bluuebunny/crossref_metadata_2025 huggingface dataset:
Prediction of Pathological Subjects Using Genetic Algorithms
Authors: Sari Murat , Tuna Can
Published: January 2018

This paper aims at estimating pathological subjects from a population through various physical information using genetic algorithm (GA). For comparison purposes,K-Means (KM) clustering algorithm has also been used for the estimation. Dataset consisting of some physical factors (age, weight, and height) and tibial rotation values was provided from the literature. Tibial rotation types are four groups as RTER, RTIR, LTER, and LTIR. Each tibial rotation group is divided into three types. Narrow (Type 1) and wide (Type 3) angular values were called pathological and normal (Type 2) angular values were called nonpathological. Physical information was used to examine if the tibial rotations of the subjects were pathological. Since the GA starts randomly and walks all solution space, the GA is seen to produce far better results than the KM for clustering and optimizing the tibial rotation data assessments with large number of subjects even though the KM algorithm has similar effect with the GA in clustering with a small number of subjects. These findings are discovered to be very useful for all health workers such as physiotherapists and orthopedists, in which this consequence is expected to help clinicians in organizing proper treatment programs for patients.
Use of Jianpi Jiedu Herbs in Patients with Advanced Colorectal Cancer: A Systematic Review and Meta‐Analysis
Authors: Zhang Shaofan , Shi Li , Mao Dan , Peng Weijun , Sheng Chenxia , Ding Chenchen , Lin Fengxia , Lei Caiyun , Zhang Sifang
Published: January 2018

Objective. To systematically review the effect of invigorating Pi and detoxification (Jianpi Jiedu, (JPJD)) herbs in advanced colorectal cancer (CRC) patients receiving chemotherapy. Methods. Three English and four Chinese databases were searched. Literature was screened by EndNote X7 and data were analyzed by RevMan 5.2. Results. This review comprised 12 randomized clinical studies of 701 patients. The results showed that JPJD herbs improved the therapeutic effect on Chinese medicine symptoms [risk ratio (RR) = 1.59; 95% confidence interval (CI): 1.35~1.88] and Karnofsky performance score [RR = 2.07; 95% CI: 1.52~2.82] for advanced CRC patients receiving chemotherapy, lowered the Chinese medicine symptoms’ score [weighted mean difference = −2.44; 95% CI: −3.23~−1.64], reduced the incidence of nausea and vomiting [RR = 0.23; 95% CI: 0.11~0.49], improved platelet at toxicity grades III‐IV [odds ratio = 0.29; 95% CI: 0.12~0.74] and I–IV [RR = 0.65; 95% CI: 0.51~0.82], and improved white blood cell at toxicity grades III‐IV [RR = 0.37; 95% CI: 0.23~0.58] and I–IV [RR = 0.69; 95% CI: 0.60~0.79]. However, the results showed no significant effect on tumor response. Conclusion. JPJD herbs can improve quality of life, relieve symptoms, and reduce adverse events of advanced CRC patients receiving chemotherapy.
Pulmonary Vasculitis and a Horseshoe Kidney in Noonan Syndrome
Authors: Puvabanditsin Surasak , Abellar Rosanna , Madubuko Adaora , Mehta Rajeev , Walzer Lauren
Published: January 2018

We report a term male neonate with congenital myeloproliferative disorder, thrombocytopenia, a horseshoe kidney, feeding difficulty secondary to dysphagia/foregut dysmotility, and respiratory failure. Prenatal molecular genetic analysis revealed a fetus carrying c.184T>G (p.Tyr62Asp) pathogenic variant in PTPN11. The infant eventually succumbed to respiratory failure. Bacterial and viral cultures/studies were all no growth/negative. Pulmonary capillaritis and vasculitis were noted at autopsy. This report presents a new case of Noonan syndrome with unusual associated disorders and a review of the literature.
Cardiac Aspergilloma: A Rare Case of a Cardiac Mass Involving the Native Tricuspid Valve, Right Atrium, and Right Ventricle in an Immunocompromised Patient
Authors: Chen-Milhone Christina S. , Chakravarthy Potu Kalyan , Mungee Sudhir
Published: January 2018

Aspergillus can cause devastating opportunistic infections in immunocompromised patients. Rarely does this fungus invade the heart, and when it does, survival is especially poor despite optimal medical and surgical treatment. We report a case of cardiac aspergilloma with involvement of the tricuspid valve and both the right atrium and ventricle found on a transthoracic echocardiogram in an immunocompromised patient after developing atrial fibrillation with rapid ventricular rate. The findings from this case suggest that early clinical suspicion is critical in early diagnosis and thus early treatment.
False-Positive Blood Cultures in Acute Leukemia: An Underrecognized Finding
Authors: Karakonstantis Stamatis , Manika Ioanna , Vakonaki Maria , Boula Anna
Published: January 2018

The occurrence of false-positive blood cultures in patients with acute myeloid leukemia has been rarely described in the literature. Awareness of this finding is important to avoid unnecessary delays in initiating appropriate cytoreductive therapy. Here, we present the case of a 70-year-old male with acute leukemia and persistently positive blood cultures despite broad-spectrum antibiotic therapy. No source of infection could be found clinically, and no pathogen could be isolated from blood cultures. Inspection of the CO2plots of the positive blood cultures showed a steady linear increase in CO2levels, suggesting false-positive detection by the automated microbial detection system. Cytoreductive therapy was then initiated, and several subsequent blood cultures were negative.
Modulating Metabolism to Improve Cancer‐Induced Muscle Wasting
Authors: Penna Fabio , Ballarò Riccardo , Beltrá Marc , De Lucia Serena , Costelli Paola
Published: January 2018

Muscle wasting is one of the main features of cancer cachexia, a multifactorial syndrome frequently occurring in oncologic patients. The onset of cachexia is associated with reduced tolerance and response to antineoplastic treatments, eventually leading to clinical conditions that are not compatible with survival. Among the mechanisms underlying cachexia, protein and energy dysmetabolism play a major role. In this regard, several potential treatments have been proposed, mainly on the basis of promising results obtained in preclinical models. However, at present, no treatment yet reached validation to be used in the clinical practice, although several drugs are currently tested in clinical trials for their ability to improve muscle metabolism in cancer patients. Along this line, the results obtained in both experimental and clinical studies clearly show that cachexia can be effectively approached by a multidirectional strategy targeting nutrition, inflammation, catabolism, and inactivity at the same time. In the present study, approaches aimed to modulate muscle metabolism in cachexia will be reviewed.
Fixed Point and Newton’s Methods in the Complex Plane
Authors: Dubeau François , Gnang Calvin
Published: January 2018

We revisit the necessary and sufficient conditions for linear and high order of convergence of fixed point and Newton’s methods in the complex plane. Schröder’s processes of the first and second kind are revisited and extended. Examples and numerical experiments are included.
Complex Reaction Kinetics in Chemistry: A Unified Picture Suggested by Mechanics in Physics
Authors: Agliari Elena , Barra Adriano , Landolfi Giulio , Murciano Sara , Perrone Sarah
Published: January 2018

Complex biochemical pathways can be reduced to chains of elementary reactions, which can be described in terms of chemical kinetics. Among the elementary reactions so far extensively investigated, we recall the Michaelis‐Menten and the Hill positive‐cooperative kinetics, which apply to molecular binding and are characterized by the absence and the presence, respectively, of cooperative interactions between binding sites. However, there is evidence of reactions displaying a more complex pattern: these follow the positive‐cooperative scenario at small substrate concentration, yet negative‐cooperative effects emerge as the substrate concentration is increased. Here, we analyze the formal analogy between the mathematical backbone of (classical) reaction kinetics in Chemistry and that of (classical) mechanics in Physics. We first show that standard cooperative kinetics can be framed in terms of classical mechanics, where the emerging phenomenology can be obtained by applying the principle of least action of classical mechanics. Further, since the saturation function plays in Chemistry the same role played by velocity in Physics, we show that a relativistic scaffold naturally accounts for the kinetics of the above‐mentioned complex reactions. The proposed formalism yields to a unique, consistent picture for cooperative‐like reactions and to a stronger mathematical control.
Using the Schwarz Alternating Method to Identify Critical Water‐Resistant Thickness between Tunnel and Concealed Cavity
Authors: Guo Jiaqi , Chen Jianxun , Chen Fan , Huang Shanxiu , Wang Hongyu
Published: January 2018

This paper aims to estimate the stability of the water‐resistant strata between the tunnel and the small‐medium‐sized concealed cavity filled with high‐pressurized water or other fillings at optional position around tunnel through solving the double‐hole problem. The analytical method to identify the critical water‐resistant thickness is proposed based on the Schwarz alternating method and Griffith strength criterion, and the program to calculate the critical thickness was prepared according to this method using mathematical software. Parametric study of the critical thickness indicates that the critical water‐resistant thickness will increase with the buried depth of the tunnel and cavity size; the lateral pressure coefficient has more complicated influence on the critical thickness, which is affected by cavity position; when the cavity is filled with sand or gravel, the critical water‐resistant thickness will decrease with the increase of the filling pressure; and when the cavity is filled with the high‐pressurized water, the critical thickness will decrease as the water pressure initially and increase afterwards. The analytical result of the critical thickness is consistent with that obtained by numerical simulation using the user‐defined program based on FLAC3D, demonstrating the rationality and feasibility of the proposed method in this study.
Prediction of China’s Sulfur Dioxide Emissions by Discrete Grey Model with Fractional Order Generation Operators
Authors: Meng Wei , Yang Daoli , Huang Hui
Published: January 2018

Sulfur dioxide is an important source of atmospheric pollution. Many countries are developing policies to reduce sulfur dioxide emissions. In this paper, a novel prediction model is proposed, which could be used to forecast sulfur dioxide emissions. To improve the modeling procedure, fractional order accumulating generation operator and fractional order reducing generation operator are introduced. Based on fractional order operators, a discrete grey model with fractional operators is developed, which also makes use of genetic algorithms to optimize the modeling parameter r. The improved performance of the model is demonstrated via comparison studies with other grey models. The model is then used to predict China’s sulfur dioxide emissions. The forecast result shows that the amount of sulfur dioxide emissions is steadily decreasing and the policies of sulfur dioxide reduction in China are effective. According to the current trend, by 2020, the value of China’s sulfur dioxide emissions will be only 86.843% of emissions in 2015. Fractional order generation operators can be used to develop other fractional order system models.
High Prevalence of Hypertension in Ethiopian and Non-Ethiopian HIV-Infected Adults
Authors: Korem Maya , Wallach Tali , Bursztyn Michael , Maayan Shlomo , Olshtain-Pops Karen
Published: January 2018

Objectives. Prevalence of hypertension has not been studied in the Ethiopian HIV-infected population, which represents 60% of the patients in our AIDS unit. Our aim was to identify risk factors and characterize the prevalence of hypertension in the population monitored at our unit. Methods. A retrospective chart review categorized subjects according to their blood pressure levels. Hypertension prevalence was determined and stratified according to variables perceived to contribute to elevated blood pressure. Results. The prevalence of hypertension in our study population was significantly higher compared to the general population (53% versus 20%, P<0.0001) and was associated with known risk factors and not with patients’ viral load and CD4 levels. Ethiopian HIV-infected adults had a prominently higher rate of blood pressure rise over time as compared to non-Ethiopians (P=0.016). Conclusions. The high prevalence of hypertension in this cohort and the rapid increase in blood pressure in Ethiopians are alarming. We could not attribute high prevalence to HIV-related factors and we presume it is part of the metabolic syndrome. The lifelong cardiovascular risk associated with HIV infection mandates hypertension screening and close monitoring in this population.
Regiospecific Analysis of Fatty Acids and Calculation of Triglyceride Molecular Species in Marine Fish Oils
Authors: Zhang Huijun , Shen Yingbin , Zhang Youwei , Li Lirong , Wang Xingguo
Published: January 2018

The regiospecific distribution of fatty acids (FAs) and composition of triglyceride (TAG) molecular species of fishes were analyzed and calculated by pancreatic lipase (PL) hydrolysis and Visual Basic (VB) program. DHA was preferentially located at sn-2 position in TAG molecule, whereas EPA was almost equally distributed in each position of glycerol backbone. DOP, DPP, EPP, PoPP, PPO, and PPP were the predominant TAG species. MPP in anchovy, DDP, DOP, DPP in tuna, and EOO and OOO in salmon were the characteristic TAG molecules, which were meaningful to differentiate marine fish oils. Furthermore, the data management, according to TCN and ECN, was firstly applied to classify the TAG molecular species. The ECN42, ECN46, and ECN48 groups were rich in TAGs. The lower ECN values, compared to the higher TCN values, indicated that the most abundant TAGs exhibited a higher unsaturated degree. Therefore, our study not only offered a simple and feasible approach for the analysis of TAG composition but also firstly summarized the information by data management within ECN and TCN.
Traders’ Networks of Interactions and Structural Properties of Financial Markets: An Agent‐Based Approach
Authors: Ponta Linda , Cincotti Silvano
Published: January 2018

An information‐based multiasset artificial stock market characterized by different types of stocks and populated by heterogeneous agents is presented and studied so as to determine the influences of agents’ networks on the market’s structure. Agents are organized in networks that are responsible for the formation of the sentiments of the agents. In the market, agents trade risky assets in exchange for cash and share their sentiments by means of interactions that are determined by sparsely connected graphs. A central market maker (clearing house mechanism) determines the price process for each stock at the intersection of the demand and the supply curves. A set of market’s structure indicators based on the main single‐assets and multiassets stylized facts have been defined, in order to study the effects of the agents’ networks. Results point out an intrinsic structural resilience of the stock market. In fact, the network is necessary in order to archive the ability to reproduce the main stylized facts, but also the market has some characteristics that are independent from the network and depend on the finiteness of traders’ wealth.
A Case of Anterior Spinal Artery Syndrome Caused by Streptococcus mitis Endocarditis
Authors: Mahtabfar Aria , Eshraghi Hamoon , D’Souza Melroy , Berrigan William , Casey Kathleen
Published: January 2018

Background. Infectious endocarditis (IE) typically occurs in the setting of intravenous drug use, prosthetic heart valves, or rheumatic heart disease. However, there are a few reports of IE occurring in the setting of immunosuppression secondary to cancer and/or chemotherapy. Here, we present a case of a cancer patient who developed anterior spinal artery (ASA) syndrome secondary to a septic embolus from IE. Case Presentation. A 78-year-old male with a history of gastroesophageal cancer treated with chemotherapy and radiation presented to the hospital after a fall at home. He reported experiencing dyspnea and orthopnea for two weeks prior to presentation. In the ED, his vital signs were stable, and his examination was significant for a flaccid paralysis of the right lower extremity. Diagnosis of septic emboli secondary to IE was made after the echocardiogram showed the presence of vegetations on the aortic valve, blood cultures were positive for Streptococcus mitis, and thoracic spine MRI was indicative of an infarction at T10. Discussion. This case highlights the presence of IE in the setting of cancer and chemotherapy. Although cancer is a rare cause of IE, clinicians must maintain a high index of suspicion in order to minimize the sequelae of IE.
Antispasmodic Effect of Blackcurrant (Ribes nigrum L.) Juice and Its Potential Use as Functional Food in Gastrointestinal Disorders
Authors: Miladinovic Bojana , Brankovic Suzana  , Kostic Milica , Milutinovic Milica , Kitic Nemanja , Šavikin Katarina , Kitic Dušanka
Published: January 2018

Objective: The purpose of this study was to investigate the relaxative effects of blackcurrant juice on the gastrointestinal smooth muscle in vitro. Materials and Methods: Berries of the blackcurrant cultivar Ometa were used for the preparation of the juice used. The spasmolytic activity of blackcurrant juice was tested on rat ileum isolated from male Wistar rats by monitoring its influence on spontaneous contractions, as well as contractions induced by potassium chloride (KCl), barium chloride (BaCl2), calcium chloride (CaCl2), and acetylcholine (Ach). The results are expressed as the mean ± standard deviation obtained in 6 measurements and statistical significance was determined by the Student t test, with p < 0.05 taken as significant. Results: The blackcurrant cultivar Ometa significantly reduced the frequency and the amplitude of spontaneous contractions (57.94 ± 3.44%) and Ach-induced contractions (42.74 ± 5.36%; p < 0.05) of the isolated rat ileum. Cumulative concentrations (0.01–3 mg/mL) of the Ometa juice also reduced contractions of the isolated rat ileum stimulated by KCl (51.46 ± 6.87%), CaCl2 (57.54 ± 6.47%), and BaCl2 (58.54 ± 10.55%). The inhibitory effects of the juice were proportional to the applied concentration. Conclusion: The antispasmodic effect of Ometa cultivar shows that common gastrointestinal disorders could be treated by the functional food.
A Genome-wide Study of Common and Rare Genetic Variants Associated with Circulating Thrombin Activatable Fibrinolysis Inhibitor
Authors: Stanne Tara , Olsson Maja , Lorentzen Erik , Pedersen Annie , Gummesson Anders , Gils Ann , Jood Katarina , Engström Gunnar , Melander Olle , Declerck Paul , Jern Christina
Published: January 2018

Thrombin-activatable fibrinolysis inhibitor (TAFI) plays a central role in haemostasis, and plasma TAFI concentrations are heritable. Candidate gene studies have identified several variants within the gene encoding TAFI, CPB2, that explain part of the estimated heritability. Here, we describe an exploratory genome-wide association study to identify novel variants within and outside of the CPB2 locus that influence plasma concentrations of intact TAFI and/or the extent of TAFI activation (measured by released TAFI activation peptide, TAFI-AP) amongst 3,260 subjects from Southern Sweden. We also explored the role of rare variants on the HumanExome BeadChip. We confirmed the association with previously reported common variants in CPB2 for both intact TAFI and TAFI-AP, and discovered novel associations with variants in putative CPB2 enhancers. We identified a gene-based association with intact TAFI at CPB2 (P
SKAT-O = 2.8 × 10−8), driven by two novel rare nonsynonymous single nucleotide polymorphisms (SNPs; I420N and D177G). Carriers of the rare variant of D177G (rs140446990; MAF 0.2%) had lower intact TAFI and TAFI-AP concentrations compared with non-carriers (intact TAFI, geometric mean 53 vs. 78%, P
T-test = 5 × 10−7; TAFI-AP 63 vs. 99%, P
T-test = 7.2 × 10−4). For TAFI-AP, we identified a genome-wide significant association at an intergenic region of chromosome 3p14.1 and five gene-based associations (all P
SKAT-O < 5 × 10−6). Using well-characterized assays together with a genome-wide association study and a rare-variant approach, we verified CPB2 to be the primary determinant of TAFI concentrations and identified putative secondary loci (candidate variants and genes) associated with intact TAFI and TAFI-AP that require independent validation.
Relation of Renal Dysfunction to Quality of Anticoagulation Control in Patients with Atrial Fibrillation: The FANTASIIA Registry
Authors: Esteve-Pastor María , Rivera-Caravaca José , Roldán-Rabadán Inmaculada , Roldán Vanessa , Muñiz Javier , Raña-Míguez Paula , Ruiz-Ortiz Martín , Cequier Ángel , Bertomeu-Martínez Vicente , Badimón Lina , Anguita Manuel , Lip Gregory , Marín Francisco ,   on behalf of FANTASIIA Study Investigators
Published: January 2018

Background One-third of atrial fibrillation (AF) patients have chronic kidney disease (CKD), a condition that itself increases thromboembolic and major bleeding risks, especially in patients with severe CKD. Bleeding would be accentuated by suboptimal anticoagulation control with vitamin K antagonists (VKA).

Purpose This article aimed to investigate the incidence of cardiovascular events, mortality and quality of anticoagulation in relation to CKD in a ‘real-world’ prospective cohort of AF patients included in the FANTASIIA registry.

Methods We analysed consecutive AF patients who were prospectively recruited with a year of follow-up. The quality of anticoagulation was estimated by time in therapeutic range (TTR). The annual incidence of events was analysed.

Results We studied 1,936 patients (male: 55.7%, mean: 73.8 ± 9.4 years): 445 (22.9%) had normal function, 698 (36.1%) had mild CKD, 713 (36.8%) had moderate CKD and 80 (4.2%) had severe CKD. Patients with estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m2 (severe CKD) had lower TTR (53.3 ± 25.6% vs. 61.8 ± 25.1%, p = 0.007) and higher proportion of poor TTR (67.2 vs. 51.8%; p = 0.014) than patients with eGFR ≥30 mL/min/1.73 m2. Severe CKD was significantly associated with cardiovascular mortality (hazard ratio [HR]: 9.33; p = 0.002), major bleeding (HR: 2.94; p = 0.036) and major adverse cardiovascular events (MACE) (HR: 4.93; p = 0.004). Importantly, 375 patients (21.1%) showed a deteriorating eGFR of ≥10 mL/min during the follow-up, with significantly higher mortality and cardiovascular events.

Conclusion In a prospective and real-world AF registry, approximately 67% of patients with severe CKD had poor anticoagulation control while taking VKA. The presence of severe CKD was an independent factor for cardiovascular mortality, MACE and major bleeding. Worsening eGFR of only ≥10 mL/min during follow-up was significantly associated with mortality and major bleeding.
P2X1 Receptors Amplify FcγRIIa-Induced Ca2+ Increases and Functional Responses in Human Platelets
Authors: Ilkan Zeki , Watson Stephanie , Watson Steve , Mahaut-Smith Martyn
Published: January 2018

Platelets express key receptors of the innate immune system such as FcγRIIa and Toll-like receptors (TLR). P2X1 cation channels amplify the platelet responses to several major platelet stimuli, particularly glycoprotein (GP)VI and TLR2/1, whereas their contribution to Src tyrosine kinase-dependent FcγRIIa receptors remains unknown. We investigated the role of P2X1 receptors during activation of FcγRIIa in human platelets, following stimulation by cross-linking of an anti-FcγRIIa monoclonal antibody (mAb) IV.3, or bacterial stimulation with Streptococcus sanguinis. Activation was assessed in washed platelet suspensions via measurement of intracellular Ca2+ ([Ca2+]i) increases, ATP release and aggregation. P2X1 activity was abolished by pre-addition of α,β-meATP, exclusion of apyrase or the antagonist NF449. FcγRIIa activation evoked a robust increase in [Ca2+]i (441 ± 33 nM at 30 μg/mL mAb), which was reduced to a similar extent (to 66–70% of control) by NF449, pre-exposure to α,β-meATP or apyrase omission, demonstrating a significant P2X1 receptor contribution. FcγRIIa activation-dependent P2X1 responses were partially resistant to nitric oxide (NO), but abrogated by 500 nM prostacyclin (PGI2). Aggregation responses to bacteria and FcγRIIa activation were also inhibited by P2X1 receptor desensitization (to 66 and 42% of control, respectively). However, FcγRIIa-mediated tyrosine phosphorylation and ATP release were not significantly altered by the loss of P2X1 activity. In conclusion, we show that P2X1 receptors enhance platelet FcγRIIa receptor-evoked aggregation through an increase in [Ca2+]i downstream of the initial tyrosine phosphorylation events and early dense granule release. This represents a further route whereby ATP-gated cation channels can contribute to platelet-dependent immune responses in vivo.
Activated Factor X-Based versus Thrombin-Based Antithrombin Testing in Thrombophilia Workup in the DOAC Era
Authors: Rühl Heiko , Reda Sara , Müller Jens , Oldenburg Johannes , Pötzsch Bernd
Published: January 2018

Antithrombin (AT) activity tests are used for diagnosing hereditary AT deficiency, a main genetic determinant of thrombophilia. They are either based on inhibition of thrombin (FIIa) or activated factor X (FXa). FXa-based assays have been suggested to be preferable to FIIa-based assays due to their higher sensitivity for certain AT deficiency causing mutations. To assess the performance of these two methods in a real-world scenario, 745 consecutively collected samples from patients referred to our institute during a 3-month period for thrombophilia testing were analysed. In samples from patients not receiving direct-acting oral anticoagulants or heparins (n = 485), both methods showed good agreement (r = 0.874, Bland–Altman limits of agreement 6.57%, −15.76%). While similar results were obtained in patients receiving low-molecular-weight heparin (LMWH, n = 76, r = 0.891, 4.09%, −14.35%), the agreement was lower in patients receiving rivaroxaban (n = 86, r = 0.570, 5.97%, −49.43%) and apixaban (n = 72, r = 0.735, 3.77%, −42.45%). Direct FXa inhibitors but not LMWH increased FXa-based assay results in a dose-dependent manner, while the FIIa-based test was unaffected. Both assay types were equally successful in detecting hereditary AT deficiency in our study population, as samples from 9 out of 10 patients with AT deficiency causing mutations were detected by each method. These data suggest that FXa-based AT testing can be preferred over FIIa-based methods only in the absence of direct FXa inhibitors. In patients receiving direct FXa inhibitors, AT activity testing should be performed using FIIa-based assays.
Predictors of Post-Thrombotic Ulcer after Acute DVT: The RIETE Registry
Authors: Galanaud Jean-Philippe , Bertoletti Laurent , Amitrano Maria , Fernández-Capitán Carmen , Pedrajas José , Rosa Vladimir , Barrón Manuel , Lorenzo Alicia , Madridano Olga , Quéré Isabelle , Kahn Susan , Prandoni Paolo , Monreal Manuel ,   for the RIETE registry investigators
Published: January 2018

In patients with deep-vein thrombosis (DVT) in the lower limbs, venous ulcer is the most debilitating and end-stage clinical expression of the post-thrombotic syndrome (PTS). To date, risk factors for PTS-related ulcer in DVT patients have not been identified.

We used the international observational RIETE registry to assess the evolution of PTS signs and symptoms during a 3-year follow-up period and to identify independent predictors of PTS ulcer at 1 year in patients with acute DVT.

Among 1,866 eligible patients, cumulative rates of PTS ulcer at 1, 2 and 3 years were 2.7% (n = 50), 4.3% (n = 54) and 7.1% (n = 60), respectively. The proportion of patients with PTS symptoms at 1, 2 or 3 years remained stable (≈40%), while the proportion of patients with PTS signs increased slightly over time (from 49 to 53%). Prior history of venous thromboembolism (VTE) (odds ratio [OR] = 5.5 [2.8–10.9]), diabetes (OR = 2.3 [1.1–4.7]), pre-existing leg varicosities (OR = 3.2 [1.7–6.1]) and male sex (OR = 2.5 [1.3–5.1]) independently increased the risk of PTS ulcer at 1 year. Obesity also increased the risk but failed to reach statistical significance (OR = 1.8 [0.9–3.3]). DVT treatment characteristics (duration or drug) did not influence the risk.

Our results evidence that after acute DVT, pre-existing leg varicosities, prior venous thromboembolism, diabetes and male gender independently increased the risk for PTS ulcer. This suggests that clinicians should consider strategies aimed to prevent ulcers in high-risk DVT patients, such as preventing VTE recurrence, use of stockings in those with pre-existing venous insufficiency, careful monitoring of diabetic patients and encouraging weight loss in obese patients.
Computational Design and Simulation of Bending-Active Auxetic Structures
Authors: Naboni Roberto , Mirante Lorenzo
Published: January 2018

O artigo investiga a potencial aplicação de estruturas auxéticas na arquitetura através da combinação de métodos de desenho computacional e Manufatura Aditiva (MA). Essa classe de materiais apresenta comportamento interessante relacionado à característica pouco comum de possuir coeficiente de Poisson negativo, ou seja, ao contrário de outros materiais, quando tracionados expandem-se transversalmente e quando comprimidos contraem-se transversalmente. Explora-se um novo campo de pesquisa e design onde diferentes arranjos de auxéticos são estudados com intuito de informar um processo de form-finding de estruturas de cascas nervuradas sinclásticas de flexão-ativa (bending-active). Metodologias computacionais foram empregadas para visualizar o comportamento dinâmico destas estruturas utilizando Sistemas Massa-Mola. Princípios para o projeto e fabricação de cascas nervuradas auxéticas são investigados através de fabricação aditiva em diferentes escalas. Este processo é empregado para produzir modelos em escala úteis para a compreensão do comportamento auxético, assim como visionar a fabricação de mega-estruturas auxéticas com organização micro estrutural ótima. A resistência à flexão destes sistemas é cautelosamente controlada pelo uso de arranjos de enchimento variável informados por análise estrutural. Finalmente, é proposto um protótipo de casca nervurada em tamanho real como estudo de caso, em conjunto com um novo conceito para sua construção em fabricação aditiva in situ.
Proto-tectonic Weaving System: Computational Design Workflow for Semi-permeable Self-Supporting Enclosures
Authors: Naboni Roberto , Breseghello Luca
Published: January 2018

Este artigo tem como intuito apresentar um trabalho baseado em uma metodologia computacional e os resultados decorrentes da aplicação de técnicas de tecelagem para a construção de um sistema arquitetônico experimental, oWeaving Enclosure. A pesquisa explora a correspondência entre as propriedades do material e a montagem de sistemas encontrados em cestos trançados tradicionais, estudados através de ensaios analíticos, de laboratório e, realizando análise de elementos finitos com processo de trabalho algorítmico. O objetivo é explorar como ampliar o conhecimento obtido através de uma relação milenar entre o homem e a tecelagem sob a perspectiva do design contemporâneo sob as técnicas de fabricação. Com essa finalidade, foi introduzida uma série de experimentos computacionais e simulações para destacar a integração da materialidade, morfogênese digital e fabricação. O artigo apresenta um processo de design para a geração de geometrias específicas relacionadas com a natureza flexível do material e a simulação do seu comportamento com base nas condições ambientais variáveis. Os resultados deste método mostram o projeto e a fabricação de uma divisória, que destaca as propriedades de padrões digitalmente concebidos, definidos parametricamente para oferecer resistência estrutural e anteparo visual. A interação entre técnicas digitais e artesanais para materiais naturais representa um campo promissor para diminuir o impacto ambiental da indústria da construção. No entanto, novos sistemas de montagem, tais como a tecelagem com madeira parecem ainda não ter sido explorados em termos de características performativas e tectônicas que destacam importantes descobertas quando abordadas como um processo de design e fabricação orientada ao material.
O desenvolvimento de elementos de proteção de fachada responsivos – exploração e controle de um processo
Authors: Vaz Carlos Eduardo Verzola , Sousa Joana Pack Melo , Pinto Hugo Rodrigues de Souza , Cardoso Adriano Rodrigo Barreto , Queiroz Natalia
Published: January 2018

Este artigo tem como objetivo apresentar um processo exploratório de pesquisa para a integração de ferramentas e técnicas visando a criação de elementos de proteção de fachada. Como será visto neste documento, o cobogó foi utilizado como referência para o desenvolvimento de um protótipo físico funcional. Este elemento foi criado por dois comerciantes e um engenheiro radicados no Recife no início do século XX — Coimbra, Boeckmann e Góes. O Cobogó apresenta como características básicas o modo de produção seriado, a capacidade de proteger ambientes internos da luz direta do sol e de promover a adequada ventilação destes espaços, a possibilidade de, mesmo sendo um elemento vazado, permitir a sensação de privacidade e, além disso, funcionar como um elemento compositivo na fachada das edificações. O trabalho irá apresentar as diferentes etapas da pesquisa que envolveram, a coleta de dados sobre o uso do Cobogó na cidade do Recife, o processo de desenvolvimento de um conceito geométrico, a elaboração dos diferentes protótipos físicos e digitais e as demais metodologias e softwares utilizados no processo de trabalho.
Spanish adaptation and validation of the supportive & palliative care indicators tool – SPICT-ES™
Authors: Fachado Alfonso Alonso , Martínez Noemí Sansó , Roselló Marisa Martín , Ria José Javier Ventosa , Oliver Enric Benito , García Rafael Gómez , García José Manuel Fernández
Published: January 2018

OBJECTIVE: To culturally adapt and validate the SPICTTM to Spanish, which is a brief and simple tool to support a better identification of chronic patients who have palliative care needs. METHODS: For this study, we designed a multicenter and national project between the centers of Galicia, Balearic Islands, and Andalusia. For the process of translation and cross-cultural adaptation of the SPICTTM to Spanish, we followed the steps proposed by Beaton et al. with successive translations and subsequent consensus of experts using the debriefing methodology. After the content validation was completed, the psychometric properties were validated. A prospective longitudinal study was designed with 188 patients from Galicia, the Balearic Islands, and Andalusia. The internal consistency and reliability of the test and retest was analyzed for 10 days by the same researcher. RESULTS: For more than 90% of the participants of the SPICT-ESTM, it seems simple to be filled out, and they consider it written in an understandable language. The average time to apply the questionnaire without prior knowledge was 4 minutes and 45 seconds. To evaluate the internal consistency of the instrument, we used the Kuder-Richardson formula 20. Internal consistency is 0.71. The agreement index of the Kappa test is between 0.983 and 0.797 for the different items. CONCLUSIONS: In this study, we demonstrate the equivalence of content with the original. In addition, the validation of the psychometric properties establishes that the SPICT-ESTM maintains adequate reliability and stability. If we add the satisfaction shown by the professionals and the ease of use, the SPICT-ESTM is an adequate tool for the identification of palliative patients with chronic diseases and palliative care needs.
Systemic Right Ventricle in Adults With Congenital Heart Disease
Authors: Brida Margarita , Diller Gerhard-Paul , Gatzoulis Michael A.
Published: January 2018

The systemic right ventricle (SRV) is commonly encountered in congenital heart disease representing a distinctly different model in terms of its anatomic spectrum, adaptation, clinical phenotype, and variable, but overall guarded prognosis. The most common clinical scenarios where an SRV is encountered are complete transposition of the great arteries with previous atrial switch repair, congenitally corrected transposition of the great arteries, double inlet right ventricle mostly with previous Fontan palliation, and hypoplastic left heart syndrome palliated with the Norwood-Fontan protocol. The reasons for the guarded prognosis of the SRV in comparison with the systemic left ventricle are multifactorial, including distinct fibromuscular architecture, shape and function, coronary artery supply mismatch, intrinsic abnormalities of the tricuspid valve, intrinsic or acquired conduction abnormalities, and varied SRV adaptation to pressure or volume overload. Management of the SRV remains an ongoing challenge because SRV dysfunction has implications on short- and long-term outcomes for all patients irrespective of underlying cardiac morphology. SRV dysfunction can be subclinical, underscoring the need for tertiary follow-up and timely management of target hemodynamic lesions. Catheter interventions and surgery have an established role in selected patients. Cardiac resynchronization therapy is increasingly used, whereas pharmacological therapy is largely empirical. Mechanical assist device and heart transplantation remain options in end-stage heart failure when other management strategies have been exhausted. The present report focuses on the SRV with its pathological subtypes, pathophysiology, clinical features, current management strategies, and long-term sequelae. Although our article touches on issues applicable to neonates and children, its main focus is on adults with SRV.
Myeloid CD11c
+
Antigen-Presenting Cells Ablation Prevents Hypertension in Response to Angiotensin II Plus High-Salt Diet
Authors: Hevia Daniel , Araos Patricio , Prado Carolina , Fuentes Luppichini Eugenia , Rojas Macarena , Alzamora Rodrigo , Cifuentes-Araneda Flavia , Gonzalez Alexis A. , Amador Cristian A. , Pacheco Rodrigo , Michea Luis
Published: January 2018

Increasing evidence shows that antigen-presenting cells (APCs) are involved in the development of inflammation associated to hypertension. However, the potential role of APCs in the modulation of renal sodium transport has not been addressed. We hypothesized that APCs participate in renal sodium transport and, thus, development of high blood pressure in response to angiotensin II plus a high-salt diet. Using transgenic mice that allow the ablation of CD11c
high
APCs, we studied renal sodium transport, the intrarenal renin–angiotensin system components, blood pressure, and cardiac/renal tissue damage in response to angiotensin II plus a high-salt diet. Strikingly, we found that APCs are required for the development of hypertension and that the ablation/restitution of APCs produces rapid changes in the blood pressure in mice with angiotensin II plus a high-salt diet. Moreover, APCs were necessary for the induction of intrarenal renin–angiotensin system components and affected the modulation of natriuresis and tubular sodium transporters. Consistent with the prevention of hypertension, the ablation of APCs also prevented cardiac hypertrophy and the induction of several indicators of renal and cardiac damage. Thus, our findings indicate a prominent role of APCs as modulators of blood pressure by mechanisms including renal sodium handling, with kinetics that suggest the involvement of tubular cell functions in addition to the modulation of inflammation and adaptive immune response.
Left Ventricular Hypertrophy and Remodeling and Risk of Cognitive Impairment and Dementia
Authors: Moazzami Kasra , Ostovaneh Mohammad Reza , Ambale Venkatesh Bharath , Habibi Mohammadali , Yoneyama Kihei , Wu Colin , Liu Kiang , Pimenta Isabel , Fitzpatrick Annette , Shea Steven , McClelland Robyn L. , Heckbert Susan , Gottesman Rebecca F. , Bluemke David A. , Hughes Timothy M. , Lima João A.C.
Published: January 2018

Limited information exists on the longitudinal association between the left ventricular (LV) structure and function and future cognitive impairment and dementia in a large population without clinically recognized cardiovascular disease at baseline. The aim of the present study was to investigate the association between cardiac structure and function and risk of dementia and cognitive impairment in the MESA (Multi-Ethnic Study of Atherosclerosis) cohort. Measures of LV structure and function were determined using magnetic resonance imaging at baseline in 4999 participants free of clinically diagnosed cardiovascular disease and dementia. Probable incident clinical dementia was ascertained from hospitalization discharge records. Cognitive function was evaluated using tests addressing global cognitive function, processing speed, and memory. Associations of measures of LV structure and function with the incidence of clinically diagnosed dementia and cognitive performance were evaluated using Cox proportional hazard regression models adjusted for demographics, cardiovascular risk factors, and cardiovascular events. During a median follow-up of 12 years, 130 probable incident dementia cases were documented. Higher LV mass index (hazard ratio, 1.01; 95% confidence interval, 1.00–1.02) and LV mass-to-volume ratio (hazard ratio, 2.37; 95% confidence interval, 1.25–4.43) were independently associated with incident dementia and impaired cognitive function. Measures of LV function were not associated with risk of dementia or cognitive impairment. In conclusion, in a multiethnic cohort of participants without clinically detected cardiovascular disease and dementia at baseline, LV hypertrophy and concentric remodeling were independently associated with incident dementia and cognitive impairment.
Socioeconomic Status and Hypertension Control in Sub-Saharan Africa
Authors: Antignac Marie , Diop Ibrahima Bara , Macquart de Terline Diane , Kramoh Kouadio Euloge , Balde Dadhi M. , Dzudie Anastase , Ferreira Beatriz , Houenassi Martin Dèdonougbo , Hounsou Dominique , Ikama Méo Stéphane , Kane Adama , Kimbally-Kaki Suzy Gisèle , Kingue Samuel , Kouam Kouam Charles , Limbole Emmanuel , Mfeukeu Kuate Liliane , Mipinda Jean Bruno , N’Guetta Roland , Nhavoto Carol , Sesso Zouwera , Sidy Ali Abdallahi , Ali Toure Ibrahim , Plouin Pierre François , Perier Marie Cécile , Narayanan Kumar , Empana Jean Philippe , Jouven Xavier
Published: January 2018

Systemic hypertension is a rapidly growing epidemic in Africa. The role of socioeconomic status on blood pressure control has not been well studied in this part of the world. We, therefore, aimed to quantify the association of socioeconomic status both at the individual and at the country level with blood pressure control in Sub-Saharan Africa. We conducted a cross-sectional survey in urban clinics of 12 countries, both low income and middle income, in Sub-Saharan Africa. Standardized blood pressure measures were made among the hypertensive patients attending the clinics. Blood pressure control was defined as blood pressure <140/90 mm Hg, and hypertension grades were defined according to the European Society of Cardiology guidelines. A total of 2198 hypertensive patients (58.4±11.8 years; 39.9% men) were included. Uncontrolled hypertension was present in 1692 patients (77.4%), including 1044 (47.7%) with ≥grade 2 hypertension. The proportion of uncontrolled hypertension progressively increased with decreasing level of patient individual wealth, respectively, 72.8%, 79.3%, and 81.8% (
P
for trend, <0.01). Stratified analysis shows that these differences of uncontrolled hypertension according to individual wealth index were observed in low-income countries (
P
for trend, 0.03) and not in middle-income countries (
P
for trend, 0.26). In low-income countries, the odds of uncontrolled hypertension increased 1.37-fold (odds ratio, 1.37 [0.99–1.90]) and 1.88-fold (odds ratio, 1.88 [1.10–3.21]) in patients with middle and low individual wealth as compared with high individual wealth. Similarly, the grade of hypertension increased progressively with decreasing level of individual patient wealth (
P
for trend, <0.01). Strategies for hypertension control in Sub-Saharan Africa should especially focus on people in the lowest individual wealth groups who also reside in low-income countries.
A Buddhist Foundation in Śārdīysa
Authors: Bakker Hans
Published: January 2018

The article adduces reasons in support of the view that the famous Schøyen Copper Scroll does not come from Afghanistan (Bactria), as maintained by its editor Gudrun Melzer, but belongs to the land south of the Hindu Kush. The donation of a Buddhist Stūpa, recorded in the scroll, was officially made by the Devaputra King of Tālagāna, which may have been a place in the Panjab. It is argued, however, that this pious foundation was organized in particular by his Queen, who is said to have been the daughter of the King of Sārada. The first person speaking in the last 7 verses of the inscription may be identified as this Queen of Tālagāna, who speaks of her homecountry, indicating that the donated Stūpa was erected in the land of Sārada. The village in which the Stūpa was erected is called Śārdīysa. This village, it is argued, can be identified with the present-day village of Śārdi in the Neelum Valley of Kashmir. This region of Kashmir was controlled by the Hūṇa (Alchon) king Mehama, under whose rule the foundation is said to have taken place. The Alchon kings Khīṅgīla and Toramāna may have been mentioned in the scroll on account of their control over Gandhāra and the Panjab, in which the donor institution of Tālagāna was situated. The fourth Alchon king mentioned in the scroll, Javūkha, probably reigned in the Swat Valley. These four Alchon kings formed a confederacy, well-known from their common coinage. The scroll evinces that they were involved in the patronage of Buddhism.
Procedure of Issuing Religious Divorce and Resolving Matrimonial Disputes at Sharīʿah Councils in the uk
Authors: Cusairi Rafidah Mohamad , Zahraa Mahdi
Published: January 2018

The unavailability of civil courts to hear cases relating to Muslim family law and other related matters persuaded community leaders and religious scholars in the United Kingdom to establish several Sharīʿah councils. This article explores the role played by these councils in resolving matrimonial disputes, especially the process and procedure of issuing an Islamic divorce. Library and empirical research methods were employed. Three main uk Sharīʿah councils were visited wherein mediation and arbitration sessions, as well as monthly meetings, were observed to examine how disputes are handled and decisions made. The study leads to several findings. Mediation and arbitration are the main methods used in the process, and despite the relative success of Sharīʿah councils, they face challenges resulting from the dichotomy and overlapping jurisdictions of Islamic and English family law and the non-alignment of divorce issued by uk courts and religious divorce.