bluuebunny/crossref_metadata_2025 huggingface dataset:
ELKO applications in cosmology
Authors: Pereira S. H. , Pinho S. S. A.
Published: December 2014

A brief review is presented about the ELKO spinor field applied to cosmology, with the main results and limitations of the theory. As a simple application, we have analyzed a model involving the interaction of the ELKO spinor field with dark matter in the universe from a dynamical system approach. When the system is rewritten in terms of the deceleration parameter q and under the assumption that such parameter is nearly constant for some different stages of the evolution, stability points were found for different types of interaction between dark matter and ELKO spinors. Within this new analysis several interesting scenarios are possible, depending on the interaction term. For example, if it is assumed that the equation of the state parameter of the ELKO field is of the phantom type, ωϕ < -1, the current acceleration of the universe can be driven by the decay of dark matter particles into ELKO field. Furthermore, even for ωϕ > 0, the inflationary period can be driven by the decay of the inflaton field (described by the ELKO spinor) into dark matter particles.
Investigation of the Effects of Data Collection on Visual Stylometry
Authors: Jacobsen C. Robert , Nielsen Morten
Published: December 2014

Visual stylometry is the task of analysing visual art by mathematical and statistical methods. One branch of visual stylometry is to classify if a painting/drawing is made by the claimed artist; that this is achievable has been demonstrated for several artists and by different approaches. The present authors developed a contourlet-based classification method in a previous paper and here it is investigated how robust the conclusions of this method are to variations in the data collection.
FIBER-OPTIC GONIOMETER FOR MEASURING JOINT ANGLES
Authors: JUNG GU-IN , KIM JI-SUN , LEE TAE-HEE , CHOI JU-HYEON , OH HAN-BYEOL , KIM A-HEE , JUN JAE-HOON
Published: December 2014

Measuring joint angles is an important task for therapists to monitor and evaluate a patient's recovery progress. A fiber-optic goniometer with modified fiber tips was developed and employed to measure joint angles. The effects of the fiber tip's angle in various off-center positions of the detector on the output beam pattern were investigated. The proper combination of these variables increased the measuring range of joint angles with asymmetric light signals from the modified fiber tips. With inverse mathematical models and LabVIEW computer program, the joint angle was obtained and displayed in real time. The reference joint angle correlated well with the calculated output angle over the test range. This method can be used not only in hospitals and laboratories, but also at home, with a simple and cost-effective optical sensor. This method can be applied in the field of rehabilitation and sports science.
Performances of Sulfonated Polyether Ether Ketone Composite Membranes for Fuel Cell Applications
Authors: Ma Jun , Su Dongyun , Ni Hongjun , Huang Mingyu , Wang Xingxing
Published: December 2014

A variety of modification approaches such as cross-linking and nano blending have been explored to prepare efficient membranes based on Sulfonated polyether ether ketone (SPEEK). The addition filler is also one of the most widely used approaches to modify the SPEEK. The crosslinked membranes were utilized as proton exchange membranes (PEM) for fuel cell application. The performances of these composite membranes were comparative researched in terms of water uptake, ion exchange capacity, proton conductivity, and methanol permeability.While the nanohybrid membranes display remarkably enhanced proton conduction property due to the incorporation of additional sites for proton transport and the formation of well-connected channels by bridging the hydrophilic domains in SPEEK matrix. The as-prepared nanohybrid membranes also show elevated thermal and mechanical stabilities as well as decreased methanol permeability.
Quantifying the leakage of quantum protocols for classical two-party cryptography
Authors: Salvail Louis , Schaffner Christian , Sotáková Miroslava
Published: December 2014

We study quantum protocols among two distrustful parties. By adopting a rather strict definition of correctness — guaranteeing that honest players obtain their correct outcomes only — we can show that every strictly correct quantum protocol implementing a non-trivial classical primitive necessarily leaks information to a dishonest player. This extends known impossibility results to all non-trivial primitives. We provide a framework for quantifying this leakage and argue that leakage is a good measure for the privacy provided to the players by a given protocol. Our framework also covers the case where the two players are helped by a trusted third party. We show that despite the help of a trusted third party, the players cannot amplify the cryptographic power of any primitive. All our results hold even against quantum honest-but-curious adversaries who honestly follow the protocol but purify their actions and apply a different measurement at the end of the protocol. As concrete examples, we establish lower bounds on the leakage of standard universal two-party primitives such as oblivious transfer.
Complex dielectric modulus and relaxation response at low microwave frequency region of dielectric ceramic Ba6-3xNd8+2xTi18O54
Authors: Lee Chian Heng , Hassan Jumiah , Hashim Mansor , Aziz Raba'ah Syahidah , Saiden Norlaily Mohd
Published: December 2014

The desirable characteristics of Ba 6-3x Nd 8+2x Ti 18 O 54 include high dielectric constant, low loss tangent, and high quality factor developed a new field for electronic applications. The microwave dielectric properties of Ba 6-3x Nd 8+2x Ti 18 O 54, with x = 0.15 ceramics at different sintering temperatures (600–1300°C) were investigated. The phenomenon of polarization produced by the applied electric field was studied. The dielectric properties with respect to frequency from 1 MHz to 1.5 GHz were measured using Impedance Analyzer, and the results were compared and analyzed. The highest dielectric permittivity and lowest loss factor were defined among the samples. The complex dielectric modulus was evaluated from the measured parameters of dielectric measurement in the same frequency range, and used to differentiate the contribution of grain and grain boundary.
MicroRNAs associated with exercise and diet: a systematic review
Authors: Flowers Elena , Won Gloria Y. , Fukuoka Yoshimi
Published: December 2014

MicroRNAs are posttranscriptional regulators of gene expression. MicroRNAs reflect individual biologic adaptation to exposures in the environment. As such, measurement of circulating microRNAs presents an opportunity to evaluate biologic changes associated with behavioral interventions (i.e., exercise, diet) for weight loss. The aim of this study was to perform a systematic review of the literature to summarize what is known about circulating microRNAs associated with exercise, diet, and weight loss. We performed a systematic review of three scientific databases. We included studies reporting on circulating microRNAs associated with exercise, diet, and weight loss in humans. Of 1,219 studies identified in our comprehensive database search, 14 were selected for inclusion. Twelve reported on microRNAs associated with exercise, and two reported on microRNAs associated with diet and weight loss. The majority of studies used a quasiexperimental, cross-sectional design. There were numerous differences in the type and intensity of exercise and dietary interventions, the biologic source of microRNAs, and the methodological approaches used quantitate microRNAs. Data from several studies support an association between circulating microRNAs and exercise. The evidence for an association between circulating microRNAs and diet is weaker because of a small number of studies. Additional research is needed to validate previous observations using methodologically rigorous approaches to microRNA quantitation to determine the specific circulating microRNA signatures associated with behavioral approaches to weight loss. Future directions include longitudinal studies to determine if circulating microRNAs are predictive of response to behavioral interventions.
Advanced Extrauterine Pregnancy at 33 Weeks with a Healthy Newborn
Authors: Dabiri Tajudeen , Marroquin Guillermo A. , Bendek Boleslaw , Agamasu Enyonam , Mikhail Magdy
Published: December 2014

Abdominal pregnancy is a very rare form of ectopic pregnancy, associated with high morbidity and mortality for both fetus and mother. It is, and often, seen in poor resource nations, where early diagnosis is often a major challenge due to poor prenatal care and lack of medical resources. An advanced abdominal pregnancy with a good fetal and maternal outcome is therefore a more extraordinary occurrence in the modern developed world. We present a case of an abdominal pregnancy at 33.4 weeks in an individual with no documented prenatal care, who arrived in a hospital in the Bronx, in June 25th 2014, with symptoms of generalized, severe lower abdominal pain. Upon examination it was found that due to category III fetal tracing an emergent cesarean section was performed. At the time of laparotomy the fetus was located in the pelvis covered by the uterine serosa, with distortion of the entire right adnexa and invasion to the right parametrium. The placenta invaded the pouch of Douglas and the lower part of the sigmoid colon. A massive hemorrhage followed, followed by a supracervical hysterectomy. A viable infant was delivered and mother discharged on postoperative day 4.
A Pilot Study on Effects of Acupuncture and Moxibustion by Hyperspectral Imaging Technique
Authors: Zhang Dong , Li Yin-long , Wang Shu-you , Bai Xiao-dong , Song Xiao-jing , Li Shun-yue
Published: December 2014

This study was to observe the effects of acupuncture and moxibustion on spectrum features of acupoint using hyperspectral imaging (HSI) technique. HSI of the Neiguan (PC6) in the acupuncture groups, moxibustion groups, and control groups was scanned by the hyperspectral imager to analyze the spectrum features and the variations within the wavelength of 400–1000 nm and explore the relationship between the spectral characteristics and effects of acupuncture and moxibustion. The light absorption intensity was slightly reduced within the wave band of 540–590 nm after acupuncture. The absorption intensity of PC6 before moxibustion was significantly higher than that after moxibustion, and the maximum reduction was found at the wavelength of 580 nm with 20.5% reduction, P < 0.05. There was no significant change of the spectrum of palm and PC6 and the spectrum curves of the acupoint were basically identical in control group. The light absorption intensity of PC6 of human body was weakened after Acu‐mox. Specific wavelengths were all exhibited at 580 nm and the effect of moxibustion was more significant. HSI technique can be used to measure the spectral characteristics of the acupoint areas. This first time research would be significant and beneficial for study on the effect of acupuncture and moxibustion.
Dynamical Tangles in Third-Order Oscillator with Single Jump Function
Authors: Petržela Jiří , Gotthans Tomas , Guzan Milan
Published: December 2014

This contribution brings a deep and detailed study of the dynamical behavior associated with nonlinear oscillator described by a single third-order differential equation with scalar jump nonlinearity. The relative primitive geometry of the vector field allows making an exhaustive numerical analysis of its possible solutions, visualizations of the invariant manifolds, and basins of attraction as well as proving the existence of chaotic motion by using the concept of both Shilnikov theorems. The aim of this paper is also to complete, carry out and link the previous works on simple Newtonian dynamics, and answer the question how individual types of the phenomenon evolve with time via understandable notes.
Candida glabrataEsophagitis: Are We Seeing the Emergence of a New Azole-Resistant Pathogen?
Authors: Wilson Aze , Delport Johan , Ponich Terry
Published: December 2014

Background.Candida glabrata(C. glabrata) has become a recognized pathogen in fungal esophagitis. A proportion of these isolates are azole-resistant which may have treatment implications. Variability in the prevalence of this organism exists in the limited data available.Objective. To determine the incidence ofC. glabrataesophagitis in a North American hospital setting and to highlight factors that may predispose patients to this condition.Methods. Patient charts were collected from January 1, 2009 to July 30, 2011. Any charts of patients identified as having esophagitis with a positive fungal culture were reviewed for the species ofCandidaand the presence of factors that would predispose them to esophageal candidiasis.Results. The prevalence ofCandidaesophagitis based on culture was 2.2% (37 subjects).C. glabratawas the 2nd most prevalent pathogen identified (24.3% or 9 subjects). Of theC. glabratacohort, all patients had at least one factor predisposing them to candidiasis.Conclusion.C. glabrataesophagitis makes up a large portion of the candidal esophagitis seen in hospital.C. glabratainfections were associated with at least one risk factor for candidal infection. Given its resistance to azole-based therapy, this may have treatment implications for how candidal esophagitis is approached by the clinician.
The Effect of Local Injections of Bupivacaine Plus Ketamine, Bupivacaine Alone, and Placebo on Reducing Postoperative Anal Fistula Pain: A Randomized Clinical Trial
Authors: Kazemeini Alireza , Rahimi Mojgan , Fazeli Mohammad Sadegh , Mirjafari Seyedeh Adeleh , Ghaderi Hamid , Fani Kamal , Forozeshfard Mohammad , Matin Marzieh
Published: December 2014

Background and Objective. This study aimed to compare the effects of different local anesthetic solutions on postoperative pain of anal surgery in adult patients.Method. In this randomized double-blind prospective clinical trial, 60 adult patients (18 to 60 years old) with physical status class I and class II that had been brought to a university hospital operating room for fistula anal surgery with spinal anesthesia were selected. Patients were randomly divided into 4 equal groups according to table of random numbers (created by Random Allocation Software 1). Group 1 received 3 mL of normal saline, group 2, 1 mL of normal saline plus 2 mL of bupivacaine 0.5%, group 3, 1 mL of ketamine plus 2 mL of bupivacaine 0.5%, and group 4, no infiltration. Intensity of pain in patients was measured using visual analogue scale (VAS) at 0 (transfer to ward), 2, 6, 12, and 24 hours after surgery. Time interval to administration of drugs and overall dose of drugs were measured in 4 groups.Results. Mean level of pain was the lowest in group 3 at all occasions with a significant difference, followed by groups 2, 4, and lastly 1 (P<0.001). Furthermore, groups 2 and 3 compared to groups 1 and 4 had the least overall dose of analgesics and requested them the latest, with a significant difference (P<0.05).Conclusion. Local anesthesia (1 mL of ketamine plus 2 mL of bupivacaine 0.5% or 1 mL of normal saline plus 2 mL of bupivacaine 0.5%) combined with spinal anesthesia reduces postoperative pain and leads to greater comfort in recovering patients.
Comprehensive Orthodontic Treatment of Adult Patient with Cleft Lip and Palate
Authors: Leiva Villagra Noemí , Muñoz Domon Miguel , Véliz Méndez Sebastian
Published: December 2014

The aim of the paper is to present full orthodontic treatment of an operated cleft lip adult patient.Case Report. An 18-year-old patient consulted for severe crowded teeth. He comes from a poor family. At that time he already had four operations (velum, palate, lip, and myringotomy). Treatment included maxillary expansion, tooth extraction, and fixed orthodontic, as well as kinesiology and speech therapy treatment. A multidisciplinary approach allowed us to achieve successfully an excellent result for this patient and gave him a harmonic smile and an optimal function without orthognathic surgery. Two years after treatment, occlusion remains stable.
Appendiceal Diverticulitis Clinically Masquerading as an Appendiceal Carcinoma
Authors: Terada Tadashi
Published: December 2014

Appendiceal diverticulosis is a rare condition. Herein reported is a case of appendiceal diverticulosis and diverticulitis clinically masquerading as appendiceal carcinoma. A 62-year-old woman presented with abdominal pain. US and CT showed a tumor measuring 5 × 4 × 4 cm in vermiform appendix. Colon endoscopy showed mucosal elevation and irregularity in the orifice of vermiform appendix. A biopsy of the appendiceal mucosa showed no significant changes. Clinical diagnosis was appendiceal carcinoma and wide excision of terminal ileum, appendix, cecum, and ascending colon was performed. Grossly, the appendix showed a tumor measuring 5 × 3 × 4 cm. The appendiceal lumen was opened, and the appendiceal mucosa was elevated and irregular. The periappendiceal tissue showed thickening. Microscopically, the lesion was multiple appendiceal diverticula. The diverticula were penetrating the muscle layer. The mucosa showed erosions in places. Much fibrosis, abscess formations, and lymphocytic infiltration were seen in the subserosa. Abscesses were also seen in the diverticular lumens. Some diverticula penetrated into the subserosa. The pathologic diagnosis was appendiceal diverticulitis. When they encounter an appendiceal mass, clinicians should consider appendiceal diverticulitis as a differential diagnosis.
Asymmetric Bellow Flexible Pneumatic Actuator for Miniature Robotic Soft Gripper
Authors: Udupa Ganesha , Sreedharan Pramod , Sai Dinesh P. , Kim Doik
Published: December 2014

The necessity of the soft gripping devices is increasing day-by-day in medical robotics especially when safe, gentle motions and soft touch are necessary. In this paper, a novel asymmetric bellow flexible pneumatic actuator (AFPA) has been designed and fabricated to construct a miniaturised soft gripper that could be used to grip small objects. The model of AFPA is designed using solid works and its bending motion is simulated in Abaqus software for optimisation and compared with experimental results. The actuator is fabricated using compression molding process that includes micromachining of the molds. Experiments conducted show the bending characteristics of the actuator at different pressures. The actuator shows excellent bending performance and the eccentricity in its design supports increased bending or curling motion up to a certain extent compared to normal bellows without eccentricity. The effects of profile shape and eccentricity on the actuator performance are analysed and the results are presented.
Renal Cell Carcinoma Metastasis from Biopsy Associated Hematoma Disruption during Robotic Partial Nephrectomy
Authors: Caputo Christopher , Lee Ziho , Harbin Andrew , Eun Daniel
Published: December 2014

We describe a case in which a patient with a past medical history of ovarian cancer received a diagnostic renal biopsy for an incidentally discovered renal mass. During left robotic partial nephrectomy (RPN), a perinephric hematoma was encountered. The hematoma was not present on preoperative imaging and was likely a result of the renal biopsy. The renal cell carcinoma (RCC) and the associated hematoma were widely excised with negative surgical margins. On follow-up imaging at five months postoperatively, a recurrent renal mass at the surgical resection bed and several new nodules in the omentum were detected. During completion left robotic total nephrectomy and omental excision, intraoperative frozen sections confirmed metastatic RCC. We believe that a hematoma seeded with RCC formed as a result of the renal biopsy, and subsequent disruption of the hematoma during RPN caused contamination of RCC into the surrounding structures.
Improving Power to Detect Changes in Blood miRNA Expression by Accounting for Sources of Variability in Experimental Designs
Authors: Daniels Sarah I. , Sillé Fenna C.M. , Goldbaum Audrey , Yee Brenda , Key Ellen F. , Zhang Luoping , Smith Martyn T. , Thomas Reuben
Published: December 2014

Background: Blood miRNAs are a new promising area of disease research, but variability in miRNA measurements may limit detection of true-positive findings. Here, we measured sources of miRNA variability and determine whether repeated measures can improve power to detect fold-change differences between comparison groups.

Methods: Blood from healthy volunteers (N = 12) was collected at three time points. The miRNAs were extracted by a method predetermined to give the highest miRNA yield. Nine different miRNAs were quantified using different qPCR assays and analyzed using mixed models to identify sources of variability. A larger number of miRNAs from a publicly available blood miRNA microarray dataset with repeated measures were used for a bootstrapping procedure to investigate effects of repeated measures on power to detect fold changes in miRNA expression for a theoretical case–control study.

Results: Technical variability in qPCR replicates was identified as a significant source of variability (P < 0.05) for all nine miRNAs tested. Variability was larger in the TaqMan qPCR assays (SD = 0.15–0.61) versus the qScript qPCR assays (SD = 0.08–0.14). Inter- and intraindividual and extraction variability also contributed significantly for two miRNAs. The bootstrapping procedure demonstrated that repeated measures (20%–50% of N) increased detection of a 2-fold change for approximately 10% to 45% more miRNAs.

Conclusion: Statistical power to detect small fold changes in blood miRNAs can be improved by accounting for sources of variability using repeated measures and choosing appropriate methods to minimize variability in miRNA quantification.

Impact: This study demonstrates the importance of including repeated measures in experimental designs for blood miRNA research.

See all the articles in this CEBP Focus section, “Biomarkers, Biospecimens, and New Technologies in Molecular Epidemiology.”

Cancer Epidemiol Biomarkers Prev; 23(12); 2658–66. ©2014 AACR.
A Phase I Study of Cixutumumab (IMC-A12) in Combination with Temsirolimus (CCI-779) in Children with Recurrent Solid Tumors: A Children's Oncology Group Phase I Consortium Report
Authors: Fouladi Maryam , Perentesis John P. , Wagner Lars M. , Vinks Alexander A. , Reid Joel M. , Ahern Charlotte , Thomas George , Mercer Carol A. , Krueger Darcy A. , Houghton Peter J. , Doyle L. Austin , Chen Helen , Weigel Brenda , Blaney Susan M.
Published: December 2014

Purpose: To determine the MTD, dose-limiting toxicities (DLT), pharmacokinetics, and biologic effects of cixutumumab administered in combination with temsirolimus to children with refractory solid tumors.

Experimental Design: Cixutumumab and temsirolimus were administered intravenously once every 7 days in 28-day cycles. Pharmacokinetic and biology studies, including assessment of mTOR downstream targets in peripheral blood mononuclear cells, were performed during the first cycle.

Results: Thirty-nine patients, median age 11.8 years (range, 1–21.5), with recurrent solid or central nervous system tumors were enrolled, of whom 33 were fully assessable for toxicity. There were four dose levels, which included two dose reductions and a subsequent intermediated dose escalation: (i) IMC-A12 6 mg/kg, temsirolimus 15 mg/m2; (ii) IMC-A12 6 mg/kg, temsirolimus 10 mg/m2; (iii) IMC-A12 4 mg/kg, temsirolimus 8 mg/m2; and (iv) IMC-A12 6 mg/kg, temsirolimus 8 mg/m2. Mucositis was the predominant DLT. Other DLTs included hypercholesterolemia, fatigue, thrombocytopenia, and increased alanine aminotransferase. Target inhibition (decreased S6K1 and PAkt) in peripheral blood mononuclear cells was noted at all dose levels. Marked interpatient variability in temsirolimus pharmacokinetic parameters was noted. At 8 mg/m2, the median temsirolimus AUC was 2,946 ng • h/mL (range, 937–5,536) with a median sirolimus AUC of 767 ng • h/mL (range, 245–3,675).

Conclusions: The recommended pediatric phase II doses for the combination of cixutumumab and temsirolimus are 6 mg/kg and 8 mg/m2, respectively. Clin Cancer Res; 21(7); 1558–65. ©2014 AACR.
A Phase I Study of DMS612, a Novel Bifunctional Alkylating Agent
Authors: Appleman Leonard J. , Balasubramaniam Sanjeeve , Parise Robert A. , Bryla Christine , Redon Christophe E. , Nakamura Asako J. , Bonner William M. , Wright John J. , Piekarz Richard , Kohler David R. , Jiang Yixing , Belani Chandra P. , Eiseman Julie , Chu Edward , Beumer Jan H. , Bates Susan E.
Published: December 2014

Purpose: DMS612 is a dimethane sulfonate analog with bifunctional alkylating activity and preferential cytotoxicity to human renal cell carcinoma (RCC) in the NCI-60 cell panel. This first-in-human phase I study aimed to determine dose-limiting toxicity (DLT), maximum tolerated dose (MTD), pharmacokinetics (PK), and pharmacodynamics (PD) of DMS612 administered by 10-minute intravenous infusion on days 1, 8, and 15 of an every-28-day schedule.

Experimental Design: Patients with advanced solid malignancies were eligible. Enrollment followed a 3+3 design. PKs of DMS612 and metabolites were assessed by mass spectroscopy and PD by γ-H2AX immunofluorescence.

Results: A total of 31 patients, including those with colorectal (11), RCC (4), cervical (2), and urothelial (1) cancers, were enrolled. Six dose levels were studied, from 1.5 mg/m2 to 12 mg/m2. DLTs of grade 4 neutropenia and prolonged grade 3 thrombocytopenia were observed at 12 mg/m2. The MTD was determined to be 9 mg/m2 with a single DLT of grade 4 thrombocytopenia in 1 of 12 patients. Two patients had a confirmed partial response at the 9 mg/m2 dose level, in renal (1) and cervical (1) cancer. DMS612 was rapidly converted into active metabolites. γ-H2AX immunofluorescence revealed dose-dependent DNA damage in both peripheral blood lymphocytes and scalp hairs.

Conclusions: The MTD of DMS12 on days 1, 8, and 15 every 28 days was 9 mg/m2. DMS612 appears to be an alkylating agent with unique tissue specificities. Dose-dependent PD signals and two partial responses at the MTD support further evaluation of DMS612 in phase II trials. Clin Cancer Res; 21(4); 721–9. ©2014 AACR.
High HER2 Expression Correlates with Response to the Combination of Lapatinib and Trastuzumab
Authors: Scaltriti Maurizio , Nuciforo Paolo , Bradbury Ian , Sperinde Jeff , Agbor-Tarh Dominique , Campbell Christine , Chenna Ahmed , Winslow John , Serra Violeta , Parra Josep Lluis , Prudkin Ludmila , Jimenez José , Aura Claudia , Harbeck Nadia , Pusztai Lajos , Ellis Catherine , Eidtmann Holger , Arribas Joaquin , Cortes Javier , de Azambuja Evandro , Piccart Martine , Baselga José
Published: December 2014

Purpose: Expression of p95HER2 has been associated with resistance to trastuzumab-based therapy in patients with metastatic breast cancer. Conversely, high levels of HER2 have been linked with increased clinical benefit from anti-HER2 therapy. In this work, we aimed to investigate whether the levels of p95HER2 and HER2 can predict response to anti-HER2 therapy in patients with breast cancer.

Experimental Design: We measured p95HER2 and HER2 by VeraTag and HERmark, respectively, in primary tumors of patients enrolled in the neoadjuvant phase III study NeoALTTO and correlated these variables with pathologic complete response (pCR) and progression-free survival (PFS) following lapatinib (L), trastuzumab (T), or the combination of both agents (L+T).

Results: A positive correlation between p95HER2 and HER2 levels was found in the 274 cases (60%) in which quantification of both markers was possible. High levels of these markers were predictive for pCR, especially in the hormone receptor (HR)–positive subset of patients. High HER2 expression was associated with increased pCR rate upon L+T irrespective of the HR status. To examine whether the levels of either p95HER2 or HER2 could predict for PFS in patients treated with lapatinib, trastuzumab or L+T, we fit to the PFS data in Cox models containing log2(p95HER2) or log2(HER2). Both variables correlated with longer PFS.

Conclusions: Increasing HER2 protein expression correlated with increased benefit of adding lapatinib to trastuzumab. HER2 expression is a stronger predictor of pCR and PFS than p95HER2 for response to lapatinib, trastuzumab and, more significantly, L+T. Clin Cancer Res; 21(3); 569–76. ©2014 AACR.
In vitro Differentiation of Human Adipose Tissue-Derived Stem Cells into Islet-Like Clusters Promoted by Islet Neogenesis-Associated Protein Pentadecapeptide
Authors: Ren Lili , Chen Lijuan , Qi Hui , Li Furong , Gong Feili
Published: December 2014

Human adipose tissue-derived stem cells (hASCs) are considered an ideal tool for the supply of insulin-producing cells to treat diabetes mellitus, with high differentiation efficiency. Islet neogenesis-associated protein (INGAP) is an initiator of islet neogenesis, and the peptide sequence comprising amino acids 104-118, named INGAP pentadecapeptide (INGAP-PP), has been shown to increase β-cell mass in animals and human pathological states. Here, we report a novel 4-step method to promote hASCs to differentiate into islet-like clusters (ILCs) more efficiently by adding INGAP-PP. The hASCs were isolated, purified and differentiated using a 4-step protocol including trichostatin A, INGAP-PP/scrambled peptide (Scrambled-P), dexamethasone, nicotinamide, glucagon-like peptide-1, transforming growth factor β1 and exendin-4. Results showed that ILCs in the INGAP-PP group were more similar to the fresh islets with regard to both size and morphology and expressed significantly higher levels of both insulin and C-peptide than those in the Scrambled-P group. Moreover, the ILCs from the INGAP-PP group secreted higher levels of insulin and C-peptide than those from the Scrambled-P group in response to both a low (5.6 mM) and high (25 mM) glucose challenge and secreted 6 times more hormones under the high-glucose challenge. Real-time PCR and immunocytochemistry showed that ILCs of the INGAP-PP group expressed human pancreatic endocrine hormones and transcription factors. Transplantation of ILCs into diabetic rats partially reversed diabetes and prolonged their life span. In conclusion, the INGAP-PP protocol can efficiently induce hASCs to differentiate into ILCs in vitro, and thus hASCs could be a promising source of cells for transplantation to treat diabetes mellitus.
Reliability of Pulse Oximetry during Cardiopulmonary Resuscitation in a Piglet Model of Neonatal Cardiac Arrest
Authors: Hassan Mohammad Ahmad , Mendler Marc , Maurer Miriam , Waitz Markus , Huang Li , Hummler Helmut D.
Published: December 2014

Background: Pulse oximetry is widely used in intensive care and emergency conditions to monitor arterial oxygenation and to guide oxygen therapy. Objective: To study the reliability of pulse oximetry in comparison with CO-oximetry in newborn piglets during cardiopulmonary resuscitation (CPR). Methodology: In a prospective cohort study in 30 healthy newborn piglets, cardiac arrest was induced, and thereafter each piglet received CPR for 20 min. Arterial oxygen saturation was monitored continuously by pulse oximetry (SpO2). Arterial blood was analyzed for functional oxygenation (SaO2) every 2 min. SpO2 was compared with coinciding SaO2 values and bias considered whenever the difference (SpO2 - SaO2) was beyond ±5%. Results: Bias values were decreased at the baseline measurements (mean: 2.5 ± 4.6%) with higher precision and accuracy compared with values across the experiment. Two minutes after cardiac arrest, there was a marked decrease in precision and accuracy as well as an increase in bias up to 13 ± 34%, reaching a maximum of 45.6 ± 28.3% after 10 min over a mean SaO2 range of 29-58%. Conclusion: Pulse oximetry showed increased bias and decreased accuracy and precision during CPR in a model of neonatal cardiac arrest. We recommend further studies to clarify the exact mechanisms of these false readings to improve reliability of pulse oximetry during the marked desaturation and hypoperfusion found during CPR. © 2014 S. Karger AG, Basel
Factors Influencing Blood Loss and Postoperative Morbidity in Children Undergoing Craniosynostosis Surgery: A Retrospective Study
Authors: Ali Achmet , Basaran Burcu , Yornuk Mesut , Altun Demet , Aydoseli Aydin , Sencer Altay , Akinci I. Ozkan
Published: December 2014

Background: Craniosynostosis is a condition resulting from the premature fusion of cranial sutures. Corrective surgery is often associated with a large amount of blood loss, with transfusion of red blood cells (RBC) and fresh frozen plasma (FFP). The aims of this study were to determine the variables associated with increased blood loss and postoperative complications. Methods: A retrospective analysis was performed of 42 pediatric patients who underwent craniosynostosis surgery. We analyzed the following: demographic parameters, duration of surgery, intraoperative blood loss, RBC, FFP and fluid transfusion, urine output, and hemodynamic parameters. In addition, we recorded the postoperative length of stay in the intensive care unit and hospital, postoperative blood loss and early complications. Results: The mean age, weight and surgical duration were 9.2 ± 3.2 months, 9.3 ± 2.0 kg and 255.8 ± 46.7 min, respectively. Intraoperative blood loss was 61.2 ± 15.3 ml/kg and RBC, FFP and fluid transfusion were 27.3 ± 7.1 ml/kg, 16.5 ± 4.7 ml/kg and 21.7 ± 4.6 ml/kg/h, respectively. Greater intraoperative blood loss was associated with longer surgical duration (p = 0.001, correlation coefficient = 0.495, R2 = 0.245) and lower patient weight (p < 0.001, correlation coefficient = -0.557, R2 = 0.311). Longer hospital stay was associated with greater intraoperative blood loss (p < 0.001, correlation coefficient = 0.754, R2 = 0.568) and greater intraoperative RBC transfusion (p < 0.001, correlation coefficient = 0.795, R2 = 0.632). Conclusion: Severe blood loss occurred in all children who underwent craniosynostotic corrections. Furthermore, the duration of surgery, patient weight and certain surgical procedures correlated with greater blood loss. Careful hemodynamic monitoring and evaluation of a patient's hematocrit value and volume status together may be helpful in maintaining the balance between insufficient and excessive blood product transfusion.
23-Gauge versus 25-Gauge Vitrectomy for Proliferative Diabetic Retinopathy: A Comparison of Surgical Outcomes
Authors: Guthrie Grant , Magill Henry , Steel David H.W.
Published: December 2014

Purpose: This study compared clinical outcomes and complications between 23-gauge (23g) and 25-gauge (25g) transconjunctival sutureless vitrectomy in patients with proliferative diabetic retinopathy. Study Design: It was a retrospective study using data prospectively defined and collected. 80 eyes underwent 23g transconjunctival sutureless vitrectomy, and 80 eyes underwent 25g surgery using the same vitrectomy system by one surgeon. Primary outcome measures were best-corrected visual acuity, intraocular pressure (IOP), and incidence of intraoperative and postoperative complications. Results: Vision was significantly improved after intervention in both groups (p ≥ 0.0001). There was no significant difference in visual outcomes between the groups (p = 0.43) or in the type and frequency of retinal breaks occurring during surgery (p = 0.63). The 23g group had significantly more patients with a day 1 IOP of <6 mm Hg (p = 0.034) and significantly more patients requiring a sclerostomy suture postoperatively (p = 0.014). Conclusion and Message: Both gauges are equally effective for the treatment of proliferative diabetic retinopathy.
Differential Impact of the Neutrophil-Lymphocyte Ratio on the Survival of Patients with Stage IV Gastric Cancer
Authors: Tanaka Hiroaki , Muguruma Kazuya , Toyokawa Takahiro , Kubo Naoshi , Ohira Masaichi , Hirakawa Kosei
Published: December 2014

Background and Aim: The neutrophil to lymphocyte ratio (NLR) may be related to progression in several cancers. The aim of this study was to investigate the impact of pretreatment NLR in advanced gastric cancer on the prognosis of the patients stratified by metastatic pattern. Methods: We retrospectively investigated clinical data from 191 patients with stage IV gastric cancer who had undergone surgery for primary gastric cancer between 1997 and 2010 at the Department of Surgical Oncology of Osaka City University. Results: All patients had unresectable metastatic factors including peritoneal metastasis (P) and liver metastasis (H). Sixty-one (32%) patients had more than two unresectable factors. We determined a cutoff value of 2.5 for the NLR to be optimal to discriminate the patient's characteristics and divided patients into low (<2.5) and high (>2.5) NLR group for subsequent analysis. In the low NLR group, long survival was found in patients with H, P, or multiple site metastases. Conclusion: Our results suggest that NLR well reflects the progression of critical metastasis and surgical resection might improve prognosis for patients with low NLR. In conclusion, NLR might be used as a predictive marker to decide on surgical therapy for patients with Stage IV gastric cancer. i 2014 S. Karger AG, Basel
Local Treatment with Triamcinolone Acetonide and Bevacizumab for Ocular Symptoms in a Patient with POEMS Syndrome
Authors: Prost Marcin G. , Gilhuis H. Jacobus , Brouwer Rolf E. , Gawda Piotr
Published: December 2014

Purpose: To report our experience in managing a case of bilateral optic disc oedema and unilateral cystoid macular oedema with a posterior subtenon (PST) injection of triamcinolone acetonide and intravitreal bevacizumab (IVB) in a patient with polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome. Case Report: A 50-year-old healthy woman complaining of bilateral blurred vision for several days was referred to the ophthalmologist. An eye examination showed a bilateral optic disc swelling and small preretinal haemorrhages. In addition, a peripheral neuropathy was found. Laboratory tests showed elevated levels of M-protein type IgA of 1.4 g/l and a vascular endothelial growth factor (VEGF) concentration of 6.1 ng/ml. The cerebrospinal fluid protein content was 131 mg/dl. An abdominal CT scan revealed hepatosplenomegaly. The diagnosis of POEMS syndrome was made based on the polyneuropathy, hepatosplenomegaly, IgA lambda monoclonal proteinemia, and optic disc swelling. As vision declined, 40 mg PST injection of triamcinolone was given bilaterally. Ten weeks thereafter, 2 IVB injections of 2.5 mg were administered to the left eye, with a 4-week interval. Because of an incomplete recovery of her visual functions, diarrhoea and general malaise, melphalan, followed by autologous peripheral blood stem cell transplantation, was initiated. After systemic treatment, she had no visual complaints anymore, the optic disc oedema had resolved, and the VEGF serum concentration had normalized. Discussion: Local treatment with IVB and PST injection of triamcinolone can be an option for ocular symptoms in POEMS syndrome. However, given the incomplete recovery of the ocular abnormalities and the other symptoms, systemic treatment remains standard.
Latency Period until the Development of Thyroid Cancer in Young Patients Submitted to Radiotherapy: Report of 10 Cases
Authors: Simões-Pereira Joana , Silva Vieira Margarida , Pereira Maria Conceição
Published: December 2014

Background: Radiotherapy increases the risk of thyroid cancer (TC); patients submitted to this treatment should undergo a long-term follow-up. Our aim is to describe the features and outcomes of young patients who developed TC after radiotherapy. Methods: At our center, patients undergoing radiotherapy directly or indirectly involving the thyroid are regularly followed up in order to detect early dysfunction or nodules. Herein, we report the cases of 10 patients who were submitted to radiotherapy and developed TC. Clinical Findings: Seven patients were irradiated in the neck and 3 in nearby regions. The mean age at the last radiotherapy session was 10 ± 5.5 years. The average time until the appearance of the first thyroid nodule was 14 ± 4.7 years. The mean size increment of the nodules was 2.4 ± 1.6 mm/year. On the first cytology, only 2 results were suspicious of papillary thyroid cancer (PTC). All patients presented a histology of PTC. Eight were in stage I and 2 in stage II. The median follow-up from primary diagnosis to TC and beyond was 20 and 3 years, respectively. Conclusions: In these patients, cytologies may be difficult to interpret due to persistent benign results. The threshold for surgical indication may be anticipated, considering the increased risk of TC. We report the evolution of these nodules over time, from the end of primary oncological treatment.
Port-Site Metastasis of Mucinous Borderline Ovarian Tumor after Laparoscopy
Authors: Furukawa Naoto , Nishioka Kazuhiro , Noguchi Taketoshi , Kajihara Hirotaka , Horie Kiyoshige
Published: December 2014

We report a case of port-site metastasis after laparoscopic surgery for borderline mucinous ovarian tumors (mBOTs) without spillage and review the related literature. The patient was a 50-year-old nulligravida who presented with abdominal distension. Magnetic resonance imaging showed a 20 × 10-cm multilocular mass with various signal intensities. The wall and septa of the mass were neither thick nor enhanced. A laparoscopy was performed. An intact left ovarian tumor was observed. The weight of the tumor was 1,540 g. The final diagnosis was stage IA intestinal-type mBOT, so the patient did not undergo adjuvant therapy. Twenty-six months after surgery, the patient presented with a 3 × 5-cm palpable mass on the umbilicus. Biopsy of the mass revealed mucinous adenocarcinoma and computed tomography showed a 3.5 × 4.0-cm mass at the umbilicus without additional metastases. A laparotomy was performed and no metastasis in the peritoneal cavity was observed by gross examination. An umbilical mass resection, hysterectomy, right salpingo-oophorectomy, appendectomy, and partial omentectomy were performed. Hematoxylin and eosin-stained sections of the umbilical mass revealed glands of varying size infiltrating the stroma, immunohistologic staining for cytokeratin 7 was positive, and cytokeratin 20 was negative, but no other metastases were observed. The patient was diagnosed with port-site metastasis and invasive recurrence of mBOT. She underwent six cycles of adjuvant paclitaxel and carboplatin therapy. Large ovarian tumors should be carefully extracted without spillage of the tumor contents to prevent port-site metastasis, despite the low incidence.
Anti‐Inflammatory Peptides From Cardiac Progenitors Ameliorate Dysfunction After Myocardial Infarction
Authors: Liu Mei‐Lan , Nagai Toshio , Tokunaga Masakuni , Iwanaga Koji , Matsuura Katsuhisa , Takahashi Toshinao , Kanda Masato , Kondo Naomichi , Naito Atsuhiko T. , Komuro Issei , Kobayashi Yoshio
Published: December 2014

Background

Cardiac cell therapy has been proposed as one of the new strategies against myocardial infarction. Although several reports showed improvement of the function of ischemic heart, the effects of cell therapy vary among the studies and the mechanisms of the beneficial effects are still unknown. Previously, we reported that clonal stem cell antigen‐1–positive cardiac progenitor cells exerted a therapeutic effect when transplanted into the ischemic heart. Our aims were to identify the cardiac progenitor‐specific paracrine factor and to elucidate the mechanism of its beneficial effect.

Methods and Results

By using an antibody array, we found that soluble junctional adhesion molecule‐A (
JAM
‐A) was abundantly secreted from cardiac progenitor cells. Pretreatment of neutrophils with conditioned medium from cultured cardiac progenitor cells or soluble
JAM
‐A inhibited transendothelial migration and reduced motility of neutrophils. These inhibitory effects were attenuated by anti–
JAM
‐A neutralizing antibody. Injection of cardiac progenitor cells into infarct heart attenuated neutrophil infiltration and expression of inflammatory cytokines. Injection of soluble
JAM
‐A–expressing, but not of
JAM
‐A si
RNA
–expressing, cardiac progenitor cells into the infarct heart prevented cardiac remodeling and reduced fibrosis area.

Conclusions

Soluble
JAM
‐A secreted from cardiac progenitor cells reduces infiltration of neutrophils after myocardial infarction and ameliorates tissue damage through prevention of excess inflammation. Our finding may lead to a new therapy for cardiovascular disease by using the anti‐inflammatory effect of
JAM
‐A.
Dietary Salt Restriction Improves Cardiac and Adipose Tissue Pathology Independently of Obesity in a Rat Model of Metabolic Syndrome
Authors: Hattori Takuya , Murase Tamayo , Takatsu Miwa , Nagasawa Kai , Matsuura Natsumi , Watanabe Shogo , Murohara Toyoaki , Nagata Kohzo
Published: December 2014

Background

Metabolic syndrome (MetS) enhances salt sensitivity of blood pressure and is an important risk factor for cardiovascular disease. The effects of dietary salt restriction on cardiac pathology associated with metabolic syndrome remain unclear.

Methods and Results

We investigated whether dietary salt restriction might ameliorate cardiac injury in DahlS.Z‐
Lepr

fa

/
Lepr

fa

(
DS
/obese) rats, which are derived from a cross between Dahl salt‐sensitive and Zucker rats and represent a model of metabolic syndrome.
DS
/obese rats were fed a normal‐salt (0.36% NaCl in chow) or low‐salt (0.0466% NaCl in chow) diet from 9 weeks of age and were compared with similarly treated homozygous lean littermates (DahlS.Z‐
Lepr

+

/
Lepr

+

, or
DS
/lean rats).
DS
/obese rats fed the normal‐salt diet progressively developed hypertension and showed left ventricular hypertrophy, fibrosis, and diastolic dysfunction at 15 weeks. Dietary salt restriction attenuated all of these changes in
DS
/obese rats. The levels of cardiac oxidative stress and inflammation and the expression of cardiac renin–angiotensin–aldosterone system genes were increased in
DS
/obese rats fed the normal‐salt diet, and dietary salt restriction downregulated these parameters in both
DS
/obese and
DS
/lean rats. In addition, dietary salt restriction attenuated the increase in visceral adipose tissue inflammation and the decrease in insulin signaling apparent in
DS
/obese rats without reducing body weight or visceral adipocyte size. Dietary salt restriction did not alter fasting serum glucose levels but it markedly decreased the fasting serum insulin concentration in
DS
/obese rats.

Conclusions

Dietary salt restriction not only prevents hypertension and cardiac injury but also ameliorates insulin resistance, without reducing obesity, in this model of metabolic syndrome.