bluuebunny/crossref_metadata_2025 huggingface dataset:
Trends in sex-specific differences in outcomes in extreme preterms: progress or natural barriers?
Authors: Garfinkle Jarred , Yoon Eugene W , Alvaro Ruben , Nwaesei Chuks , Claveau Martine , Lee Shoo K , Shah Prakesh S
Published: June 2019

Objective

To examine the differences and trends of outcomes of preterm boys and girls born at <29 weeks’ gestation.

Design

A retrospective cohort study.

Setting

Data collected by the Canadian Neonatal Network.

Patients

Neonates born at <29 weeks’ gestation between January 2007 and December 2016.

Main outcome measures

We examined rate differences in mortality, major morbidities (bronchopulmonary dysplasia, severe brain injury, retinopathy of prematurity, necrotising enterocolitis and late-onset sepsis) and care practices (antenatal steroids, magnesium sulfate, maternal antibiotics, ventilation and surfactant administration) between boys and girls and evaluated trends in these rate differences over the study period. Our primary outcome was a composite of mortality and any one of the five morbidities.

Results

Our study included 8219 boys and 6934 girls with median gestational age of 26 (IQR 25–28) weeks. The composite of death or major morbidity was more common in boys (adjusted risk ratio 1.07, 95% CI 1.05 to 1.10) and remained higher in boys over the study period. The gap between boys and girls for mortality, however, decreased over time: the slope for boys was −0.043 (95% CI −0.071 to −0.015) and for girls was −0.012 (95% CI −0.045 to 0.020) (p=0.04). All other morbidities remained higher in boys. Care practices changed at similar rates between the sexes.

Conclusion

The difference between the mortality rates for boys and girls decreased over the study period but the difference between rates of the major morbidities was unchanged. More research is needed to understand biological differences and outcome disparities.
Paediatric Horner’s syndrome: is investigation for underlying malignancy always required?
Authors: Braungart Sarah , Craigie Ross J , Farrelly Paul , Losty Paul Damian
Published: June 2019

Objective

Horner’s syndrome (HS) is characterised by a triad of ocular miosis, ptosis and anhidrosis. HS may be a subtle sign of occult pathology in otherwise asymptomatic children, neuroblastoma (NBL) being the the most common associated malignant tumour. Despite such knowledge, the incidence of underlying malignancy in children with HS remains unclear and robust evidence to guide best clinical practice is sparse. We performed a systematic review of the literature with the aim of identifying the incidence of NBL in children with HS of unknown aetiology, and establishing if screening for NBL should be routinely performed in this patient population.

Methods

Systematic review of the literature (PubMed and Ovid/Medline database, 1961–2018).

Results

The initial search identified 334 manuscripts, of which 8 studies were included in the final analysis. All reports were single-centre retrospective studies without control groups and included a total of 152 patients (age range 0–20 years). All studies investigated patients with HS but without previously established diagnosis. In the studies included, 17 out of a total of 152 patients were diagnosed with a space-occupying lesion. 12 out of the 152 patients were subsequently detected with NBL.

Conclusion

HS in children may be the first sign of occult malignancy. We report the first systematic review that comprehensively investigates the incidence of malignancy in this unique patient cohort. We show that HS of unknown aetiology in children warrants further investigation(s) to exclude an underlying space-occupying lesion. This should include cross-sectional imaging of the brain, neck and thorax, plus urinary catecholamines for prompt diagnosis and treatment.
Serum 25OHD concentration as a predictor of haemoglobin A1c among adults living in the USA: NHANES 2003 to 2010
Authors: Nicolo Michele , Boullata Joseph I
Published: June 2019

Background

Vitamin D status influences glucose metabolism. Serum 25-hydroxyvitamin D (25OHD) concentrations have been inversely associated with type 2 diabetes risk. The optimal serum 25OHD level needed for adequate glycaemic control is unknown.

Objective

To determine the relationship among serum 25OHD concentrations and degree of glucose regulation using percentage of haemoglobin A1c (HbA1c%).

Methods

Data for adults ≥ 20 years from the National Health and Nutrition Examination Survey (NHANES) (2003–2010) were included. A binary logistic regression was used for serum 25OHD (nmol/L) as a continuous variable to determine the OR and 95% CI for HbA1c >6.5%, adjusting for sex, race and body mass index (BMI). Measures of serum 25OHD were grouped into quartiles and entered into a binary logistic regression model to determine the OR and 95% CI for HbA1c >6.5% in an adjusted model.

Results

Across all NHANES cycles, lower serum 25OHD was associated with greater odds of HbA1c ≥ 6.5% when adjusting for sex, race, age and BMI (NHANES 2003–2004 (N=4402): OR 0.985, 95% CI 0.979 to 0.990; NHANES 2005–2006 (N=4409): OR 0.976, 95% CI 0.969 to 0.982; NHANES 2007–2008 (N=4525): OR 0.989, 95% CI 0.984 to 0.993; and NHANES 2009–2010 (N=5660): OR 0.988, 95% CI 0.984 to 0.991). In an adjusted model, the lowest quartile of serum 25OHD (0–41 nmol/L, N=4879) was associated with greater odds of HbA1c ≥ 6.5% compared with the highest quartile (73–260 nmol/L, N=4472), OR 2.37, 95% CI 2.03 to 2.77. The odds of HbA1c ≥ 6.5% were also greater for adults with serum 25OHD considered to be sufficient compared with the highest quartile, OR 1.68, 95% CI 1.56 to 1.61).

Conclusion

Lower serum 25OHD concentrations are associated with poor glycaemic control (HbA1c ≥ 6.5%). Sufficient serum 25OHD levels were also associated with poorer blood glucose control. Further research is needed to investigate an optimal serum concentration or threshold to support adequate blood glucose control.
New insights into 5α-reductase type 2 deficiency based on a multi-centre study: regional distribution and genotype–phenotype profiling ofSRD5A2in 190 Chinese patients
Authors: Gui Baoheng , Song Yanning , Su Zhe , Luo Fei-Hong , Chen Linqi , Wang Xiumin , Chen Ruimin , Yang Yu , Wang Jin , Zhao Xiu , Fan Lijun , Liu Xia , Wang Yi , Chen Shaoke , Gong Chunxiu
Published: June 2019

Background

The 5α-reductase type 2 (5α-RD2) deficiency caused by mutations in the steroid 5α-reductase 2 (SRD5A2) gene results in variable degrees of undervirilisation in patients with 46,XY disorders of sex development. This study aims to profile the regional distribution and phenotype–genotype characteristics ofSRD5A2in a large Chinese 5α-RD2 deficiency cohort through multi-centre analysis.

Methods

190 subjects diagnosed with 5α-RD2 deficiency were consecutively enrolled from eight medical centres in China. Their clinical manifestations and genetic variants were analysed.

Results

Hypospadias (isolated or combined with microphallus and/or cryptorchidism) was fairly common in the enrolled subjects (66.32%). 42 variants, including 13 novel variants, were identified inSRD5A2. Homozygous and compound heterozygous mutations presented in 38.42% and 61.58% of subjects, respectively, and predominated in exons 1, 4 and 5. The most prevalent variant was c.680G > A (52.37%), followed by c.16C > T, (10.79%), c.607G > A, (9.21%) and c.737G > A, (8.95%). However, their distributions were different: c.680G > A was more common in South China than in North China (62.62% vs 39.16%, p < 0.001), whereas the regional prevalence of c.16C > T was reversed (6.07% vs 16.87%, p = 0.001). Furthermore, c.680G > A prevailed in cases with normal meatus (68.75%) or distal hypospadias (66.28%), compared with those with proximal hypospadias (35.54%, p < 0.001). However, cases with proximal hypospadias showed a higher frequency of c.16C > T (20.48%) than those with normal meatus (3.13%) or distal hypospadias (3.49%, p < 0.001).

Conclusions

This study profiled variable phenotypic presentation and wide mutational spectrum ofSRD5A2,revealing its distinctive regional distribution in Chinese patients and further shaping the founder effect and genotype–phenotype correlation ofSRD5A2.
Eigenvalues, absolute continuity and localizations for periodic unitary transition operators
Authors: Tate Tatsuya
Published: June 2019

The localization phenomenon for periodic unitary transition operators on a Hilbert space consisting of square summable functions on an integer lattice with values in a finite-dimensional Hilbert space, which is a generalization of the discrete-time quantum walks with constant coin matrices, is discussed. It is proved that a periodic unitary transition operator has an eigenvalue if and only if the corresponding unitary matrix-valued function on a torus has an eigenvalue which does not depend on the points on the torus. It is also proved that the continuous spectrum of a periodic unitary transition operator is absolutely continuous. As a result, it is shown that the localization happens if and only if there exists an eigenvalue, and when there exists only one eigenvalue, the long-time limit of transition probabilities coincides with the point-wise norm of the projection of the initial state to the eigenspace. The results can be applied to certain unitary operators on a Hilbert space on a covering graph, called a topological crystal, over a finite graph. An analytic perturbation theory for matrices in several complex variables is employed to show the result about absolute continuity for periodic unitary transition operators.
Certain functionals of squared telegraph processes
Authors: Martinucci Barbara , Meoli Alessandra
Published: June 2019

We investigate the stochastic process defined as the square of the (integrated) symmetric telegraph process. Specifically, we obtain its probability law and a closed form expression of the moment generating function. Some results on the first-passage time through a fixed positive level are also provided. Moreover, we analyze some functionals [Formula: see text] of two independent squared telegraph processes, both in the case [Formula: see text] and [Formula: see text]. Starting from this study, we provide some results on the probability density functions of the two-dimensional radial telegraph process and of the product of two independent symmetric telegraph processes. Some of the expressions obtained are given in terms of new results about derivatives of hypergeometric functions with respect to parameters.
Switchable second-order nonlinear optical response of platinum-sensitized dithienylethenes
Authors: Liu Xiao-Yun , Shi Zhi-Yuan , Ye Jin-Ting , Wang Hui-Ying , Wang Hong-Qiang , Qiu Yong-Qing
Published: June 2019

The electronic structure and the nonlinear optical (NLO) properties of a series of platinum-sensitized dithienylethenes (DTEs) were investigated by using the density functional theory (DFT) method. DFT calculations reveal that the second-order NLO properties of complexes significantly increase with the DTE ligand being directly linked with terpyridine–Pt(II) complexes. Due to the good [Formula: see text]-conjugated characteristics, closed-ring complexes possess much larger second-order NLO properties than the corresponding open-ring complexes. The computational [Formula: see text] values are in the order of 3c ([Formula: see text] esu) [Formula: see text] 3o ([Formula: see text] esu) [Formula: see text] 4c ([Formula: see text] esu) [Formula: see text] 4o ([Formula: see text] esu) [Formula: see text] 1 ([Formula: see text] esu) [Formula: see text] 2c ([Formula: see text] esu) [Formula: see text] 2o ([Formula: see text] esu). Among all calculated platinum-sensitized dithienylethenes, 3c has the largest second-order NLO properties. The 4c and 4o have almost the same [Formula: see text] values and the [Formula: see text] value of 4o is slightly larger than that of 2o because the ether bonds can significantly prevent charge transfer within the complexes.
Fast fluorescence lifetime imaging techniques: A review on challenge and development
Authors: Liu Xiongbo , Lin Danying , Becker Wolfgang , Niu Jingjing , Yu Bin , Liu Liwei , Qu Junle
Published: June 2019

Fluorescence lifetime imaging microscopy (FLIM) is increasingly used in biomedicine, material science, chemistry, and other related research fields, because of its advantages of high specificity and sensitivity in monitoring cellular microenvironments, studying interaction between proteins, metabolic state, screening drugs and analyzing their efficacy, characterizing novel materials, and diagnosing early cancers. Understandably, there is a large interest in obtaining FLIM data within an acquisition time as short as possible. Consequently, there is currently a technology that advances towards faster and faster FLIM recording. However, the maximum speed of a recording technique is only part of the problem. The acquisition time of a FLIM image is a complex function of many factors. These include the photon rate that can be obtained from the sample, the amount of information a technique extracts from the decay functions, the efficiency at which it determines fluorescence decay parameters from the recorded photons, the demands for the accuracy of these parameters, the number of pixels, and the lateral and axial resolutions that are obtained in biological materials. Starting from a discussion of the parameters which determine the acquisition time, this review will describe existing and emerging FLIM techniques and data analysis algorithms, and analyze their performance and recording speed in biological and biomedical applications.
Extension of Maddox’s space l(μ) with Nörlund means
Authors: Gökçe Fadime , Sarigöl Mehmet Ali
Published: June 2019

In this paper, we introduce a new series space [Formula: see text] as the set of all series summable by the absolute Nörlund summability method, which includes the spaces [Formula: see text] and [Formula: see text] of Maddox [Spaces of strongly summable sequences, Quart. J. Math. 18(1) (1967) 345–355], Sarıgöl [Spaces of series summable by absolute Cesàro and matrix operators, Comm. Math Appl. 7(1) (2016) 11–22], Hazar and Sarıgöl [On absolute Nörlund spaces and matrix operators, Acta Math. Sinica, (English Ser.) 34(5) (2018) 812–826], respectively. Also, we study its some algebraic and topological structures such as isomorphism, the [Formula: see text], [Formula: see text], [Formula: see text] duals, Schauder basis, and characterize certain matrix transformations on that space.
Some basic properties of solvable Leibniz algebras
Authors: Mansuroğlu Nil
Published: June 2019

In this paper, we commence the systematic study of the structure of solvable Leibniz algebras and we give some basic properties on solvable non-Lie Leibniz algebras. Our main aim is to show a close relationship between solvable Leibniz algebras and nilpotent Leibniz algebras. Furthermore, we give some examples on solvable non-Lie Leibniz algebras over a field of characteristic zero.
The slant helices according to N-Bishop frame of the spacelike curve with spacelike principal normal in Minkowski 3-space
Authors: Kusak Samanci Hatce , Yildiz Ayhan
Published: June 2019

If the principal normal vector field of a curve makes a constant angle with constant direction, this curve is called as slant helix. In this paper, a slant helix is defined according to N-Bishop frame of the spacelike curve with a spacelike principal normal. Some characterizations of the slant helices are obtained according to spacelike curve N-Bishop frame with a spacelike principal normal, benefiting from the definition of the slant helices.
追随与自主：新加坡华文文学教材嬗变
Authors: 李 佳
Published: June 2019

新加坡的华文文学教育可追溯至早期华校的中学华文课本，发展至今经历了曲折历程。本文以1959年颁布的《华文中小学华文课程标准》、2006年颁布的《2006 中学华文文学课程标准》、2012年颁布的《中学华文文学课程标准2013》, 以及2018年颁布的《中学华文文学课程标准2019》为主要线索, 探讨在这些框架指导下，新加坡华文文学教材发生的几次重要嬗变，并探讨在此过程中新加坡对于建构自身文学教育的不断探索与努力。
Prediction of tunnelling impact on flow rates of adjacent extraction water wells
Authors: Golian Mohsen , Katibeh Homayoon , Singh Vijay P. , Ostad-Ali-Askari Kaveh , Rostami Hamed Tavasoli
Published: June 2019

The decline or drying up of groundwater sources near a tunnel route is damaging to groundwater users. Therefore, forecasting the impact of a tunnel on nearby groundwater sources is a challenging task in tunnel design. In this study, numerical and analytical approaches were applied to the Qomroud water conveyance tunnel (located in Lorestan province, Iran) to assess the impact of tunnelling on the nearby extraction water wells. Using simulation of groundwater-level fluctuation owing to tunnelling, the drawdown at the well locations was determined. From the drawdowns and using Dupuit's equation, the depletion of well flow rates after tunnelling was estimated. To evaluate the results, observed well flow rates before and after tunnelling were compared with the predicted flow rates. The observed and estimated water well flows (before and after tunnelling) showed a regression factor of 0.64, pointing to satisfactory results
A General Framework for Adversarial Examples with Objectives
Authors: Sharif Mahmood , Bhagavatula Sruti , Bauer Lujo , Reiter Michael K.
Published: June 2019

Images perturbed subtly to be misclassified by neural networks, calledadversarial examples, have emerged as a technically deep challenge and an important concern for several application domains. Most research on adversarial examples takes as its only constraint that the perturbed images are similar to the originals. However, real-world application of these ideas often requires the examples to satisfy additional objectives, which are typically enforced through custom modifications of the perturbation process. In this article, we proposeadversarial generative nets(AGNs), a general methodology to train ageneratorneural network to emit adversarial examples satisfying desired objectives. We demonstrate the ability of AGNs to accommodate a wide range of objectives, including imprecise ones difficult to model, in two application domains. In particular, we demonstratephysicaladversarial examples—eyeglass frames designed to fool face recognition—with better robustness, inconspicuousness, and scalability than previous approaches, as well as a new attack to fool a handwritten-digit classifier.
Alone versus In-a-group
Authors: Mou Wenxuan , Gunes Hatice , Patras Ioannis
Published: June 2019

Recognition and analysis of human affect has been researched extensively within the field of computer science in the past two decades. However, most of the past research in automatic analysis of human affect has focused on the recognition of affect displayed by people in individual settings and little attention has been paid to the analysis of the affect expressed in group settings. In this article, we first analyze the affect expressed by each individual in terms of arousal and valence dimensions in both individual and group videos and then propose methods to recognize the contextual information, i.e., whether a person is alone or in-a-group by analyzing their face and body behavioral cues. For affect analysis, we first devise affect recognition models separately in individual and group videos and then introduce a cross-condition affect recognition model that is trained by combining the two different types of data. We conduct a set of experiments on two datasets that contain both individual and group videos. Our experiments show that (1) the proposed Volume Quantized Local Zernike Moments Fisher Vector outperforms other unimodal features in affect analysis; (2) the temporal learning model, Long-Short Term Memory Networks, works better than the static learning model, Support Vector Machine; (3) decision fusion helps to improve affect recognition, indicating that body behaviors carry emotional information that is complementary rather than redundant to the emotion content in facial behaviors; and (4) it is possible to predict the context, i.e., whether a person is alone or in-a-group, using their non-verbal behavioral cues.
GPLADD
Authors: Outkin Alexander V. , Eames Brandon K. , Galiardi Meghan A. , Walsh Sarah , Vugrin Eric D. , Heersink Byron , Hobbs Jacob , Wyss Gregory D.
Published: June 2019

Trust in a microelectronics-based system can be characterized as the level of confidence that a system is free of subversive alterations made during system development, or that the development process of a system has not been manipulated by a malicious adversary. Trust in systems has become an increasing concern over the past decade. This article presents a novel game-theoretic framework, called GPLADD (Graph-based Probabilistic Learning Attacker and Dynamic Defender), for analyzing and quantifying system trustworthiness at the end of the development process, through the analysis of risk of development-time system manipulation. GPLADD represents attacks and attacker-defender contests over time. It treats time as an explicit constraint and allows incorporating the informational asymmetries between the attacker and defender into analysis. GPLADD includes an explicit representation of attack steps via multi-step attack graphs, attacker and defender strategies, and player actions at different times. GPLADD allows quantifying the attack success probability over time and the attacker and defender costs based on their capabilities and strategies. This ability to quantify different attacks provides an input for evaluation of trust in the development process. We demonstrate GPLADD on an example attack and its variants. We develop a method for representing success probability for arbitrary attacks and derive an explicit analytic characterization of success probability for a specific attack. We present a numeric Monte Carlo study of a small set of attacks, quantify attack success probabilities, attacker and defender costs, and illustrate the options the defender has for limiting the attack success and improving trust in the development process.
Plant Virus Vectors 3.0: Transitioning into Synthetic Genomics
Authors: Cody Will B. , Scholthof Herman B.
Published: June 2019

Plant viruses were first implemented as heterologous gene expression vectors more than three decades ago. Since then, the methodology for their use has varied, but we propose it was the merging of technologies with virology tools, which occurred in three defined steps discussed here, that has driven viral vector applications to date. The first was the advent of molecular biology and reverse genetics, which enabled the cloning and manipulation of viral genomes to express genes of interest (vectors 1.0). The second stems from the discovery of RNA silencing and the development of high-throughput sequencing technologies that allowed the convenient and widespread use of virus-induced gene silencing (vectors 2.0). Here, we briefly review the events that led to these applications, but this treatise mainly concentrates on the emerging versatility of gene-editing tools, which has enabled the emergence of virus-delivered genetic queries for functional genomics and virology (vectors 3.0).
Investigation of an Alternative Sulfonated Silane in Ceramic Carbon Electrodes for Fuel Cell Applications
Authors: Reid O'Rian O. , Easton E. Bradley
Published: June 2019

In this work the sulfonated CCE material developed by Eastcott and Easton was replaced with a more alternative sulfonated organosilane monomer component. Specifically, 3-(trihydroxysilyl) propane-1-sulfonic acid (TPS) was replaced with 4-(2-(trihydroxysilyl)ethyl) benzenesulfonic acid (TEBS) and compared to the previous TPS-based system as well as the traditional Nafion ionomer electrode. The sulfonated CCEs were characterized using BET surface area analysis, thermogravimetric analysis, SEM, and TEM. The electrodes were then evaluated a full cell environment. The TEBS-based electrode showed a decrease in performance at both high and low relative humidities compared to the TPS/TEOS and Nafion ionomers. Impedance studies revealed that water retention with the TEBS was significantly lower that TPS, which accounted for the lower performance.
Knowledge, Attitude, and Practice Related to Malaria Diagnosis among Healthcare Workers in Hospitals: A Cross-Sectional Survey
Authors: Kotepui Kwuntida Uthaisar , Kotepui Manas , Punsawad Chuchard
Published: June 2019

Malaria is a potential medical emergency and should be treated immediately because delays in diagnosis and treatment are the leading causes of death in many countries. This study aimed to assess the knowledge, attitude, and practice related to malaria diagnosis for early detection among healthcare workers in the laboratories of hospitals in Thailand. The design of the study was a descriptive cross-sectional study carried out between January 2016 and March 2017 at 11 hospitals in Thailand. The interviewees included any scientists who were currently working in a medical laboratory. Mean scores for knowledge, attitude, and practice for each healthcare group were calculated and compared between groups. Data analysis was performed using the SPSS version 11.5 software package (SPSS Inc., Chicago, IL, USA). Among a total of 118 healthcare workers, most of the healthcare workers had fair to good knowledge, attitude, and practice related to malaria detection. Among the various positions of healthcare workers, medical technologists possessed a greater knowledge on malaria detection than medical technician assistants or laboratory assistants (X2 = 9.822, d.f. = 2, and P value=0.007). This study infers that knowledge, attitude, and practice related to malaria detection among healthcare workers in laboratories were adequate. However, some points of knowledge and practice must be updated. There is a very urgent need to update knowledge on malaria, especially about the number ofPlasmodiumspecies causing relapse in malaria patients. In addition, there is an urgent need to update the practice related to malaria detection, especially about the staining process for early detection of malaria.
A New Method for Biostatistical miRNA Pattern Recognition with Topological Properties of Visibility Graphs in 3D Space
Authors: Babič Matej , Marina Ninoslav , Mrvar Andrej , Dookhitram Kumar , Calì Michele
Published: June 2019

Visibility is a very important topic in computer graphics and especially in calculations of global illumination. Visibility determination, the process of deciding which surface can be seen from a certain point, has also problematic applications in biomedical engineering. The problem of visibility computation with mathematical tools can be presented as a visibility network. Instead of utilizing a 2D visibility network or graphs whose construction is well known, in this paper, a new method for the construction of 3D visibility graphs will be proposed. Drawing graphs as nodes connected by links in a 3D space is visually compelling but computationally difficult. Thus, the construction of 3D visibility graphs is highly complex and requires professional computers or supercomputers. A new method for optimizing the algorithm visibility network in a 3D space and a new method for quantifying the complexity of a network in DNA pattern recognition in biomedical engineering have been developed. Statistical methods have been used to calculate the topological properties of a visibility graph in pattern recognition. A new n-hyper hybrid method is also used for combining an intelligent neural network system for DNA pattern recognition with the topological properties of visibility networks of a 3D space and for evaluating its prospective use in the prediction of cancer.
Analysis of Exponential Stability for Neutral Stochastic Cohen-Grossberg Neural Networks with Mixed Delays
Authors: Yang Tianqing , Xiong Zuoliang , Yang Cuiping
Published: June 2019

This paper is concerned with the mean-square exponential input-to-state stability problem for a class of stochastic Cohen-Grossberg neural networks. Different from prior works, neutral terms and mixed delays are discussed in our system. By employing the Lyapunov-Krasovskii functional method, Itô formula, Dynkin formula, and stochastic analysis theory, we obtain some novel sufficient conditions to ensure that the addressed system is mean-square exponentially input-to-state stable. Moreover, two numerical examples and their simulations are given to illustrate the correctness of the theoretical results.
Reconstruction of the Peroneus Brevis Tendon Tears with Semitendinosus Tendon Autograft
Authors: Nishikawa Danilo Ryuko Cândido , Duarte Fernando Aires , Saito Guilherme Honda , de Cesar Netto Cesar , Monteiro Augusto César , Prado Marcelo Pires , de Sousa Ivan Furlan Grava
Published: June 2019

Peroneal tendon disorders are common causes of lateral and retromalleolar ankle pain. For irreparable tears of the tendon, a salvage procedure is indicated with segmental resection followed by reconstruction with tenodesis, tendon transfer, or bridging the defect using allograft or autograft. Although there is insufficient evidence to guide which of these treatment options provides the best outcomes, reconstruction with tendon allograft has provided satisfactory clinical results and is effective for pain relief and restoration of tendon function. However, there are concerns about the use of tendon allografts which include its cost and availability, disease transmission, delayed incorporation, and stretching of the graft. The aim of this study is to present the surgical technique for the reconstruction of the peroneus brevis tendon tears using semitendinosus tendon autograft as an alternative to the allograft and report the short-term results of three cases.
Guided Bone Regeneration of an Atrophic Maxilla Using Heterologous Cortical Lamina
Authors: Polis-Yanes Carlos , Cadenas-Sebastián Carla , Gual-Vaqués Patricia , Ayuso-Montero Raúl , Marí-Roig Antoni , López-López José
Published: June 2019

Alloplastic dental implants are currently the best way to replace lost teeth. In order to achieve good function and prognosis of dental implants, having bone and soft tissue to support them is necessary. When the amount of bone left is not enough to ensure the outcome of the implant, techniques such as shorts implants, zygomatic implants, or guided bone regeneration have been used. Even though autologous bone is mostly the “gold standard,” other biomaterials such as xenografts have led to the reduction of the morbidity of treatments and to the improvement of the regeneration technique outcomes. We present a clinical case of severe atrophy of the maxilla in which we used different types of biomaterials: heterologous cortical lamina, xenograft and autologous bone, and microscrews.
Corrigendum to “Zeaxanthin: Review of Toxicological Data and Acceptable Daily Intake”
Authors: Edwards James A. , Cremer Dirk
Published: June 2019

Zeaxanthin is a nutritional carotenoid with a considerable amount of safety data based on regulatory studies, which forms the basis of its safety evaluation. Subchronic OECD guideline studies with mice and rats receiving beadlet formulations of high-purity synthetic zeaxanthin in the diet at dosages up to 1000 mg/kg body weight (bw)/day, and in dogs at over 400 mg/kg bw/day, produced no adverse effects or histopathological changes. In developmental toxicity studies, there was no evidence of fetal toxicity or teratogenicity in rats or rabbits at dosages up to 1000 or 400 mg/kg bw/day, respectively. Formulated zeaxanthin was not mutagenic or clastogenic in a series of in vitro and in vivo tests for genotoxicity. A 52-week chronic oral study in cynomolgus monkeys at doses of 0.2 and 20 mg/kg  bw/day, mainly designed to assess accumulation and effects in primate eyes, showed no adverse effects. In a two-generation study in rats, the NOAEL was 150 mg/kg  bw/day. In 2012, this dosage was used by EFSA (NDA Panel), in association with a 200-fold safety factor, to propose an acceptable daily intake equivalent to 53 mg/day for a 70 kg adult. The requested use level of 2 mg/day was ratified by the EU Commission. Recent reevaluation of the data from the two-generation study indicated that the NOAEL should be redefined as the high dosage of 500 mg/kg bw/day, rather than the intermediate dosage of 150 mg/kg bw/day. The NOAEL of this study was formally amended to the high dosage. Also in 2018, JECFA raised the group ADI of lutein and zeaxanthin to “not specified,” due to the low toxicity of these substances.
Using Machine Learning Algorithms to Predict Hepatitis B Surface Antigen Seroclearance
Authors: Tian Xiaolu , Chong Yutian , Huang Yutao , Guo Pi , Li Mengjie , Zhang Wangjian , Du Zhicheng , Li Xiangyong , Hao Yuantao
Published: June 2019

Hepatitis B surface antigen (HBsAg) seroclearance during treatment is associated with a better prognosis among patients with chronic hepatitis B (CHB). Significant gaps remain in our understanding on how to predict HBsAg seroclearance accurately and efficiently based on obtainable clinical information. This study aimed to identify the optimal model to predict HBsAg seroclearance. We obtained the laboratory and demographic information for 2,235 patients with CHB from the South China Hepatitis Monitoring and Administration (SCHEMA) cohort. HBsAg seroclearance occurred in 106 patients in total. We developed models based on four algorithms, including the extreme gradient boosting (XGBoost), random forest (RF), decision tree (DCT), and logistic regression (LR). The optimal model was identified by the area under the receiver operating characteristic curve (AUC). The AUCs for XGBoost, RF, DCT, and LR models were 0.891, 0.829, 0.619, and 0.680, respectively, with XGBoost showing the best predictive performance. The variable importance plot of the XGBoost model indicated that the level of HBsAg was of high importance followed by age and the level of hepatitis B virus (HBV) DNA. Machine learning algorithms, especially XGBoost, have appropriate performance in predicting HBsAg seroclearance. The results showed the potential of machine learning algorithms for predicting HBsAg seroclearance utilizing obtainable clinical data.
Efficiency of Repetitive Transcranial Direct Current Stimulation of the Dorsolateral Prefrontal Cortex in Disorders of Consciousness: A Randomized Sham-Controlled Study
Authors: Wu Min , Yu Yamei , Luo Lunjie , Wu Yuehao , Gao Jian , Ye Xiangming , Luo Benyan
Published: June 2019

Conventional transcranial direct current stimulation (tDCS) targeting the left dorsolateral prefrontal cortex (DLPFC) could improve arousal in disorders of consciousness (DOC). However, the comparative effectiveness of anodal stimulation of the left DLPFC and the electrophysiological effect of tDCS are yet to be determined. In this randomized sham-controlled design, patients were separated into three groups (left/right anodal tDCS, sham). Data on the clinical assessments and EEG were collected at baseline and after 2 weeks of tDCS. The outcome at 3-month follow-up was evaluated using the Glasgow Outcome Scale-Extended. Results showed that sessions of the left tDCS facilitated the excitability of the prefrontal cortex, whereas only one patient had a positive outcome. Targeting the right DLPFC was less effective, merely leading to activation of the stimulation site, with no effect on the state of arousal. Moreover, sham stimulation had minimal or no effect on any of the outcomes. These results provide evidence for a hemispheric asymmetry of tDCS effects in patients with DOC. Left anodal tDCS might be more effective for modulating cortical excitability compared to tDCS on the right DLPFC. However, future studies with large sample sizes are needed to confirm these findings. This trial is registered with NCT03809936.
Predominantly Superior Retinal Tears Detected by B-Scan Ultrasonography
Authors: Streho M. , Perrenoud F. , Abraham N. , Hawa K. , Puech M. , Giocanti-Aurégan A.
Published: June 2019

Introduction. When fundus examination is not possible, ultrasonography (US) is an accurate tool for the diagnosis of retinal tears (RT). The aim of this study was to describe the predominant location of RT, the factors influencing their location, and the vitreous status of eyes with RT using US. Methods. A prospective study was conducted in all patients diagnosed with RT by B-scan US (Aviso, Quantel Médical, Clermont-Ferrand, France). The primary endpoint was to assess RT preferential location using US. Secondary endpoints were the rate of posterior vitreous detachment (PVD), number of eyes with multiple RT, and axial length (AL). Results. A total of 101 eyes of 100 patients with RT were included. RT main location was in the superior quadrants (either nasal superior, strictly superior, or temporal superior) in 71% of cases. All patients were diagnosed with PVD by US, and 79% had a vitreous hemorrhage. Twelve eyes (13%) were diagnosed with multiple RT. The mean AL was 24.62 ± 2 mm, and it was significantly longer in eyes without superior RT (25.52 mm versus 24.37 mm; p=0.004). Conclusion. In this study, we showed a superior location of RT diagnosed by US in more than two-thirds of cases associated with a significantly shorter AL than in other locations. This finding could increase US sensitivity for RT detection and help to improve the US learning curve of ophthalmologists in training and surgical decision-making when the retina is inaccessible due to opacity media.
A Case Report of Takayasu’s Arteritis and Ulcerative Colitis in a Pediatric Patient with Chronic Recurrent Multifocal Osteomyelitis Successfully Treated with Infliximab: Diagnostic Clues in Disease Associations and Immune Dysregulation
Authors: De Guerra Viveka Clare , Hashmi Humaira , Kramer Bree , Balluz Rula , Son Mary Beth , Stein Deborah , Lieberman Alicia , Zahra Mahmoud , Abdul-Aziz Rabheh
Published: June 2019

Background. Takayasu’s arteritis with comorbid chronic recurrent multifocal osteomyelitis and ulcerative colitis is rare in the pediatric population. Treatment with anti-TNF alpha agents such as infliximab has been a successful treatment strategy in adults and can be used effectively in the pediatric population. Case Presentation. We present the case of a 15-year-old Caucasian girl with a history of chronic recurrent multifocal osteomyelitis and ulcerative colitis presenting with hypertensive emergency secondary to Takayasu’s arteritis with middle aortic syndrome. She was treated with corticosteroids and methotrexate and ultimately required infliximab infusions of 15 mg/kg every 4 weeks to successfully control her symptoms and normalize her inflammatory markers. Conclusions. In this case, we discuss the use of infliximab in an adolescent patient with chronic recurrent multifocal osteomyelitis, ulcerative colitis, and Takayasu’s arteritis. The significance of this case is determined by the unique occurrence of all three conditions in a pediatric patient, the important consideration of vasculitis in the differential of a pediatric patient presenting with hypertensive emergency, the need for vigilance for detecting diagnostic clues, signs, and symptoms, knowledge of disease associations when evaluating a patient with a predisposition for autoinflammatory conditions, and the use of increasing doses of infliximab to control symptoms.
Data‐Driven Synchronization Analysis of a Bouncing Crowd
Authors: Chen Jun , Tan Huan , Van Nimmen Katrien , Van den Broeck Peter
Published: June 2019

Vibration serviceability problems concerning lightweight, flexible long‐span floors and cantilever structures such as grandstands generally arise from crowd‐induced loading, in particular due to bouncing or jumping activities. Predicting the dynamic responses of these structures induced by bouncing and jumping crowds has therefore become a critical aspect of vibration serviceability design. Although accurate models describing the load induced by a single person are available, essential information on the level of synchronization within the crowd is missing. In answer to this lack of information, this paper experimentally investigates the inter‐ and intraperson variability as well as the global crowd behavior in bouncing crowds. A group size of 48 persons is considered in the experiment whereby the individual body motions are registered synchronously by means of a 3D motion capture system. Preliminary tests verified a new approach to characterize the bouncing motion via markers on the clavicle. Subsequently, the full‐scale experimental study considered various crowd spacing parameters, auditory stimuli, and bouncing frequencies. Moreover, special test cases were performed whereby each participant was wearing an eyepatch to exclude visual effects. Through the analysis of 330 test cases, the interperson variability at the bouncing frequency is identified. In addition, the cross‐correlation and coherence between participants are analyzed. The coherence coefficients between each pair of participants in the same row or column are calculated and can be described by a lognormal distribution function. The influence of the spatial configurations and visual and auditory stimuli is analyzed. For the considered spatial configurations, no relevant impact on the inter‐ and intraperson variability in the bouncing motion nor in the global crowd behavior is observed. Visual stimuli are found to enhance the coordination and synchronization. Without eyesight, the participants are feeling uncertain about their bouncing behavior. The results evaluating the auditory cues indicate that significantly higher levels of synchronization and a lower degree of the intraperson variability are attained when a metronome cue is used in comparison to songs where the tempo often varies.
Matrix Metalloproteinases in Renal Diseases: A Critical Appraisal
Authors: Zakiyanov Oskar , Kalousová Marta , Zima Tomáš , Tesař Vladimír
Published: June 2019

Matrix metalloproteinases (MMPs) are endopeptidases within the metzincin protein family that not only cleave extracellular matrix (ECM) components, but also process the non-ECM molecules, including various growth factors and their binding proteins. MMPs participate in cell to ECM interactions, and MMPs are known to be involved in cell proliferation mechanisms and most probably apoptosis. These proteinases are grouped into six classes: collagenases, gelatinases, stromelysins, matrilysins, membrane type MMPs, and other MMPs. Various mechanisms regulate the activity of MMPs, inhibition by tissue inhibitors of metalloproteinases being the most important. In the kidney, intrinsic glomerular cells and tubular epithelial cells synthesize several MMPs. The measurement of circulating MMPs can provide valuable information in patients with kidney diseases. They play an important role in many renal diseases, both acute and chronic. This review attempts to summarize the current knowledge of MMPs in the kidney and discusses recent data from patient and animal studies with reference to specific diseases. A better understanding of the MMPs’ role in renal remodeling may open the way to new interventions favoring deleterious renal changes in a number of kidney diseases.
Cure of Underactive and Overactive Bladder Symptoms in Women by 1,671 Apical Sling Operations Gives Fresh Insights into Pathogenesis and Need for Definition Change
Authors: Liedl Bernhard , Goeschen Klaus , Yassouridis Alexander , Inoue Hiromi , Abendstein Burghard , Müller-Funogea Ion-Andrei , Caliskan Alpaslan
Published: June 2019

Introduction:To check evidence that symptoms identical with those constituting “underactive bladder” (UAB) and “overactive bladder” (OAB) are caused by apical prolapse and cured by repair thereof. Material and Methods: After repair of apical prolapse by mesh tape reinforcement of lax uterosacral ligaments (USL) data form 1,671 women were retrospectively examined to determine the presence of OAB and UAB symptoms and to check, how many were cured surgically. Thereby 3 different techniques were performed: elevate (n = 277), “Posterior IVS” (n = 1,049), and TFS cardinal (CL)/USL (n = 345). Results: Symptoms identical with those comprising UAB and OAB were cured in up to 80% of cases following surgical repair of the CL/USL complex. Conclusions: These symptoms may be consistent with symptoms of the posterior fornix syndrome, which comprises 4 main symptoms: micturition difficulties, urge/frequency, nocturia, chronic pelvic pain, all consequent on USL laxity. Surgical cure of OAB and UAB is inconsistent with existing definitions, which imply pathogenesis of the detrusor muscle itself. A reconsideration and reformulation of existing definitions may be required. Altering UAB definition to “bladder emptying difficulties” and return to former definitions for OAB such as “detrusor” or “bladder instability” may help to restore compatibility with surgical cure of these conditions.
Application of Periareolar Mammaplasty with the Tissue Folding Technique in Breast Reshaping following Polyacrylamide Hydrogel Removal
Authors: Cai Yantao , Liu Bin , Liao Mingjuan , He Liu , Zhu Chenfang
Published: June 2019

Background: Polyacrylamide hydrogel (PAAG) was used as an injectable implant for augmentation mammoplasty for over 30 years, but its use was ceased due to various related complications. The only way to treat these complications is PAAG removal, but this causes breast ptosis, nipple retraction, breast asymmetry, and skin laxity. Objectives: This article reports a new technique for breast reshaping after PAAG removal without prosthesis implantation. Method: From January 2015 to June 2018, twenty-three patients underwent periareolar mammoplasty with the tissue folding technique (PMTFT) for breast reshaping after PAAG removal. Postoperative breast shape and the degree of satisfaction of the patients were evaluated during follow-up. Results: All patients recovered well without severe complications. All patients were satisfied with their postoperative breast shape and their symptoms were relieved after surgery. Conclusions: PMTFT provides satisfactory postoperative breast shape results. Economical, practical, and technical advantages were found over traditional prosthesis-mediated breast reconstruction. PMTFT can be an ideal surgical choice in appropriate cases.
The Traditional Medicine Banhasasim-Tang Depolarizes Pacemaker Potentials of Cultured Interstitial Cells of Cajal through M3 Muscarinic and 5-HT3 Receptors in Murine Small Intestine
Authors: Kim Jeong Nam , Nam Joo Hyun , Lee Jong Rok , Kim Sang Chan , Kim Byung Joo
Published: June 2019

Background: Banhasasim-tang (BHSST) is a classic herbal formulation in traditional Chinese medicine widely used for gastrointestinal (GI) tract motility disorder. We investigated the effects of BHSST on the pacemaker potentials of cultured interstitial cells of Cajal (ICCs) in small intestine in vitro and its effects on GI motor functions in vivo. Methods: We isolated ICCs from the small intestines and recorded pacemaker potentials in cultured ICCs with the whole-cell patch-clamp configuration in vitro. Intestinal transit rates (ITR%) were investigated in normal mice and GI motility dysfunction (GMD) mouse models in vivo. Results: BHSST (20–50 mg/mL) depolarized pacemaker potentials and decreased their amplitudes in a concentration-dependent manner. Pretreatment with methoctramine (a muscarinic M2 receptor antagonist) did not inhibit BHSST-induced pacemaker potential depolarization. However, when we applied 1,1-dimethyl-4-diphenylacetoxypiperidinium iodide (4-DAMP; a muscarinic M3 receptor antagonist), BHSST-induced effects were blocked. Pretreatment with Y25130 (a 5-HT3 receptor antagonist) blocked BHSST-induced effects in ICCs. In addition, when we applied 4-DAMP and Y25130 together, BHSST-induced effects were completely blocked. Pretreatment with Ca2+-free solution or thapsigargin inhibited BHSST-induced effects. Moreover, BHSST blocked both the transient receptor potential melastatin (TRPM) 7 and voltage-sensitive calcium-activated chloride (anoctamin-1, ANO1) channels. In normal mice, ITR% values were significantly increased by BHSST in a dose-dependent manner. The ITR% of GMD mice was significantly reduced relative to those of normal mice, which were significantly reversed by BHSST in a dose-dependent manner. Conclusion: These results suggested that BHSST depolarizes the pacemaker potentials of ICCs in a dose-dependent manner through the M3 and 5-HT3 receptors via internal and external Ca2+-dependent and TRPM7- and ANO1-independent pathways in vitro. Moreover, BHSST increased ITR% in vivo in normal mice and GMD mouse models. Taken together, the results of this study showed that BHSST had the potential for development as a prokinetic agent in GI motility function.