bluuebunny/crossref_metadata_2025 huggingface dataset:
Prediction of inverted velocity profile for gas flow in nanochannel
Authors: Zhang T. T. , Ren Y. R.
Published: November 2014

Velocity inversion is an interesting phenomenon of nanoscale which means that the velocity near the wall is greater than that of center. To solve this problem, fluid flow in nanochannel attracts more attention in recent years. The physical model of gas flow in two-dimensional nanochannel was established here. To describe the process with conventional control equations, Navier–Stokes equations combined with high-order accurate slip boundary conditions was used as mathematical model. With the introduction of new dimensionless variables, the problem was reduced to an ordinary differential equation. Then it was analytically solved and investigated using homotopy analysis method (HAM). The results were verified by comparing with other available experiment data. Result shows that the proposed method could predict velocity phenomenon.
Negative differential resistance induced by SiNx co-dopant in armchair graphene nanoribbon
Authors: Cheng Cai-ping , Hu Hui-fang , Zhang Zhao-jin , Liu Quanhui , Chen Ying , Peng Ping
Published: November 2014

By adopting density functional theory in combination with nonequilibrium Green's functions, we investigated the electronic structure and transport properties of silicon/nitrogen ( Si / N ) co-doping armchair graphene nanoribbons (AGNRs) with SiN x co-dopant incorporated in neighboring carbon atoms. The results demonstrate that the electronic structure can be modulated by introducing SiN x co-dopants in AGNRs. The striking negative differential resistance behaviors in the range of low bias can be observed in Si / N co-doped AGNR devices. These remarkable properties suggest the potential application of Si / N co-doping AGNRs in molectronics.
Plasmonic analogue of electromagnetically induced transparency in a T-shaped metallic nanohole array and its sensing performance
Authors: Wan Ming Li , Sun Xiao Jun , Song Yue Li , Li Yong , Zhou Feng Qun
Published: November 2014

In this paper, a plasmonic analogue of electromagnetically induced transparency (EIT) is demonstrated theoretically in a T-shaped silver nanohole array. A sharply narrow reflectance transparency window is clearly observed within the background spectrum of the broad dipole-like resonance at optical frequencies when structural asymmetry is introduced. Furthermore, the transparency peak exhibits highly sensitive response to the refractive index of surrounding medium and yield a sensitivity of 725 nm/refractive index unit (RIU), which ensures our proposed nanohole array as an excellent plasmonic sensor. In addition, the dependence of figure of merit (FOM) on structural asymmetry is investigated numerically to optimize the sensing performance of the EIT-based sensor.
Numerical analysis for neutral SPDEs driven by α-stable processes
Authors: Bao Jianhai , Yuan Chenggui
Published: November 2014

In this note, we discuss strong convergence of exponential integrator scheme based on spatial and time discretization for a class of neutral stochastic partial differential equations driven by α-stable processes.
Phosphorus(V) tetrapyrazinocorrolazines — first corrolazine derivatives with fused heterocyclic rings
Authors: Ivanova Svetlana S. , Moryganova Yulia , Hamdoush Mahmoud , Koifman Oscar I. , Sal'nikov Denis S. , Stuzhin Pavel A.
Published: November 2014

Tetrapyrazinocorrolazines — first corrolazine derivatives with annulated heterocycles — have been prepared as phosphorus(V) complexes by the reaction of metal free tetrapyrazinoporphyrazines [( R 8 TPyzPA ) H 2] (R = Ph, Me) with phosphorus(III) chloride or bromide in pyridine. Oxophosphorus(V) complexes [( R 8 TPyzCA ) P = O ] were obtained when the reaction mixture was poured into water, while dilution with methanol leads to dimethoxyphosphorus(V) complexes [( R 8 TPyzCA ) P ( OMe )2]. The obtained compounds were characterized by MALDI-TOF mass-spectrometry and by IR, 1 H , 31 P NMR measurements. Their UV-vis spectral and basic properties in CH 2 Cl 2– CF 3 COOH medium were studied in comparison to phosphorus(V) complex of octaphenylcorrolazine [( Ph 8 CA ) P = O ].
Noncommutative stable homotopy and stable infinity categories
Authors: Mahanta Snigdhayan
Published: November 2014

The noncommutative stable homotopy category NSH is a triangulated category that is the universal receptacle for triangulated homology theories on separable C*-algebras. We show that the triangulated category NSH is topological as defined by Schwede using the formalism of (stable) infinity categories. More precisely, we construct a stable presentable infinity category of noncommutative spectra and show that NSHop sits inside its homotopy category as a full triangulated subcategory, from which the above result can be deduced. We also introduce a presentable infinity category of noncommutative pointed spaces that subsumes C*-algebras and define the noncommutative stable (co)homotopy groups of such noncommutative spaces generalizing earlier definitions for separable C*-algebras. The triangulated homotopy category of noncommutative spectra admits (co)products and satisfies Brown representability. These properties enable us to analyze neatly the behavior of the noncommutative stable (co)homotopy groups with respect to certain (co)limits. Along the way we obtain infinity categorical models for some well-known bivariant homology theories like KK-theory, E-theory, and connective E-theory via suitable (co)localizations. The stable infinity category of noncommutative spectra can also be used to produce new examples of generalized (co)homology theories for noncommutative spaces.
Decreased insulin secretion and incretin concentrations and increased glucagon concentrations after a high-fat meal when compared with a high-fruit and -fiber meal
Authors: Dandona Paresh , Ghanim Husam , Abuaysheh Sanaa , Green Kelly , Batra Manav , Dhindsa Sandeep , Makdissi Antoine , Patel Reema , Chaudhuri Ajay
Published: November 2014

This study was conducted to investigate whether a high-fat/high-carbohydrate (HFHC) meal induces an increase in plasma concentrations of glucagon, dipeptidyl peptidase-IV (DPP-IV), and CD26 expression in mononuclear cells (MNC) while reducing insulin, C-peptide, proinsulin, GIP, and GLP-1 concentrations. Ten healthy normal subjects were given either a 910-calorie HFHC meal or an American Heart Association (AHA) meal rich in fruit and fiber during the first visit and the other meal during the second visit in crossover design. Blood samples were collected at baseline and at 15, 30, 45, 60, 75, 90, 120, 180, and 300 min following the meal. There was a significantly greater increase in glucose concentrations and lower increase in postprandial insulin, C-peptide, and proinsulin concentrations and lower insulin/glucose ratios following the HFHC meal. HFHC meal intake induced marked increases in plasma glucagon and DPP-IV concentrations and an increase in CD26 mRNA expression in MNC compared with the AHA meal. In addition, the HFHC meal induced a reduction in GIP and peak GLP-1 secretion compared with the AHA meal. This was associated with a significantly greater increase in oxidative stress and proinflammatory mediators including, ROS generation, TNFα, and IL-1β mRNA expression and plasma concentrations of TBARS, FFA, and LPS. We conclude that the proinflammatory HFHC meals result in lower insulin, C-peptide, proinsulin, and GIP secretion in association with higher plasma glucagon and DPP-IV concentrations and CD26 expression in MNC compared with the AHA meal.
Psychogenic Nonepileptic Spells in Chronic Epilepsy Patients with Moderate Cognitive Impairment: The Need for Video EEG Monitoring for Adequate Diagnosis
Authors: Robinson Diana Mungall , Kirmani Batool F.
Published: November 2014

The objective of our study was to emphasize the importance of intensive video EEG monitoring in patients with a well-established diagnosis of epilepsy with moderate cognitive impairment. The idea was to diagnose new onset frequent atypical events prompting the need for frequent emergency room and clinic visits and hospital admissions. Retrospective chart reviews were conducted on patients with chronic epilepsy with moderate cognitive impairment who had an increased incidence of new onset episodes different from the baseline seizures. Data were acquired from electronic medical records. The hospital’s Institutional Review Board gave approval for this retrospective analysis of patient records. We retrospectively analyzed data from three patients with an established diagnosis of epilepsy. Extensive chart reviews were performed with emphasis on type and duration of epilepsy and description of baseline seizures and description of new events. There were two men and one woman with moderate cognitive impairment. One subject had generalized epilepsy and other two had temporal lobe epilepsy. The patients were on an average of two to three antiepileptic medicines. The duration of follow-up in our neurology clinic ranged from 9 months to 5 years. The occurrence of increased frequency of these atypical events as described by the caregivers, despite therapeutic anticonvulsant levels, prompted the need for 5-day intensive video EEG monitoring. New atypical spells were documented in all three patients and the brain waves were normal during those episodes. The diagnosis of pseudoseizures was made based on the data acquired during the epilepsy monitoring unit stay. Our data analysis showed that intensive video EEG monitoring is an important tool to evaluate change in frequency and description of seizures even in cognitively impaired patients with an established diagnosis of epilepsy for adequate seizure management.
Endodontic Management of a Maxillary Molar with Three Mesiobuccal Canals
Authors: Gundam Sirisha , Maddu Radhika , Gurram Sindhura Reddy
Published: November 2014

It is imperative that the clinician should have comprehensive knowledge about the normal anatomy and its variations of the teeth as the deviations from the usual are very common. An increased awareness of unusual anatomy and a better understanding of the root canal system guide the clinician in accurate diagnosis and treatment of such variations in order to achieve a successful endodontic outcome. The maxillary first molar has been shown to have a wide variation in respect to the number of canals specifically noted in the mesiobuccal root. The current case report shows the successful management of a maxillary molar in which the mesiobuccal root had three canals.
Mental Health Promotion in School: Schoolchildren’s and Families’ Viewpoint
Authors: Puolakka Kristiina , Konu Anne , Kiikkala Irma , Paavilainen Eija
Published: November 2014

While developing mental health work in schools, it is very important to consider the viewpoint of pupils. Parents can also give remarkable information on their children’s viewpoint. The purpose of this study was to produce a description of the concepts used by schoolchildren aged 12–16 years and their families associated with promoting mental health in schools. The research material comprised interviews with schoolchildren and mothers, and verbal answers from the school well-being profile survey(n=426). The analysis was conducted by applying the grounded theory method as introduced by Strauss. The study was conducted in a Finnish comprehensive school.
The Experience of Melanoma Follow-Up Care: An Online Survey of Patients in Australia
Authors: Mitchell Janine , Callaghan Peta , Street Jackie , Neuhaus Susan , Bessen Taryn
Published: November 2014

Investigating patients’ reports on the quality and consistency of melanoma follow-up care in Australia would assist in evaluating if this care is effective and meeting patients’ needs. The objective of this study was to obtain and explore the patients’ account of the technical and interpersonal aspects of melanoma follow-up care received. An online survey was conducted to acquire details of patients’ experience. Participants were patients treated in Australia for primary melanoma. Qualitative and quantitative data about patient perceptions of the nature and quality of their follow-up care were collected, including provision of melanoma specific information, psychosocial support, and imaging tests received. Inconsistencies were reported in the provision and quality of care received. Patient satisfaction was generally low and provision of reassurance from health professionals was construed as an essential element of quality of care. “Gaps” in follow-up care for melanoma patients were identified, particularly provision of adequate psychosocial support and patient education. Focus on strategies for greater consistency in the provision of support, information, and investigations received, may generate a cost dividend which could be reinvested in preventive and supportive care and benefit patient well-being.
Evaluation of Neonatal Streptozotocin Induced Diabetic Rat Model for the Development of Cataract
Authors: Patil Madhoosudan A. , Suryanarayana Palla , Putcha Uday Kumar , Srinivas Myadara , Reddy G. Bhanuprakash
Published: November 2014

Type 2 diabetes (T2D) generally follows prediabetes (PD) conditions such as impaired fasting glucose (IFG) and/or impaired glucose tolerance (IGT). Although studies reported an association of IGT or IFG with cataract, the experimental basis for PD associated cataract is not known. Hence, we evaluated neonatal streptozotocin (nSTZ) induced rat model to study PD associated cataractogenesis by injecting STZ to two-day old rats. While majority (70%) of nSTZ injected pups developed IGT (nSTZ-PD) by two months but not cataract even after seven months, remaining (30%) nSTZ rats developed hyperglycemia (nSTZ-D) by two months and mature cataract by seven months. Lens biochemical analysis indicated increased oxidative stress as indicated by increased SOD activity, lipid peroxidation, and protein carbonyl levels in nSTZ-D cataractous lens. There was also increased polyol pathway as assessed by aldose reductase activity and sorbitol levels. Though nSTZ-PD animals have not shown any signs of lenticular opacity, insolubilization of proteins along with enhanced polyol pathway was observed in the lens. Further there was increased oxidative stress in lens of IGT animals. These results suggest that oxidative stress along with increased polyol pathway might play a role in IGT-associated lens abnormalities. In conclusion, nSTZ-PD rat model could aid to investigate IGT-associated lens abnormalities.
Necrotising Myositis, the Deadly Impersonator
Authors: Rahman A. , Abou-Foul A. K. , Yusaf A. , Holton J. , Cogswell L.
Published: November 2014

We report two cases of patients with necrotising myositis who presented initially with limb pain and swelling on a background of respiratory complaints. Patient 1, a previously well 38-year-old female, underwent various investigations in the emergency department for excessive lower limb pain and a skin rash. Patient 2, a 61-year-old female with a background of rheumatoid arthritis and hypertension, presented to accident and emergency feeling generally unwell and was treated for presumed respiratory sepsis. Both deteriorated rapidly and were referred to the plastic surgery team with soft tissue necrosis, impending multiorgan failure and toxaemia. Large areas of necrotic muscle and skin were debrided, which grew group A streptococci,Streptococcus pyogenes. Patient 1 had a high above knee amputation of the left leg with extensive debridement of the right. Despite aggressive surgical intervention and microbiological input with intensive care support, patient 2 died. These two cases highlight the importance of early diagnosis and prompt surgical and pharmacological intervention in managing this life-threatening disease. Pain is the primary symptom with skin changes being a late and subtle sign in a septic patient. The Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC) may be of use if there is concern to aid diagnosis of this life-threatening disease.
Serum Leptin Levels in Treatment-Naive Patients with Clinically Isolated Syndrome or Relapsing-Remitting Multiple Sclerosis
Authors: Evangelopoulos Maria Eleftheria , Koutsis Georgios , Markianos Manolis
Published: November 2014

Several studies have investigated leptin levels in patients with multiple sclerosis (MS) with somewhat conflicting results. They have all focused on patients with established relapsing-remitting (RR) MS but have not specifically looked at patients with clinically isolated syndrome (CIS) suggestive of MS, in the early stages of disease. In this study, serum leptin levels were measured in 89 treatment-naïve patients with CIS (53 patients) or RRMS (36 patients) and 73 controls searching for differences between the groups and for associations with several disease parameters. The expected significant sexual dimorphism in leptin levels (higher levels in females) was observed in both MS patients and controls. Increased leptin levels were found in female patients with RRMS compared to female controls (P=.003) and female CIS patients (P=.001). Female CIS patients had comparable levels to controls. Leptin levels correlated positively to disease duration, but not to EDSS, in female patients with RRMS. The results of the present study do not indicate involvement of leptin in the early stages of MS. Normal leptin levels in patients with CIS suggest that leptin does not have a pathogenic role. The ratio leptin/BMI increases during disease course in female MS patients in a time-dependent and disability-independent manner.
Spectral Domain Optical Coherence Tomographic Findings of Bietti Crystalline Dystrophy
Authors: Saatci Ali Osman , Doruk Hasan Can , Yaman Aylin , Öner Ferit Hakan
Published: November 2014

We analyzed the OCT features of 24 eyes of 12 patients with Bietti crystalline dystrophy (BCD) with the Heidelberg HRA2-OCT. Seventeen of 24 eyes were in intermediate stage of the disease and seven in advanced stage of the disease at the time of latest OCT examination performed in 2014. Outer retinal tubulations and retinal hyperreflective dots were present in 20 of 24 eyes. The remaining four eyes had advanced disease with very thin retina. Appearance of bright plaque on top of RPE-Bruch membrane was present in all eyes. Choroidal hyperreflective spots were noted in 19 of 24 eyes. The remaining five eyes had advanced disease stage with very thin choroid. Mean central macular thickness was 163.08 μm ± 62.52 for all eyes (170.35 μm ± 56.46 in eyes with intermediate disease and 145.42 μm ± 77.2 in eyes with advanced disease). Mean subfoveal choroidal thickness was 95.37 μm ± 55.93 for the study eyes (116.47 ± 46.92 μm in eyes with intermediate disease and 44.14 μm ± 42.43 in eyes with advanced disease). Choroidal hyperreflective spots were noted in 21 of 24 eyes (87.5%). SD-OCT shows the disease progression in retinal and choroidal layers delicately in eyes with BCD and expands our knowledge about the ongoing disease process.
Team Training (Training at Own Facility) versus Individual Surgeon’s Training (Training at Trainer’s Facility) When Implementing a New Surgical Technique: Example from the ONSTEP Inguinal Hernia Repair
Authors: Rosenberg Jacob , Andresen Kristoffer , Laursen Jannie
Published: November 2014

Background.When implementing a new surgical technique, the best method for didactic learning has not been settled. There are basically two scenarios: the trainee goes to the teacher’s clinic and learns the new technique hands-on, or the teacher goes to the trainee’s clinic and performs the teaching there.Methods.An informal literature review was conducted to provide a basis for discussing pros and cons. We also wanted to discuss how many surgeons can be trained in a day and the importance of the demand for a new surgical procedure to ensure a high adoption rate and finally to apply these issues on a discussion of barriers for adoption of the new ONSTEP technique for inguinal hernia repair after initial training.Results and Conclusions.The optimal training method would include moving the teacher to the trainee’s department to obtain team-training effects simultaneous with surgical technical training of the trainee surgeon. The training should also include a theoretical presentation and discussion along with the practical training. Importantly, the training visit should probably be followed by a scheduled visit to clear misunderstandings and fine-tune the technique after an initial self-learning period.
Hypochondroplasia, Acanthosis Nigricans, and Insulin Resistance in a Child with FGFR3 Mutation: Is It Just an Association?
Authors: Mustafa Manal , Moghrabi Nabil , Bin-Abbas Bassam
Published: November 2014

FGFR3 mutations cause wide spectrum of disorders ranging from skeletal dysplasias (hypochondroplasia, achondroplasia, and thanatophoric dysplasia), benign skin tumors (epidermal nevi, seborrhaeic keratosis, and acanthosis nigricans), and epithelial malignancies (multiple myeloma and prostate and bladder carcinoma). Hypochondroplasia is the most common type of short-limb dwarfism in children resulting from fibroblast growth factor receptor 3 (FGFR3) mutation. Acanthosis nigricans might be seen in severe skeletal dysplasia, including thanatophoric dysplasia and SADDAN syndrome, without a biochemical evidence of hyperinsulinemia. Insulin insensitivity and acanthosis nigricans are uncommonly seen in hypochondroplasia patients with FGFR3 mutations which may represent a new association. We aim to describe the association of hypochondroplasia, acanthosis nigricans, and insulin resistance in a child harboring FGFR3 mutation. To our knowledge, this is the first case report associating the p.N540 with acanthosis nigricans and the second to describe hyperinsulinemia in hypochondroplasia. This finding demonstrates the possible coexistence of insulin insensitivity and acanthosis nigricans in hypochondroplasia patients.
Giant Mature Primary Retroperitoneal Teratoma in a Young Adult: Report of a Rare Case and Literature Review
Authors: Sasi Walid , Ricchetti Giuseppe A. , Parvanta Laila , Carpenter Robert
Published: November 2014

Teratomas are neoplasms of the embryonic tissues that typically arise in the gonadal and sacrococcygeal regions of adults and children. Primary adult retroperitoneal teratomas are rare and demand challenging management options. We report a case of a unilateral primary retroperitoneal mature cystic teratoma mimicking an adrenal mass in a 28-year-old female patient. Complete resection of the mass was performed by a laparotomy approach. Because of the risk of malignancy, follow-up radiographic studies were performed to ensure the oncologic efficacy of resection. The patient remains free of recurrence to date.
The Influence of Antiobesity Media Content on Intention to Eat Healthily and Exercise: A Test of the Ordered Protection Motivation Theory
Authors: Ritland Raeann , Rodriguez Lulu
Published: November 2014

This study extended the ordered protection motivation framework to determine whether exposure and attention to antiobesity media content increases people’s appraisals of threat and their ability to cope with it. It also assesses whether these cognitive processes, in turn, affected people’s intention to abide by the practices recommended to prevent obesity. The results of a national online survey using a nonprobability sample indicate that attention to mediated obesity and related information significantly increased people’s intention to exercise as well as their overall coping appraisals (the perceived effectiveness of the recommended behaviors and their ability to perform them). Likewise, increased threat and coping appraisals were both found to significantly influence people’s intention to exercise and diet. Coping (rather than threat) appraisals more strongly predicted behavioral intent. Following the attitude-behavior literature, behavioral intention was used as the most proximate predictor of actual behavior (i.e., stronger intentions increase the likelihood of behavior change).
Vaginal Evisceration: An Unexpected Complication of Conization
Authors: Ghassani Ali , Andre Benoit , Simon-Toulza Caroline , Tanguy le Gac Yann , Martinez Alejandra , Vidal Fabien
Published: November 2014

Background.Large loop excision of the transformation zone (LLETZ) is routinely performed for the management of high grade intracervical neoplasia (CIN). Several uncommon complications have been described, including postoperative peritonitis, pseudoaneurysm of uterine artery, and bowel fistula. We report a unique case of postoperative vaginal evisceration and the subsequent management.Case.A 73-years-old woman underwent LLETZ for high grade CIN. On postoperative day 3, she was admitted for small bowel evisceration through the vagina. Surgical management was based on combined laparoscopic and transvaginal approach and consisted in bowel inspection and reinstatement, peritoneal washing, and dehiscence repair.Conclusions.Vaginal evisceration is a rare but potentially serious complication of pelvic surgery. This case report is to make clinicians aware of such complication following LLETZ and its management.
Three Years Later: Report on the State of Well-Being of Patients with Chronic Tinnitus Who Underwent Modified Tinnitus Retraining Therapy
Authors: Seydel Claudia , Haupt Heidemarie , Szczepek Agnieszka J. , Hartmann Anne , Rose Matthias , Mazurek Birgit
Published: November 2014

Successful management of patients with chronic tinnitus is an important health issue. One of the tinnitus management strategies used at our Tinnitus Center is a combination of tinnitus retraining therapy (TRT) with physiotherapy and psychological management [called modified TRT (MTRT)]. We have used this type of management for over a decade and have described the protocol in detail elsewhere. In the present study, we wanted to determine the effect of MTRT on the well-being of tinnitus patients 3 years after treatment onset. One hundred and thirty patients with chronic tinnitus were assessed using psychometric instruments immediately before 7-day MTRT, immediately after the therapy and 3 years later. Patients with very severe tinnitus-related distress associated with major depression and a risk of suicide were excluded from this study. MTRT resulted in a sustained reduction of tinnitus-related distress. Moreover, the quality of life of patients had increased, as assessed by a separate questionnaire. The effect of MTRT was influenced by the degree of tinnitus-related distress and by the patients' age, the latter being gender dependent. Hearing loss and tinnitus duration had only a minor influence on the therapeutic effect. Taken together, we report a positive change in the state of well-being of patients with chronic tinnitus measurable with various psychometric instruments 3 years after the onset of MTRT. i 2014 S. Karger AG, Basel
Peripheral Glutamate Levels in Schizophrenia: Evidence from a Meta-Analysis
Authors: Song Jiali , Viggiano Andrea , Monda Marcellino , De Luca Vincenzo
Published: November 2014

Background: Recent research attempting to develop novel medications has turned to glutamatergic signaling pathways to find effective treatments for symptom clusters of schizophrenia. This meta-analysis was undertaken to clarify whether a difference in peripheral glutamate levels exists between patients with schizophrenia and healthy controls. Methods: The electronic databases Ovid MEDLINE, PubMed, and PsycINFO were systematically searched up to April 2013. The search was limited to case-control studies of blood glutamate levels in schizophrenia written in English. The differences in glutamate levels were evaluated by calculating standardized mean differences (SMD). Results: We found ten studies that met the inclusion criteria for a total of 320 schizophrenia patients and 294 controls. The meta-analysis showed that peripheral glutamate levels in schizophrenia patients were significantly higher overall than in controls (SMD = 0.635, p = 0.004). However, a significant effect of the method used to measure glutamate concentrations was found (F = 7.36, p = 0.01) where fluorometric assay was associated with effect sizes in the opposite direction. Conclusion: A higher blood glutamate concentration was found in patients with schizophrenia. However, given the small sample size and methodological differences among studies, this result is not conclusive. More comprehensive research is needed to understand the relationship between glutamate levels in schizophrenia in the blood and the brain.
Correlating the Accuracy of Colposcopy with Practitioner Experience when Diagnosing Cervical Pathology Using the Dynamic Spectral Imaging System
Authors: Coronado Pluvio J. , Fasero Maria
Published: November 2014

Background/Aims: To assess the performance of colposcopists and correlate it with their experience when diagnosing cervical pathology by reviewing conventional colposcopy (CC) digital images and the Dynamic Spectral Imaging System (DySIS) cervical map. Methods: Images from 50 women with normal and abnormal cervix collected during CC and the corresponding DySIS maps were projected consecutively to 63 participating colposcopists. Participants were asked for their diagnosis (normal, abnormal findings or cancer). The clinical experience of the participants was divided into low (n = 27), medium (n = 18) and high (n = 18), considering the number of colposcopies each one performed routinely. Results: The mean of overall correct diagnoses was significantly higher with DySIS than CC for the low and medium experience group (20.4 vs. 24.4, and 21.9 vs. 26.0, respectively; p < 0.001), but not in the high experience group. The correct diagnosis was significantly higher with DySIS than CC for all experience groups in cases with a normal cervix and cervical intraepithelial neoplasia 2+ (CIN2+), but not for those with CIN1. All groups agreed that DySIS guides biopsies better, offers more information and allows performing colposcopy even without extensive experience. Conclusions: The results of evaluating projected colposcopy images were more successful with DySIS than with CC in the diagnosis of cervical pathology, especially among less experienced colposcopists.
Loss of Interface Pressure in Various Compression Bandage Systems over Seven Days
Authors: Protz Kerstin , Heyer Kristina , Verheyen-Cronau Ida , Augustin Matthias
Published: November 2014

Background: Manufacturers' instructions of multi-component compression bandage systems inform that these products can remain up to 7 days during the therapy of venous leg ulcer. This implies that the pressure needed will be sustained during this time. Objective: The present research investigated the persistence of pressure of compression systems over 7 days. Methods: All 6 compression systems available in Germany at the time of the trial were tested on 35 volunteering persons without signs of venous leg disease. Bandaging with short-stretch bandages was included for comparison. Pressure was measured by using PicoPress®. Results: Initially, all products showed sufficient resting pressure of 40 mm Hg checked with a pressure monitor, except for one system in which the pressure fell by at least 23.8%, the maximum being 47.5% over a period of 7 days. Conclusion: The currently available compression systems are not fit to keep the required pressure. Optimized products need to be developed.
Screening of Current Post-Traumatic Stress Disorder in Patients with Substance Use Disorder Using the Depression, Anxiety and Stress Scale (DASS-21): A Reliable and Convenient Measure
Authors: Kok Tim , de Haan Hein A. , van der Meer Margreet , Najavits Lisa M. , De Jong Cor A.J.
Published: November 2014

Background: Several instruments have been developed and validated as screens for post-traumatic stress disorder (PTSD) in substance use disorder (SUD) patients. Unfortunately, many of these instruments have one or several disadvantages (e.g. low specificity, low sensitivity or high costs). No research has been conducted on instruments that screen simultaneously for other psychiatric disorders, which would be a potentially time-saving and cost-effective approach. In the current study we tested the psychometric properties of the Depression, Anxiety and Stress Scale (DASS) as a screen for PTSD. Methods: The DASS was assessed in an inpatient facility during intake with 58 patients and again 4 weeks after admission. Another 138 patients were assessed 4 weeks after admission only. The results were compared to the Clinician-Administered PTSD Scale (CAPS) that was also administered after 4 weeks of abstinence. Results: ROC curve analyses showed an area under the curve of 0.84 for the DASS at intake and 0.78 for the DASS after 4 weeks' abstinence. Conclusion: The DASS is therefore a reliable and convenient measure to use as a screen for PTSD in SUD patients.
Alterations of Ionized and Total Magnesium Levels in Pregnant Women with Gestational Diabetes Mellitus
Authors: Goker Tasdemir Ufuk , Tasdemir Nicel , Kilic Sevtap , Abali Remzi , Celik Cem , Gulerman Hacer Cavidan
Published: November 2014

Background/Aims: The aim of this prospective study was to determine ionized and total magnesium (Mg) levels in pregnant subjects with and without gestational diabetes mellitus (GDM). Methods: Eighty-five women, 26-28 weeks pregnant, were recruited for routine oral glucose tolerance tests (OGTT); 45 had normal OGTT results and 40 were diagnosed with GDM. Electrolyte levels, including ionized and total Mg, were analyzed. Results: Gestational age and BMI were similar between the two groups (p = 0.800, p = 0.025). Multivitamin use was higher in the control group (p = 0.036). Fasting blood glucose was higher in the GDM group (p < 0.001). The median total Mg levels were 1.9 mg/dl (range 1.6-2.2) in the control group and 1.8 mg/dl (range 1.2-2.1) in the GDM group (p < 0.001). The median ionized Mg levels were 0.5 mmol/l (range 0.4-0.6) in the control group and 0.4 mmol/l (range 0.4-0.5) in the GDM group (p < 0.001). Conclusion: Our study revealed a relationship between low total and ionized Mg levels and GDM, as in type 2 diabetes mellitus (DM). The literature regarding type 2 DM and our findings suggest that Mg is the key ion in the pathophysiology of GDM. Low-dose Mg supplementation was not related to GDM; however, pharmacological doses in the various stages of pregnancy could be beneficial and should be investigated.
Lösungsvorschläge für Probleme in der integrativmedizinischen Weiterbildung von Ärzten an anthroposophischen Kliniken Deutschlands und der Schweiz
Authors: Eberhard Sabine , Weinzirl Johannes , Orlow Pascale , Berger Bettina , Heusser Peter
Published: November 2014

Hintergrund: Im Rahmen einer erstmaligen Untersuchung zu Qualität und Problemen der integrativmedizinischen Weiterbildung der anthroposophisch-medizinischen (AM) Kliniken Deutschlands und der Schweiz wurden alle 240 Assistenzärzte und alle 214 Weiterbilder gleichzeitig nach möglichen Maßnahmen zur Problemlösung befragt. Methode: Die Studie umfasste eine Querschnittserhebung mit Fragebögen inklusive Freitextfeldern. Die potenziellen Maßnahmen zur Problemlösung wurden über Freitextantworten erfragt. Die qualitative Inhaltsanalyse erfolgte nach Mayring. 56 (51,8%) von 108 Assistenzärzten und 54 (54%) von 100 Weiterbildern gaben Lösungsvorschläge an. Die beiden Gruppen wurden gemeinsam ausgewertet. Ergebnisse: Die vorgeschlagenen Lösungsmaßnahmen beinhalteten auf interner Ebene ein Umdenken bei der Klinikleitung und -verwaltung, d.h. Aufwertung der Weiterbildung zu einer Kernaufgabe anthroposophischer Kliniken, bessere Auswahl von Klinikpersonal, mehr Fach- und Lehrkompetenz der Weiterbilder in AM, ein strukturiertes und inhaltlich ausgeweitetes Weiterbildungsangebot, Abstimmung der Weiterbildung mit Stations- bzw. Klinikbetrieb, Entlastung der Mediziner durch Prozessoptimierung, Ressourcenplanung und Senkung der Arbeitsbelastung. Auf externer Ebene umspannten die Lösungsvorschläge finanzielle Unterstützung, externe Weiterbildungsangebote, Vernetzung der AM-Kliniken im Bereich der Weiterbildung, Einrichtung eines übergeordneten Kompetenzzentrums für AM-Weiterbildung, ein schulmedizinisches und AM-Weiterbildungscurriculum sowie die Verbesserung der Wissenschaftsbasis und des öffentlichen Diskurses zur AM. Schlussfolgerung: Die Lösungsvorschläge erwachsen der konkreten Wahrnehmung betroffener Assistenzärzte und Weiterbilder. Sie bieten eine Grundlage für konkrete Verbesserungen der Weiterbildung, die professionell und international vernetzt verwirklicht werden könnten. Die Voraussetzungen dazu sind durch die universitäre Anbindung der AM und durch die gute nationale und internationale Vernetzung der anthroposophischen Kliniken und Ärztegesellschaften gegeben.
Women's Preferences of Dynamic Spectral Imaging Colposcopy
Authors: Louwers J.A. , Zaal A. , Kocken M. , Papagiannakis E. , Meijer C.J.L.M. , Verheijen R.H.M.
Published: November 2014

Background: The focus of testing the dynamic spectral imaging (DSI) colposcope has been on the technical characteristics and clinical performance. However, aspects from a patient's perspective are just as important. Methods: This study was designed as a substudy of the DSI validation study, a prospective comparative, multicenter clinical trial to assess the clinical performance of DSI colposcopy. All women included in this study were asked to complete two questionnaires: a patient characteristics questionnaire and a patient satisfaction questionnaire. Results: In the initial study a total of 239 women were included in the intention-to-treat cohort. Of these, 230 women (96.2%) completed both questionnaires. When assessing the women's preferences for some of the possible uses of DSI colposcopy, a high level of agreement was noted for all potential implementations. In general, women found the additional time DSI colposcopy took acceptable: just 15 women (6.5%) thought the time DSI colposcopy took made them feel uncomfortable. Furthermore, women ranked test accuracy as the most important characteristic, followed by (more) rapid testing and comfort. Quick notification of the results and costs were considered the least important characteristics. Conclusion: Women are willing to accept discomfort in the form of an additional or longer test if there is clinical benefit.
Intravitreal Ranibizumab for Patients with Neovascular Age-Related Macular Degeneration with Good Baseline Visual Acuity
Authors: Kato Aki , Yasukawa Tsutomu , Suga Keiji , Hirano Yoshio , Nozaki Miho , Yoshida Munenori , Ogura Yuichiro
Published: November 2014

Purpose: To report the 1-year results of intravitreal ranibizumab (IVR) injections for neovascular age-related macular degeneration (nAMD) in patients with good baseline visual acuity (VA). Methods: Thirty-six eyes of 36 patients with nAMD with best-corrected VAs (BCVAs) >0.6 (equal to 0.22 in the logarithm of the minimum angle of resolution unit) were enrolled. IVR was the primary treatment; additional treatment was administered as needed. BCVAs and central retinal thickness (CRT) were measured periodically. Results: The mean number of injections at month 12 was 3.3. The mean BCVAs were 0.11 ± 0.02 at baseline and 0.12 ± 0.03 at month 12, which did not significantly differ. The mean CRT significantly improved from 320 ± 15 to 254 ± 12 μm at month 12 (p < 0.01). Photodynamic therapy was applied in 2 cases because of frequent recurrences. Conclusions: IVR maintained VA and improved morphological changes in wet AMD with good baseline VA.
Esophageal Cytology Sponge Diagnostic Test Results in Kenyatta National Referral Hospital, Kenya
Authors: Muriithi Ruth W. , Muchiri Lucy W. , Lule Godfrey N.
Published: November 2014

Objective: To describe the cytological findings of the esophagus using sponge cytology as a triage test in patients referred for esophageal endoscopy at Kenyatta National Hospital. Study Design: A cross-sectional descriptive study was undertaken to obtain specimens from the esophagus for cytological evaluation using a sponge. The cellular yield and pattern of esophageal cytological findings was described by cytopathologists using the Bethesda system. The cytological findings were compared with endoscopy findings and whenever possible with biopsy results. Results: All the participants (100%) swallowed the encapsulated sponge successfully and had smears with satisfactory material for evaluation. Negative smears for intraepithelial lesion or malignancy were the most common (86.6%), with intestinal metaplasia reported in 10% of all patients, high-grade squamous intraepithelial lesions in 1.7% and squamous cell carcinoma in 1.7%. There was good agreement between endoscopic and cytological findings. Conclusion: Sponge cytology is a simple and inexpensive technique which seems to have promising results as a primary test as well as a triage test whenever there is any suspicion of an esophageal lesion, especially in clinical settings where endoscopic facilities and medical professionals are not available. Hence, further evaluation using a larger sample size is recommended.
Four-Copy Number Intervals in SNP Microarray Analysis: Unique Patterns and Positions
Authors: Papenhausen Peter R. , Kelly Carla A. , Zvereff Val , Schwartz Stuart
Published: November 2014

Over the past several years, the utility of microarray technology in delineating copy number changes has become well established. In the past 4 years, we have used the SNP array to detect and analyze allele ratios in 150 cases with 4-copy intervals, confirmed by FISH, offering insight into the underlying mechanisms of formation. These cases may be divided into 5 allele patterns - the first 4 of which involve a single homologue - as detected by the genotyping aspects of the microarray: (1) triplications combining homozygous and heterozygous alleles, with a 3:1 ratio of heterozygotes; (2) triplications with allele patterns combining homozygous and heterozygous alleles, with heterozygote ratios of both 3:1 and 2:2; (3) triplications that have homozygous alleles combined with only 2:2 heterozygous alleles; (4) triplications that are completely homozygous; and (5) homozygous duplications on each homologue with no heterozygous alleles. The implications of copy number variants with diverse allelic segregations are presented in this study.
Reasons for Discontinuation of Lipid-Lowering Medications in Patients with Chronic Kidney Disease
Authors: Morrison Fritha J.R. , Zhang Huabing , Skentzos Stephen , Shubina Maria , Bentley-Lewis Rhonda , Turchin Alexander
Published: November 2014

Background/Aims: Many patients with chronic kidney disease (CKD) do not receive lipid-lowering therapy despite their high cardiovascular risk. The reasons for this are unknown. Methods: We have conducted a retrospective cohort study of discontinuation of lipid-lowering drugs in patients with CKD stage 3 and higher treated in practices affiliated with two academic medical centers between 2000 and 2010. Information on medication discontinuation and its reasons was obtained from electronic medical records, including natural language processing of electronic notes using previously validated software. Results: Out of 14,034 patients in the study cohort, 10,072 (71.8%) stopped their lipid-lowering drugs at least once, and 2,444 (17.4%) stopped them for at least 1 month. Patients who had a comorbidity associated with higher cardiovascular risk were less likely to stop lipid-lowering drugs. Insurance request was the most common explicitly documented reason for discontinuation, and adverse reactions were the most common reason for long-term discontinuation. In a multivariable analysis, patients were more likely to stop a lipid-lowering drug because of an insurance request if they had government insurance and they were also more likely to stop a lipid-lowering drug because of adverse reactions if they had a history of multiple adverse reactions to other medications. There was no significant relationship between CKD stage and the reason for discontinuation of lipid-lowering drugs. Conclusions: Patients with CKD frequently stop lipid-lowering drugs. Insurance requests and adverse reactions are common reasons for the discontinuation. Further research is needed to ensure appropriate lipid-lowering therapy for these individuals at high cardiovascular risk. i 2014 S. Karger AG, Basel
A Patient with a Large Gastric Tumor and Protein-Losing Gastroenteropathy Successfully Treated with Neoadjuvant TS-1 Combined with CDDP Therapy
Authors: Hashimoto Tatsuya , Yamashita Yuichi , Shibata Ryosuke , Satou Keisuke , Yamana Ippei , Maki Kenji , Takeno Shinsuke , Nimura Satoshi
Published: November 2014

Gastric cancer with protein-losing gastroenteropathy is relatively rare worldwide. The most important problem for the treatment of these patients is their low nutritional status and protein level, which can cause severe postoperative complications. We report a 49-year-old Japanese female with a large gastric tumor and protein-losing gastroenteropathy successfully treated with neoadjuvant TS-1 combined with CDDP therapy. She had a type 5 tumor with partially cauliflower-like appearance. Her blood chemistry revealed low serum total protein (3.3 g/dl) and low albumin (1.7 g/dl). She was additionally diagnosed with protein-losing gastroenteropathy based on 99mTc-human serum albumin scintigraphy. Initial neoadjuvant chemotherapy decreased the size of the tumor and led to a marked improvement in her serum protein levels. She then underwent a total gastrectomy and lymph node dissection (D2) with a combined resection of the spleen and gallbladder. Therefore, neoadjuvant chemotherapy may provide a safe treatment before definitive surgery for gastric cancer with protein-losing gastroenteropathy.
Karyotype Analysis and Chromosomal Distribution of Repetitive DNA Sequences of Cucumis metuliferus Using Fluorescence in situ Hybridization
Authors: Yagi Kouhei , Siedlecka Ewa , Pawełkowicz Magdalena , Wojcieszek Michał , Przybecki Zbigniew , Tagashira Norikazu , Hoshi Yoshikazu , Malepszy Stefan , Pląder Wojciech
Published: November 2014

Cucumis metuliferus (2n = 24) is a cultivated species of the Cucumis genus which is a potential genetic resource for Cucumis crops. Although some cytogenetic research has been reported, there is no study of karyotyping in this species. Here, we used 4′,6-diamidino-2-phenylindole and chromomycin A3 staining to identify 12 pairs of chromosomes in early-metaphase cells. Fluorescence in situ hybridization revealed the chromosomal distribution patterns of the 5S and 45S ribosomal DNA (rDNA) genes, telomeres, and 3 different satellite repeats. The 2 major signals of the 45S rDNA were located on the satellite of chromosome 11, and the 2 signals of the 5S rDNA and 2 minor signals of the 45S rDNA were located on chromosome 12. The telomere probes hybridized to the ends of all chromosomes. The 3 satellite DNAs were localized at the ends of chromosomes 1, 2, 4-10, and at the end of the short arm of chromosome 3. In summary, we reported the identification of all chromosomes of C. metuliferus. We also depicted the location of 5S and 45S rDNA, the telomere motif sequence, CmetSat1, CmetSatT2, and CmetmSat1 in an ideogram.