bluuebunny/crossref_metadata_2025 huggingface dataset:
Time Series Imputation via L1 Norm-Based Singular Spectrum Analysis
Authors: Kalantari Mahdi , Yarmohammadi Masoud , Hassani Hossein , Silva Emmanuel Sirimal
Published: March 2018

Missing values in time series data is a well-known and important problem which many researchers have studied extensively in various fields. In this paper, a new nonparametric approach for missing value imputation in time series is proposed. The main novelty of this research is applying the [Formula: see text] norm-based version of Singular Spectrum Analysis (SSA), namely [Formula: see text]-SSA which is robust against outliers. The performance of the new imputation method has been compared with many other established methods. The comparison is done by applying them to various real and simulated time series. The obtained results confirm that the SSA-based methods, especially [Formula: see text]-SSA can provide better imputation in comparison to other methods.
Three-Layer Supply Chain Production/By-Production Inventory Model Under Fuzzy Rough Environment
Authors: Ghosh Prasanta Kr , Hazari Samar , Dey Jayanta Kumar , Kar Samarjit
Published: March 2018

An integrated three-layer supply chain model for production and by-production system is formulated under fuzzy-rough (Fu-Ro)-environment. At first, supplier receives the deteriorating items in a lot and supplies the fresh units to manufacturer for production. Manufacturer has two plants: plant-1 and plant-2. Manufacturer purchases these fresh raw materials at a constant rate from supplier to produce the main product in plant-1. Retailer-I has purchased this product from manufacturer of plant-1 to sale to the customers. The residue units of plant-1 have transferred to plant-2 with constant rate to manufacture another usable by-product. Retailer-II purchases this usable by-product and sales to the customers. Ideal costs of supplier, manufacturer and retailer have been taken into account. By-production of residue units of plant-1 not only minimizes the environmental pollution, but also gives some return to the manufacturer. Due to the complexity of environment, inventory holding costs, idle costs and setup costs are considered as Fu-Ro type and these are reduced to crisp ones using Fu-Ro expectation. Supply rate, production and by-production rates are assumed as decision variables. Integrated model has been developed and solved analytically in crisp and Fu-Ro environments to find the optimum value of the decision variables and corresponding individual profits of the members of the supply chain are calculated numerically and graphically. Finally, the model has been realized with a case study of sugar mill.
A Checkpoint of Research on Parallel I/O for High-Performance Computing
Authors: Boito Francieli Zanon , Inacio Eduardo C. , Bez Jean Luca , Navaux Philippe O. A. , Dantas Mario A. R. , Denneulin Yves
Published: March 2018

We present a comprehensive survey on parallel I/O in the high-performance computing (HPC) context. This is an important field for HPC because of the historic gap between processing power and storage latency, which causes application performance to be impaired when accessing or generating large amounts of data. As the available processing power and amount of data increase, I/O remains a central issue for the scientific community. In this survey article, we focus on a traditional I/O stack, with a POSIX parallel file system. We present background concepts everyone could benefit from. Moreover, through the comprehensive study of publications from the most important conferences and journals in a 5-year time window, we discuss the state of the art in I/O optimization approaches, access pattern extraction techniques, and performance modeling, in addition to general aspects of parallel I/O research. With this approach, we aim at identifying the general characteristics of the field and the main current and future research topics.
Deterministic Truncation of Linear Matroids
Authors: Lokshtanov Daniel , Misra Pranabendu , Panolan Fahad , Saurabh Saket
Published: March 2018

Let
M
=(
E
,
I
) be a matroid of rank
n
. A
k
-
truncation
of
M
is a matroid
M
′
=(
E
,
I
′
) such that for any
A
⊆
E
,
A
∈ ∈
I
′
if and only if |
A
|≤
k
and
A
∈
I
. Given a linear representation,
A
, of
M
, we consider the problem of finding a linear representation,
A

k

, of the
k
-truncation of
M
. A common way to compute
A

k

is to multiply the matrix
A
with a random
k
×
n
matrix, yielding a simple randomized algorithm. Thus, a natural question is whether we can compute
A

k

deterministically
. In this article, we settle this question for matrices over any field in which the field operations can be done efficiently. This includes any finite field and the field of rational numbers (Q).

Our algorithms are based on the properties of the classical Wronskian determinant, and the folded Wronskian determinant, which was recently introduced by Guruswami and Kopparty [23, 24] and Forbes and Shpilka [14]. Our main conceptual contribution in this article is to show that the Wronskian determinant can also be used to obtain a representation of the truncation of a linear matroid in deterministic polynomial time. An important application of our result is a deterministic algorithm to compute representative sets over linear matroids, which derandomizes a result of Fomin et al. [11, 12]. This result derandomizes several parameterized algorithms, including an algorithm for ℓ-M
atroid
P
arity
to which several problems, such as ℓ-M
atroid
I
ntersection
, can be reduced.
Fluids of the Lower Crust: Deep Is Different
Authors: Manning Craig E.
Published: March 2018

Deep fluids are important for the evolution and properties of the lower continental and arc crust in tectonically active settings. They comprise four components: H2O, nonpolar gases, salts, and rock-derived solutes. Contrasting behavior of H2O-gas and H2O-salt mixtures yields immiscibility and potential separation of phases with different chemical properties. Equilibrium thermodynamic modeling of fluid-rock interaction using simple ionic species known from shallow-crustal systems yields solutions too dilute to be consistent with experiments and resistivity surveys, especially if CO2is added. Therefore, additional species must be present, and H2O-salt solutions likely explain much of the evidence for fluid action in high-pressure settings. At low salinity, H2O-rich fluids are powerful solvents for aluminosilicate rock components that are dissolved as polymerized clusters. Addition of salts changes solubility patterns, but aluminosilicate contents may remain high. Fluids with Xsalt= 0.05 to 0.4 in equilibrium with model crustal rocks have bulk conductivities of 10−1.5to 100 S/m at porosity of 0.001. Such fluids are consistent with observed conductivity anomalies and are capable of the mass transfer seen in metamorphic rocks exhumed from the lower crust.
Induced Seismicity
Authors: Keranen Katie M. , Weingarten Matthew
Published: March 2018

The ability of fluid-generated subsurface stress changes to trigger earthquakes has long been recognized. However, the dramatic rise in the rate of human-induced earthquakes in the past decade has created abundant opportunities to study induced earthquakes and triggering processes. This review briefly summarizes early studies but focuses on results from induced earthquakes during the past 10 years related to fluid injection in petroleum fields. Study of these earthquakes has resulted in insights into physical processes and has identified knowledge gaps and future research directions. Induced earthquakes are challenging to identify using seismological methods, and faults and reefs strongly modulate spatial and temporal patterns of induced seismicity. However, the similarity of induced and natural seismicity provides an effective tool for studying earthquake processes. With continuing development of energy resources, increased interest in carbon sequestration, and construction of large dams, induced seismicity will continue to pose a hazard in coming years.
The Spiral Discovery Network as an Automated General‐Purpose Optimization Tool
Authors: Csapo Adam B.
Published: March 2018

The Spiral Discovery Method (SDM) was originally proposed as a cognitive artifact for dealing with black‐box models that are dependent on multiple inputs with nonlinear and/or multiplicative interaction effects. Besides directly helping to identify functional patterns in such systems, SDM also simplifies their control through its characteristic spiral structure. In this paper, a neural network‐based formulation of SDM is proposed together with a set of automatic update rules that makes it suitable for both semiautomated and automated forms of optimization. The behavior of the generalized SDM model, referred to as the Spiral Discovery Network (SDN), and its applicability to nondifferentiable nonconvex optimization problems are elucidated through simulation. Based on the simulation, the case is made that its applicability would be worth investigating in all areas where the default approach of gradient‐based backpropagation is used today.
Diagnosis and Management of Ovarian Tumor in Mayer-Rokitansky-Küster-Hauser (MRKH) Syndrome
Authors: Miao Yali , Wen Jirui , Huang Liwei , Wu Jiang , Zhao Zhiwei
Published: March 2018

In the most recent publications on Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, the uterine remnants and ovaries in patients may develop uterine remnant leiomyoma, adenomyosis, or ovarian tumor, and this can lead to problems in differential diagnosis. Here we summarize the diagnosis methods and available interventions for ovarian tumor in MRKH syndrome, with emphasis on the relevant clinical findings and illustrative relevant case. According to the clinical findings and illustrative relevant case, with the help of imaging techniques, ovarian tumors can be detected in the pelvis in patients with MRKH syndrome and evaluated in terms of size. Laparoscopy could further differentiate ovarian tumors into different pathological types. In addition, laparoscopic surgery not only is helpful for the diagnosis of MRKH combined ovarian tumor, but also has a good treatment role for excising ovarian tumor at the same time. Moreover, laparoscopic removals of ovarian tumor can be considered as a safe and reliable treatment for conservative management.
Gravitational Lensing of Charged Ayon-Beato-Garcia Black Holes and Nonlinear Effects of Maxwell Fields
Authors: Ghaffarnejad H. , Amirmojahedi M. , Niad H.
Published: March 2018

Nonsingular Ayon-Beato-Garcia (ABG) spherically symmetric static black hole (BH) with charge to mass ratio q=g/2m is metric solution of Born Infeld nonlinear Maxwell-Einstein theory. Central region of the BH behaves as (anti-)de Sitter for (|q|>1)  |q|<1. In the case where |q|=1, the BH central region behaves as Minkowski flat metric. Nonlinear Electromagnetic (NEM) fields counterpart causes deviation of light geodesics and so light rays will be forced to move on from effective metric. In this paper we study weak and strong gravitational lensing of light rays by seeking effects of NEM fields counterpart on image locations and corresponding magnification. We set our calculations to experimentally observed Sgr A⁎ BH. In short we obtained the following: for large distances, the NEM counterpart is negligible and it reduces to linear Maxwell fields. The NEM field enlarges radius of the BH photon sphere linearly by raising |q|>1 but decreases by raising |q|≤1. Sign of deflection angle of bending light rays is changed in presence of NEM effects with respect to ones obtained in absence of NEM fields. Absolute value of deflection angle rises by increasing |q|→1. Image locations in weak deflection limit (WDL) decrease (increases) by raising 0<|q|<1 in presence (absence) of NEM fields. By raising the closest distance of the bending light rays image locations in WDL change from left (right) to right (left) in absence (presence) of NEM fields. In WDL, radius of Einstein rings and corresponding magnification centroid become larger (smaller) in presence (absence) of NEM fields. Angular separation called s between the innermost and outermost relativistic images increases (decreases) by increasing 0<|q|<1 in absence (presence) of NEM fields. Corresponding magnification r decreases (increases) by raising 0<|q|<1 in absence (presence) of NEM fields.
Statistical Analysis of Wind‐Induced Dynamic Response of Power Towers and Four‐Circuit Transmission Tower‐Line System
Authors: Zhang Xiaolei , Ju Yanzhong , Wang Fuwang
Published: March 2018

Only one wind field model loading the transmission tower or the tower‐line system was investigated in the previous studies, while the influence of two different wind field models was not considered. In addition, only one sample of the wind speed random process was used in the past numerical simulations, and the multiple dynamic response statistical analysis should be carried out. In this paper, statistical analysis of the wind‐induced dynamic response of single towers and the transmission tower‐line system is performed with the improved accuracy. A finite element model of the transmission tower‐line system (the tower consisted of both steel tubes and angel steels) is established by ANSYS software. The analysis was performed by three statistical methods. The effects of the length of the time history and of the number of samples were investigated. The frequency histograms of samples follow the Gaussian distribution. The characteristic statistical parameters of samples were random. The displacements and the axial forces of the low tower are larger than those of the high tower. Two wind field models were applied to simulate the wind speed time history. In field 1 model, Davenport wind speed spectrum and Shiotani coherence function were applied, while in field 2 model Kaimal wind speed spectrum and Davenport coherence function were used. The results indicate that wind field 1 is calmer than wind field 2. The displacements and the axial forces of the tower‐line system are less than those of single towers, which indicate damping of wind‐induced vibrations by the transmission line. An extended dynamic response statistical analysis should be carried out for the transmission tower‐line system.
Predictors of Broad Dimensions of Psychopathology among Patients with Panic Disorder after Cognitive-Behavioral Therapy
Authors: Ogawa Sei , Kondo Masaki , Ino Keiko , Imai Risa , Ii Toshitaka , Furukawa Toshi A. , Akechi Tatsuo
Published: March 2018

Background. Many patients with panic disorder meet criteria for at least one other diagnosis, most commonly other anxiety or mood disorders. Cognitive-behavioral therapy is the best empirically supported psychotherapy for panic disorder. There is now evidence indicating that cognitive-behavioral therapy for panic disorder yields positive benefits upon comorbid disorders.Objectives. The present study aimed to examine the predictors of broad dimensions of psychopathology in panic disorder after cognitive-behavioral therapy.Methods. Two hundred patients affected by panic disorder were treated with manualized group cognitive-behavioral therapy. We examined if the baseline personality dimensions of NEO Five Factor Index predicted the subscales of Symptom Checklist-90 Revised at endpoint using multiple regression analysis based on the intention-to-treat principle.Results. Conscientiousness score of NEO Five Factor Index at baseline was a predictor of four Symptom Checklist-90 Revised subscales including obsessive-compulsive (β=-0.15,P<0.01), depression (β=-0.13,P<0.05), phobic anxiety (β=-0.15,P<0.05), and Global Severity Index (β=-0.13,P<0.05).Conclusion. Conscientiousness at baseline may predict several dimensions of psychopathology in patients with panic disorder after cognitive-behavioral therapy. For the purpose of improving a wide range of psychiatric symptoms with patients affected by panic disorder, it may be useful to pay more attention to this personal trait at baseline.
Polyphenol Content, Physicochemical Properties, Enzymatic Activity, Anthocyanin Profiles, and Antioxidant Capacity ofCerasus humilis(Bge.) Sok. Genotypes
Authors: Liu Suwen , Li Xiaoying , Guo Zhaoyuan , Zhang Xuan , Chang Xuedong
Published: March 2018

Seven varieties of Chinese dwarf cherries were evaluated and compared with respect to their weight, diameter, titratable acidity, total soluble solids, color, polyphenol contents, ascorbic acid levels, anthocyanin profiles, enzymatic activity, and antioxidant capacity. The fruits are rich in phenolic content (339.07–770.30 mg/100 g fresh weight). Nine anthocyanins were obtained from fruits after chromatographic separation and their structures analyzed using HPLC-ESI-MS/MS. Cyanidin-3-glucoside was the major anthocyanin with 50.36–78.39% concentration. Three anthocyanins were reported for the first time in these cherries. They exhibit low polyphenol oxidase and peroxidase activities, but their superoxide dismutase activity is high (572.75–800.17 U/g FW). The highest amounts of soluble solid content (15.67 Brix %), total titratable acid (1.90%), ascorbic acid (18.47 mg/100 g FW), and total anthocyanin (152.66 mg/100 g FW) were observed. Three methods (DPPH-scavenging ability, oxygen radical absorbance capacity assay, and cellular antioxidant activity assay) were employed to evaluate the antioxidant capacity of the phenolic extracts of these cherries. Number 5 has the highest values of ORAC and CAA of 205.68 μmol TE/g DM and 99.67 μmol QE/100 g FW, respectively.
Risk Factors for Failure of Direct Current Cardioversion in Patients with Type 2 Diabetes Mellitus and Atrial Fibrillation
Authors: Soran Handrean , Banerjee Moulinath , Mohamad Jamal B. , Adam Safwaan , Ho Jan Hoong , Ismaeel Shakawan M. , Dhage Shaishav , Syed Akheel A. , Abdulla Ibrahem M. A. , Younis Naveed , Malik Rayaz A.
Published: March 2018

Introduction. Type 2 diabetes mellitus (T2DM) is a well-recognised risk factor for cardiovascular disease and the prevalence of atrial fibrillation (AF) is higher among patients with T2DM. Direct current cardioversion (DCCV) is an important management option in persistent AF. We sought to determine independent risk factors for immediate and short-term outcomes of DCCV for treatment of AF in patients with T2DM. Methods. Retrospective outcome analysis of DCCV for persistent AF in 102 T2DM patients compared with 102 controls. Results. DCCV was successful in 68 (66.6%) people with T2DM compared to 86 (84.3%) in the control group (P=0.003). After initial successful cardioversion, only 38 (37.2%) T2DM patients remained in sinus rhythm compared to 63 (61.8%) in the control group (P=0.007) at a median follow-up of 74.5 days (IQR 69.4–77.4). Multiple logistic regression analysis showed that the presence of T2DM (P=0.014), digoxin use (P=0.01), statin use (P=0.005), left-atrial size (P=0.01), and LV ejection fraction (P=0.008) were independent risk factors for immediate DCCV failure. T2DM (P=0.034) was an independent risk factor for AF relapse. Among patients with T2DM, previous DCCV (P=0.033), digoxin use (P=0.035), left-atrial size (P=0.01), LV ejection fraction (P=0.036), and HbA1c (P=0.011) predicted immediate failure of DCCV whilst digoxin use (P=0.026) was an independent risk factor for relapse of AF. Conclusion. T2DM, higher HbA1c, digoxin treatment, and structural and functional cardiac abnormalities are independent risk factors for immediate DCCV failure and AF relapse.
The Parallel Algorithm Based on Genetic Algorithm for Improving the Performance of Cognitive Radio
Authors: Miao Liu , Sun Zhenxing , Jie Zhang
Published: March 2018

The intercarrier interference (ICI) problem of cognitive radio (CR) is severe. In this paper, the machine learning algorithm is used to obtain the optimal interference subcarriers of an unlicensed user (un‐LU). Masking the optimal interference subcarriers can suppress the ICI of CR. Moreover, the parallel ICI suppression algorithm is designed to improve the calculation speed and meet the practical requirement of CR. Simulation results show that the data transmission rate threshold of un‐LU can be set, the data transmission quality of un‐LU can be ensured, the ICI of a licensed user (LU) is suppressed, and the bit error rate (BER) performance of LU is improved by implementing the parallel suppression algorithm. The ICI problem of CR is solved well by the new machine learning algorithm. The computing performance of the algorithm is improved by designing a new parallel structure and the communication performance of CR is enhanced.
Evaluation of Skeletal Muscle Function and Effects of Early Rehabilitation during Acute Heart Failure: Rationale and Study Design
Authors: Węgrzynowska-Teodorczyk Kinga , Siennicka Agnieszka , Josiak Krystian , Zymliński Robert , Kasztura Monika , Banasiak Waldemar , Ponikowski Piotr , Woźniewski Marek
Published: March 2018

Background. Acute heart failure (AHF) is associated with disturbances of the peripheral perfusion leading to the dysfunction of many organs. Consequently, an episode of AHF constitutes a “multiple organ failure” which may also affect the skeletal muscles. However, the abnormalities within skeletal muscles during AHF have not been investigated so far. The aim of this project is to comprehensively evaluate skeletal muscles (at a functional and tissue level) during AHF. Methods. The study will include ≥63 consecutive AHF patients who will be randomized into 2 groups: ≥42 with cardiac rehabilitation group versus ≥21 with standard pharmacotherapy alone. The following tests will be conducted on the first and last day of hospitalization, at rest and after exercise, and 30 days following the discharge: clinical evaluation, medical interview, routine physical examination, echocardiography, and laboratory tests (including the assessment of NT-proBNP, inflammatory markers, and parameters reflecting the status of the kidneys and the liver); hemodynamic evaluation, noninvasive determination of cardiac output and systemic vascular resistance using the impedance cardiography; evaluation of biomarkers reflecting myocyte damage, immunochemical measurements of tissue-specific enzymatic isoforms; evaluation of skeletal muscle function, using surface electromyography (sEMG) (maximum tonus of the muscles will be determined along with the level of muscular fatigability); evaluation of muscle tissue perfusion, assessed on the basis of the oxygenation level, with noninvasive direct continuous recording of perfusion in peripheral tissues by local tissue oximetry, measured by near-infrared spectroscopy (NIRS). Results and Conclusions. Our findings will demonstrate that the muscle tissue is another area of the body which should be taken into consideration in the course of treatment of AHF, requiring a development of targeted therapeutic strategies, such as a properly conducted rehabilitation.
A Numerical Algorithm for Solving Higher‐Order Nonlinear BVPs with an Application on Fluid Flow over a Shrinking Permeable Infinite Long Cylinder
Authors: Al Sakkaf Laila Y. , Al-Mdallal Qasem M. , Al Khawaja U.
Published: March 2018

We present an efficient iterative power series method for nonlinear boundary‐value problems that treats the typical divergence problem and increases arbitrarily the radius of convergence. This method is based on expanding the solution around an iterative initial point. We employ this method to study the unsteady, viscous, and incompressible laminar flow and heat transfer over a shrinking permeable cylinder. More precisely, we solve the unsteady nonlinear Navier–Stokes and energy equations after reducing them to a system of nonlinear boundary‐value problems of ordinary differential equations. The present method successfully captures dual solutions for both the flow and heat transfer fields and a unique solution at a specific critical unsteadiness parameter. Comparisons with previous numerical methods and an exact solution verify the validity, accuracy, and efficiency of the present method.
Doctors’ Knowledge of Hypertension Guidelines Recommendations Reflected in Their Practice
Authors: Ahmad Nafees , Khan Amer Hayat , Khan Irfanullah , Khan Amjad , Atif Muhammad
Published: March 2018

Aim. To evaluate doctors’ knowledge, attitude, and practices and predictors of adherence to Malaysian hypertension guidelines (CPG 2008). Methods. Twenty-six doctors involved in hypertension management at Penang General Hospital were enrolled in a cross-sectional study. Doctors’ knowledge and attitudes towards guidelines were evaluated through a self-administered questionnaire. Their practices were evaluated by noting their prescriptions written to 520 established hypertensive outpatients (20 prescriptions/doctor). SPSS 17 was used for data analysis. Results. Nineteen doctors (73.07%) had adequate knowledge of guidelines. Specialists and consultants had significantly better knowledge about guidelines’ recommendations. Doctors were positive towards guidelines with mean attitude score of 23.15±1.34 points on a 30-point scale. The median number of guidelines compliant prescriptions was 13 (range 5–20). Statistically significant correlation (rs = 0.635, P<0.001) was observed between doctors’ knowledge and practice scores. A total of 349 (67.1%) prescriptions written were guidelines compliant. In multivariate analysis hypertension clinic (OR = 0.398, P=0.008), left ventricular hypertrophy (OR = 0.091, P=0.001) and heart failure (OR = 1.923, P=0.039) were significantly associated with guidelines adherence. Conclusion. Doctors’ knowledge of guidelines is reflected in their practice. The gap between guidelines recommendations and practice was seen in the pharmacotherapy of uncomplicated hypertension and hypertension with left ventricular hypertrophy, renal disease, and diabetes mellitus.
Single Stage Nipple-Sparing Mastectomy and Reduction Mastopexy in the Ptotic Breast
Authors: Pontell M. E. , Saad N. , Brown A. , Rose M. , Ashinoff R. , Saad A.
Published: March 2018

Purpose. Given the proposed increased risk of nipple-areolar complex (NAC) necrosis, nipple-sparing mastectomy (NSM) is generally not recommended for patients with large or significantly ptotic breasts. NAC preserving strategies in this subgroup include staged or simultaneous NSM and reduction mastopexy. We present a novel approach towards simultaneous NSM and reduction mastopexy in patients with large, ptotic breasts. Methods. Literature pertaining to NSM for women with large, ptotic breasts was reviewed and a surgical approach was designed to allow for simultaneous NSM and reduction mastopexy in such patients. Results. Eight patients underwent bilateral NSM with simultaneous reduction mammaplasty and immediate reconstruction. The majority of breasts demonstrated advanced ptosis (69% grade III, 31% grade II) and the average breast volume excised was 760 grams. In those patients without a history of smoking, NAC necrosis rates were 0%. In those patients with a history of smoking, 83% of breasts experienced NAC necrosis (60% total, 40% partial). One hundred percent of patients who smoked experienced some degree of NAC necrosis. Among breasts with grade II versus grade III ptosis, NAC necrosis rates were roughly equal. Conclusions. Historically, patients with large, ptotic breasts were excluded from NSM due to the proposed increased risk of NAC necrosis. This study demonstrates a safe approach towards NSM and reduction mastopexy using an inferior, wide-based, epithelialized pedicle. While all patients eventually achieved satisfactory results, there was an association between smoking and NAC necrosis. Smoking cessation is paramount to the operation’s success.
Establishing Differences in Thermographic Patterns between the Various Complications in Diabetic Foot Disease
Authors: Gatt Alfred , Falzon Owen , Cassar Kevin , Ellul Christian , Camilleri Kenneth P. , Gauci Jean , Mizzi Stephen , Mizzi Anabelle , Sturgeon Cassandra , Camilleri Liberato , Chockalingam Nachiappan , Formosa Cynthia
Published: March 2018

Aim. To evaluate the potential of thermography as an assessment tool for the detection of foot complications by understanding the variations in temperature that occur in type 2 diabetes mellitus (DM). Methods. Participants were categorized according to a medical examination, ankle brachial index, doppler waveform analysis, and 10-gram monofilament testing into five groups: healthy adult, DM with no complications, DM with peripheral neuropathy, DM with neuroischaemia, and DM with peripheral arterial disease (PAD) groups. Thermographic imaging of the toes and forefeet was performed. Results. 43 neuroischaemic feet, 41 neuropathic feet, 58 PAD feet, 21 DM feet without complications, and 126 healthy feet were analyzed. The temperatures of the feet and toes were significantly higher in the complications group when compared to the healthy adult and DM healthy groups. The higher the temperatures of the foot in DM, the higher the probability that it is affected by neuropathy, neuroischaemia, or PAD. Conclusions. Significant differences in mean temperatures exist between participants who were healthy and those with DM with no known complications when compared to participants with neuroischaemia, neuropathy, or PAD. As foot temperature rises, so does the probability of the presence of complications of neuropathy, neuroischaemia, or peripheral arterial disease.
Biomarkers of Rehabilitation Therapy Vary according to Stroke Severity
Authors: Quinlan Erin Burke , Dodakian Lucy , See Jill , McKenzie Alison , Stewart Jill Campbell , Cramer Steven C.
Published: March 2018

Biomarkers that capture treatment effects could improve the precision of clinical decision making for restorative therapies. We examined the performance of candidate structural, functional, and angiogenesis-related MRI biomarkers before and after a 3-week course of standardized robotic therapy in 18 patients with chronic stroke and hypothesized that results vary significantly according to stroke severity. Patients were 4.1 ± 1 months poststroke, with baseline arm Fugl-Meyer scores of 20–60. When all patients were examined together, no imaging measure changed over time in a manner that correlated with treatment-induced motor gains. However, when also considering the interaction with baseline motor status, treatment-induced motor gains were significantly related to change in three functional connectivity measures: ipsilesional motor cortex connectivity with (1) contralesional motor cortex (p=0.003), (2) contralesional dorsal premotor cortex (p=0.005), and (3) ipsilesional dorsal premotor cortex (p=0.004). In more impaired patients, larger treatment gains were associated with greater increases in functional connectivity, whereas in less impaired patients larger treatment gains were associated with greater decreases in functional connectivity. Functional connectivity measures performed best as biomarkers of treatment effects after stroke. The relationship between changes in functional connectivity and treatment gains varied according to baseline stroke severity. Biomarkers of restorative therapy effects are not one-size-fits-all after stroke.
Targeted Neuromodulation of Abnormal Interhemispheric Connectivity to Promote Neural Plasticity and Recovery of Arm Function after Stroke: A Randomized Crossover Clinical Trial Study Protocol
Authors: Borich Michael R. , Wolf Steven L. , Tan Andrew Q. , Palmer Jacqueline A.
Published: March 2018

Background. Despite intensive rehabilitation efforts, most stroke survivors have persistent functional disability of the paretic arm and hand. These motor impairments may be due in part to maladaptive changes in structural and functional connections between brain regions. The following early stage clinical trial study protocol describes a noninvasive brain stimulation approach to target transcallosally mediated interhemispheric connections between the ipsi- and contralesional motor cortices (iM1 and cM1) using corticocortical paired associative stimulation (ihPAS). This clinical trial aims to characterize ihPAS-induced modulation of interhemispheric connectivity and the effect on motor skill performance and learning in chronic stroke survivors.Methods/Design. A repeated-measures, cross-over design study will recruit 20 individuals post-stroke with chronic mild–moderate paretic arm impairment. Each participant will complete an active ihPAS and control ihPAS session. Assessments of cortical excitability and motor skill performance will be conducted prior to and at four time points following the ihPAS intervention. The primary outcome measures will be: TMS-evoked interhemispheric motor connectivity, corticomotor excitability, and response time on a modified serial reaction time task.Discussion/Conclusion. The findings from this single-site early stage clinical trial will provide foundational results to inform the design of larger-scale, multisite clinical trials to evaluate the therapeutic potential of ihPAS-based neuromodulation for upper limb recovery after stroke. This trial is registered withNCT02465034.
High p95HER2/HER2 Ratio Associated With Poor Outcome in Trastuzumab-Treated HER2-Positive Metastatic Breast Cancer NCCTG N0337 and NCCTG 98-32-52 (Alliance)
Authors: Chumsri Saranya , Sperinde Jeff , Liu Heshan , Gligorov Joseph , Spano Jean-Philippe , Antoine Martine , Moreno Aspitia Alvaro , Tan Winston , Winslow John , Petropoulos Christos J. , Chenna Ahmed , Bates Michael , Weidler Jodi Marie , Huang Weidong , Dueck Amylou , Perez Edith A.
Published: March 2018

Purpose: p95HER2 is a truncated form of HER2 that confers resistance to trastuzumab in vitro, but clinical results have been conflicting to date. Given that p95HER2 levels correlate with total HER2 expression levels, which confer better outcomes, we sought to evaluate the p95HER2/HER2 ratio in the North Central Cancer Treatment Group N0337 and N98-32-52 trials.

Experimental Design: The HERmark assay and VeraTag technology (Monogram Biosciences) were used to measure total HER2 and p95HER2 expression levels in 91 patient samples.

Results: In the multivariate model, increasing total HER2 level was significantly associated with longer (OS; HR, 0.33; P = 0.002) and decreasing p95HER2 level was significantly associated with longer OS (HR, 4.2; P = 0.01). Total HER2 expression level was significantly associated with longer progression-free survival (PFS) (HR, 0.57; P = 0.04), whereas p95HER2 level was not (HR, 1.7; P = 0.25). However, there was a positive association between p95HER2 and total HER2 expression levels (R2 = 0.48; P < 0.001). Consistent with our hypothesis, the ratio of p95HER2/HER2 was significantly associated with worsening PFS (HR, 1.7; P = 0.04) and OS (HR, 2.8; P = 0.002). Patients with the highest tertile of p95HER2/HER2 values had significantly less favorable PFS (HR, 1.8; P = 0.06) and OS (HR, 2.3; P = 0.02).

Conclusions: A high p95HER2/HER2 ratio identified patients with metastatic breast cancer with poor outcomes on trastuzumab-based therapies. Further investigation of the p95HER2/HER2 ratio as a potential prognostic or predictive biomarker for HER2-targeted therapy is warranted. Clin Cancer Res; 24(13); 3053–8. ©2018 AACR.
Novel Mutations in the PKD1 and PKD2 Genes of Chinese Patients with Autosomal Dominant Polycystic Kidney Disease
Authors: Xu Dechao , Ma Yiyi , Gu Xiangchen , Bian Rongrong , Lu Yunhui , Xing Xiaohong , Mei Changlin
Published: March 2018

Background/Aims: Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited kidney disorder with mutations in PKD1 or PKD2. This study aimed to identify novel PKD1 and PKD2 mutations in Chinese patients with ADPKD. Methods: Mutational analyses of both PKD genes were performed in 120 Chinese families with inherited ADPKD using long-range PCR and targeted next-generation sequencing approaches. Sanger sequencing was performed to check the positive mutations, while multiplex ligation-dependent probe amplification was adopted to examine those without mutations for the presence of large deletions. Results: A total of 93 mutations in PKD1 and PKD2 were identified in 98 Chinese families with ADPKD inheritance and the detection rate was 81.7% (98/120). The mutation rates of PKD1 and PKD2 were 91.4% (85/93) and 8.6% (85/93), respectively. Among the 93 mutations, 59.1% (55/93) were reported for the first time. A total of 65 mutations (26 nonsense, 33 frameshift, 2 large deletion, and 4 typical splicing mutations) were identified as definite pathogenic mutations. The remaining 28 mutations (21 missense, 3 in-frame deletion, and 4 atypical splicing mutations) were determined as probable pathogenic mutations. In addition, 9 de novo mutations were found by pedigree analysis. Correlation analysis between genotype and phenotype revealed that patients with PKD1 mutations or truncating mutations exhibited the most severe clinical outcome. Conclusion: The newly identified sites for known mutations will facilitate the early diagnosis and prediction of prognosis in patients with ADPKD, and provide fundamental genetic information for clinical intervention to prevent the inheritance of this disease in affected families.
Clinicopathological Features to Predict Progression of IgA Nephropathy with Mild Proteinuria
Authors: Chen Ding , Liu Jian , Duan Shuwei , Chen Pu , Tang Li , Zhang Li , Feng Zhe , Cai Guangyan , Wu Jie , Chen Xiangmei
Published: March 2018

Background/Aims: In the past, little attention has been paid to patients with IgA nephropathy (IgAN) who had minimal proteinuria upon the onset. The aim of this study was to analyze the clinicopathological features and the prognostic factors in patients with IgA nephropathy. Methods: Data of patients that had their first renal biopsy in our hospital and were diagnosed with primary IgAN with proteinuria <1 g/d from January 1995 to December 2014 were retrospectively examined. Clinical records of the clinicopathological features, renal function, and proteinuria were collected and investigated. The factors affecting the renal function and proteinuria were analyzed by Cox regression. The predictive efficiencies of clinical and pathological models were evaluated by Harrell concordance index (C-index). Results: A total of 506 patients with IgA nephropathy were included in this study. (1) Baseline proteinuria greater than 0.5 g/d was positively associated with Oxford M, S, and T lesions. eGFR less than 90 mL/min/1.73 m2 were positively associated with Oxford T. (2) In the follow-up with a median of 50 months, 82 patients (16.2%) achieved complete clinical remission (CCR), whereas 54 patients (10.6%) showed an increase in creatinine by more than 50% (not progressing to end-stage renal disease). The cumulative proportion of creatinine increased >50%, and the values obtained by life-table analysis in 10, 15, and 20 years were 15%, 21%, and 22%, respectively. Significant differences were found in baseline age, proteinuria, and Oxford T between the group of creatinine increase >50% and the CCR group. (4) Multivariate COX regression showed that baseline age and proteinuria > 0.5 g/d were independent risk factors of adverse outcome. C-index suggested that the clinical model was more effective than the pathological models in predicting endpoint events. (5) Effect of the mean value during the follow-up on adverse endpoint events: Multivariate COX regression found that the mean proteinuria during follow-up was an independent influencing factor for the increase of creatinine by more than 50%. Conclusion: (1) Proteinuria > 0.5g/d and eGFR < 90 mL/min/1.73 m2 may predict more severe pathological changes; (2) With the increase in age and baseline proteinuria, the risks of adverse endpoint events would increase significantly; (3) Pathology could roughly predict the adverse endpoint events but is less efficient than the clinical indicators; (4) Data during follow-up suggested that the patients should regularly test their renal function and proactively control their proteinuria.
Combined Inhibition of Soluble Epoxide Hydrolase and Renin-Angiotensin System Exhibits Superior Renoprotection to Renin-Angiotensin System Blockade in 5/6 Nephrectomized Ren-2 Transgenic Hypertensive Rats with Established Chronic Kidney Disease
Authors: Čertíková Chábová Věra , Kujal Petr , Škaroupková Petra , Varňourková Zdeňka , Vacková Šárka , Husková Zuzana , Kikerlová Soňa , Sadowski Janusz , Kompanowska-Jezierska Elzbieta , Baranowska Iwona , Hwang Sung Hee , Hammock Bruce D. , Imig John D. , Tesař Vladimír , Červenka Ludek
Published: March 2018

Background/Aims: We found recently that increasing renal epoxyeicosatrienoic acids (EETs) levels by blocking soluble epoxide hydrolase (sEH), an enzyme responsible for EETs degradation, shows renoprotective actions and retards the progression of chronic kidney disease (CKD) in Ren-2 transgenic hypertensive rats (TGR) after 5/6 renal ablation (5/6 NX). This prompted us to examine if additional protection is provided when sEH inhibitor is added to the standard renin-angiotensin system (RAS) blockade, specifically in rats with established CKD. Methods: For RAS blockade, an angiotensin-converting enzyme inhibitor along with an angiotensin II type receptor blocker was used. RAS blockade was compared to sEH inhibition added to the RAS blockade. Treatments were initiated 6 weeks after 5/6 NX in TGR and the follow-up period was 60 weeks. Results: Combined RAS and sEH blockade exhibited additional positive impact on the rat survival rate, further reduced albuminuria, further reduced glomerular and tubulointerstitial injury, and attenuated the decline in creatinine clearance when compared to 5/6 NX TGR subjected to RAS blockade alone. These additional beneficial actions were associated with normalization of the intrarenal EETs deficient and a further reduction of urinary angiotensinogen excretion. Conclusion: This study provides evidence that addition of pharmacological inhibition of sEH to RAS blockade in 5/6 NX TGR enhances renoprotection and retards progression of CKD, notably, when applied at an advanced stage.
Acetic Acid Influences BRL-3A Cell Lipid Metabolism via the AMPK Signalling Pathway
Authors: Li Lin , He Meilin , Xiao Hang , Liu Xiaoqian , Wang Kai , Zhang Yuanshu
Published: March 2018

Background/Aims: Acetic acid (AcOH), a short-chain fatty acid, is reported to have some beneficial effects on metabolism. Therefore, the aim of this study was to investigate the regulatory mechanism of acetic acid on hepatic lipid metabolism in BRL-3A cells. Methods: We cultured and treated BRL-3A cells with different concentrations of sodium acetate (neutralized acetic acid) and BML-275 (an AMPKα inhibitor). The total lipid droplet area was measured by oil red O staining, and the triglyceride content was determined by a triglyceride detection kit. We detected mRNA and protein levels of lipid metabolism-related signalling molecules by RT-PCR and Western blot. Results: Acetic acid treatment increased AMPKα phosphorylation, which subsequently increased the expression and transcriptional activity of peroxisome proliferator-activated receptor α and upregulated the expression of lipid oxidation genes. These changes ultimate led to increasing levels of lipid oxidation in BRL-3A cells. Furthermore, elevated AMPKα phosphorylation reduced the expression and transcriptional activity of the sterol regulatory element-binding protein 1c, which reduced the expression of lipogenic genes, thereby decreasing lipid biosynthesis in BRL-3A cells. Consequently, triglyceride content in acetate-treated BRL-3A cells was significantly decreased. Conclusions: These results indicate that acetic acid activates the AMPKα signalling pathway, leading to increased lipid oxidation and decreased lipid synthesis in BRL-3A cells, thereby reducing liver fat accumulation in vitro.
Montagem e aplicação de modelo de baixo custo de dissecção venosa
Authors: Cunha Carlos Magno Queiroz da , Frota Júnior José Alberto Guilherme , Ferreira James Dantas , Troiani Neto Giovanni , Félix Diego Freitas , Menezes Francisco Julimar Correia de
Published: March 2018

Objetivo: Desenvolver e aplicar modelo de baixo custo para treinamento de dissecção venosa para acadêmicos de Medicina. Métodos: O modelo foi elaborado com custo fixo de 35 reais (10,5 dólares) e mais 50 centavos a cada reposição, tendo sido aprovados por 6 cirurgiões vinculados ao curso de Medicina da Universidade de Fortaleza e utilizados durante curso teórico prático. Os alunos responderam a um teste pré e pós-atividade, foram avaliados durante a prática através de check list e responderam questionário de percepção sobre o modelo. Resultados: Foi notado crescimento teórico, porém, percebeu-se a necessidade de mais treinamento procedural, o que é viável com nosso modelo de baixo custo. Em relação aos questionários de percepção, 91,95% dos alunos concordaram que os modelos mantinham boa correlação anatômica, 89,96% que o material utilizado é de boa qualidade, 95,40% que o modelo permitiu o aprendizado da dissecção venosa e 96,55% que o modelo pode ser utilizado para ensino do procedimento, números que reafirmam a eficácia e viabilidade do modelo. Conclusões: É possível a criação de modelo realista, de boa qualidade e viável para o ensino, apenas com materiais de baixo custo para treinamento de dissecção venosa.
Análise da produção científica sobre comunicação terapêutica no campo da saúde, saúde mental e álcool e outras drogas
Authors: Jalles Marina Paranhos , Santos Viviane Silva Januário dos , Reinaldo Amanda Márcia dos Santos
Published: March 2018

Introdução: A comunicação terapêutica é o conjunto de técnicas/habilidades/intervenções com potencial terapêutico no processo de recuperação e reabilitação no campo da saúde, com vistas a atender as necessidades do paciente. Objetivo: O objetivo deste trabalho é analisar as produções disponíveis sobre as técnicas, estratégias e importância da comunicação terapêutica em saúde, saúde mental e álcool e outras drogas. Metodologia: Trata-se de uma revisão narrativa da literatura de 2000 a 2016, cujos dados foram coletados de fevereiro a junho de 2016 na Biblioteca Virtual de Saúde (BVS-BIREME) e Pubmed. Os descritores utilizados foram: dependência química, dependência de substâncias psicoativas e comunicação em saúde. Resultados: Foram encontradas 697 produções, sendo selecionados 15 artigos com texto completo disponível em suporte eletrônico e que obedeciam aos critérios de inclusão. Não foram encontradas publicações que abordassem a comunicação terapêutica no cuidado com os usuários de álcool e outras drogas. O maior número de publicações ocorreu entre os anos de 2004-2005, 2009 e 2012, com duas publicações em cada ano. Discussão: Os resultados apresentados evidenciaram a importância da comunicação terapêutica em saúde e no campo da saúde mental no processo de cuidar. Apesar de ser um instrumento de trabalho reconhecido, pouco tem se estudado no âmbito da saúde mental e álcool e outras drogas. Conclusão: A comunicação terapêutica é uma necessidade na construção e avaliação do Projeto Terapêutico Singular. Aponta-se a necessidade de estudos empíricos sobre o tema, associado ao cuidado com usuários de álcool e outras drogas.
Operation and characteristics of the Academic League of Pediatric Surgery in quaternary Center
Authors: Vaisberg Victor Van , Cotrim Fernanda Pereira , Ghaffar Sumaya Abdul , Hara Lucas Arjona de Andrade , Figueiredo Roberta Monteiro , Tannuri Uenis , Tannuri Ana Cristina Aoun
Published: March 2018

Academic Leagues are student interest groups for the development and in-depth learning of a certain field of study, being the one most popular extracurricular in some Medical Schools. We present the Pediatric Surgery Academic League in a quaternary center in São Paulo, Brazil, where 23 students ranging from 2nd to 5th Medical School year are regular members, having regular activities such as visits to the operation room, outpatient clinic rotation, inpatient rounds and seminars. To be part of the Academic League, students have to pass a multiple question test based on an introductory course. In 2015, 65.00% of candidates were 1st year students, and the average grade obtained was 74.50%. Overall, we believe being a member of the Academic League promotes first exposure to a surgical specialty, greater workload in Pediatric Surgery, learning Semiology and development of teaching skills.