузійних порушень на прояви синдрому цитолізу залежно від величини внутрішньочеревного тиску та ефективність корекції виявлених порушень тіоцетамом.Матеріали і методи. В експерименті використано 90 статевозрілих білих щурів-самців лінії Wistar масою 200–250 г, які знаходилися на стандартному раціоні віварію. Усіх піддослідних тварин наркотизували (тіопентал-натрію 40 мг·кг-1 внутрішньоочеревинно) та моделювали підвищення внутрішньочеревного тиску на 10, 20 і 30 мм рт. ст. шляхом нагнітання в черевну порожнину атмосферного повітря. Час експозиції становив 90 хв, після чого контрольних тварин та тварин кожної дослідної групи відразу виводили з експерименту шляхом тотального кровопускання з серця. Інших тварин кожної дослідної групи (по 6 особин) в умовах анестезії (тіопентал натрію 40 мг·кг-1 внутрішньоочеревинно) виводили з експерименту через 1, 3 і 7 діб після реперфузії. В окремих групах тваринам після реперфузії щоденно протягом 6 діб вводили препарат Тіоцетам (“Галичфарм”, Україна) в дозі 250 мг·кг-1 внутрішньоочеревинно. З експерменту їх виводили через 7 діб. У тварин забирали кров, в сироватці якої визначали активність індикаторних ферментів цитолізу аланін- і аспартатамінотрансфераз (АлАТ, АсАТ) уніфікованим методом для аналізатора біохімічного Humalyzer 2000.Результати досліджень та їх обговорення. Моделювання підвищеного ВЧТ протягом 90 хв супроводжується вираженим цитолітичним синдромом, що проявляється істотним збільшенням активності в сироватці крові АлАТ. Найбільші порушення виникають після реперфузії при величині ВЧТ 20 і 30 мм рт. ст. За цих умов активність АлАТ у сироватці крові зростає ще більше, відмічається підвищення активності АсАТ з максимумом через 3–7 діб. Застосування з корегувальною метою Тіоцетаму в дозі 250 мг·кг-1 внутіршньоочеревинно протягом 6 діб супроводжується вираженим позитивним ефектом, який проявляється істотним зниженням активності АлАТ і АсАТ в сироватці крові при величинах ВЧТ 20 і 30 мм рт. ст.
Prevalência de hipotireoidismo em pacientes com diabetes mellitus tipo 2
Authors: Fernandes Gabriel Queiroz , Freitas Giordanne Guimarães
Published: July 2018

Introdução. A diabetes mellitus tipo 2 é uma síndrome clínica que torna o corpo incapaz de normalizar os níveis séricos de glicose. O hipotireoidismo, por sua vez, reflete uma condição em que há um baixo nível de hormônios tireoidianos no corpo. A relação entre diabetes mellitus tipo 1 e o hipotireoidismo já é bem estabelecida, mas sua relação com o tipo 2 ainda não é bem descrita na comunidade acadêmica. Casuística e Métodos. Foram incluídos nesta pesquisa pacientes atendidos entre janeiro de 2015 e dezembro de 2016, que possuíam diagnóstico de diabetes mellitus tipo 2. Os instrumentos de coleta foram: ficha clínica com dados sobre perfil e identificação do paciente, inventário de saúde, aspectos clínicos do motivo da consulta, avaliação física, avaliação laboratorial, diagnóstico médico e plano de tratamento. Foram selecionados 184 prontuários médicos de pacientes atendidos no período em questão, sendo que foram excluídos 31 pacientes devido à falta de dados necessários para categorização. Foram revisados os prontuários médicos dos 153 pacientes restantes, sendo que apenas 51 possuíam diagnóstico de diabetes mellitus tipo 2 e foram incluídos nesta pesquisa. Resultados. Após a revisão dos prontuários médicos, 15 pacientes foram diagnosticados com hipotireoidismo, determinando uma prevalência de 29,4%. Discussão. A alta prevalência encontrada sugere que o rastreio para hipotireoidismo em diabéticos tipo 2 pode levar ao diagnóstico precoce. Conclusão. A alta prevalência de hipotireoidismo estabelecida neste estudo leva a recomendação de rastreio para essa doença em todos os pacientes diabéticos tipo 2.
Single-use versus reusable flexible ureteroscopes: a comprehensive cost-analysis decision model
Authors: Marchini Giovanni Scala , Torricelli Fábio César Miranda , Monga Manoj , Batagello Carlos Alfredo , Vicentini Fábio Carvalho , Danilovic Alexandre , Srougi Miguel , Nahas William Carlos , Mazzucchi Eduardo
Published: July 2018

Purpose: The significant improvements in flexible ureterorenoscopes have made flexible ureteroscopy the main treatment modality to target upper urinary pathologies. The purpose of this study was to critically evaluate all literature concerning the cost-effectiveness of flexible ureteroscopy comparing single-use with reusable scopes. Methods: A systematic online literature review was performed in PubMed, Embase and Google Scholar databases. Two separate urologists (GSM and FCT) performed the online search and reviewed all papers considered suitable and relevant for this analysis. Because of the paucity of high quality publications, not only prospective assessments but also case control and case series studies were included in the final analysis. All factors potentially affecting surgical costs or clinical outcomes were considered in the analysis. Results: 741 studies with the previously elected terms were found. Of those, 18 were duplicated and 77 were not related to urology procedures and were excluded. Of the remaining 646 studies, 59 published between 2000 and 2018 were considered of relevance to the pre-defined queries and were selected for further analysis. Stone free and complication rates were similar between single-use and reusable scopes. In special, urinary tract infection rate following flexible ureteroscopy is not inferior if a single-use device is used instead of a reusable scope. Operative time was in average 20% shorter if a digital scope was used, single-use or not. There is a suggestion that the learning curve is shorter with single-use devices but this is not consistent in the literature. Surgeon expertise impacts the longevity of the flexible scope. Reusable digital scopes seem to last longer than optic ones, though scope longevity is very variable worldwide. New scopes usually last three to four times more than refurbished ones and single-use ureterorenoscopes have good resilience throughout long cases. Both sterilization method and cleaning process impact scope longevity, the best results being achieved with Cidex and a dedicated nurse to take care of the sterilization process. The main factors that negatively impact device longevity regarding patient and disease are lower pole pathologies, large stone burden and non-use of a ureteral access sheath. Conclusions: The cost-effectiveness of a flexible ureteroscopy program is dependent of several aspects that must be considered when deciding whether to choose between a single-use and a reusable ureterorenoscope. Disposable devices are already a reality and will progressively become the standard as manufacturing price falls significantly.
The transrectal ultrasound/MRI fusion biopsy for prostate cancer diagnosis after previous negative biopsy: a case report
Authors: Pontes-Júnior José , Oliveira Luiz Carlos Neves de , Coelho Rafael Ferreira , Srougi Miguel , Nahas William Carlos
Published: July 2018

Introduction: The adoption of multiparametric MRI (mpMRI) guided fusion biopsy is becoming an important tool to improve the diagnostic yield in those suspected of having prostate cancer, especially for patients with suspicious lesion located at the anterior region that is uncommonly sampled at randomized biopsy. Methods: Herein we report a case of a man with persistent elevated PSA and a previous negative randomized prostate biopsy. His PSA was 8.1 ng/dL and a multiparametric MRI showed a 2cm suspicious PIRADS-4 lesion located at the anterior region of the right transition zone at base and mid gland. A transrectal ultrasound/MRI (TRUS/mpMRI) fusion biopsy was performed and its pathologic report showed a Gleason 3+4 (ISUP II) that was present only in the fragments that sampled the suspected area at MRI. We review the role of mpMRI in the diagnosis of prostate cancer at rebiopsy.
The Communicative Constitution of Organization, Organizing, and Organizationality
Authors: Schoeneborn Dennis , Kuhn Timothy R. , Kärreman Dan
Published: July 2018

Although the lion’s share of scholarship in management and organization studies conceives of organizations as entities within which communication occurs, “Communication Constitutes Organization” (CCO) scholarship has attracted interest because it makes a productive reversal, that is, by asking how organization happens in communication. Over the past decade, Organization Studies has become the key scholarly outlet for CCO thinking in the management and organization studies field. Accordingly, in this paper we discuss seven articles that have appeared in this journal as evidence of the perspective’s centrality. We first situate CCO theorizing within the linguistic turn, and position CCO with respect to other lines of scholarship underwritten by a rich conception of language and discourse. We examine the varied ways CCO thinking has found organization in communication, locating in the seven articles productive tensions between the process of communication, on the one hand, and organization, organizing, and organizationality, on the other. We contribute to CCO scholarship with reflections on these three theoretical orientations and provide a set of possibilities for its further development.
Toxic Stress and Vulnerable Mothers: A Multilevel Framework of Stressors and Strengths
Authors: Condon Eileen M. , Sadler Lois S.
Published: July 2018

Toxic stress is associated with poor health outcomes that extend across the life span. Although caregivers can protect their children from toxic stress through supportive caregiving, this can be challenging for vulnerable mothers living in socioeconomically disadvantaged environments. We aim to advance the science of toxic stress prevention by exploring the stressors and strengths experienced by vulnerable mothers through application of a theoretical framework, Bronfenbrenner’s bioecological model. Following Arksey and O’Malley’s five-stage scoping study framework, 179 articles were included. Key information was abstracted and each article was reviewed for relevance to the bioecological model. Results revealed that the sources of stress and strength are multilayered, transactional, and have a complex influence on caregiving in families at risk of toxic stress. Future research should include empirical investigations of the complex relationships among these stressors and strengths, and the development of preventive interventions to support vulnerable families at risk of toxic stress.