bluuebunny/crossref_metadata_2025 huggingface dataset:
The Intrauterine Bigatti Shaver System: An Alternative Option for Focal Retained Products of Conception
Authors: Sutherland Neveta S. V. , Rajesh Hemashree
Published: November 2018

The management of retained products of conception (RPOC) may be medical or surgical. Surgical options include blind curettage, ultrasound guided curettage, or curettage under direct vision via hysteroscopy. The definitive management of patients presenting with retained products of conception will depend on several factors: severity of bleeding, presence of hemodynamic instability or infection, and patient preference. Optimal management of retained products of conception should result in complete evacuation of the uterine cavity while minimizing endometrial trauma. This is of utmost importance in patients with reproductive desires. We report patients with RPOC managed via hysteroscopic removal using the Bigatti Morcellator. Both patients had complete evacuation of the visualized RPOC. The purpose of this paper is to present this approach as an effective management option particularly in patients with a history of subfertility and failed blind curettage.
Operational Evaluation of Part‐Time Shoulder Use for Interstate 476 in the State of Pennsylvania
Authors: Coffey Sean , Park Seri
Published: November 2018

Part‐time shoulder use (PTSU) is a capacity‐adding strategy that utilized the shoulder temporarily during the peak commuting period and is used sporadically throughout the United States of America (USA). This strategy aids in addressing a transportation‐related issue for major metropolitan areas. Around major metropolitan areas, the land availability is limited due to high population counts, which makes widening roadways for growing populations complex and expensive. Many countries are looking at methods that better utilize the transportation infrastructure currently constructed before widening the roadway. PTSU provides a possible solution to this problem, and this research aims to evaluate the operational benefits of PTSU using a case study based in the state of Pennsylvania. Interstate 476 (I‐476), in the Philadelphia, Pennsylvania, metropolitan area is a prime candidate for PTSU. This four‐lane highway has peak directional volumes of around 4,700 vehicles per hour in particular sections during the morning commuting period. I‐476 is a major commuting route for the region, and the additional capacity during the commuting periods would greatly improve the flow of the surrounding network. This analysis was completed using a Vissim model simulating the 7 AM to 9 AM commuting period. A variety of PTSU scenarios were analyzed including (1) general purpose PTSU lane, (2) passenger cars only PTSU lane, (3) heavy trucks only PTSU lane, and (4) general purpose PTSU lane where additional traffic is induced. Overall, this study determined that PTSU could significantly decrease the travel time on I‐476, regardless of vehicle type restrictions, and could provide a more stable traffic density throughout the I‐476 network. This research provides additional insight into the effects of vehicle type restrictions on the effectiveness of PTSU and further strengthens the understanding of the operational benefit of PTSU.
A Double‐Blind Placebo‐Controlled Randomized Trial Evaluating the Effect of Polyphenol‐Rich Herbal Congee on Bone Turnover Markers of the Perimenopausal and Menopausal Women
Authors: Wattanathorn Jintanaporn , Somboonporn Woraluk , Sungkamanee Sudarat , Thukummee Wipawee , Muchimapura Supaporn
Published: November 2018

Based on the benefit of polyphenolic compounds on osteoporosis, we hypothesized that the polyphenol‐rich herbal congee containing the combined extract of Morus alba and Polygonum odoratum leaves should improve bone turnover markers in menopausal women. To test this hypothesis, a randomized double‐blind placebo‐controlled study was performed. A total of 45 menopausal participants were recruited in this study. They were randomly divided into placebo, D1, and D2 groups, respectively. The subjects in D1 and D2 groups must consume the congee containing the combined extract of M. alba and P. odoratum leaves at doses of 50 and 1500 mg/day, respectively. At the end of an 8‐week consumption period, all subjects were determined serum bone markers including calcium, alkaline phosphatase, osteocalcin, and beta CTX. In addition, the hematological and blood clinical chemistry changes, and total phenolic content in the serum were also determined. The results showed that the menopausal women in D2 group increased serum alkaline phosphatase, osteocalcin, and total phenolic compounds content but decreased CTX level. Clinical safety assessment failed to show toxicity and adverse effects. Therefore, herbal congee containing the combined extract of M. alba and P. odoratum leaves is the potential functional food that can decrease the risk of osteoporosis.
Mobile Hardware-Information System for Neuro-Electrostimulation
Authors: Kublanov Vladimir S. , Babich Mikhail V. , Dolganov Anton Yu.
Published: November 2018

The article describes organizational principles of the mobile hardware-informational system based on the multifactorial neuro-electrostimulation device. The system is implemented with two blocks: the first block forms the spatially distributed field of low-frequency monopolar current pulses between two multielement electrodes in the neck region. Functions of the second block, specialized control interface, are performed by a smartphone. Information is exchanged between two blocks through a telemetric channel. The mobile hardware-informational system allows to remotely change the structure of the current pulses field, to control its biotropic characteristics and to change the targets of the stimulation. Moreover, it provides patient data collection and processing, as well as access to the specialized databases. The basic circuit solutions for the neuro-electrostimulation device, implemented by means of microcontroller and elements of high-level hardware integration, are described. The prospects of artificial intelligence and machine learning application for treatment process management are discussed.
Delayed Drainage of a Largely Deformed Aquitard due to Abrupt Water Head Decline in Adjacent Aquifer
Authors: Li Zhaofeng , Zhou Zhifang , Li Mingyuan , Zhang Boran , Dai Beibing
Published: November 2018

A governing equation of drawdown was put forward to describe the one-dimensional large-strain consolidation behavior of an aquitard without consideration of the creeping effect. An analytical solution was derived to characterize the drawdown variation in the aquitard subjected to sudden hydraulic head decline in adjacent confined aquifer. The characteristics of the groundwater dynamics and water balance in the aquitard have been analyzed based on the analytical solution. A comparison analysis of results has been made between the large-strain theory and the classical small-strain theory. The type-curve fitting method was used to determine the hydrogeological parameters, on the basis of the observed variations of aquitard deformation with time. The analytical solution was thus validated by a comparison with the observed experimental results. It is found that the water drainage of aquitard is obviously delayed in response to the water head decline in the adjacent aquifer. All delayed water release from the aquitard terminates when the consolidation time reaches the value ofl2/cv0. The aquitard deformation predicted by the large-strain theory is less than that given by the small-strain theory, and the prediction discrepancy of these two theories increases with the increasing soil compressibility.
Comparing the Efficacy of Triamcinolone Acetonide Iontophoresis versus Topical Calcipotriol/Betamethasone Dipropionate in Treating Nail Psoriasis: A Bilateral Controlled Clinical Trial
Authors: Saki Nasrin , Hosseinpoor Shahla , Heiran Alireza , Mohammadi Ali , Zeraatpishe Mehdi
Published: November 2018

Background and Objective. Psoriasis is a common chronic inflammatory skin disorder affecting any age and gender. The clinical presentation of the nail disease depends on the location of the pathology: nail bed or nail matrix. We aimed to compare the therapeutic effects of triamcinolone acetonide iontophoresis (TI) and topical calcipotriol/betamethasone dipropionate in the nail bed and nail matrix involvements of psoriasis using Nail Psoriasis Severity Index (NAPSI). Materials and Methods. In the present bilateral comparison clinical trial, sixteen patients with clinical diagnosis of nail psoriasis were enrolled and randomized to receive six monthly TI treatment sessions either on their right or on the left hand target nails and daily application of topical calcipotriol/betamethasone dipropionate for six months on their other hand. Clinical efficacy was evaluated according to target nails NAPSI before and after the treatment. Wilcoxon sign-rank test and repeated measures ANOVA were used to compare the efficacy of the treatments. Results. The results did not show any difference between the therapeutic effects of TI and topical calcipotriol/betamethasone dipropionate regarding the nail bed score (P value =  .356), matrix score (P value =  .137), and total NAPSI (P-value =  .098). Conclusion. Monthly TI has an equal efficacy compared to daily topical calcipotriol/betamethasone dipropionate. It can be used as a safe, easy, and compliant treatment for nail psoriasis. This study is registered under IRCT2017050233778N1.
Modifications of Surgical Suction Tip Geometry for Flow Optimisation: Influence on Suction-Induced Noise Pollution
Authors: Friedrich M. G. , Tirilomis T. , Kollmeier J. M. , Wang Y. , Hanekop G. G.
Published: November 2018

Introduction. Suction devices for clearing the surgical field are among the most commonly used tools of every surgeon because a better view of the surgical field is essential. Forced suction may produce disturbingly loud noise, which acts as a nonnegligible stressor. Especially, in emergency situations with heavy bleeding, this loud noise has been described as an impeding factor in the medical decision-making process. In addition, there are reports of inner ear damage in patients due to suction noises during operations in the head area. These problems have not been solved yet. The purpose of this study was to analyse flow-dependent suction noise effects of different surgical suction tips. Furthermore, we developed design improvements to these devices.Methods. We compared five different geometries of suction tips using an in vitro standardised setup. Two commercially available standard suction tips were compared to three adapted new devices regarding their flow-dependent (10–2000 mL/min) noise emission (dB, weighting filter (A), distance 10 cm) and acoustic quality of resulting noises (Hamilton fast Fourier analysis) during active suction at the liquid-air boundary. Noise maps at different flow rates were created for all five suction devices, and the proportion of extracted air was measured. The geometries of the three custom-made suction tips (new models 1, 2, and 3) were designed considering the insights after determining the key characteristics of the two standard suction models.Results. The geometry of a suction device tip has significant impact on its noise emission. For the standard models, the frequency spectrum at higher flow rates significantly changes to high-frequency noise patterns (>3 kHz). A number of small side holes designed to prevent tissue adhesion lead to increased levels of high-frequency noise. Due to modifications of the tip geometry in our new models, we are able to achieve a highly significant reduction of noise level at low flow rates (new model 2 vs. standard modelsp<0.001) and also the acoustic quality improved. Additionally, we attain a highly significant reduction of secondary air intake (new model 2 vs. the other modelsp<0.001).Conclusion. Improving flow-relevant features of the geometry of suction heads is a suitable way to reduce noise emissions. Optimized suction tips are significantly quieter. This may help us to reduce noise-induced hearing damage in patients as well as stress of medical staff during surgery and should lead to quieter operation theatres overall. Furthermore, the turbulence reduction and reduced secondary air intake during the suction process are expected to result in protective effects on the collected blood and thus could improve the quality of autologous blood retransfusions. We are on the way to evaluate potential benefits.
Efficacy of a Recombinant Turkey Herpesvirus AI (H5) Vaccine in Preventing Transmission of Heterologous Highly Pathogenic H5N8 Clade 2.3.4.4b Challenge Virus in Commercial Broilers and Layer Pullets
Authors: Palya Vilmos , Tatár-Kis Tímea , Walkóné Kovács Edit , Kiss István , Homonnay Zalán , Gardin Yannick , Kertész Krisztián , Dán Ádám
Published: November 2018

Outbreaks caused by the highly pathogenic avian influenza virus (HPAIV) H5N8 subtype clade 2.3.4.4 were first reported in 2014 in South Korea then spread very rapidly in Asia, to Europe, and for the first time, to North America. Efficacy of a recombinant HVT-AI (H5) vaccine (rHVT-H5) to provide clinical protection as well as to significantly reduce the shedding of an H5N8 challenge virus has already been demonstrated in SPF chickens. The aim of our studies was to test the efficacy of the same rHVT-H5 vaccine in controlling the transmission of a recent Hungarian HPAIV H5N8 challenge virus in commercial chickens. Broilers and layers were vaccinated at day old according to the manufacturer’s recommendation and then challenged with a 2017 Hungarian HPAIV H5N8 (2.3.4.4b) isolate at 5 or 7 weeks of age, respectively. Evaluation of clinical protection, reduction of challenge virus shedding, and transmission to vaccinated contact birds was done on the basis of clinical signs/mortality, detection, and quantitation of challenge virus in oronasal and cloacal swabs (regularly between 1 and 14 days postchallenge). Measurement of seroconversion to AIV nucleoprotein was used as an indicator of infection and replication of challenge virus. Our results demonstrated that rHVT-H5 vaccination could prevent the development of clinical disease and suppress shedding very efficiently, resulting in the lack of challenge virus transmission to vaccinated contact chickens, regardless the type of birds. Single immunization with the tested rHVT-H5 vaccine proved to be effective to stop HPAIV H5N8 (2.3.4.4b) transmission within vaccinated poultry population under experimental conditions.
Systematic Investigation of Scutellariae Barbatae Herba for Treating Hepatocellular Carcinoma Based on Network Pharmacology
Authors: Gong Benjiao , Kao Yanlei , Zhang Chenglin , Sun Fudong , Zhao Huishan
Published: November 2018

As the fifth most common type of malignant cancers globally, hepatocellular carcinoma (HCC) is the second leading cause of cancer‐related mortality worldwide. As a long‐time medicinal herb in Traditional Chinese Medicine (TCM), Scutellariae Barbatae Herba (SBH) has also been used for treating various cancers including HCC, but its underlying mechanisms have not been completely clarified. Presently, an innovative network‐pharmacology platform was introduced to systematically elucidate the pharmacological mechanisms of SBH against HCC, adopting active ingredients prescreening, target fishing, and network analysis. The results revealed that SBH appeared to work on HCC probably through regulating 4 molecular functions, 20 biological processes, and hitting on 21 candidate targets involved in 40 pathways. By in‐depth analysis of the first‐ranked signaling pathway and hit genes, only TTR was highly and specially expressed in the liver tissue. TTR might play a crucial role in neutrophil degranulation pathway during SBH against HCC. Hence, TTR might become a therapeutic target of HCC. The study investigated the anti‐hepatoma mechanisms of SBH from a holistic perspective, which provided a theoretical foundation for further experimental research and rational clinical application of SBH.
New Structure for Strengthening Soil Embankments
Authors: Xu Fang , Leng Wuming , Nie Rusong , Zhang Qishu , Yang Qi
Published: November 2018

A new prestressed reinforcement device (PRD) consisting of two lateral pressure plates (LPPs) and a reinforcement bar is developed to strengthen soil embankments by improving the soil confining pressure and providing lateral constraint on embankment slopes. The reinforcement effects of PRDs were demonstrated by investigating the beneficial effects of increasing confining pressure on the soil behavior via the performance of a series of large‐scale static and cyclic triaxial tests on a coarse‐grained embankment soil. The results show that PRDs can effectively improve the soil shear strength, bearing capacity, ability to resist elastic and plastic deformation, critical dynamic stress, and dynamic shear modulus, and empirical methods were also developed to determine the critical dynamic stress and initial dynamic shear modulus of the embankment soil. Moreover, 3D finite element analyses (FEAs) with an LPP width of 1.2 m were performed to analyze the additional stress field in a prestressed heavy‐haul railway embankment. The FEAs showed that the additional stress at a given external distance from the border of an LPP first increased to a maximum value and then gradually decreased with increasing depth; the additional stress was transferred to the zones where the subgrade tends to have higher stresses with peak stress diffusion angles of 34° (slope direction) and 27° (longitudinal direction); and a continuous effective reinforcement zone with a minimum additional stress coefficient of approximately 0.2 was likely to form at the diffusion surface of the train loads, provided that the net spacing of the LPPs was 0.7 m. The reinforcement zone above the diffusion surface of the train loads can act as a protective layer for the zones that tend to have higher stresses. Finally, the advantages and application prospects of PRDs are discussed in detail. The newly developed PRDs may provide a cost‐effective alternative for strengthening soil embankments.
Dysmorphic Short Stature: Radiological Diagnosis of Trichorhinophalangeal Syndrome
Authors: Nicolescu Corina Ramona , Kasongo Laura , Rausin Léon
Published: November 2018

Trichorhinophalangeal syndrome (TRPS), a type of skeletal dysplasia, is characterized by a triad of dysmorphic (bulbous nose and large ears); ectodermal (thin and sparse hair); and skeletal (short stature and cone-shaped epiphyses) findings, and this combination is helpful for early diagnosis and appropriate follow-up. A 14-year-old boy presented with short stature and distinctive facial features, and following the first clinical and biological evaluation, no precise diagnosis was reached. Progressive bilateral development of noninflammatory and painless deformity of his second finger required a radiological exam that highlighted the key elements (cone-shaped epiphyses) for final diagnosis. This case illustrates the difficulties to early recognition of TRPS when the clinical presentation is not complete and radiological findings are missing.
Antioxidant Activities and Repair Effects on Oxidatively Damaged HK‐2 Cells of Tea Polysaccharides with Different Molecular Weights
Authors: Sun Xin-Yuan , Wang Jian-Min , Ouyang Jian-Ming , Kuang Li
Published: November 2018

This study aims at investigating the antioxidant activity and repair effect of green tea polysaccharide (TPS) with different molecular weights (Mw) on damaged human kidney proximal tubular epithelial cells (HK‐2). Scavenging activities on hydroxyl radical (⋅OH) and ABTS radical and reducing power of four kinds of TPS with Mw of 10.88 (TPS0), 8.16 (TPS1), 4.82 (TPS2), and 2.31 kDa (TPS3) were detected. A damaged cell model was established using 2.6 mmol/L oxalate to injure HK‐2 cells. Then, different concentrations of TPSs were used to repair the damaged cells. Index changes of subcellular organelles of HK‐2 cells were detected before and after repair. The four kinds of TPSs possessed radical scavenging activity and reducing power, wherein TPS2 with moderate Mw presented the strongest antioxidant activity. After repair by TPSs, cell morphology of damaged HK‐2 cells was gradually restored to normal conditions. Reactive oxygen species production decreased, and mitochondrial membrane potential (Δψm) of repaired cells increased. Cells of G1 phase arrest were inhibited, and cell proportion in the S phase increased. Lysosome integrity improved, and cell apoptotic rates significantly reduced in the repaired group. The four kinds of TPSs with varying Mw displayed antioxidant activity and repair effect on the mitochondria, lysosomes, and intracellular DNA. TPS2, with moderate Mw, showed the strongest antioxidant activity and repair effect; it may become a potential drug for prevention and treatment of kidney stones.
Hemopericardium and Cardiac Tamponade Secondary to Migrated Inferior Vena Cava Filter
Authors: Mehta Jeet J. , DeMarco Benjamin , Vavalle John P. , Tahir Khola S. , Rossi Joseph S.
Published: November 2018

A 73-year-old female presented with cardiogenic shock secondary to hemopericardium and cardiac tamponade. Imaging revealed two fractured legs of an inferior vena cava filter, with one leg within the anterior myocardium of the right ventricle and another penetrating the inferior septum through the middle cardiac vein. Hemopericardium and cardiac tamponade were treated with pericardiocentesis. A multidisciplinary meeting resulted in deferring further action against the embedded fractured legs of the filter with consideration of the patient’s age and comorbidities. This case report should alert clinicians to think about hemopericardium as a cause of cardiac tamponade and cardiogenic shock in a patient with a history of an inferior vena cava filter placement.
Effects of Strategically Placed Water Droplets on Monolayer Growth of Molybdenum Disulfide
Authors: Jiang Yan , Lin Yuankun , Cui Jingbiao , Philipose Usha
Published: November 2018

Two-dimensional (2D) molybdenum disulfide (MoS2) films with a tunable bandgap hold great promise for next-generation electronic and optoelectronic devices. Synthesis of large areas of high-quality MoS2 monolayers lacks experimental reproducibility. Moreover, the outcome of MoS2 growth by chemical vapor deposition is dependent on several interconnected growth parameters. In this study, we present results of MoS2 monolayer growth by strategically placing water droplets on the growth substrate and/or in the source prior to its loading in the growth chamber. The volume and distribution of water on the growth substrate and in the source had a direct impact on the morphology of the as-grown MoS2. Characterized by scanning electron microscopy (SEM), Raman microscopy, and atomic force microscopy (AFM), the number and size of MoS2 layers as well as its distribution on the growth substrate were found to have a strong dependence on the positioning of the water droplet. This study on MoS2 monolayer growth using water droplets as a promoter provides a simple and reproducible experimental technique enabling growth with high reliability.
Diagnosis and Management of Rare Case of Mesenteric Hematoma Rupture after Transcatheter Aortic Valve Replacement (TAVR): A Case Report and Review of the Literature
Authors: Abbasi Danish , Vanhook Jeffrey E. , Salartash Khashayar , Levite Howard
Published: November 2018

We present a case of a 78-year-old female with history of diastolic heart failure and paroxysmal atrial fibrillation on apixaban presenting with worsening shortness of breath. She underwent transesophageal echocardiogram showing severe aortic stenosis with a valve area of 0.8 cm2. Coronary angiography did not reveal significant coronary artery disease. CT of chest, abdomen, and pelvis did not show any evidence of hematoma or dissection. Patient was scheduled for transfemoral TAVR. Patient’s apixaban was discontinued prior to the procedure. She received heparin during the procedure. She successfully underwent left transfemoral aortic valve replacement. Shortly after the procedure, she complained of abdominal pain and became hypotensive. Blood pressure was 76/44 mm of Hg (MAP 58). Hemoglobin dropped to 8.1 g/dl (baseline 13). Stat CT abdomen and pelvis showed a large volume of hemorrhage in the peritoneal cavity. CTA of abdomen showed no evidence of aortic aneurysm or dissection but active extravasation below the inferior aspect of the spleen. Catheterization of the superior mesenteric artery (SMA) identified ileal branch of SMA as the source of bleeding. Embolization using gel foam slurry followed by a coil insertion was performed. Repeat angiogram demonstrated continued extravasation through arcade collaterals. A rapid exploration of the abdominal cavity revealed ruptured mesenteric hematoma. Evacuation of hematoma was performed. Portion of small ileum and bleeding mesenteric branch vessel was resected. Her condition stabilized with no postoperative bleeding and she was discharged on warfarin postoperatively. Use of antithrombotic therapy increases risk of bleeding in TAVR patients. Mesenteric hematoma rupture if not identified can be life-threatening. We believe that this is the first reported case of mesenteric hematoma rupture after a TAVR procedure.
Supplementation of Stingless Bee Honey from Heterotrigona itama Improves Antiobesity Parameters in High‐Fat Diet Induced Obese Rat Model
Authors: Mohd Rafie Ahmad Zulkifli , Syahir Amir , Wan Ahmad Wan Amir Nizam , Mustafa Mohd Zulkifli , Mariatulqabtiah Abdul Razak
Published: November 2018

Heterotrigona itama is a common stingless bee species found in Southeast Asia. Studies on the health benefits of its honey are limited in comparison with other stingless bee species. This study examines the antiobesity benefits found in stingless bee honey (SBH) from H. itama. The parameters used to measure the benefits were weight change, morphological structures, and biochemical characteristics. The research was conducted by using rats that were given a high‐fat diet (HFD). In total 48 male Sprague Dawley (SD) rats were given a formulated HFD to increase the levels of obesity, the HFD was administered with a value of 0.68 g/cm2. The duration of the treatment was six weeks, and the results show that the induction obesity using the HFD was successful. Following this, the rats were then treated with SBH (at dosages of 1000 mg/kg, 750 mg/kg or 500 mg/kg), with orlistat or with a placebo. Compared with typical obesity treatment methods, the one that used the three dosages of SBH showed a higher reduction in body mass index (BMI), percentage of body weight gain, adiposity index, and relative organ weight (ROW). The levels of liver enzymes (ALT, AST, and ALP) were also significantly lower in SBH‐treated groups. The levels of triglycerides and LDL‐cholesterol were significantly lower, while the level of HDL‐cholesterol was significantly higher in comparison with the control obese group. In terms of morphological structures, the number of adipocyte cells was reduced, and the hepatocytes found in the liver were less prone to rupturing when treated with SBH. In conclusion, the administration of SBH led to an improvement in indicators associated with obesity reduction. SBH also possesses a hepatoprotective potential which can reduce the health risks related to obesity.
A 64-Line Lidar-Based Road Obstacle Sensing Algorithm for Intelligent Vehicles
Authors: Wang Hai , Lou Xinyu , Cai Yingfeng , Chen Long
Published: November 2018

Based on the 64-line lidar sensor, an object detection and classification algorithm with both effectiveness and real time is proposed. Firstly, a multifeature and multilayer lidar points map is used to separate the road, obstacle, and suspension object. Then, obstacle grids are clustered by a grid-clustering algorithm with dynamic distance threshold. After that, by combining the motion state information of two adjacent frames, the clustering results are corrected. Finally, the SVM classifier is used to classify obstacles with clustered object position and attitude features. The good accuracy and real-time performance of the algorithm are proved by experiments, and it can meet the real-time requirements of the intelligent vehicles.
Analysis on Port and Maritime Transport System Researches
Authors: Chen Lingshan , Xu Xiang , Zhang Ping , Zhang Xiaotian
Published: November 2018

This paper examines the past and current research in the container port and maritime field. Using rigorous bibliometric analysis, the paper identifies the core authors/affiliations, their rankings, and collaboration patterns. The analysis of the paper will enable new researchers to quickly build an understanding of the container port and maritime field by reading core authors’ papers published in specific journals.
Identification of Levels of Serum Amyloid A and Apolipoprotein A1 in Serum Proteomic Analysis of Neuropsychiatric Systemic Lupus Erythematosus Patients
Authors: Duarte-Delgado Nancy P. , Lujan Tania P. , Arbeláez-Cortés Álvaro , García-Valencia Jenny , Zapata Adriana , Rojas Mauricio , Restrepo-Escobar Mauricio , Vásquez Gloria , Ortiz-Reyes Blanca L.
Published: November 2018

Neuropsychiatric Systemic Lupus Erythematosus (NPSLE) has multiple pathogenic mechanisms that cause diverse manifestations and whose diagnosis is challenging because of the absence of appropriate diagnostic tests. In the present study the application of proteomics using two-dimensional electrophoresis (2D) and mass spectrometry (MS) allowed the comparison of the protein profile of the serum low and high abundance protein fractions of NPSLE patients (NPSLE group) and SLE without neuropsychiatric syndromes (SLE group), Neuropsychiatric syndromes not associated with SLE (NPnoSLE groups), and healthy controls (CTRL group). The gels obtained were digitalized and analyzed with the PDQuest software. The statistical analysis of the spots was performed using the nonparametric Kruskal Wallis and Dunn's multiple comparison tests. Two spots showed significant differences and were identified by MS. Spot 4009 was significantly lower in NPSLE with regard to NPnoSLE (p= 0,004) and was identified as apolipoprotein A1 (APOA1) (score 809-1132). Spot 8001 was significantly higher in NPSLE regarding CTRL and NPnoSLE (p= 0,01 y 0,03, respectively) and was identified as serum amyloid A (SAA) (score 725-2488). The proinflammatory high density lipoproteins (HDL) have been described in SLE. In this HDL the decrease of APOA1 is followed by an increase in SAA. This altered level of both proteins may be related to the inflammatory state that is characteristic of an autoimmune disease like SLE, but this is not specific for NPSLE.
Effects of 8-Week Complex Balance Training in Young Alpine Skiers: A Pilot Study
Authors: Słomka Kajetan J. , Pawłowski Michał , Michalska Justyna , Kamieniarz Anna , Brachman Anna , Juras Grzegorz
Published: November 2018

Objectives. The purpose of this study was to determine the effects of an 8-week complex balance training program on dynamic balance in skiers according to the new balance training protocol. Design. Intervention study, comprising 8 weeks of core stability, plyometric, balance, and stretching exercises. Participants. Ten young skiers volunteered to take part in this study (average age, height, and body mass were 16,44 +/- 1,07 years, 172,76+/-8,84 cm, and 67,4 11,44 kg, respectively (mean +/- SD)). Main Outcome Measures. Subjects’ dynamic balance performance was assessed and retested after training completion with the use of dynamic balance measurement within the Optojump Next System. Results. The results of 8-week complex balance training showed significant improvements for jump height (H) and flight time (FT) for the left leg and jumping area in both legs. Conclusion. The complex balance training program improved parameters of dynamic stability in young skiers and led to decreased asymmetry between lower extremities.
Upregulated TSG-6 Expression in ADSCs Inhibits the BV2 Microglia-Mediated Inflammatory Response
Authors: Hu Yang , Li Gaigai , Zhang Ye , Liu Na , Zhang Ping , Pan Chao , Nie Hao , Li Qi , Tang Zhouping
Published: November 2018

Objectives. The microglial cells are immune surveillance cells in the central nervous system and can be activated during neurological disorders. Adipose-derived stem cells (ADSCs) were reported to inhibit the inflammatory response in microglia by secreting proteins like tumor necrosis factor-inducible gene 6 protein (TSG-6). We aim to explore the mechanisms and the associated microRNAs. Methods. ADSCs were cultured and TSG-6 expression was evaluated. ADSCs were cocultured with lipopolysaccharide- (LPS-) induced BV2 microglia and the supernatant was harvested for detecting cytokines. The total RNA was extracted and sequenced by high-throughput sequencing. MicroRNA profiles were compared between two treatment groups of ADSCs. A comprehensive bioinformatics analysis and confirmation experiments were performed to identify the microRNAs targeting at TSG-6. Results. We found that ADSCs could secrete TSG-6 to inhibit the proinflammatory cytokines, including interleukin-1 beta and interleukin-6, and tumor necrosis factor alpha (TNFα), produced by LPS-induced microglia-mediated inflammatory response. Bioinformatics analysis showed a total of 35 microRNAs differentially expressed between the two groups of ADSCs, and miR-214-5p was identified as a regulator of TSG-6 mRNA. Conclusion. Following a treatment with TNFα, ADSCs can regulate the inflammatory response in LPS-activated BV2 microglia by upregulating TSG-6 expression, which itself is under the negative control of miR-214-5p.
Verification That Mouse Chromosome 14 Is Responsible for Susceptibility to Streptozotocin in NSY Mice
Authors: Babaya Naru , Ueda Hironori , Noso Shinsuke , Hiromine Yoshihisa , Itoi-Babaya Michiko , Kobayashi Misato , Fujisawa Tomomi , Ikegami Hiroshi
Published: November 2018

Introduction. Streptozotocin- (STZ-) induced diabetes is under polygenic control, and the genetic loci for STZ susceptibility are mapped to chromosome (Chr) 11 in Nagoya-Shibata-Yasuda (NSY) mice. In addition to Chr11, other genes on different chromosomes may contribute to STZ susceptibility in NSY mice. The aim of this study was to determine whether NSY-Chr14 contributes to STZ susceptibility and contains the STZ-susceptible region. Materials and Methods. A consomic C3H-14NSY strain (R0: homozygous for NSY-derived whole Chr14 on the control C3H background), two congenic strains (R1: the region retained proximal and middle segments of NSY-Chr14 and R2: the region retained a proximal segment of NSY-Chr14), and parental NSY and C3H mice were intraperitoneally injected with a single injection of STZ at a dose of 175 mg/kg body weight at 12 weeks of age. Blood glucose levels and body weights were measured at days 0, 1, 2, 4, 5, 7, 8, and 14 after STZ injection. At day 14 after STZ injection, pancreata were dissected and fixed. Results. After STZ injection, blood glucose levels were significantly higher in R0 mice than in C3H mice. However, blood glucose levels in R0 mice were not as severely affected as those in NSY mice. In R1 and R2 mice, blood glucose levels were similar to those in C3H mice and were significantly lower than those in R0 mice. Body weights were decreased in NSY and R0 mice; however, this change was not observed in R1, R2, and C3H mice. Although islet tissues in all strains exhibited degeneration and cellular infiltration, histological changes in NSY and R0 mice were more severe than those in R1, R2, and C3H mice. Conclusions. These data demonstrated that NSY-Chr14 was a STZ-susceptible chromosome and that STZ susceptibility was mapped to the distal segment of NSY-Chr14.
Learning Outside the Classroom: How Principals Define and Prepare to Be Instructional Leaders
Authors: Vogel Linda R.
Published: November 2018

This qualitative study surveyed 50 practicing principals in a Rocky Mountain state to explore what elements of their responsibilities these educational leaders identified as part of their instructional leadership roles. The study also examined what experiences these principals identified as helpful in preparing them to assume the role of school instructional leader, specifically in the areas of teacher supervision and evaluation, the use of technology to support student learning, and the use of data to inform instructional practices. These areas have been identified through research as significant elements of instructional leadership. By identifying the specific actions that principals identify as their instructional leadership responsibilities, programs that prepare school leaders and state and district personnel who provide professional development for principals can develop learning experiences that could more effectively support principals’ success as instructional leaders.
An Unusual Adenomatoid Tumor of Fimbria with Pronounced Psammoma Bodies in a BRCA Positive Patient as a Pitfall for Carcinoma on Frozen Section
Authors: Lee Christine M. , Moh Michelle , Sullivan Peggy S. , Moatamed Neda A.
Published: November 2018

Background. BRCA gene mutations significantly increase the risk of breast and ovarian cancers where the lifetime risk of the ovarian cancer is about 40%. Therefore, many women with such mutations undergo prophylactic bilateral mastectomy and salpingo-oophorectomy. About 5-6% of these individuals display occult carcinomas in tubo-ovarian locations of which over 85% are tubal in origin. The objective of this case study was to emphasize emergence of benign lesions mimicking cancer under these circumstances. Case Report. We present a case with positive BRCA1 mutation who underwent the prophylactic procedure where a small mass was identified in her fallopian tube. Our initial encounter with this tumor was during intraoperative consultation. The tumor was associated with extensive psammoma bodies arranged in closely packed small tubules, mimicking serous carcinoma. Frozen section limitations including artifact, time constraint, and lack of ancillary studies as well as the clinical history further complicated our diagnostic assessment, which was deferred. A diagnosis of adenomatoid tumor was rendered on permanent sections. Conclusion. It is important to be familiar with this morphologic presentation of adenomatoid tumor as it is a pitfall for carcinoma, particularly on frozen section, and inaccurate diagnosis could lead to further unnecessary extensive procedures.
Internal Parasites of Pigs and Worm Control Practices in Bamboutos, Western Highlands of Cameroon
Authors: Kouam Marc K. , Ngueguim Fabrice D. , Kantzoura Vaia
Published: November 2018

Internal parasites are limiting factors to successful, sustainable livestock production. Knowledge on how they are dealt with is important to prevent resistance to anthelmintics. The aim of this study was to describe the internal parasitism of indoor pigs in Bamboutos Division in Cameroon, as well as the attendant worm control practices. Thus, 324 pigs from 50 small scale farms were sampled for feces which were qualitatively and quantitatively examined for parasite eggs, cysts, or oocysts. Data on worm control practices were also collected. The overall prevalence was 74.7% (95 % Confidence Interval (CI): 69.6–79.3%) and the overall mean egg/oocyst per gram of feces (epg/opg) was 304.1±1218.0. The following parasites were found: Strongylid parasites (58.6%; epg= 105.0±134.7); Coccidia (26.9; opg=517.2± 1862.1); Strongyloides ransomi (25.9%; epg=61.9± 40.8); A. suum (3.7%. epg=50±0); Metastrongylus sp (0.9%; epg=50±0); Trichuris suis (0.9%; epg=50±0); and Macracanthorhynchus hirudinaceus (0.62%; epg=50±0). Single to septuple infestations occurred. The majority of farmers resorted to modern veterinary services (64%) and mostly used conventional drugs (88%). Internal parasitism was associated with the person in charge of animal health, the implementation of a prophylaxis program on the farm, and the annual deworming frequency. The implementation of a prophylaxis program significantly reduced the overall egg/oocyst load while high treatment frequency (more than thrice a year) did not, indicating that prophylaxis measures such as general hygiene must be reinforced in pig herds in the country, and the treatment frequency reduced as much as possible to prevent the selection of anthelmintic resistance.
A Rare Cause of Acute Hepatopancreatitis in a Nepalese Teen
Authors: Adhikari Swastika , Shrestha Ashish Lal , Thapa Sanjay Raj , Ghimire Amrit
Published: November 2018

Background. Acute pancreatitis (AP) coexisting with acute hepatitis (AH) in children is uncommon. Moreover, a single bacterial cause explaining both the complications is even rarer. Despite familiarity with the usual presentation of enteric fever, atypical presentations can go unnoticed. Case Presentation. A 16-year-old previously healthy male presented to the emergency unit with recurrent swinging pyrexia, abdominal symptoms, and jaundice for a week. Blood work-up revealed deranged liver function tests (LFTs) and elevated pancreatic enzymes. Further assessment with imaging made a diagnosis of AH and AP without necrosis. Blood culture positivity for Salmonella typhi eventually confirmed the diagnosis. Conclusion. This is an uncommon presentation of an infection that is fairly common in our part of globe. Nevertheless, early suspicion and recognition is the key to timely management. Regular follow-ups are required to pick complications up early.
Low Serum Tryptophan Levels as an Indicator of Global Cognitive Performance in Nondemented Women over 50 Years of Age
Authors: Ramos-Chávez L. A. , Roldán-Roldán G. , García-Juárez B. , González-Esquivel D. , Pérez de la Cruz G. , Pineda B. , Ramírez-Ortega D. , García Muñoz I. , Jiménez Herrera B. , Ríos C. , Gómez-Manzo S. , Marcial-Quino J. , Sánchez Chapul L. , Carrillo Mora P. , Pérez de la Cruz V.
Published: November 2018

Aging is a physiological decline process. The number of older adults is growing around the world; therefore, the incidence of cognitive impairment, dementia, and other diseases related to aging increases. The main cellular factors that converge in the aging process are mitochondrial dysfunction, antioxidant impairment, inflammation, and immune response decline, among others. In this context, these cellular changes have an influence on the kynurenine pathway (KP), the main route of tryptophan (Trp) catabolism. KP metabolites have been involved in the aging process and neurodegenerative diseases. Although there are changes in the metabolite levels with age, at this time, there is no study that has evaluated cognitive decline as a consequence of Trp catabolism fluctuation in aging. The aim of this study was to evaluate the relation between the changes in Trp catabolism and cognitive impairment associated with age through KP metabolites level alterations in women over 50 years of age. Seventy‐seven nondemented women over 50 years old were examined with a standardized cognitive screening evaluation in Spanish language (Neuropsi), Beck anxiety inventory (BAI), and the geriatric depression scale (GDS). Also, serum levels of Trp, kynurenine (Kyn), kynurenic acid (KYNA), and 3‐hydroykynurenine (3‐HK) and the glutathione ratio (GSH/GSSG) were measured. Results showed a negative correlation between age and Trp levels and a positive correlation between age and KYNA/Trp and 3‐HK/Trp ratios. The level of cognitive impairment showed a significant positive association with age and with kynurenine pathway activation and a significant negative correlation with Trp levels. The GSH/GSSG ratio correlated positively with Trp levels and negatively with Kyn/Trp and 3‐HK/Trp ratios. The depression score correlated negatively with Trp and positively with the 3‐HK/Trp ratio. We concluded that KP activation increases with age and it is strongly associated with the level of cognition performance in nondemented women over 50 years of age.
Diagnostic Value of CA 19-9 and Carcinoembryonic Antigen for Pancreatic Cancer: A Meta-Analysis
Authors: Xing Haibo , Wang Jing , Wang Yanling , Tong Mengting , Hu Hong , Huang Changxin , Li Da
Published: November 2018

Background. CA 19-9 and carcinoembryonic antigen (CEA) are widely used for the diagnosis of pancreatic cancer. The purpose of the present study was to compare the diagnostic value of CA 19-9 with CEA for pancreatic cancer. Methods. The studies were obtained from electronic searches conducted in PubMed, Embase, and Cochrane Library databases until December 2017. The keywords included diagnosis of pancreatic cancer, CA 19-9, and CEA. The ratio of sensitivity, the specificity, the diagnostic odds ratio (DOR), and the summary of the receiver operating characteristic (SROC) with regard to CA 19-9 and CEA were measured using the random effects model. The current study included 13 studies that comprised 4,537 participants and 1,277 patients with pancreatic cancer. Results. The levels of CA 19-9 for use for the detection of pancreatic cancer were associated with higher sensitivity (ratio of sensitivity: 1.54; 1.31–1.81; P<0.001), DOR (DOR: 3.50; 95% CI: 2.24–5.45; P<0.001), and AUC (ratio of AUC: 1.24; 95% CI: 1.15–1.33; P<0.001) compared with the variable CEA, while no significant difference between CA 19-9 and CEA was noted with regard to specificity (ratio of specificity: 0.97; 95% CI: 0.89–1.06; P=0.517). The findings of the subgroup analyses suggested that different cutoff values of CA 19-9 and CEA might affect the diagnostic value. Conclusions. The findings of the present study indicated that CA 19-9 levels were associated with higher sensitivity, DOR, and AUC compared with the corresponding levels of CEA with regard to the diagnosis of pancreatic cancer.
A Case Report of Basal Cell Carcinoma in a Non-Sun-Exposed Area: A Rare Presentation Mimicking Recurrent Perianal Abscess
Authors: Carr Audrey V. , Feller Edward , Zakka Fouad R. , Griffith Rogers C. , Schechter Steven
Published: November 2018

Basal cell carcinoma (BCC), a common malignancy, arises most often in sun-exposed areas but does rarely occur in non-sun-exposed sites. Prior tissue injury, especially sharp trauma and chronic inflammation, increases the risk of BCC. We describe a 66-year-old male patient with recurrent perianal abscesses who was found to have a large pigmented basal cell carcinoma. The mass was excised without recurrence at two-year follow-up. Perianal BCC is commonly larger at the time of diagnosis than tumors in sun-exposed sites, likely related to delay in diagnosis. Increased size can lead to increased surgical complexity and more pronounced effects on nearby structures. Early detection is important for optimal patient outcomes. In selected patients presenting with a perianal mass, basal cell carcinoma should be included on the differential diagnosis.