bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Insulin-Induced Lipodystrophy on Glycemic Control among Children and Adolescents with Diabetes in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
Authors: Tsadik Afewerki Gebremeskel , Atey Tesfay Mehari , Nedi Teshome , Fantahun Bereket , Feyissa Mamo
Published: July 2018

Background. Lipodystrophy is one of the clinical complications of insulin injection that affects insulin absorption and leads to poor glycemic control. Objective. To assess insulin-induced lipodystrophy and glycemic control. Methods. A cross sectional study was done on 176 diabetic children and adolescents who inject insulin for a minimum of one year. First, anthropometric and clinical characteristics of the patients were recorded in questionnaire, and then observation and palpation techniques were used in assessing lipodystrophy. Result. Out of the total 176 participants, 103 (58.5%) had insulin-induced lipodystrophy, of them 100 (97.1%) had lipohypertrophy and 3 (2.9%) had lipoatrophy. Being younger, failure to rotate the injection site every week and multiple reuse of insulin syringe had significant influence in development of insulin-induced lipohypertrophy. Lipohypertrophy in turn was associated with the use of higher dose of insulin and nonoptimal glycemic control. Conclusion. Findings of this study revealed that in spite of using recombinant human insulin, the magnitude of the lipohypertrophy still remained high. Therefore, a routine workup of insulin-injecting patients for such complication is necessary, especially in the individuals who have a nonoptimal glycemic control.
Longitudinal Evaluation of Humoral Immunity and Bacterial and Clinical Parameters Reveals That Antigen-Specific Antibodies Suppress Inflammatory Responses in Active Tuberculosis Patients
Authors: Niki Mamiko , Yoshiyama Takashi , Miyamoto Yuji , Okumura Masao , Niki Makoto , Oinuma Ken-ichi , Kaneko Yukihiro , Matsumoto Sohkichi , Sasaki Yuka , Ogata Hideo , Goto Hajime , Kudoh Shoji , Hoshino Yoshihiko
Published: July 2018

A novel tuberculosis vaccine to replace BCG has long been desired. However, recent vaccine trials focused on cell-mediated immunity have failed to produce promising results. It is worth noting that most commercially available successful vaccines rely on humoral immunity. To establish a basic understanding of humoral immunity against tuberculosis, we analyzed and evaluated longitudinal levels and avidity of immunoglobulin to various tuberculosis antigens compared with bacterial and clinical parameters during treatment. We found that levels of IgG antibodies against HrpA and HBHA prior to treatment exhibited a positive correlation with bacterial burden. Analysis of changes in CRP during treatment revealed an association with high levels of specific IgG and IgA antibodies against mycobacterial antigens. Levels of CRP prior to treatment were negatively associated with IgG avidity to CFP-10 and MDP1 and IgA avidity to HrpA, while IgA avidity to MDP1 and Acr exhibited a negative correlation with CRP levels after 60 days of treatment. These results may provide insight for the development of a novel tuberculosis (TB) vaccine candidate to induce protective humoral immunity against tuberculosis.
Topological Aspects of Boron Nanotubes
Authors: Liu Jia-Bao , Shaker Hani , Nadeem Imran , Hussain Muhammad
Published: July 2018

The degree‐based topological indices are used to correlate the physical and chemical properties of a molecule with its chemical structure. Boron nanotubular structures are high‐interest materials due to the presence of multicenter bonds and have novel electronic properties. These materials have some important issues in nanodevice applications like mechanical and thermal stability. Therefore, they require theoretical studies on the other properties. In this paper, we present certain degree‐based topological indices such as ABC, the fourth ABC, GA, and the fifth GA indices for boron triangular and boron‐α nanotubes.
Optimal Sensor Placement for Inverse Finite Element Reconstruction of Three-Dimensional Frame Deformation
Authors: Zhao Yong , Du Jingli , Bao Hong , Xu Qian
Published: July 2018

The inverse finite element method (iFEM) for the 3D framework deformation reconstruction was introduced. As the process of iFEM did not require a priori knowledge, such as the modal shape, the loading, and the elastic-inertial material information of the structure, it presented high potential in the framework deformation reconstruction. With the current research, it was observed that the key step in the deformation reconstruction of the frame structure with iFEM was the section strains computing of the beam element from the surface strain measurements. The corresponding stability was severely affected by the placement of strain sensors. Therefore, it was necessary to discover a suitable sensor placement to maintain the stability of section strains computing. For this problem, one optimal model of sensor placement was proposed in this paper. Firstly, the well-separated eigenvalues were applied as the optimization target to construct the optimal model. Following, an optimal sensor placement was obtained through the optimal placement model solution, with the particle swarm optimization (PSO) method. Finally, the effectiveness of optimal placement was verified though the accuracy comparison of iFEM deformation reconstruction of a wing-like frame subjected to various loads for different schemes of sensor placement.
Abernethy Malformation Type II and Concurrent Nodular Hyperplasia in a Rare Female Case
Authors: Kang Zhen , Min Xiangde , Wang Liang
Published: July 2018

Background. Abernethy malformation is a rare splanchnic vascular abnormality characterizing extrahepatic abnormal shunts that is classified into types I and II. Abernethy malformation type I has a female predilection and is associated with a variety of concurrent hepatic benign or malignant tumours while type II with concurrent tumours is very rare in females. Case Report. We report a rare female case of Abernethy malformation type II with concurrent occupying lesion in the right liver, which was successfully transplanted; the occupying lesion was pathologically proven to be nodular hyperplasia. Conclusion. This case might provide further knowledge regarding Abernethy malformation. On imaging, the anatomy of portal vein should be carefully investigated to categorize Abernethy malformation, and a wide variety of differential diagnosis of concurrent occupying lesions should be taken into account.
Relationship of Serum Uric Acid Level with Demographic Features, Risk Factors, Severity, Prognosis, Serum Levels of Vitamin D, Calcium, and Magnesium in Stroke
Authors: Saadat Payam , Ahmadi Ahangar Alijan , Babaei Mansor , Kalantar Mandana , Bayani Mohammad Ali , Barzegar Hiva , Gholinia Hemmat , Zahedi Tajrishi Farbod , Faraji Sekineh , Frajzadeh Fatemeh
Published: July 2018

Introduction. Stroke is one of the most common neurological disorders with high mortality rates. A large financial burden is imposed on the families and health systems of countries in addition to the problems related to the disabilities caused by the disease for the patients. Extensive research is being conducted on the disease, including studies seeking possible relationships between some biomarkers such as uric acid and stroke. Methods. This descriptive-analytic cross-sectional study was conducted on 170 stroke patients at Babol Ayatollah Rohani Hospital during 2015-2016. Serum uric acid (SUA) levels were measured and recorded at admission time. Patients’ demographic data as well as the stroke type and some of their risk factors were entered in a checklist. The data were analyzed by SPSS.v.23 using chi-square and logistic regression tests. P<0.05 was considered as significant in all analyses. Results. Of the total 170 included patients, 57% had normal, 25% had low, and the remaining patients (18%) had high SUA levels. There was no significant difference in SUA levels in different types of stroke in both genders. Diabetic ischemic embolic patients had higher levels of SUA than diabetic ischemic thrombotic cases. Patients with low magnesium levels had higher rate of low levels of SUA in ischemic stroke. Conclusion. Serum uric acid levels are not associated with stroke types and gender. Diabetic embolic ischemic stroke cases had high SUA levels than thrombotic types and in ischemic stroke patients with low serum levels of magnesium, SUA levels were also lower.
Speed of the Goldstone Sound Mode of an Atomic Fermi Gas Loaded on a Square Optical Lattice with a Non-Abelian Gauge Field in the Presence of a Zeeman Field
Authors: Koinov Zlatko , Villalpando Israel Chávez
Published: July 2018

The speed of the Goldstone sound mode of a spin-orbit-coupled atomic Fermi gas loaded in a square optical lattice with a non-Abelian gauge field in the presence of a Zeeman field is calculated within the Gaussian approximation and from the Bethe-Salpeter equation in the generalized random phase approximation. It is found that (i) there is no sharp change of the slope of the Goldstone sound mode across the topological quantum phase transition point and (ii) the Gaussian approximation significantly overestimates the speed of sound of the Goldstone mode compared to the value provided by the BS formalism.
Understanding the Relationship between Atherogenic Index of Plasma and Cardiovascular Disease Risk Factors among Staff of an University in Malaysia
Authors: Bo Myat Su , Cheah Whye Lian , Lwin Soe , Moe Nwe Tin , Win Than Than , Aung Myint
Published: July 2018

Background. Atherogenic index of plasma (AIP) was found to be one of the strongest markers in predicting the cardiovascular disease (CVD) risk. This study was to determine the AIP and its relationship with other CVD risk factors. Materials and Methods. This cross-sectional study was done among 349 staff of a public university in Sarawak. Data were collected using questionnaire, blood sampling, and anthropometric and blood pressure measurement. Data were analyzed using IBM SPSS version 20. Results. A total of 349 respondents participated with majority females (66.8%), aged 38.5 ± 7.82 years. Nearly 80% of the respondents were overweight and obese, 87.1% with high and very high body fat, and 46.9% with abnormal visceral fat. For AIP category, 8.9% were found to be in intermediate and 16.4% were at high risk. Elevated lipid profile showed that total cholesterol (TC) is 15.5%, low density lipoprotein (LDL) is 16.1%, and triglyceride (TG) is 10.6%. AIP was significantly correlated with body mass index (r=0.25), visceral fat (r=0.37), TC (r=0.22), LDL (0.24), HDL (r=−0.72), TG (r=0.84), glucose (r=0.32), systolic blood pressure (r=0.22), and diastolic blood pressure (r=0.28). Conclusion. It indicated that AIP is associated with other CVD risk factors. Modification of lifestyle is strongly recommended.
Theoretical Calculation and Experimental Analysis on Initial Shock Pressure of Borehole Wall under Axial Decoupled Charge
Authors: Lou Xiaoming , Wang Zhenchang , Chen Bigang , Yu Jin
Published: July 2018

This paper attempts to calculate the exact initial shock pressure of borehole wall induced by the blasting with axially decoupled charge. For this purpose, Starfield superposition was introduced considering the attenuation and superposition of blasting pressure, and the theoretical solution of initial borehole wall pressure was obtained for the upper and middle air‐decked charging structures. Then, the explosive pressure field around the borehole was measured by cement mortar models and a dynamic pressure test system, and the pressures at multiple measuring points were simulated with numerical models established by ANSYS/LS‐DYNA. The results show that the deviations between simulated and theoretical pressures are smaller than 10%, indicating the reliability of the theoretical formula derived by Starfield superposition. For the upper air‐decked charging structure, the initial shock pressure of the charging section followed a convex distribution, with the peak value near the charge centre. With the increase in the distance from the charging section, the borehole wall shock pressure in the air gap underwent a sharp decline initially before reaching a relatively constant level. The minimum pressure was observed at the hole collar. For the middle air‐decked charging structure, the pressures at both ends of the charging section obeyed a convex distribution, with the peak value near the charge centre. Finally, the author optimized air‐decked charging structure of periphery boreholes within Grade III surrounding rocks of Banjie tunnel, China, and proved the enhancement effect of the theoretical findings on smooth blasting. The research findings provide valuable references to the theoretical and experimental calculation of air column length and other key parameters of air‐deck blasting and shed new light on the charging structure determination of smooth blasting and blasting vibration control for the excavation of large‐section, deep mining roadways.
Laparoendoscopic Single-Site Surgery for Management of Heterotopic Pregnancy: A Case Report and Review of Literature
Authors: Rezai Shadi , Giovane Richard A. , Minton Heather , Bardawil Elise , Zhang Yiming , Patil Ninad M. , Henderson Cassandra E. , Guan Xiaoming
Published: July 2018

Background. Heterotopic pregnancy occurs when two pregnancies occur simultaneously in the uterus and an ectopic location. Treatment includes removal of the ectopic pregnancy with preservation of the intrauterine pregnancy. Treatment is done laparoscopically with either a Laparoendoscopic Single-Site Surgery (LESS) or a multiport laparoscopic surgery. Case. We present a case of a first trimester heterotopic pregnancy in a 42-year-old gravida 5, para 0-1-3-1 female with previous history of left salpingectomy, who underwent laparoscopic right salpingectomy and lysis of adhesions (LOA) via Single-Incision Laparoscopic Surgery (SILS). Conclusion. Although LESS for benign OB/GYN cases is feasible, safe, and equally effective compared to the conventional laparoscopic techniques, studies have suggested no clinically relevant advantages in the frequency of perioperative complications between LESS and conventional methods. No data on the cost effectiveness of LESS versus conventional methods are available. LESS utilizes only one surgical incision which may lead to decreased pain and better cosmetic outcome when compared to multiport procedure. One significant undesirable aspect of LESS is the crowding of the surgical area as only one incision is made. Therefore, all instruments go through one port, which can lead to obstruction of the surgeon’s vision and in some cases higher rate of procedure failure resulting in conversion to multiport procedure.
A Meta-Analysis of Therapeutic Efficacy and Safety of Gabapentin in the Treatment of Postherpetic Neuralgia from Randomized Controlled Trials
Authors: Zhang Meng , Gao Cun-Xiang , Ma Ke-Tao , Li Li , Dai Zhi-Gang , Wang Sheng , Si Jun-Qiang
Published: July 2018

Objective. The study aims to systematically evaluate the clinical effect of gabapentin in the treatment of postherpetic neuralgia (PHN). Method. Data were retrieved electronically from PubMed, Embase, CNKI, the China Biomedical Database, and the Library of Clinical Database, beginning from the time of inception to April 2017, in order to collect data on randomized controlled trials (RCTs) of gabapentin and placebo in PHN treatment. Results. A total of 11 RCTs (2376 people) were retrieved. The gabapentin group reported significantly reduced pain intensity [MD=−0.91, 95% CI −1.32 to −0.51, P<0.00001] compared with the placebo group. Those treated with gabapentin also experienced significantly improved sleep quality [SMD=−0.44, 95% CI −0.66 to −0.23, P<0.0001], but were more likely to experience incidence of adverse events, such as somnolence, dizziness, and peripheral edema. Results of the subgroup analysis showed that the source of heterogeneity may be related to the formulations of the drug. Conclusion. Gabapentin can be used to effectively and safely treat PHN.
The Effect of Different Implant Surfaces and Photodynamic Therapy on Periodontopathic Bacteria Using TaqMan PCR Assay following Peri-Implantitis Treatment in Dog Model
Authors: Madi M. , Alagl A. S.
Published: July 2018

Introduction. Peri-implantitis is one of the late complications that leads to implant failure and is associated with specific microorganisms identified as periodontopathic bacteria. The objective of this study was to evaluate the relationship between the different implant surfaces and number ofPorphyromonas gingivalis, Tannerella forsythia,andTreponema denticolausing TaqMan PCR assay after peri-implantitis treatment using photodynamic therapy.Method. Forty-eight dental implants with four different surface treatments (M: machined; SA: sandblasted acid-etched; S: 1µm sputter HA-coated; and P: plasma spraying HA-coated) were inserted in six beagle dogs. After nine months of peri-implantitis induction, a split mouth design was used; on control side decontamination was performed using open flap mechanical debridement OFD with plastic curette, while photodynamic therapy PDT using diode laser (Ga Al As 830-nm) was used in the test side. For the following 2 weeks low-level laser therapy LLLT (10mW) was applied for the test side on alternative days for 6 sec on each implant side. Peri-implant microbial samples were collected using paper points and analyzed using TaqMan PCR before peri-implantitis treatment, immediately after treatment and 5 months posttreatment.Results. Both treatment modalities showed significant decrease in all bacterial count from baseline to immediately after treatment (P< 0.0001). The count increased between immediately after treatment to 5 months after treatment (P< 0.0001); however, the count after 5 months was significantly lower than at baseline. PDT had a stronger effect on reducingP. gingivaliscount than T.denticolaandT. forsythia compared to OFD. ForT. forsythia, implant surface treatment had the greatest effect which was also statistically significant (P= 0.02) with considerably lower effect of PDT or their interaction.Conclusion. The results suggest that PDT and OFD have significant benefits in peri-implantitis treatment by reducing bacterial count. The presence of bacterial complex with different response to therapeutic modality suggests the use of combined decontamination methods for peri-implantitis treatment.
AFM and FluidFM Technologies: Recent Applications in Molecular and Cellular Biology
Authors: Amarouch Mohamed Yassine , El Hilaly Jaouad , Mazouzi Driss
Published: July 2018

Atomic force microscopy (AFM) is a widely used imaging technique in material sciences. After becoming a standard surface-imaging tool, AFM has been proven to be useful in addressing several biological issues such as the characterization of cell organelles, quantification of DNA-protein interactions, cell adhesion forces, and electromechanical properties of living cells. AFM technique has undergone many successful improvements since its invention, including fluidic force microscopy (FluidFM), which combines conventional AFM with microchanneled cantilevers for local liquid dispensing. This technology permitted to overcome challenges linked to single-cell analyses. Indeed, FluidFM allows isolation and injection of single cells, force-controlled patch clamping of beating cardiac cells, serial weighting of micro-objects, and single-cell extraction for molecular analyses. This work aims to review the recent studies of AFM implementation in molecular and cellular biology.
Miniature Multiband Inverted‐F Antenna over an Electrically Small Ground Plane for Compact IoT Terminals
Authors: Lizzi Leonardo , Ferrero Fabien , Danchesi Christophe , Boudaud Stephane
Published: July 2018

This paper describes the design of a miniaturized multiband Inverted‐F Antenna (IFA) suitable for integration in compact Internet‐of‐things (IoT) terminals. The antenna efficiently operates over the LoRa (915 MHz) and GPS L1 (1.57 GHz) and L2 (1.23 GHz) bands. Its dimensions are 13 × 25 × 1 mm3 (0.04λ × 0.08λ × 0.003λ compared to the lower operating frequency) for a total device size of 40 × 25 × 10 mm3. Measurements of the antenna when integrated into an IoT position tracking device as well as of the whole terminal in a real application scenario are reported.
Regulation of Metabolic Disease-Associated Inflammation by Nutrient Sensors
Authors: Yamashita Alex S. , Belchior Thiago , Lira Fábio S. , Bishop Nicolette C. , Wessner Barbara , Rosa José C. , Festuccia William T.
Published: July 2018

Visceral obesity is frequently associated with the development of type 2 diabetes (T2D), a highly prevalent chronic disease that features insulin resistance and pancreatic β-cell dysfunction as important hallmarks. Recent evidence indicates that the chronic, low-grade inflammation commonly associated with visceral obesity plays a major role connecting the excessive visceral fat deposition with the development of insulin resistance and pancreatic β-cell dysfunction. Herein, we review the mechanisms by which nutrients modulate obesity-associated inflammation.
A Collocation-Based Algorithm for Analyzing Bifurcations in Phase Locked Loops with Tanlock and Sawtooth Phase Detectors
Authors: Harb Bassam A. , Al-Ajlouni Ahmad , Eyadeh Ali
Published: July 2018

Analysis of bifurcation of second-order analog phase locked loop (PLL) with tanlock and sawtooth phase detectors is investigated. Both qualitative and quantitative analyses are carried out. Qualitatively, the basin boundaries of the attractors were constructed by plotting the stable and the unstable manifolds of the system. The basin boundaries show that the PLL under consideration for certain loop parameters has a separatrix cycle which terminates the limit cycle (out-of-lock state) and the loop pulls-in. This behavior is known in literature as homoclinic bifurcation and the value of the bifurcation parameter where this process occurs is called the pull-in range. Quantitatively, we propose a collocation-based algorithm to compute the separatrix cycle and the pull-in range. The separatrix cycle is approximated by a finite set of harmonics N with unknown amplitudes and by utilizing the fact that this limit cycle bifurcates from a separatrix cycle, a system of nonlinear algebraic equations is derived. For given values of filter parameters and gain, the algorithm numerically solves for the unknown amplitude of the harmonics and the value of the pull-in range simultaneously by evaluating the system at the collocation points. Results demonstrate that phase locked loop with sawtooth phase detector characteristics has the wider pull-in range followed by tanlock and sinusoidal, respectively.
Guarana (Paullinia cupana) Extract Protects Caenorhabditis elegans Models for Alzheimer Disease and Huntington Disease through Activation of Antioxidant and Protein Degradation Pathways
Authors: Boasquívis Patrícia Ferreira , Silva Giovanna Melo Martins , Paiva Franciny Aparecida , Cavalcanti Rodrigo Marinho , Nunez Cecília Verônica , de Paula Oliveira Riva
Published: July 2018

Guarana (Paullinia cupana) is largely consumed in Brazil in high energy drinks and dietary supplements because of its stimulant activity on the central nervous system. Although previous studies have indicated that guarana has some protective effects in Parkinson’s (PD), Alzheimer’s (AD), and Huntington’s (HD) disease models, the underlying mechanisms are unknown. Here, we investigated the protective effects of guarana hydroalcoholic extract (GHE) in Caenorhabditis elegans models of HD and AD. GHE reduced polyglutamine (polyQ) protein aggregation in the muscle and also reduced polyQ‐mediated neuronal death in ASH sensory neurons and delayed β‐amyloid‐induced paralysis in a caffeine‐independent manner. Moreover, GHE’s protective effects were not mediated by caloric restriction, antimicrobial effects, or development and reproduction impairment. Inactivation of the transcription factors SKN‐1 and DAF‐16 by RNAi partially blocked the protective effects of GHE treatment in the AD model. We show that the protective effect of GHE is associated with antioxidant activity and modulation of proteostasis, since it increased the lifespan and proteasome activity, reduced intracellular ROS and the accumulation of autophagosomes, and increased the expression of SOD‐3 and HSP‐16.2. Our findings suggest that GHE has therapeutic potential in combating age‐related diseases associated with protein misfolding and accumulation.
A Comprehensive Review on Phytochemistry and Pharmacological Activities of Clinacanthus nutans (Burm.f.) Lindau
Authors: Khoo Leng Wei , Audrey Kow Siew , Lee Ming Tatt , Tan Chin Ping , Shaari Khozirah , Tham Chau Ling , Abas Faridah
Published: July 2018

Clinacanthus nutans (Burm.f.) Lindau (Acanthaceae), commonly known as Sabah snake grass, is a vegetable and a well‐known herb that is considered an alternative medicine for insect bites, skin rashes, herpes infection, inflammation, and cancer and for health benefits. Current review aims to provide a well‐tabulated repository of the phytochemical screening, identification and quantification, and the pharmacological information of C. nutans according to the experimental design and the plant preparation methods which make it outstanding compared to existing reviews. This review has documented valuable data obtained from all accessible library databases and electronic searches. For the first time we analyzed the presence of flavonoids, triterpenoids, steroids, phytosterols, and glycosides in C. nutans based on the results from phytochemical screening which are then further confirmed by conventional phytochemical isolation methods and advanced spectroscopic techniques. Phytochemical quantification further illustrated that C. nutans is a good source of phenolics and flavonoids. Pharmacological studies on C. nutans revealed that its polar extract could be a promising anti‐inflammation, antiviral, anticancer, immune and neuromodulating, and plasmid DNA protective agent; that its semipolar extract could be a promising antiviral, anticancer, and wound healing agent; and that its nonpolar extract could be an excellent anticancer agent.
Estimating Typhoid Fever Risk Associated with Lack of Access to Safe Water: A Systematic Literature Review
Authors: Mogasale Vijayalaxmi V. , Ramani Enusa , Mogasale Vittal , Park Ju Yeon , Wierzba Thomas F.
Published: July 2018

Background. Unsafe water is a well-known risk for typhoid fever, but a pooled estimate of the population-level risk of typhoid fever resulting from exposure to unsafe water has not been quantified. An accurate estimation of the risk from unsafe water will be useful in demarcating high-risk populations, modeling typhoid disease burden, and targeting prevention and control activities. Methods. We conducted a systematic literature review and meta-analysis of observational studies that measured the risk of typhoid fever associated with drinking unimproved water as per WHO-UNICEF’s definition or drinking microbiologically unsafe water. The mean value for the pooled odds ratio from case-control studies was calculated using a random effects model. In addition to unimproved water and unsafe water, we also listed categories of other risk factors from the selected studies. Results. The search of published studies from January 1, 1990, to December 31, 2013 in PubMed, Embase, and World Health Organization databases provided 779 publications, of which 12 case-control studies presented the odds of having typhoid fever for those exposed to unimproved or unsafe versus improved drinking water sources. The odds of typhoid fever among those exposed to unimproved or unsafe water ranged from 1.06 to 9.26 with case weighted mean of 2.44 (95% CI: 1.65–3.59). Besides water-related risk, the studies also identified other risk factors related to socioeconomic aspects, type of food consumption, knowledge and awareness about typhoid fever, and hygiene practices. Conclusions. In this meta-analysis, we have quantified the pooled risk of typhoid fever among people exposed to unimproved or unsafe water which is almost two and a half times more than people who were not exposed to unimproved or unsafe water. However, caution should be exercised in applying the findings from this study in modeling typhoid fever disease burden at country, regional, and global levels as improved water does not always equate to safe water.
Distinctive Olfactory Pattern in Parkinson’s Disease and Non-Neurodegenerative Causes of Hyposmia
Authors: Crespo Cuevas Ane Miren , Ispierto Lourdes , Vilas Dolores , Planas Anna , Planas Albert , Isern Irina , Sanchez Josep , De Haro Josep , Alvarez Ramiro
Published: July 2018

Background: Olfactory dysfunction is common in Parkinson’s disease (PD). The characteristics of the hyposmia in PD have not been well defined. Objective: To characterize the pattern of the olfactory deficit in PD and in other non-neurodegenerative aetiologies of hyposmia. Methods: We evaluated 36 PD patients, 20 patients with hyposmia secondary to acute respiratory infection (ARI), and 19 patients with hyposmia secondary to traumatic brain injury (TBI). For comparison purposes, we included a group of 15 controls age and sex matched with PD patients. PD patients were classified based on disease duration and severity in de novo PD, and PD with and without chronic levodopa-related complications. The Barcelona Smell Identification Test was applied to all participants. Results: For the first cranial nerve odours, PD patients scored lower than controls on smell detection (85.28 vs. 97.67%, p = 0.006), definition (79.58 vs. 93.33%, p = 0.007), recognition (63.33 vs. 81%, p = 0.020), and forced choice (58.06 vs. 82%, p < 0.001). Compared with ARI, forced choice was significantly better in PD patients (p < 0.001), but no differences were found regarding other olfactory characteristics. TBI patients showed significantly lower scores than the other study groups in all the olfaction items. For the fifth cranial nerve odours, recognition (p = 0.003) and identification (p = 0.019) were lower in the TBI group than in the others. No differences were found among PD subgroups regarding any olfactory characteristic. Conclusions: A differential pattern of hyposmia was observed in PD patients compared to other non-neurodegenerative aetiologies. Further studies with larger samples should replicate our results.
Reducing Fibrinogen and Factor XIII Using Double-Filtration Plasmapheresis for Antibody-Mediated Rejection: Predictive Models
Authors: Jouve Thomas , Marlu Raphaël , Malvezzi Paolo , Seyve Landry , Maurizi Jocelyne , Carron Pierre-Louis , Polack Benoît , Rostaing Lionel
Published: July 2018

Background/Aims: Antibody-mediated rejection (AMR) is related to circulating donor-specific anti-human leukocyte antigen alloantibodies (DSAs). DSAs can be removed by apheresis, for example, double-filtration plasmapheresis (DFPP). However, DFPP removes some clotting factors (fibrinogen and factor XIII [FXIII]). Methods: This was a prospective trial including 6 DSA-mediated AMR kidney transplant recipients. Patients received 2 cycles of 3–4 consecutive DFPP sessions followed by 1 injection of rituximab (break of 4–5 days between the 2 cycles). We monitored fibrinogen and FXIII levels before and after each session of DFPP. Results: Overall, fibrinogen and FXIII levels were significantly decreased after each session, and were significantly reduced between the very first and very last sessions. In addition, we established a model that predicted fibrinogen and FXIII values after each session and after 2 cycles. Conclusion: We established a model in order to predict fibrinogen and FXIII depletion after DFPP sessions; it may help clinicians supplement fibrinogen and/or FXIII when appropriate.
Plasma Level of Retinol-Binding Protein 4, N-Terminal proBNP and Renal Function in Older Patients Hospitalized for Heart Failure
Authors: Majerczyk Marcin , Choręza Piotr , Mizia-Stec Katarzyna , Bożentowicz-Wikarek Maria , Brzozowska Aniceta , Arabzada Habibullah , Owczarek Aleksander J. , Szybalska Aleksandra , Grodzicki Tomasz , Więcek Andrzej , Olszanecka-Glinianowicz Magdalena , Chudek Jerzy
Published: July 2018

Background/Aim: Elevated plasma concentration of retinol-binding protein 4 (RBP4) has recently emerged as a potential new risk factor for cardiovascular diseases, including hypertension (HT) and coronary artery disease (CAD). Limited data suggest that RBP4 promotes inflammatory damage to cardiomyocytes and participates in the development of heart failure (HF). This study aimed to analyze the relationship between concentrations of plasma RBP4 and serum N-terminal proBNP (NT-proBNP), a powerful biomarker of left ventricle dysfunction, in the older Polish population. Methods: The study sample consisted of 2,826 (1,487 men) participants of the PolSenior study, aged 65 years and older, including a subgroup hospitalized for HF (n = 282). In all subjects, plasma concentrations of RBP4, interleukin-6 (IL-6), serum level of NT-proBNP, and hs-CRP were measured. Additionally, BMI, estimated glomerular filtration rate (eGFR), and HOMA-IR were calculated. The prevalence of HT, CAD, atrial fibrillation (AF), and medication were considered as potential confounders. Results: Similar RBP4 levels were found in subjects with NT-proBNP < 125 and ≥125 ng/mL, with and without AF, and in the subgroups hospitalized for HF with and without AF. Regression analysis revealed no association between log10(NT-proBNP) and log10(RBP4). Plasma levels of RBP4 were increased by HT occurrence and diuretic therapy, while diminished with regard to female gender, age, eGFR values, AF, and IL-6 levels. Conclusion: Our results show that RBP4 is affected by GFR but cannot be considered as an independent biomarker of heart muscle dysfunction.
Language Exposure of Preterm Infants in the Neonatal Unit: A Systematic Review
Authors: Best Kobi , Bogossian Fiona , New Karen
Published: July 2018

Background: Elevated sound levels and low language exposures of preterm infants (< 37 weeks) cared for in the neonatal unit contribute to poorer growth, cognition, language and motor outcomes. These delays can have lasting effects on childhood development and continue throughout adult life. Whilst recommendations have been established for appropriate sound exposure levels in neonatal units, very little is known about the optimal level of language exposure. Objectives: To examine the evidence regarding language exposure, both measured (observational) and prescribed (interventional), in preterm infants (< 37 weeks) cared for in neonatal units and to identify optimal exposure levels to promote neurodevelopment. Search Methods: An electronic search of English-language articles with an open date range was conducted in the PubMed, MEDLINE, Joanna Briggs, CINAHL and Cochrane databases and in Google Scholar. The criteria were limited to original research studies of preterm infants (< 37 weeks) in which language was either measured as it naturally occurred in the neonatal unit environment or through a language intervention. Results: The search produced a total of 2,367 articles, 49 of which were related to language. A full-text review of these articles identified 10 eligible studies and 6 studies from reference searches. Conclusions: Preterm infants experience low levels of language exposure and high sound exposures in neonatal units. There is a lack of conclusive evidence to recommend an optimal level of language exposure to support improved neurodevelopmental outcomes in preterm infants. Further research from large, good-quality clinical trials is required before clear direction can be provided to inform clinical practice.
Harmonization of the Genetic Code Effectively Enhances the Recombinant Production of the Major Birch Pollen Allergen Bet v 1
Authors: Asam Claudia , Roulias Anargyros , Parigiani Maria A. , Haab Astrid , Wallner Michael , Wolf Martin , Briza Peter , Bohle Barbara , Ferreira Fatima , Hauser Michael
Published: July 2018

Background: Enhancing the quality and yield of protein production in heterologous expression systems is an important issue for developing new biopharmaceuticals. It has been shown that the dynamics of protein folding is influenced by codon frequencies. As codon usage frequencies are species specific, this can affect heterologous protein expression. In this respect, “codon harmonization,” that is, the usage of synonymous codons with usage frequencies in the host resembling the usage frequencies in the native organism, is a promising strategy. As recombinant proteins are important tools in the area of allergy research, we investigated in this study the influence of codon harmonization on the production of the major birch pollen allergen Bet v 1.0101. Methods: To accomplish this task, parallel production of several batches of rBet v 1, BWT, together with a harmonized variant, BH, was applied. The expression yield of soluble and insoluble protein was assayed via densitometric analysis of ­SDS-PAGEs for every batch. The quality of purified proteins was assessed with a variety of physicochemical methods including mass spectrometry, circular dichroism, dynamic light scattering, Fourier transform infrared spectroscopy, in vitro degradation, and 1-anilino-8-naphthalene sulfonate-binding assays. Patients’ IgE reactivity was tested in enzyme-linked immunosorbent assays and rat basophil mediator release experiments. Results: No significant differences in the ligand-binding capacity and secondary structure elements, as well as, in immunological assays could be found; however, the production yield was drastically increased for BH. Conclusion: We could show that codon harmonization is a powerful method to enhance protein yields in heterologous expression systems and should be considered especially for difficult-to-express proteins.
Exploring Cognitive Concomitants of Mental Fatigue in Patients with Coronary Artery Disease
Authors: Burkauskas Julius , Bunevičius Adomas , Brožaitienė Julija , Neverauskas Julius , Fineberg Naomi A. , Wellsted David , Bunevičius Robertas , Mickuvienė Narseta
Published: July 2018

Objective: Fatigue and reduced exercise capacity are common concomitants of coronary artery disease (CAD). They are known to be associated with the deterioration in mental health, including emotional and cognitive status. However, the precise nature of the inter-relationship is poorly understood. The aim of this study was to investigate the relationship between fatigue and exercise capacity on the one hand and changes in cognitive functioning on the other, to generate new heuristics for clinical management and outcome prediction of CAD. Methods: A cross-sectional study included 827 in-patients (58 ± 9 years, 75% men) with CAD. Patients were evaluated for demographic, cardiac characteristics, and exercise capacity. The Multidimensional Fatigue Inventory-20 was used to assess fatigue, the Mini Mental State Examination for global cognitive function, the Digit Span Test, Digit Symbol Test, and Trail Making Test for executive aspects of cognitive functioning, and the Hospital Anxiety and Depression Scale for anxiety and depression symptom severity. Results: Using multiple regression analysis, after adjusting for possible confounders such as anxiety and depression, mental fatigue was associated with several executive aspects of cognitive function including short-term memory (Digit Symbol Test pairs recalled correctly [β = –0.127, p < 0.005]), psychomotor performance (time to complete the Digit Symbol Test [β = 0.089, p < 0.03]), and cognitive processing speed (Trail Making Test A [β = 0.081, p < 0.05]). Conclusion: In rehabilitating CAD patients, certain aspects of executive functioning were independently associated with mental fatigue. These findings suggest that the subjective experience of mental fatigue, rather than reduced exercise capacity, is significantly associated with cognitive function.
Onychotillomania: A Chameleon-Like Disorder: Case Report and Review of Literature
Authors: Sidiropoulou Polytimi , Sgouros Dimitrios , Theodoropoulos Konstantinos , Katoulis Alexander , Rigopoulos Dimitrios
Published: July 2018

Onychotillomania, or nail-picking disorder, is an uncommon and misdiagnosed behavioral pattern focused on the nail apparatus. It is demarcated by the compulsive or irresistible urge in patients to constantly injure their own nails, with the fingers or tools, inflicting noticeable or even irreversible self-destruction of the nail unit. Despite its rarity, this self-injurious coercion often poses a diagnostic and therapeutic challenge. Not only do many patients deny nail manipulation, but also the disorder has long been recognized to present itself with a wide range of clinical features, which hampers early and indisputable diagnosis. Furthermore, onychotillomania constitutes a persistent and hardly manageable problem, mostly because of its psychocutaneous nature as well as its high propensity to coexist with underlying neuropsychiatric illnesses or other behavioral disorders. However, the medical literature concerning obsessive nail picking still remains relatively scarce. Herein, we present an extraordinary, yet very intriguing case of a Caucasian patient with onychotillomania and onychophagia coexistence masquerading a weird inflammation-like lesion.
Dyskalemia in Chronic Kidney Disease: How Concerned Should We Be?
Authors: Tandukar Srijan , Fried Linda F.
Published: July 2018

Context: The widespread use of diuretics, potassium supplements, and medications that block renin angiotensin system puts the chronic kidney disease (CKD) population at high risk for dyskalemia, both hyperkalemia and hypokalemia. The optimal potassium level in a CKD patient is unknown. Subject of review: Two recent studies found conflicting results on the association of dyskalemia with outcomes. The Renal Research Institute CKD study [Clin J Am Soc Nephrol 2010; 5: 762–769] found increased mortality and incidence of end-stage renal disease (ESRD) with mild to moderate hypokalemia, whereas hyperkalemia was not significantly associated, compared to eukalemia. On the other hand, the Multi-Ethnic Study of Atherosclerosis (MESA)/Cardiovascular Health Study [Clin J Am Soc Nephrol 2017; 12: 245–252] showed both cardiovascular and noncardiovascular mortality to be higher with hyperkalemic patients, whereas associations with hypokalemic patients were statistically nonsignificant. Second opinion: If mild hypo- or hyperkalemia is associated with adverse outcomes, is it related to the hyperkalemia per se or to conditions associated with dyskalemia, such as kidney disease or cardiovascular disease? We interpret these articles in the context of criteria to support causality in epidemiologic studies. The cardiovascular effects of dyskalemia is well described and there is biological plausibility for increased cardiovascular mortality but the association of increased non-cardiovascular mortality with dyskalemia has little mechanistic basis. The explanation for a causal association of dyskalemia with ESRD is not adequate. Based on current evidence, targeting a potassium level of 4–5 mmol/L can be considered safe.
Distinguishing Subgroups Based on Psychomotor Functioning among Patients with Major Depressive Disorder
Authors: van Diermen Linda , Schrijvers Didier , Cools Olivia , Birkenhäger Tom K. , Fransen Erik , Sabbe Bernard G.C.
Published: July 2018

Background: Retardation and agitation are symptoms of major depressive disorder (MDD), and their presence could play a role in determining clinically meaningful depressive subtypes such as nonmelancholic depression (NMD) and melancholic depression (MD). In this project, we explored whether three depression subgroups (NMD, MD with psychotic symptoms, and MD without psychotic symptoms) could be distinguished based on objective measures of psychomotor functioning. Methods: Sixty-nine patients with MDD underwent extensive clinical and psychomotor testing prior to treatment with electroconvulsive therapy. Psychomotor functioning was assessed subjectively using the Core Assessment of Psychomotor Change (CORE) and objectively by means of both 24-h actigraphy and performance on a fine motor drawing task. Results: The daytime activity levels measured by actigraphy were significantly lower (F = 7.1, p = 0.0004) in MD patients both with and without psychotic symptoms than in those with NMD. No objective psychomotor variable was able to distinguish between melancholic patients with and those without psychotic symptoms. Conclusions: The depression subtypes NMD, MD with psychotic symptoms, and MD without psychotic symptoms are not marked by increasing psychomotor retardation, possibly because psychomotor disturbance in MD with psychotic symptoms often consists of agitation rather than retardation, or a mixture of the two. However, psychomotor functioning as measured by actigraphy can be used to distinguish between NMD patients and MD patients.
Clinical and Genetic Characteristics Analysis of Korean Patients with Stargardt Disease Using Targeted Exome Sequencing
Authors: Sung Youngje , Choi Seung Woo , Shim Sung Han , Song Won Kyung
Published: July 2018

Purpose: To investigate genetic mutations in Korean patients with Stargardt disease (STGD) using exome sequencing, and to analyze the correlations between genetic mutations and clinical phenotypes. Methods: Peripheral venous blood was obtained from 24 clinically diagnosed Korean STGD patients, followed by extraction of genomic DNAs. Using exome sequencing we investigated gene mutations for the adenosine triphosphate-binding cassette, subfamily A, member 4 (ABCA4) elongation of very-long-chain fatty acids 4 (ELOVL4), and prominin 1 (PROM1), and confirmed gene mutations by the direct sequencing of polymerase chain reaction products. Results: ABCA4 mutations were confirmed in 17 of 24 patients, and 12 novel mutations were identified. ELOVL4 and PROM1 gene mutations were not identified in this study. We also identified 16 previously reported mutations related to STGD1. In patients whose disease symptoms occurred before 20 years of age, visual acuity was poorer and atrophic flecks were more frequently found. In addition, more ABCA4 mutations were found in patients who had choroidal silence or atrophic flecks. Conclusions: Novel ABCA4 gene mutations were found in Korean patients with STGD1. This study will facilitate better understanding of the relationships between ABCA4 gene mutations and clinical symptoms in Korean patients.
Fetal Hydrops Secondary to in utero Pancytopenia
Authors: Berman Deborah R. , Walkovich Kelly , Treadwell Marjorie C.
Published: July 2018

Nonimmune hydrops remains a challenge in the prenatal setting with many cases not having a clear etiology determined prior to birth. We present an unusual case of one fetus of a dichorionic twin pair presenting at 24 weeks’ gestation with hydrops and fetal pancytopenia with complete absence of white cells of unknown etiology, as revealed by cordocentesis. Serial red blood cell transfusions resulted in resolution of hydrops and continuation of the pregnancy until 35 weeks’ gestation. Pancytopenia was noted throughout gestation and persisted in the newborn period. Moreover, the T-cell receptor excision circle (TREC) assay, a newborn screening test for severe T-cell deficiency, was abnormal at birth. Further evaluation revealed detectable TRECs and normal response to lymphocyte mitogens indicating some preserved thymic and lymphocyte function. The affected child had spontaneous resolution of the pancytopenia, including her severe T-cell deficiency, by 10 weeks of life. There has been no recurrence as of 24 months of age. The self-resolving nature of the pancytopenia is an important feature of this case of nonimmune hydrops. The abnormal TREC assay at birth in the affected infant may help explain the discordant prenatal findings.