bluuebunny/crossref_metadata_2025 huggingface dataset:
What are the decision-making preferences of patients in vascular surgery? A mixed-methods study
Authors: Santema T B Katrien , Stoffer E Anniek , Kunneman Marleen , Koelemay Mark J W , Ubbink Dirk T
Published: February 2017

Objectives

Shared decision-making (SDM) has been advocated as the preferred method of choosing a suitable treatment option. However, patient involvement in treatment decision-making is not yet common practice in the field of vascular surgery. The aim of this mixed-methods study was to explore patients' decision-making preferences and to investigate which facilitators and barriers patients perceive as important for the application of SDM in vascular surgery.

Design and setting

Patients were invited to participate after visiting the vascular surgical outpatient clinic of an Academic Medical Center in the Netherlands. A treatment decision was made during the consultation for an abdominal aortic aneurysm or peripheral arterial occlusive disease. Patients filled in a number of questionnaires (quantitative part) and a random subgroup of patients participated in an in-depth interview (qualitative part).

Results

A total of 67 patients participated in this study. 58 per cent of them (n=39) indicated that they preferred a shared role in decision-making. In more than half of the patients (55%; n=37) their preferred role was in disagreement with what they had experienced. 31 per cent of the patients (n=21) preferred a more active role in the decision-making process than they had experienced. Patients indicated a good patient–doctor relationship as an important facilitator for the application of SDM.

Conclusions

The vast majority of vascular surgical patients preferred, but did not experience a shared role in the decision-making process, although the concept of SDM was insufficiently clear to some patients. This emphasises the importance of explaining the concept of SDM and implementing it in the clinical encounter.
Surveillance of paediatric exposures to liquid laundry detergent pods in Italy
Authors: Settimi Laura , Giordano Felice , Lauria Laura , Celentano Anna , Sesana Fabrizio , Davanzo Franca
Published: February 2017

Objective

To analyse paediatric exposures to pod and traditional laundry detergents in Italy and changes in exposure trends.

Methods

Analyses of a series of patients aged <5 years and exposed to laundry detergents between September 2010 and June 2015, identified by the National Poison Control in Milan.

Results

In comparison with patients exposed to traditional laundry detergents (n=1150), a higher proportion of those exposed to pods (n=1649) were managed in hospital (68% vs 42%), had clinical effects (75% vs 22%) and moderate/high severity outcomes (13% vs <1%). Exposure rates were stable over time for traditional detergents (average 0.65 cases/day), but an abrupt decline in major company pods was seen in December 2012, 4 months after the introduction of opaque outer packaging (from 1.03 to 0.36 cases/day and from 1.88 to 0.86 cases/million units sold). The odds of clinical effects was higher for exposure to pods than for traditional detergents (OR=10.8; 95% CI 9.0 to 12.9). Among patients exposed to pods, the odds of moderate/high severity outcomes was four times higher for children aged <1 years than for the other age groups (OR=3.9; 95% CI 2.2 to 7.0). Ten children exposed to laundry detergent pods had high severity outcomes while no children exposed to traditional laundry detergents developed high severity effects.

Conclusions

The study confirms that exposure to laundry detergent pods is more dangerous than exposure to traditional detergents. In Italy, 4 months after the introduction of opaque outer packaging by a major company, product-specific exposure rates decreased sharply, suggesting that reducing visibility of laundry detergent pods may be an effective preventive measure. Further efforts are needed to improve safety.
The benefit of a supplement with the antioxidant melatonin on redox status and muscle damage in resistance-trained athletes
Authors: Leonardo-Mendonça Roberto C. , Ocaña-Wilhelmi Javier , de Haro Tomás , de Teresa-Galván Carlos , Guerra-Hernández Eduardo , Rusanova Iryna , Fernández-Ortiz Marisol , Sayed Ramy K.A. , Escames Germaine , Acuña-Castroviejo Darío
Published: February 2017

Previous data showed that the administration of high doses of melatonin improved the circadian system in athletes. Here, we investigated in the same experimental paradigm whether the antioxidant properties of melatonin has also beneficial effects against exercise-induced oxidative stress and muscle damage in athletes. Twenty-four athletes were treated with 100 mg·day−1of melatonin or placebo 30 min before bedtime during 4 weeks in a randomized double-blind scheme. Exercise intensity was higher during the study that before starting it. Blood samples were collected before and after treatment, and plasma was used for oxygen radical absorption capacity (ORAC), lipid peroxidation (LPO), nitrite plus nitrate (NOx), and advanced oxidation protein products (AOPP) determinations. Glutathione (GSH), glutathione disulphide (GSSG) levels, and glutathione peroxidase (GPx) and reductase (GRd) activities, were measured in erythrocytes. Melatonin intake increased ORAC, reduced LPO and NOx levels, and prevented the increase of AOPP, compared to placebo group. Melatonin was also more efficient than placebo in reducing GSSG·GSH−1and GPx·GRd−1ratios. Melatonin, but not placebo, reduced creatine kinase, lactate dehydrogenase, creatinine, and total cholesterol levels. Overall, the data reflect a beneficial effect of melatonin treatment in resistance-training athletes, preventing extra- and intracellular oxidative stress induced by exercise, and yielding further skeletal muscle protection against exercise-induced oxidative damage.
Late canopy closure delays senescence and promotes growth of the spring ephemeral wild leek (Allium tricoccum)
Authors: Dion Pierre-Paul , Bussières Julie , Lapointe Line
Published: February 2017

Spring ephemerals take advantage of the high light conditions in spring to accumulate carbon reserves through photosynthesis before tree leaves unfold. Recent work has reported delayed leaf senescence under constant light availability in some spring ephemerals, such as wild leek (Allium tricoccum). This paper aims to establish whether tree canopy composition and phenology can influence the growth of spring ephemerals through changes in their phenology. Wild leek bulbs were planted in 31 plots in southern Quebec, Canada, under canopies varying in composition and densities. Light availability and tree phenology were measured, along with other environmental conditions, and their effect on the growth of wild leeks was assessed with a redundancy analysis. Higher light availability resulted in better growth of wild leeks. The plants postponed their senescence under trees with late bud-burst, and thus better bulb growth and seed production were achieved. The tree litter and temperature and moisture levels of the soil also influenced the growth and survival of wild leeks. Thus, tree leaf phenology appears to have a strong impact on the growth of spring ephemerals by modulating the length of their growing season and their photosynthetic capacity. This underlines the importance of considering the variation of light availability throughout the growing season in the study of spring ephemerals.
Including all the lines: data releases for spectra and opacities
Authors: Kurucz Robert L.
Published: February 2017

I present a progress report on including all the lines in the line lists, including all the lines in the opacities, and including all the lines in the model atmosphere and spectrum synthesis calculations. The increased opacity will improve stellar atmosphere, pulsation, stellar interior, asteroseismology, nova, supernova, and other radiation-hydrodynamics calculations. At present I have produced atomic line data for computing opacities for 544 million lines for elements up through Zn. Of these, 2.11 million lines are between known energy levels so have good wavelengths for computing spectra. Work is continuing on heavier elements. I also report on using stellar spectra as the laboratory source for extending analyses to higher energy levels. Data for each ion and merged line lists are available on my website kurucz.harvard.edu .
Ehrlich–Schwöbel barriers and adsorption of Au, Cu and Ag stepped (100) surfaces
Authors: Benlattar M. , Elkoraychy E. , Sbiaai K. , Mazroui M. , Boughaleb Y.
Published: February 2017

We use a combination of quenched molecular dynamics and embedded atom method to calculate the activation energy barriers for the hopping and exchange mechanisms of Au, Ag or Cu on Au(100), Ag(100) or Cu(100) stepped surfaces. Our findings show that the Ehrlich–Schwöbel (ES) barriers for an adatom to undergo jump or exchange at a step edge are found to be dependent of the nature of substrate stepped surfaces. We also find that the ES barriers for the hopping processes are too high, except for Cu/Au(100). While for exchange process the Ehrlich–Schwöbel barriers are found to be very low and even negative. These ES barriers can explain the difference in the growth modes for the different systems. On the other hand, we calculated the adsorption energies at the most stable adsorption sites near step edges. In particular, we wish to clarify the relation between the adatom diffusion energy barriers and the adatom adsorption energies. These results may serve as some guiding rules for studying stepped surface morphologies, which are of importance to surface nanoengineering.
Electron and Positron Beam–Driven Plasma Acceleration
Authors: Hogan Mark J.
Published: February 2017

Particle accelerators are the ultimate microscopes. They produce high energy beams of particles — or, in some cases, generate X-ray laser pulses — to probe the fundamental particles and forces that make up the universe and to explore the building blocks of life. But it takes huge accelerators, like the Large Hadron Collider or the two-mile-long SLAC linac, to generate beams with enough energy and resolving power. If we could achieve the same thing with accelerators just a few meters long, accelerators and particle colliders could be much smaller and cheaper. Since the first theoretical work in the early 1980s, an exciting series of experiments have aimed at accelerating electrons and positrons to high energies in a much shorter distance by having them “surf” on waves of hot, ionized gas like that found in fluorescent light tubes. Electron-beam-driven experiments have measured the integrated and dynamic aspects of plasma focusing, the bright flux of high energy betatron radiation photons, particle beam refraction at the plasma–neutral-gas interface, and the structure and amplitude of the accelerating wakefield. Gradients spanning kT/m to MT/m for focusing and 100[Formula: see text]MeV/m to 50[Formula: see text]GeV/m for acceleration have been excited in meter-long plasmas with densities of 10[Formula: see text]–10[Formula: see text][Formula: see text]cm[Formula: see text], respectively. Positron-beam-driven experiments have evidenced the more complex dynamic and integrated plasma focusing, 100[Formula: see text]MeV/m to 5[Formula: see text]GeV/m acceleration in linear and nonlinear plasma waves, and explored the dynamics of hollow channel plasma structures. Strongly beam-loaded plasma waves have accelerated beams of electrons and positrons with hundreds of pC of charge to over 5[Formula: see text]GeV in meter scale plasmas with high efficiency and narrow energy spread. These “plasma wakefield acceleration” experiments have been mounted by a diverse group of accelerator, laser and plasma researchers from national laboratories and universities around the world. This article reviews the basic principles of plasma wakefield acceleration with electron and positron beams, the current state of understanding, the push for first applications and the long range R&D roadmap toward a high energy collider.
Simulations for Plasma and Laser Acceleration
Authors: Vay Jean-Luc , Lehe Rémi
Published: February 2017

Computer simulations have had a profound impact on the design and understanding of past and present plasma acceleration experiments, and will be a key component for turning plasma accelerators from a promising technology into a mainstream scientific tool. In this article, we present an overview of the numerical techniques used with the most popular approaches to model plasma-based accelerators: electromagnetic particle-in-cell, quasistatic and ponderomotive guiding center. The material that is presented is intended to serve as an introduction to the basics of those approaches, and to advances (some of them very recent) that have pushed the state of the art, such as the optimal Lorentz-boosted frame, advanced laser envelope solvers and the elimination of numerical Cherenkov instability. The particle-in-cell method, which has broader interest and is more standardized, is presented in more depth. Additional topics that are cross-cutting, such as azimuthal Fourier decomposition or filtering, are also discussed, as well as potential challenges and remedies in the initialization of simulations and output of data. Examples of simulations using the techniques that are presented have been left out of this article for conciseness, and because simulation results are best understood when presented together, and contrasted with theoretical and/or experimental results, as in other articles of this volume.
Luminosity Limitations of Linear Colliders Based on Plasma Acceleration
Authors: Lebedev Valeri , Burov Alexey , Nagaitsev Sergei
Published: February 2017

Particle acceleration in plasma creates a possibility of exceptionally high accelerating gradients and appears to be a very attractive option for future linear electron–positron and/or [Formula: see text]–[Formula: see text] colliders. These high accelerating gradients have already been demonstrated in a number of experiments. However, a linear collider requires exceptionally high beam brightness which still needs to be demonstrated. In this article we discuss major phenomena which limit the beam brightness of accelerated beam and, consequently, the collider luminosity.
Application of Advanced Accelerator Concepts for Colliders
Authors: Schulte Daniel
Published: February 2017

In this article the potential application of advanced accelerator concepts to future high energy colliders is discussed. The emphasis is on lepton colliders, since the advanced technologies appear to be most applicable in this field.
Advanced Accelerators for Medical Applications
Authors: Uesaka Mitsuru , Koyama Kazuyoshi
Published: February 2017

We review advanced accelerators for medical applications with respect to the following key technologies: (i) higher RF electron linear accelerator (hereafter “linac”); (ii) optimization of alignment for the proton linac, cyclotron and synchrotron; (iii) superconducting magnet; (iv) laser technology. Advanced accelerators for medical applications are categorized into two groups. The first group consists of compact medical linacs with high RF, cyclotrons and synchrotrons downsized by optimization of alignment and superconducting magnets. The second group comprises laser-based acceleration systems aimed of medical applications in the future. Laser plasma electron/ion accelerating systems for cancer therapy and laser dielectric accelerating systems for radiation biology are mentioned. Since the second group has important potential for a compact system, the current status of the established energy and intensity and of the required stability are given.
Best practices in summative assessment
Authors: Kibble Jonathan D.
Published: February 2017

The goal of this review is to highlight key elements underpinning excellent high-stakes summative assessment. This guide is primarily aimed at faculty members with the responsibility of assigning student grades and is intended to be a practical tool to help throughout the process of planning, developing, and deploying tests as well as monitoring their effectiveness. After a brief overview of the criteria for high-quality assessment, the guide runs through best practices for aligning assessment with learning outcomes and compares common testing modalities. Next, the guide discusses the kind of validity evidence needed to support defensible grading of student performance. This review concentrates on how to measure the outcome of student learning; other reviews in this series will expand on the related concepts of formative testing and how to leverage testing for learning.
Teaching a changing paradigm in physiology: a historical perspective on gut interstitial cells
Authors: Drumm Bernard T. , Baker Salah A.
Published: February 2017

The study and teaching of gastrointestinal (GI) physiology necessitates an understanding of the cellular basis of contractile and electrical coupling behaviors in the muscle layers that comprise the gut wall. Our knowledge of the cellular origin of GI motility has drastically changed over the last 100 yr. While the pacing and coordination of GI contraction was once thought to be solely attributable to smooth muscle cells, it is now widely accepted that the motility patterns observed in the GI tract exist as a result of a multicellular system, consisting of not only smooth muscle cells but also enteric neurons and distinct populations of specialized interstitial cells that all work in concert to ensure proper GI functions. In this historical perspective, we focus on the emerging role of interstitial cells in GI motility and examine the key discoveries and experiments that led to a major shift in a paradigm of GI physiology regarding the role of interstitial cells in modulating GI contractile patterns. A review of these now classic experiments and papers will enable students and educators to fully appreciate the complex, multicellular nature of GI muscles as well as impart lessons on how shifting paradigms in physiology are fueled by new technologies that lead to new emerging discoveries.
Wearable Passive E-Textile UHF RFID Tag Based on a Slotted Patch Antenna with Sewn Ground and Microchip Interconnections
Authors: Virkki Johanna , Wei Zhigang , Liu Aruhan , Ukkonen Leena , Björninen Toni
Published: February 2017

We present a wearable passive UHF RFID tag based on a slotted patch antenna comprising only textile materials (e-textile, textile substrate, and conductive yearn). As a novel manufacturing approach, we realize the patch-to-ground and antenna-to-IC interfaces using only conductive thread and a sewing machine. We outline the electromagnetic optimization of the antenna for body-worn operation through simulations and present a performance comparison between the e-textile tag and a tag produced using regular electronics materials and methods. The measured results show that the textile tag achieves the electrical performance required in practical applications and that the slotted patch type antenna provides stable electromagnetic performance in different body-worn configurations.
Computing and Comparing Effective Properties for Flow and Transport in Computer-Generated Porous Media
Authors: Allen Rebecca , Sun Shuyu
Published: February 2017

We compute effective properties (i.e., permeability, hydraulic tortuosity, and diffusive tortuosity) of three different digital porous media samples, including in-line array of uniform shapes, staggered-array of squares, and randomly distributed squares. The permeability and hydraulic tortuosity are computed by solving a set of rescaled Stokes equations obtained by homogenization, and the diffusive tortuosity is computed by solving a homogenization problem given for the effective diffusion coefficient that is inversely related to diffusive tortuosity. We find that hydraulic and diffusive tortuosity can be quantitatively different by up to a factor of ten in the same pore geometry, which indicates that these tortuosity terms cannot be used interchangeably. We also find that when a pore geometry is characterized by an anisotropic permeability, the diffusive tortuosity (and correspondingly the effective diffusion coefficient) can also be anisotropic. This finding has important implications for reservoir-scale modeling of flow and transport, as it is more realistic to account for the anisotropy ofboththe permeability and the effective diffusion coefficient.
Forward Displacement Analysis of a General 6‐3 Stewart Platform Using Conformal Geometric Algebra
Authors: Wei Feng , Wei Shimin , Zhang Ying , Liao Qizheng
Published: February 2017

In this paper, a new algorithm for the forward displacement analysis of a general 6‐3 Stewart platform (6‐3SPS) based on conformal geometric algebra (CGA) is presented. First, a 6‐3SPS structure is changed into an equivalent 2RPS‐2SPS structure. Then, two kinematic constraint equations are established based on the geometric characteristics, one of which is built according to the point characteristic four‐ball intersection in CGA. A 16th‐degree univariate polynomial equation is derived from the aforementioned two equations by the Sylvester resultant elimination. Finally, a numerical example is given to verify the algorithm.
Global Dynamics and Optimal Control of a Viral Infection Model with Generic Nonlinear Infection Rate
Authors: Gan Chenquan , Yang Maobin , Zhang Zufan , Liu Wanping
Published: February 2017

This paper is devoted to exploring the combined impact of a generic nonlinear infection rate and infected removable storage media on viral spread. For that purpose, a novel dynamical model with an external compartment is proposed, and the explanations of the main model assumptions (especially the generic nonlinear infection rate) are also examined. The existence and global stability of the unique equilibrium of the model are fully investigated, from which it can be seen that computer virus would persist. On this basis, a next-best approach to controlling the level of infected computers is suggested, and the theoretical analysis of optimal control of the model is also performed. Additionally, some numerical examples are given to illustrate the main results.
Iron Reduces M1 Macrophage Polarization in RAW264.7 Macrophages Associated with Inhibition of STAT1
Authors: Gan Zhen-Shun , Wang Qian-Qian , Li Jia-Hui , Wang Xu-Liang , Wang Yi-Zhen , Du Hua-Hua
Published: February 2017

Iron metabolism in inflammation has been mostly characterized in macrophages exposed to pathogens or inflammatory conditions. The aim of this study is to investigate the cross-regulatory interactions between M1 macrophage polarization and iron metabolism. Firstly, we characterized the transcription of genes related to iron homeostasis in M1 RAW264.7 macrophages stimulated by IFN-γ. The molecular signature of M1 macrophages showed high levels of iron storage (ferritin), a low level of iron export (ferroportin), and changes of iron regulators (hepcidin and transferrin receptors), which favour iron sequestration in the reticuloendothelial system and are benefit for inflammatory disorders. Then, we evaluated the effect of iron on M1 macrophage polarization. Iron significantly reduced mRNA levels of IL-6, IL-1β, TNF-α, and iNOS produced by IFN-γ-polarized M1 macrophages. Immunofluorescence analysis showed that iron also reduced iNOS production. However, iron did not compromise but enhanced the ability of M1-polarized macrophages to phagocytose FITC-dextran. Moreover, we demonstrated that STAT1 inhibition was required for reduction of iNOS and M1-related cytokines production by the present of iron. Together, these findings indicated that iron decreased polarization of M1 macrophages and inhibited the production of the proinflammatory cytokines. The results expanded our knowledge about the role of iron in macrophage polarization.
Genetic Profiling of Cancers of the Digestive System: Biological Insights and Clinical Implications
Authors: Stenzinger Albrecht , Weichert Wilko
Published: February 2017

Massive parallel sequencing technologies (next-generation sequencing) have enabled us to draw a comprehensive landscape of the genomic aberrations underlying common cancers of the digestive system, and they have thus revolutionized our understanding of the genomic makeup and biology of these tumors. Apart from the commonly mutated founder genes, e.g., KRAS and TP53, we now have detailed information on additional and less frequent genomic events for every major digestive system cancer. However, many challenging issues remain when it comes to translating these findings into clinical applications. Recent examples are the precise definition of the role of genomic heterogeneity and tumor evolution in metastatic spread and their impact on oncologic therapy. Other unresolved issues include the usefulness of identified drivers as novel drug targets and predictive biomarkers, as well as the development of strategies to implement broad genomic testing in individualized patient care. This review aims to dissect and discuss these topics for selected major cancers.
Immunohistochemical Glomerular Expression of Phospholipase A2 Receptor in Primary and Secondary Membranous Nephropathy: A Retrospective Study in an Indian Cohort with Clinicopathological Correlations
Authors: Roy Sanjeet , Korula Anila , Basu Gopal , Jacob Shibu , Varughese Santosh , Tamilarasi Veeraswamy
Published: February 2017

Background: Limited published literature exists on the utility and standardization of anti-phospholipase A2 receptor (anti-PLA2R) immunohistochemistry (IHC) for the diagnosis of primary membranous nephropathy (MN). The study aimed to validate anti-PLA2R IHC for the diagnosis of primary MN and clinicopathological correlations in an Indian cohort. Methods: Subjects included patients with primary and secondary MN diagnosed between January 2012 and August 2014 with an adequate renal biopsy and at least 1 year of clinical follow-up. Anti-PLA2R IHC was performed in all cases with miscellaneous renal lesions as controls. Electron microscopy was performed in selected cases. Sensitivity and specificity of anti-PLA2R IHC to identify primary MN was evaluated. Histopathological analyses of primary and secondary MN were done with clinicopathological correlations including serum creatinine, eGFR, chronic kidney disease stage, 24-h urine protein, serum cholesterol, serum albumin, and hypertension at presentation and follow-up, using the Kruskal-Wallis test and Spearman rank correlation. A p value of ≤0.05 was considered statistically significant. Results: In 153 MN patients (99 primary, 54 secondary) and 37 miscellaneous controls, anti-PLA2R IHC differentiated primary from secondary MN with a sensitivity of 70.2% and a specificity of 96.6%. Secondary MN had increased mesangial matrix expansion compared to primary MN (p = 0.001). Severe nephrotic syndrome, impaired renal function, and hypertension were all more common in primary than in secondary MN. Conclusion: Anti-PLA2R IHC is a specific marker to distinguish primary MN from secondary MN.
Resolution of Cheyne-Stokes Respiration after Treatment of Heart Failure with Sacubitril/Valsartan: A First Case Report
Authors: Fox Henrik , Bitter Thomas , Horstkotte Dieter , Oldenburg Olaf
Published: February 2017

Sleep-disordered breathing (SDB) is highly prevalent in patients with heart failure (HF), and is known to be associated with a worse prognosis. The severity of central sleep apnea is thought to mirror cardiac dysfunction. The novel angiotensin receptor-neprilysin inhibitor (ARNi) sacubitril has been shown to improve HF, but a relationship between treatment with ARNi and the severity of SDB has not yet been investigated. We report the case of a 71-year-old male with HF and SDB. Treatment with sacubitril/valsartan was associated with improved cardiac function, as shown by a reduction in the level of N-terminal prohormone of brain natriuretic peptide from 3,249 to 1,720 pg/mL, and an improvement in left-ventricular ejection fraction from 30 to 35%. This was accompanied by a marked reduction in the apnea-hypopnea index (from 41 to 19/h). To the best of our knowledge, this is the first case to document parallel improvements in HF and SDB after the initiation of ARNi treatment.
Effect of Symptom Duration until Surgery on First-Year Outcome in Pseudophakic Primary Rhegmatogenous Retinal Detachment
Authors: Enders Philip , Schick Tina , Kemper Carolin , Schaub Friederike , Fauser Sascha
Published: February 2017

Purpose: To investigate the effect of symptom duration in pseudophakic primary rhegmatogenous retinal detachment (RRD) with or without macular involvement on functional and anatomical outcome during first-year follow-up. Procedures: Retrospective review of cases with pars plana vitrectomy for retinal detachment repair. Symptom duration, functional outcome, and redetachment rates were analyzed. Symptom duration was grouped (1-3, 4-7, 8-14, 15-30, >30 days) and correlated to outcome in the first year of follow-up. Results: 371 macula-off and 230 macula-on RRDs could be included. In macula-off RRDs, longer symptom duration was associated with higher redetachment rates (10-21%; p = 0.032). Patients presenting symptoms for less than 8 days showed significantly lower rates than those with a longer symptom duration (p = 0.046). In macula-on RRDs, symptom duration and outcome were not associated (p > 0.6). Conclusions: In macula-off RRD, early reattachment surgery is necessary to lower the risk for retinal redetachment. The aim in macula-on RRD is to prevent conversion to a macula-off situation.
Sudden Cardiac Arrest Triggered by Coadministration of Fluconazole and Amiodarone
Authors: Wang Jiajia , Chen Yanbin , Lei Wei , Chen Cheng , Zhu Yehan , Su Nan , Zhang Chuankai , Huang Jian-an
Published: February 2017

Fluconazole for fungal infections and amiodarone for arrhythmia are commonly prescribed medications, and coadministration of such medications is sometimes inevitable in clinical practice. However, both medications have been associated with prolonged QTc intervals and subsequent arrhythmias, which are sometimes fatal. We present the case of a 75-year-old man with sudden cardiac arrest triggered by coadministration of fluconazole and amiodarone, which raises the need for caution regarding coadministration of these medications. To our knowledge, this case has not been previously described.
German Guidelines on Screening, Diagnosis and Treatment of Alcohol Use Disorders
Authors: Mann Karl , Batra Anil , Fauth-Bühler Mira , Hoch Eva ,   and the Guideline Group
Published: February 2017

Evidence-based strategies for screening, diagnosing and treating alcohol use disorders (AUD) are instrumental in the early and better management of individuals at risk for or suffering from AUD. However, existing guidelines vary and may be biased by conflicts of interests. Unbiased recommendations can be achieved only if sufficient detail is provided on the composition and representativeness of author groups, methodological rigor, handling of potential conflicts of interest and financing. This paper presents the first evidence-based guidelines for AUD from German-speaking countries. These guidelines are based on the work of delegates from a representative sample of 46 scientific societies (mostly medical) from Austria, Germany and Switzerland dealing with AUD. It also included patients and relatives. Recommendations were derived from a standardised hierarchical process involving quality controls drawn from existing guidelines, de novo literature searches and/or expert experience. Potential conflicts of interest were assessed yearly and led to exclusion from voting in specific areas. An overall cost of more than 400,000€ (for alcohol and tobacco guidelines) were exclusively covered by the participating societies and academic institutions. More than 100 recommendations on screening, diagnostics and treatment of AUD are outlined in this paper, and their scientific background is given in the online supplementary material. Tables of aggregated study synopses (in English) and the full version of guidelines (in German) are available (see “Links”).
Variations in the Prevalence of Obesity Among European Countries, and a Consideration of Possible Causes
Authors: Blundell John E. , Baker Jennifer Lyn , Boyland Emma , Blaak Ellen , Charzewska Jadwiga , de Henauw Stefaan , Frühbeck Gema , Gonzalez-Gross Marcela , Hebebrand Johannes , Holm Lotte , Kriaucioniene Vilma , Lissner Lauren , Oppert Jean-Michel , Schindler Karin , Silva Analiza Mónica , Woodward Euan
Published: February 2017

Over the last 10 years the prevalence of obesity across the European continent has in general been rising. With the exception of a few countries where a levelling-off can be perceived, albeit at a high level, this upward trend seems likely to continue. However, considerable country to country variation is noticeable, with the proportion of people with obesity varying by 10% or more. This variation is intriguing and suggests the existence of different profiles of risk or protection factors operating in different countries. The identification of such protection factors could indicate suitable targets for interventions to help manage the obesity epidemic in Europe. This report is the output of a 2-day workshop on the ‘Diversity of Obesity in Europe'. The workshop included 14 delegates from 12 different European countries. This report contains the contributions and discussions of the materials and viewpoints provided by these 14 experts; it is not the output of a single mind. However, such is the nature of scientific analysis regarding obesity that it is possible that a different set of 14 experts may have come to a different set of conclusions. Therefore the report should not be seen as a definitive statement of a stable situation. Rather it is a focus for discussion and comment, and a vehicle to drive forward further understanding and management of obesity in Europe.
Comparison of 55° Wide-Field Spectral Domain Optical Coherence Tomography and Conventional 30° Optical Coherence Tomography for the Assessment of Diabetic Macular Edema
Authors: Munk Marion R. , Lincke Joel , Giannakaki-Zimmermann Helena , Ebneter Andreas , Wolf Sebastian , Zinkernagel Martin S.
Published: February 2017

Purpose: To compare conventional 30° spectral domain optical coherence tomography (SD-OCT) with 55° wide-field SD-OCT for the assessment of diabetic macular edema (DME). Methods: This study included 50 DME patients. Both 55° and 30° SD-OCT was conducted. Two readers evaluated scans according to a standardized grading protocol. Intergrader agreement as well as agreement between 30° and 55° SD-OCT were assessed. Results: Intergrader agreement (κ) was strong and ranged from 0.79 to 1.0. Perfect interdevice agreement (κ = 1.0) was found for the detection of intra- and subretinal fluid. Excellent agreement (κ ≥ 0.9) was found for the presence of epiretinal membrane (κ = 0.92) and cotton-wool spots (κ = 0.92). A strong agreement was found for the presence of hard exudates (κ = 0.89) and microaneurysms (κ = 0.81). A moderate correlation was found for ellipsoid zone integrity (κ = 0.69) and configuration of the vitreomacular interface (VMI) (κ = 0.69). A weak agreement was found for retinal pigment epithelium atrophy (κ = 0.51) and external limiting membrane integrity (κ = 0.35). Conclusion: Wide-field OCT imaging may be beneficial for evaluating DME, particularly for assessing the VMI and the integrity of hyperreflective bands.
Clinical Impact of Intrathoracic Herniation of Gastric Tube Pull-Up via the Retrosternal Route following Esophagectomy
Authors: Uemura Norihisa , Abe Tetsuya , Kawakami Jiro , Hosoi Takahiro , Ito Seiji , Shimizu Yasuhiro
Published: February 2017

Background: Intrathoracic herniation of gastric tube (IHGT) pull-up via the retrosternal route is a rare complication following esophagectomy, which is caused due to an injury in the parietal pleura during a blunt dissection of the retrosternal space. However, little is known regarding the clinical impact of IHGT pull-up via the retrosternal route. Patients and Methods: Clinical data of 231 patients receiving gastric tube reconstruction via the retrosternal route following esophagectomy were collected from medical charts. Results: Of the 231 patients, 19 (8%) developed IHGT. Vocal cord palsy, particularly with delayed onset, developed at a significantly high frequency in the group of patients with IHGT. There were no significant differences in the frequency of other surgical complications. Conclusion: This is the first report to examine the clinical impact of IHGT pull-up via the retrosternal route. Vocal cord palsy, particularly with delayed onset, developed in the group of patients with IHGT. Therefore, when reconstruction is performed via the retrosternal route, it is very important that blunt and blind dissection of the retrosternal space be performed with extreme care to prevent pleural injury.
ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: Pathology - Diagnosis and Prognostic Stratification
Authors: Perren Aurel , Couvelard Anne , Scoazec Jean-Yves , Costa Frederico , Borbath Ivan , Delle Fave Gianfranco , Gorbounova Vera , Gross David , Grossman Ashley , Jensen Robert T. , Kulke Matthew , Oberg Kjell , Rindi Guido , Sorbye Halfdan , Welin Staffan ,   all other Antibes Consensus Conference participants
Published: February 2017

The European Neuroendocrine Tumor Society (ENETS) proposed standard of care guidelines for pathology in 2009. Since then, profound changes in the classification have been made, dividing neuroendocrine neoplasia (NEN) into well-differentiated neuroendocrine tumors (NET) and poorly differentiated neuroendocrine carcinomas (NEC) in the 2010 WHO classification. The 7th edition of the TNM classification (2009) included NEN for the first time, widely adapting ENETS proposals but with some differences for NEC and for NET of the pancreas and the appendix. Therapy guidelines for gastroenteropancreatic NET were updated in 2016. The need for an update of the standards of care prompted the ENETS to organize a consensus conference which was held in Antibes in 2015; a working group was designated to propose pathological standards of care.
Ophthalmia Secondary to Cobra Venom Spitting in the Volta Region, Ghana: A Case Report
Authors: Lanzetta Maria Andrea , Cirtita Mihaela , Aziebu Evelyn , Cham Momodou , Lanzetta Paolo
Published: February 2017

Purpose: To report the first case of ophthalmia due to contact with cobra venom in the Volta Region, Ghana. Methods: An ointment containing vitamin A was applied to treat the patient’s unilateral defects in the corneal epithelium and the consequent diminished visual acuity. Results: Healing of the corneal epithelium and improvement of visual acuity were observed after only 1 day. Conclusions: This case suggests that consequences of cases of cobra venom spitting in the eyes can be minimal if immediate treatment is provided.
Lysophosphatidic Acid Promotes Epithelial to Mesenchymal Transition in Ovarian Cancer Cells by Repressing SIRT1
Authors: Ray Upasana , Roy Sib Sankar , Chowdhury Shreya Roy
Published: February 2017

Background/Aims: Epithelial-to-mesenchymal transition (EMT) plays an essential role in the transition from early to invasive phenotype, however the underlying mechanisms still remain elusive. Herein, we propose a mechanism through which the class-III deacetylase SIRT1 regulates EMT in ovarian cancer (OC) cells. Methods: Expression analysis was performed using Q-PCR, western blot, immunofluorescence and fluorescence-IHC study. Matrigel invasion assay was used for the invasion study. Morphological alterations were observed by phalloidin-staining. Co-immunoprecipitation study was performed to analyze protein-protein interaction. Results: Overexpression of SIRT1-WT as well as Resveratrol-mediated SIRT1 activation antagonized the invasion of OC cells by suppressing EMT. SIRT1 deacetylates HIF1α, to inactivate its transcriptional activity. To further validate HIF1α inactivation, its target gene, i.e. ZEB1, an EMT-inducing factor was found to attenuate upon SIRT1 activation. To uncover the regulatory factor governing SIRT1 expression, lysophosphatidic acid (LPA), a highly enriched oncolipid in ascites/serum of OC patients, was found to down-regulate SIRT1 expression. Importantly, LPA was found to induce the mesenchymal switch in OC cells through suppression of SIRT1. Decreased level of SIRT1 was further validated in ovarian tissue samples of OC patients. Conclusion: We have identified a mechanism that relates SIRT1 down-regulation to LPA-induced EMT in OC cells and may open new arenas on developing novel anti-cancer therapeutics.
Panteia: uma imagem verbal
Authors: Rodolpho Melina
Published: February 2017

Analisamos aqui a écfrase de personagem, já que esta é aplicada nos textos fisiognomônicos. Procuramos entender o que é a fisiognomonia e como a teoria fisiognomônica contribui para a composição de retratos por meio da análise da écfrase de Filóstrato do livro II, 9 em Imagens, texto em que retrata a aparência de Panteia por meio do ethos já conhecido da personagem. O tratado fisiognomônico adotado como base para a análise do retrato de Panteia é o De Physiognomonia Liber (IV d.C.), de autoria anônima.
Performance das Histórias: testemunhos tardios (Luciano de Samósata, Heródoto ou Aécion)
Authors: Ribeiro Tatiana
Published: February 2017

Proposta de tradução de Heródoto ou Aécion, de Luciano de Samósata.
“Para que deleite a visão e os olhos” (Tácito, Diálogo dos Oradores 22): ékphrasis ou descrição na historiografia taciteana
Authors: Belchior Ygor K.
Published: February 2017

Neste artigo temos como objetivo observar a ékphrasis na historiografia Taciteana a partir da hipótese de que a sua principal função era a de gerar o efeito de “visibilidade” e de “prova”. Para tanto, focaremos no quadro metafórico da guerra civil empregado pelo historiador para descrever os conflitos entre a aristocracia e o imperador como “provas inartísticas” de que os eventos decorreram daquela maneira e ao mesmo tempo em que evidenciam o modelo histórico empregado por Tácito.
As virtudes da narratio no De oratore de Cícero
Authors: Dibbern Cynthia Helena
Published: February 2017

Este breve trabalho tem por objetivo analisar o tratamento das virtudes da narratio – a clareza, a brevidade e a verossimilhança – no diálogo De oratore, de Cícero, verificando quais as semelhanças e diferenças com relação à preceituação sobre esta parte do discurso nos manuais de retórica Da inventione, obra anterior do próprio Cícero, e Retórica a Herênio, de autor desconhecido. Através desta comparação, será possível contrastar a proposta retórica de Cícero do De Oratore com a retórica escolar e tecnicista dos manuais, tão criticada pelas personagens do diálogo. Cícero parece colocar a brevidade e a clareza em tensão, e recomendar uma clareza mais próxima da illustratio, que, além de deleitar, comove ao dispor diante dos olhos o acontecido, sendo aliada, assim, da terceira virtude, a do provável e verossímil.
Considerações acerca do êthos germânico na Germania de Tácito
Authors: Fiebig Henrique Verri
Published: February 2017

Propõe-se neste estudo uma reflexão acerca do êthos das populações germânicas na primeira seção da Germania de Públio Cornélio Tácito. Considerando que êthos pode ser entendido como uma construção que reúne elementos tanto intradiscursivos quanto extradiscursivos, sugere-se que a construção deste êthos germânico obedece tanto aos lugares-comuns do gênero epidítico da retórica, os quais podem ser relacionados aos topoi do gênero etnográfico identificados pelos estudiosos modernos, quanto à expectativa de uma recepção condicionada aos estereótipos correntes acerca do bárbaro do Norte.
MiR30‐GALNT1/2 Axis‐Mediated Glycosylation Contributes to the Increased Secretion of Inactive Human Prohormone for Brain Natriuretic Peptide (proBNP) From Failing Hearts
Authors: Nakagawa Yasuaki , Nishikimi Toshio , Kuwahara Koichiro , Fujishima Aoi , Oka Shogo , Tsutamoto Takayoshi , Kinoshita Hideyuki , Nakao Kazuhiro , Cho Kosai , Inazumi Hideaki , Okamoto Hiroyuki , Nishida Motohiro , Kato Takao , Fukushima Hiroyuki , Yamashita Jun K. , Wijnen Wino J. , Creemers Esther E. , Kangawa Kenji , Minamino Naoto , Nakao Kazuwa , Kimura Takeshi
Published: February 2017

Background

Recent studies have shown that plasma levels of the biologically inactive prohormone for brain natriuretic peptide (pro
BNP
) are increased in patients with heart failure. This can contribute to a reduction in the effectiveness of circulating
BNP
and exacerbate heart failure progression. The precise mechanisms governing the increase in pro
BNP
remain unclear, however.

Methods and Results

We used our recently developed, highly sensitive human pro
BNP
assay system to investigate the mechanisms underlying the increase in plasma pro
BNP
levels. We divided 53 consecutive patients hospitalized with heart failure into 2 groups based on their aortic plasma levels of immunoreactive
BNP
. Patients with higher levels exhibited more severe heart failure, a higher proportion of pro
BNP
among the immunoreactive
BNP
forms secreted from failing hearts, and a weaker effect of
BNP
as estimated from the ratio of plasma cyclic guanosine monophosphate levels to log‐transformed plasma
BNP
levels. Glycosylation at threonines 48 and 71 of human pro
BNP
contributed to the increased secretion of pro
BNP
by attenuating its processing, and Gal
NA
c‐transferase (
GALNT
) 1 and 2 mediated the glycosylation‐regulated increase in cardiac human pro
BNP
secretion. Cardiac
GALNT
1 and 2 expression was suppressed by micro
RNA
(miR)‐30, which is abundantly expressed in the myocardium of healthy hearts, but is suppressed in failing hearts.

Conclusions

We have elucidated a novel miR‐30‐
GALNT
1/2 axis whose dysregulation increases the proportion of inactive pro
BNP
secreted by the heart and impairs the compensatory actions of
BNP
during the progression of heart failure.
Frailty, Physical Activity, and Mobility in Patients With Cardiac Implantable Electrical Devices
Authors: Kramer Daniel B. , Tsai Timothy , Natarajan Poorna , Tewksbury Elise , Mitchell Susan L. , Travison Thomas G.
Published: February 2017

Background

This study aimed to demonstrate the feasibility of measuring frailty in patients with cardiac implantable electrical devices while validating the physiologic significance of device‐detected physical activity by evaluating its association with frailty and mobility.

Methods and Results

Outpatients with cardiac implantable electrical devices compatible with physical activity analysis with at least 7 days of data were eligible. Office testing included frailty status (Study of Osteoporotic Fractures instrument), gait speed (m/s), mobility according to the Timed Up and Go (
TUG
) test (seconds), and daily physical activity (h/d) as measured by cardiac implantable electrical device. Among 219 patients, Study of Osteoporotic Fractures testing found 39.7% to be robust, 47.5% prefrail, and 12.8% frail. The mean gait speed for the cohort was 0.8±0.3 m/s, mean
TUG
time was 10.9±4.4 seconds, and mean activity was 2.8±1.9 h/d. Frail patients were markedly more likely to have gait speeds <0.8 m/s (
OR
6.25, 95%
CI
1.79‐33.3). In unadjusted analyses each 1‐hour increase in mean daily activity was associated with a 46% reduction of frail phenotype (
OR
0.54, 95%
CI
0.40‐0.74) versus robust and with a 27% reduction in the odds of having the prefrail phenotype (
OR
0.73, 95%
CI
0.62‐0.86). After adjustment this association per hour of activity persisted, with an adjusted
OR
for frailty of 0.71 (95%
CI
0.51‐0.99) and adjusted
OR
for prefrailty of 0.81 (95%
CI
0.67‐0.99).

Conclusions

Frailty and mobility limitation are common among cardiac implantable electrical device patients and are correlated to device‐detected physical activity.