bluuebunny/crossref_metadata_2025 huggingface dataset:
An assemblage of avatars: Digital organization as affective intensification in the GamerGate controversy
Authors: Just Sine N.
Published: May 2019

Through a study of the so-called GamerGate controversy, this article argues that a new dynamic of affective intensification is currently instating itself in the digital organization of not only highly collaborative industries, such as that of gaming, but of society as such. This dynamic may best be understood and conceptualized through reconsiderations of the notions of affective economies and affective labour. The affective constitution of digital organization is a process of affective intensification that not only works like an economy but is directly productive of economic value, and not only involves human emotionality but technological affectivity as well. Guided by the notions of assemblage, affordance and agency, the article offers a conceptual framework for studying affective intensification in and as socio-technical processes of value production.
Variation of zero entraining velocity dimple in grease-lubricated reciprocating motion
Authors: Wang Shanshan , Wang Jing , Han Yiming , Li Weimin
Published: May 2019

In this study, experiments were conducted on a ball-on-disk test rig using optical interferometry to explore the variation in grease film thickness under zero entraining velocity reciprocating motion. The steel ball and the sapphire disk move at equal speeds but in opposite directions within a triangle wave. Three types of commercially available bearing greases with different consistencies, Centoplex 2EP, Centoplex 3, and MP-3, were used in these experiments. The variations in the surface dimple phenomenon with decreasing maximum surface velocity, differing grease consistency, and grease starvation conditions were studied. Results showed that the grease consistency exerts a significant influence on the surface dimple and the starvation severity.
Family-based child weight management intervention in early childhood in low-income families: A systematic review
Authors: Kim Kisook , Lee Yoonyoung
Published: May 2019

Child obesity is more common in low-income families. Early childhood is highly influenced by the family-based environment that mostly includes parents. This systematic review synthesized and examined the effects of family-based intervention for early childhood (two to five years) weight management among low-income families. Electronic databases (MEDLINE, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Cochrane electronic databases, and Google scholar databases) and published literature were searched for empirical studies and seven articles were included based on inclusion criteria. For each study, quality assessment, data extraction, and synthesis were conducted as guidelines Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analyses. In four randomized controlled trials, two before and two after intervention studies, and one quasi-experimental study, 890 participants were included in the family-based child weight management intervention. There was significant reduction in early childhood weight in four studies. The evidence for revealing the effect of family-based intervention was insufficient and inconsistent. However, the findings suggest limitations of family-based children weight management intervention in low-income families and could contribute as an indicator for future effective intervention development.
Effects of minimal grouping on implicit prejudice, infrahumanization, and neural processing despite orthogonal social categorizations
Authors: Simon Jeremy C. , Gutsell Jennifer N.
Published: May 2019

Racial prejudice is a pervasive and pernicious form of intergroup bias. However, a mounting number of studies show that recategorization—even into minimal groups—can overcome the typical consequences of racial and other group classifications. We tested the effects of minimal grouping on implicit prejudice and infrahumanization using a paradigm in which race was orthogonal to group membership. This allowed us to examine whether knowledge of group membership overrides obvious category differences. We found that participants infrahumanized and showed implicit bias toward the minimal outgroup, despite the cross-cutting presence of race, and in fact did not show any of the usual implicit racial bias. In addition, event-related potentials (ERPs) showed an early race effect followed by distinct reactions on the basis of group as processing continued. This is evidence that arbitrary social classifications can engender ingroup preference even in the presence of orthogonal, visually salient categorizations.
The limits to ‘global’ social policy: The ILO, the social protection floor and the politics of welfare in East and Southern Africa
Authors: Seekings Jeremy
Published: May 2019

Bob Deacon’s study of the Social Protection Floors initiative, led by the International Labour Organisation (ILO), entailed a pioneering study of the making of global social policy. Just how global is this ‘global social policy’ in terms of both its making and its subsequent diffusion? African governments were minimally involved in the making of this global social policy. Most seem to have acquiesced in this global policy-making, as they have with other ‘global’ declarations, in the expectation that it would have little effect on them. Nor, in Southern Africa, is there clear evidence of any significant effect. Even the social protection strategy documents adopted by either the African Union or national governments, typically written by external consultants, have generally avoided direct use of the concept of the social protection floor, while reiterating the commitment to ‘comprehensive’ (and appropriate) social protection that predated the ILO-led initiative. The trajectory of actual policy reform in Southern African countries does not appear to have changed. There continues to be a disjuncture between ‘global social policy’ at the global and African levels.
An RNA-seq-Based Expression Profiling of Radiation-Induced Esophageal Injury in a Rat Model
Authors: Sun Zhiqiang , Li Jinhui , Lin Min , Zhang Shuyu , Luo Judong , Tang Yiting
Published: May 2019

Radiation-induced acute injury is the main reason for the suspension of radiotherapy and unsuccessful treatment of cancer. It is of great importance to understand the molecular mechanism of radiation-induced esophageal injury. We used RNA-seq data from normal esophageal tissue and irradiated esophageal tissues and applied computational approaches to identify and characterize differentially expressed genes and detected 40 059 messenger RNAs (mRNAs) previously annotated and 717 novel long noncoding RNAs (lncRNAs). There were 14 upregulated and 32 downregulated lncRNAs among the differentially expressed lncRNA group. Their target genes were involved in the mRNA surveillance pathway, pathological immune responses, and cellular homeostasis. Additionally, we found 853 differentially expressed mRNAs, and there were 384 upregulated and 469 downregulated mRNAs. Notably, we found that the differentially expressed mRNAs were enriched for steroid biosynthesis, the tumor necrosis factor signaling pathway, focal adhesion, pathways in cancer, extracellular matrix–receptor interaction, and so on. The response of normal esophageal tissues to ionizing radiation is multifarious. The radiation-induced cell damage response by multiple pathways followed by pathological immune responses activated. Studies on the dynamic network of molecules involved in radiation-induced esophageal injury are under way to clarify the regulatory mechanisms and identify the candidate targets.
Insider and Outsider Analysis: Constructing, Deconstructing, and Reconstructing Narratives of Seychelles’ Geography Education
Authors: Persaud Indra
Published: May 2019

Narrative inquiry offers a rich and rigorous approach to making meaning of the everyday. This article extends the present terrain by suggesting that different narrative meaning-making processes can be layered and unlayered across individual and aggregate narratives. To illustrate this novel approach, geography teachers’ curriculum-making stories were constructed, deconstructed, and then reconstructed. The construction of a set of geography curriculum-making narratives required the use of an outsider, and then an insider, lens. A second outsider lens was used to deconstruct the narratives and link them to broader social, cultural, and historical events. The deconstruction exposed that, in the face of curriculum power struggles, teachers often struggled to take ownership of the geography curriculum. Reconstructing their stories revealed potential strategies for understanding and resisting curriculum control and developing a sense of professional self-worth. Overall, the methodological challenges and benefits of doing narrative research in education from both outsider/insider perspectives are demonstrated. The iterative application of different lenses forms part of a “negotiated” analytical approach that offers an innovative way to analyze everyday stories by setting them within the contexts of broader social change.
Research on dimension coupling of piezoelectric three-component force unit based on sensor assembly error
Authors: Zhang Jun , Shao Jun , Ren Zongjin , Wang Bing , Shao Hengkun , Jia Zhenyuan
Published: May 2019

In the process of manufacturing and operation of mechanical equipment, accurate measurement of vector force provides an important basis for real-time control of working conditions and process adjustment to ensure the performance. Piezoelectric three-component force unit can be used to measure three-axis force with the characteristics of high frequency and stiffness, great dynamic response, and resistance to harsh conditions. Piezoelectric dynamometer consisting of four three-component force units can measure six-axis force/torque, which is widely used in vector force measurement. However, because of the limitation of manufacturing capability and assembly process, dimension coupling caused by assembly error of three-component force unit restricts improvement of test accuracy for itself and piezoelectric dynamometer. To reduce dimension coupling caused by displacement and angle assembly error, this article establishes a theoretical model of assembly error of three-component force unit. To achieve that the dimension coupling of three-component force unit is less than 3%, stiffness of relevant components is obtained by simulation analysis and experiment, and assembly tolerance range of three-component force unit is proposed. Four three-component force units are assembled to meet assembly tolerance range, and the calibration experiment is performed. The results show that the maximum of dimension coupling is less than 2.5%, which verifies the rationality of assembly tolerance range and further proves the reliability of the theoretical model. The theoretical model of assembly error clarifies the assembly accuracy of three-component force unit to ensure its test accuracy, which can further improve test accuracy of dynamometer. This article will also provide theoretical reference basis for this kind of sensors.
Experimental and numerical investigations on dynamic response performance of a cable laying vessel in complex operating conditions
Authors: Peng Weilong , Gao Lingling , Wang Yang , Li Shiqiang , He Xutao , Liu Zhen
Published: May 2019

An innovative cable laying vessel for the grid connecting project of Zhoushan Island was designed and has been constructed. The stability of the vessel under the complex sea conditions is extremely important to the cable laying operations. Experimental and numerical studies are carried out in this study to investigate the stability performance of the mooring system designed for maintaining the position of the vessel. The experiments were conducted in a wave tank under the scale ratio of 1:49, and the motions in 6 degrees of freedom of the vessel model were measured together with the tension forces of the mooring lines, which can be utilized for the numerical model validation. More environmental hydrodynamic conditions were employed for further study numerically to justify the stability of the vessel under the complex operating conditions.
Can Indian journalism survive the onslaught of social media?
Authors: Rodrigues Usha M
Published: May 2019

In recent times, researchers have examined the Indian Prime Minister Narendra Modi’s use of social media to directly connect with his followers, while largely shunning the mainstream media. This strategy of direct communication with their constituents has been adopted by other political parties too, with opposition party leaders hosting ‘Facebook Live’ sessions and tweeting their messages. A large proportion of Indian voters, who increasingly own mobile phones, are enjoying being part of the ‘like’ and ‘share’ online networks. What does this effective use of social media by Indian political parties mean for the public discourse in India? This article presents the view that this phenomenon is more than Modi’s ‘selfie nationalism’ or his attempt to marginalize the news media. The article argues that there is a structural shift in the Indian public sphere, which might prove to be the greatest challenge to Indian journalism.
The Comedy of Reflexive Modernity: Reason, Religion and the Ambivalence of Humour
Authors: Speck Simon
Published: May 2019

This article utilizes Ulrich Beck’s concept of ‘reflexive modernity’ to account for the ambivalent view of humour in the public sphere: its celebration as a form of criticism of irrationality and injustice and its censure as a vehicle for the denigration of subordinate or marginal groups and identities. The article argues that the power and ambivalence of humour in contemporary culture can be understood with reference to the two key features of reflexive modernization: the demand for the discursive justification of all claims to cognitive and normative authority and the obligation to respect the equal rights of all individuals. Drawing on Beck’s distinction between a ‘first’ and ‘second’ modernity, the article uses the example of the Danish ‘Muhammed Cartoons’ to show that critical-emancipatory joking cannot simply lay claim to an ‘Enlightenment’ view of secular-scientistic reason in conflict with an atavistic and backward ‘religion’ due to the transformation of reason by reflexive scientization and the transformation of religion resulting from the effects of globalization and cultural cosmopolitization. The article draws on accounts of the comic practice of Muslim comedians and a consideration of the British TV sit-com Rev to demonstrate the possibility of a ‘religious’ joking that is thereby eminently ‘modern’ whilst respecting the values of human universality and individual dignity. The article concludes by reiterating the centrality of Beck’s theory for the understanding of the enduring power of comic representation to constitute a cultural reflexivization endemic in contemporary society and argues for the relevance of ‘reflexive modernity’ to cultural sociology.
Severe rebound after cessation of fingolimod treated with ocrelizumab with coincidental transient aggravation: report of two cases
Authors: Schmidt Stephan , Schulten Thomas
Published: May 2019

Background:

Fingolimod (FTY), an oral treatment for patients with relapsing-remitting multiple sclerosis (RRMS), has been associated with a significant rebound of disease activity after cessation of therapy.

Methods:

We present the clinical and radiological findings of two patients with severe rebound after FTY withdrawal, which was further aggravated by the initiation of treatment with the B cell-depleting monoclonal antibody, ocrelizumab.

Results:

Both patients exhibited significant Expanded Disability Status Scale progression after administration of ocrelizumab despite immune reconstitution more than 3 months after FTY withdrawal.

Conclusions:

Although the observed effect may be coincidental, ocrelizumab may complicate recovery of rebound after cessation of FTY. Further studies are warranted to better understand and predict the clinical and immunological consequences of sequential immunosuppressive and immunomodulatory treatments in patients with highly active RRMS.
Treatment of moderate to severe psoriasis with apremilast over 2 years in the context of long-term treated HIV infection: A case report
Authors: Zarbafian Misha , Cote Benoit , Richer Vincent
Published: May 2019

Treatment of moderate-to-severe psoriasis in patients with HIV infection is a clinical challenge. We present the case of a patient with a longstanding history of well-controlled HIV. He had failed topical management, and his hypertriglyceridemia made use of acitretin potentially unsafe. He was unable to regularly attend a phototherapy unit. Physical examination revealed 12% total body surface area involvement with a Psoriasis Area Severity Index (PASI) of 10.2. His Dermatology Quality of Life Index (DLQI) was 20. After 3 months of apremilast treatment, his PASI decreased to 4.1. After 7 months, his PASI decreased to 2.7 and his DLQI to 1. Two years later, his PASI score was 2.4, with a stable CD4 count of 1200 cells/mm3 and an undetectable viral load. There were no serious opportunistic infections or laboratory abnormalities. To our knowledge, this represents the second reported case of psoriasis treatment with apremilast in a patient with HIV.
Posterior spinal fusion using a unilateral C1 posterior arch screw and a C2 laminar screw for atlantoaxial fracture dislocation
Authors: Ono Yuichi , Miyakoshi Naohisa , Hongo Michio , Kasukawa Yuji , Ishikawa Yoshinori , Kudo Daisuke , Kimura Ryota , Iida Jumpei , Shimada Yoichi
Published: May 2019

Introduction:

C1 lateral mass screws and C2 pedicle screws are usually chosen to fix atlantoaxial (C1–C2) instability. However, there are a few situations in which these screws are difficult to use, such as in a case with a fracture line at the screw insertion point and bleeding from the fracture site. A new technique using a unilateral C1 posterior arch screw and a C2 laminar screw combined with a contralateral C1 lateral mass screws–C2 pedicle screws procedure for upper cervical fixation is reported.

Case Report:

A 24-year-old woman had an irreducible C1–C2 anterior dislocation with a type III odontoid fracture on the right side due to a traffic accident. The patient underwent open reduction and posterior C1–C2 fixation. On the left side, a C1 lateral mass screws and a C2 pedicle screws were placed. Because there was bleeding from the fracture site and a high-riding vertebral artery was seen on the right side, a C1 posterior arch screw and a C2 laminar screw were chosen. Eight months after the surgery, computed tomography scans showed healing of the odontoid fracture with anatomically correct alignment.

Conclusions:

Although there have been few comparable studies, fixation with unilateral C1 posterior arch screw–C2 laminar screw could be a beneficial choice for surgeries involving the upper cervical region in patients with fracture dislocation or arterial abnormalities.
Genetic variants on chromosome 9p21 confer risks of cerebral infarction in the Chinese population: a meta-analysis
Authors: Chen Ji-Xiang , Liu Jing , Hu Feng , Bi Ying , Li Man , Zhao Lei
Published: May 2019

Ischemic stroke (IS) is the leading cause of disability. Researchers have demonstrated that IS is more a multifactorial disorder than a single-factor disease. At present, no consistent conclusions have been reached on susceptibility loci for IS on chromosome 9p21. We conducted this meta-analysis to verify whether genetic loci on chromosome 9p21 reported domestically and abroad could be responsible for IS in Chinese populations. We analyzed data from eight studies that covered a total of 9756 individuals with Chinese ancestry comprising 4254 cases and 5502 controls. Each of the four reported susceptibility loci (rs2383206, rs2383207, rs10757274, and rs10757278) was analyzed separately. The odds ratios (ORs) of rs2383206 and rs10757274 were 1.09 (95% confidence interval (CI): 1.02–1.06, P = 0.01) and 1.09 (95% CI: 1.01–1.17, P = 0.03), respectively. For rs2383207, OR value was 0.91 (95% CI: 0.84–0.98, P = 0.01). No statistical association was identified for rs10757278. We have verified previous associations for IS in Chinese populations on chromosome 9p21. Loci rs2383206 and rs10757274 may increase susceptibility to IS. Mutation at locus rs2383207 may be beneficial. However, we are unable to identify any association between rs10757278 and IS.
The Impact of Frailty on Short-Term Outcomes After Elective Hip and Knee Arthroplasty in Older Adults: A Systematic Review
Authors: Schmucker Abigail M. , Hupert Nathaniel , Mandl Lisa A.
Published: May 2019

Introduction:

This systematic literature review evaluates (1) frailty in older adults as a risk factor for short-term adverse events and suboptimal clinical outcomes after total joint arthroplasty and (2) interventions to improve arthroplasty outcomes in these frail patients.

Methods:

PubMed, EMBASE, Cochrane Register of Controlled Trials, SCOPUS, AgeLine, and Web of Science were searched from database inception to November 22, 2017; gray literature and references were also searched. Studies including adults ≥65 years of age undergoing hip or knee arthroplasty and measuring preoperative frailty and postoperative adverse events or clinical outcomes within 90 days of surgery were included. Two investigators independently screened all abstracts and extracted data; disagreements were adjudicated by a third reviewer. Risk of bias was assessed using the Newcastle–Ottawa scale for cohort studies and the Cochrane Risk of Bias tool for randomized controlled trials. Study quality was assessed using a 5-point scale modified from the Oxford Centre for Evidence-Based Medicine tool.

Results:

Of 1913 abstracts identified, 82 full texts were reviewed, and 13 met inclusion criteria: 5 prospective cohort studies, 6 retrospective cohort studies, and 2 randomized controlled trials covering 382 763 total patients. These studies used 13 frailty instruments and assessed 32 distinct outcomes. Substantial heterogeneity precluded valid meta-analysis; results were qualitatively summarized by study design, frailty instrument, and outcome type. Of the 11 cohort studies, 10 found significant associations between frailty and poor postoperative outcomes. Trials of preoperative frailty-modifying interventions found no association between interventions and improved outcomes.

Discussion:

Standardizing frailty measurement would improve generalizability, permitting the assessment of associations with patient-reported and functional outcome measures, as well as the efficacy of interventions to improve outcomes, in frail patients undergoing arthroplasty.

Conclusions:

Frailty is associated with higher rates of short-term adverse events and worse clinical outcomes after elective hip and knee arthroplasty.
Politics of Good Governance and Development in Maoist Affected Scheduled Areas in India: A Critical Engagement
Authors: Behera Anshuman
Published: May 2019

The scheduled areas (SA) of central and eastern India, many of which are affected by the Maoist violence, have been subjected to systematic deprivation of natural resources, long-standing marginalization, poverty and economic underdevelopment. Various development and governance schemes that are packaged with the brand of ‘Good Governance and Development’ in these areas have aggravated deprivation in terms of land alienation, lack of autonomy of the local communities and multiple exploitations. The Maoists who claim to represent the local communities are often seen imposing their authoritarian diktats over these communities. On the other hand, the Indian state uses a military approach to fight the Maoist violence along with promotion of development initiatives to address the local discontents. The prolonged conflict between the state and the Maoists exposes the local communities to continued exploitation and deprivation. This article highlights the contradictions between the governance mechanisms and development measures vis-à-vis the constitutional provisions related to the autonomy of local communities in the SA. Subsequently, the article interrogates the politics of control and management of natural resources through governance mechanisms and development initiatives. Second, the article identifies the commonalities between the state and the Maoists in terms of their control over the local communities. The article argues that the state-led initiatives and the Maoist movement are both instruments in sustaining the conflict and alienation of the local communities.
Recurrent Episodes of Diffuse Alveolar Hemorrhage in Systemic Sclerosis 30 Days Apart
Authors: Saab Hussien , Bajaj Tushar , Bains Kirandeep , Garcia-Pacheco Ralph
Published: May 2019

Diffuse alveolar hemorrhage (DAH) is a life-threatening clinicopathologic condition caused by accumulation of intra-alveolar red blood cells (RBCs) after disruption of the alveolar-capillary basement membrane that is often seen as a complication of various diseases, but is rare in systemic sclerosis. A 46-year-old female with systemic sclerosis presented to the emergency department complaining of right-sided chest pain. Initially, her electrocardiogram and chest X-ray (CXR) were unremarkable; however, she progressively decompensated into acute respiratory failure resulting in intubation. Repeat CXR and computed tomography scan showed diffuse bilateral alveolar infiltrates and pleural effusions. Video bronchoscopy with bronchoalveolar lavage showed numerous RBCs, neutrophils, macrophages, and respiratory epithelial cells consistent with acute DAH. She was started on intravenous pulse-dosing Solu-Medrol 1 g daily for 5 days. One month later, the patient returned with intractable nausea and vomiting. Again, she went into acute respiratory distress with a PaO2 of 59 while on a 10-L non-rebreather mask. CXR revealed development of alveolar infiltrates in the right lung. A bronchoscopy with bronchoalveolar lavage again showed numerous RBCs and neutrophils along with staining positive for hemosiderin-laden macrophages. Systemic sclerosis with alveolar hemorrhage is a rare occurrence; however, most cases are single episodes of hemorrhage, whereas we present a case with 2 confirmed episodes within 30 days. Its life-threatening nature makes a systemic approach and aggressive treatment crucial to decreasing morbidity and mortality—making it a diagnosis that should not be overlooked, especially in patients with nonspecific symptoms.
A Synchronous Diagnosis of Metastatic Male Breast Cancer and Prostate Cancer
Authors: Moosavi Leila , Kim Phyllis , Uche An , Cobos Everardo
Published: May 2019

In this article, we present a patient diagnosed synchronously with metastatic male breast cancer and prostate cancer. This is a 63-year-old male and recent immigrant from Nigeria, who sought medical attention for progressively worsening of shortness of breath and acute progression of a chronic right breast mass. An invasive breast carcinoma was diagnosed by the core biopsy of the right breast mass. Within 2 months of his breast cancer diagnosis, the patient also was diagnosed with prostate adenocarcinoma after being worked up for urinary retention. By presenting this patient with a synchronous diagnosis with metastatic male breast cancer and prostate cancer, history of chronic right breast mass, and gynecomastia, we speculate on possible cancer etiologies and risk factors.
The Association Between Attention-Deficit Hyperactivity Disorder, Injuries, and Methylphenidate
Authors: Shem-Tov Sharon , Chodick Gabriel , Weitzman Dalia , Koren Gideon
Published: May 2019

Objective. To evaluate the relationship between attention-deficit hyperactivity disorder (ADHD) and injuries and to verify whether methylphenidate (MPH), is associated with decreasing the risk of injuries. Methods. A retrospective cohort study using the computerized database of Maccabi Healthcare Services. The ADHD cohort included all children between 12 and 20 years of age, newly diagnosed with ADHD between 2003 and 2013. The comparison cohort was composed of children who were not diagnosed with ADHD. The primary outcome was traumatic injuries. A Cox proportional hazard regression analysis was conducted to estimate ADHD effects on the risk of injuries. We also conducted a nested case-control study to examine how MPH influences this relationship. Results. A total of 59 798 children were included in the cohort study; 28 921 were classified as exposed (ADHD cohort) and 30 877 were unexposed. The traumatic injuries incidence in the exposed group was significantly higher (adjusted hazard ratio = 1.63 [95% confidence interval = 1.60-1.66]). Similar increased risk was documented also for severe injuries (adjusted hazard ratio = 1.72 [1.59-1.86]). MPH use was significantly associated with 28% lower injury events. Therapy groups were significantly associated with 29% to 40% lower injuries rate for medium- or long-acting MPH. The intensity of therapy was significantly associated with 29% to 33% lower injury rate when the intensity was lower than 0.69 mg/kg/day. Conclusion. Children with ADHD have a 60% increased odds of experiencing an injury. Treatment with MPH reduced the risk by up to 28%. The individual and financial cost secondary to injuries, underscores the public health significance of this problem. Injury prevention should be considered in clinical evaluation of MPH risks and benefits, beyond the conventional consideration of enhancing academic achievements.
Methanol-Extract/Fractions of Dacryodes edulis Leaves Ameliorate Hyperglycemia and Associated Oxidative Stress in Streptozotocin-Induced Diabetic Wistar Rats
Authors: Ononamadu Chimaobi J. , Alhassan Adamu J. , Ibrahim Aminu , Imam Abdullahi A. , Ihegboro Godwin O. , Owolarafe Tajudeen A. , Sule Mohammed S.
Published: May 2019

The present study evaluated the antidiabetic and antioxidant potential of the methanolic extract/solvent fractions of the leaves of Dacryodes edulis using a streptozotocin (STZ)-induced diabetic Albino Wistar rat model. The fasting blood glucose/insulin levels and inhibition of α-amylase and α-glucosidase were determined. Antioxidant activity was assessed in vitro by 2,2-diphenyl-1-picrylhydrazyl, hydroxyl, superoxide scavenging, reducing power, and total antioxidant capacity assays and in vivo by monitoring catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) activities and reduced glutathione (GSH) and malondialdehyde (MDA) levels. The aqueous-methanol fraction exhibited the highest and significant ( P < .05) reduction in fasting blood glucose (FBG; 54.03%) with a concomitant inhibition of α-amylase and α-glucosidase activities. The ethyl acetate fraction also exhibited a significant ( P < .05) reduction in FBG and an increase in insulin levels in the treated diabetic Wistar rats. A significantly ( P < .05) higher reducing power and radical scavenging activity was observed in the aqueous-methanol and ethyl acetate fractions. The aqueous-methanol and ethyl acetate fractions also significantly ( P < .05) reversed the alterations in oxidative stress markers (GSH, MDA, CAT, and SOD) observed in the diabetic control group. In conclusion, the study demonstrated that the methanol extract of Dacryodes edulis ameliorates hyperglycemia and the associated oxidative stress in STZ-induced diabetic Wistar rats. These observed activities are largely due to the compounds that partitions into the aqueous-methanol (55:45) solvent fraction. This provides scientific evidence for the use of this plant extract in folk medicine and also a baseline data for its further characterization. Further work should be carried out to characterize the aqueous-methanol solvent fractions for the active compounds.
The cullin4A is up-regulated in chronic obstructive pulmonary disease patient and contributes to epithelial-mesenchymal transition in small airway epithelium
Authors: Ren Yidan , Zhang Yi , Fan Lixia , Jiao Qinlian , Wang Yunshan , Wang Qin
Published: May 2019

Background

Chronic obstructive pulmonary disease (COPD) is a common respiratory disease with high morbidity and mortality. The most important pathophysiological change of COPD is airway obstruction. Airway obstruction can cause airflow restriction and obstructive ventilation dysfunction. Currently, many studies have shown that there is EMT phenomenon in the process of airway remodeling of COPD. Cullin4A (CUL4A) is an E3 ubiquitin ligase that interacts with other factors to form the E3 complex. Studies have shown that CLU4A is associated with EMT in non-small cell lung cancer and other cancers. However, its relationship with EMT in COPD has not been reported systematically. In this study, we detected the expression of CUL4A in lung epithelium of COPD patients. In addition, the regulatory effect and mechanism of CUL4A on EMT in COPD were clarified in small airway epithelial cells.

Methods

The expression of CUL4A was assessed by immunohistochemistry in lung epithelium specimens from smokers, non-smokers and patients with chronic obstructive pulmonary disease. The role of CUL4A on cigarette smoke extract (CSE)-induced epithelial-mesenchymal transition (EMT) in human small airway epithelial cells (HSAEpiCs) was assessed by silencing or overexpression CUL4A in vitro. Cigarette smoke is recognized as a high-risk factor in the induction of COPD, and its damage to the airway involves airway damage, airway inflammation and airway remodeling.

Results

The results shown that CUL4A expression in small airway epithelium was significantly increased in patients with COPD. We also observed a significant negative association between CUL4A and FEV1%, a useful clinical marker for the diagnosis and evaluation of COPD severity, in small airway epithelial cells. In vitro, CSE-induced EMT is associated with high expression of CUL4A, and targeted silencing of CUL4A with shRNA inhibits CSE-induced EMT in human small airway epithelial cells.

Conclusions

Our results showed that CUL4A was overexpressed in lung epithelium of COPD patients, and CUL4A could regulate EMT of human small airway epithelium, which revealed a new mechanism of remodeling of small airway epithelium of COPD patients.
Epigenetics of hepatocellular carcinoma
Authors: Toh Tan Boon , Lim Jhin Jieh , Chow Edward Kai‐Hua
Published: May 2019

In recent years, large scale genomics and genome‐wide studies using comprehensive genomic tools have reshaped our understanding of cancer evolution and heterogeneity. Hepatocellular carcinoma, being one of the most deadly cancers in the world has been well established as a disease of the genome that harbours a multitude of genetic and epigenetic aberrations during the process of liver carcinogenesis. As such, in depth understanding of the cancer epigenetics in cancer specimens and biopsy can be useful in clinical settings for molecular subclassification, prognosis, and prediction of therapeutic responses. In this review, we present a concise discussion on recent progress in the field of liver cancer epigenetics and some of the current works that contribute to the progress of liver cancer therapeutics.
Flow Cytometry Characterization of Cerebrospinal Fluid Monocytes in Patients With Postoperative Cognitive Dysfunction: A Pilot Study
Authors: Berger Miles , Murdoch David M. , Staats Janet S. , Chan Cliburn , Thomas Jake P. , Garrigues Grant E. , Browndyke Jeffrey N. , Cooter Mary , Quinones Quintin J. , Mathew Joseph P. , Weinhold Kent J.
Published: May 2019

Animal models suggest postoperative cognitive dysfunction may be caused by brain monocyte influx. To study this in humans, we developed a flow cytometry panel to profile cerebrospinal fluid (CSF) samples collected before and after major noncardiac surgery in 5 patients ≥60 years of age who developed postoperative cognitive dysfunction and 5 matched controls who did not. We detected 12,654 ± 4895 cells/10 mL of CSF sample (mean ± SD). Patients who developed postoperative cognitive dysfunction showed an increased CSF monocyte/lymphocyte ratio and monocyte chemoattractant protein 1 receptor downregulation on CSF monocytes 24 hours after surgery. These pilot data demonstrate that CSF flow cytometry can be used to study mechanisms of postoperative neurocognitive dysfunction.
What’s New in Obstetric Anesthesia? The 2017 Gerard W. Ostheimer Lecture
Authors: Habib Ashraf S.
Published: May 2019

The “What’s New in Obstetric Anesthesia Lecture” is presented every year at the annual meeting of the Society for Obstetric Anesthesia and Perinatology. This lecture was established in 1975 to update the membership on the most relevant articles that were published in the preceding calendar year. In 1995, the lecture was renamed as the “Ostheimer Lecture” in honor of Gerard W. Ostheimer, an obstetric anesthesiologist from the Brigham and Women’s Hospital with significant contributions in the field. This review summarizes key articles published in 2017 that were presented in the 2018 Ostheimer Lecture with a focus on opioid prescriptions, anesthesia for external cephalic version, labor analgesia, maternal morbidity, and global health. A proposed list of action items based on the 2017 literature is also presented.
The Midwife and the Poet
Authors: Reinert Hugo
Published: May 2019

Triangulating narratives from a prospective mining site in northern Norway, this article works to identify (and render graspable) a particular effect of retroactive shock—tracing its resonance through experiences of chemical exposure, colonial racism, cultural erasure, and destruction of the built environment. Linking these experiences, the argument sets up and explores an analytical space within which the toxic modernity of planetary capitalism can resonate, structurally, with the racist violence of state colonialism: a space that also, the author suggests, describes an important dimension of Anthropocene experience itself.
The Impact of Morning versus Afternoon Exercise on Iron Absorption in Athletes
Authors: MCCORMICK RACHEL , MORETTI DIEGO , MCKAY ALANNAH K. A. , LAARAKKERS COBY M. , VANSWELM RACHEL , TRINDER DEBBIE , COX GREGORY R. , ZIMMERMAN MICHAEL B. , SIM MARC , GOODMAN CARMEL , DAWSON BRIAN , PEELING PETER
Published: May 2019

Purpose

This study examined postexercise inflammatory, hepcidin, and iron absorption responses to endurance exercise performed in the morning versus the afternoon.

Methods

Sixteen endurance-trained runners (10 male, 6 female) with serum ferritin (sFer) < 50 μg·L−1 completed a 90-min running protocol (65% vV˙O2max) in the morning (am), or the afternoon (pm), in a crossover design. An iron-fortified fluid labeled with stable iron isotopes (57Fe or 58Fe) was administered with a standardized meal 30 min following the exercise and control conditions during each trial, serving as a breakfast and dinner meal. Venous blood samples were collected before, immediately after, and 3 h after the exercise and control conditions to measure sFer, serum interleukin-6 (IL-6), and serum hepcidin-25. A final venous blood sample was collected 14 d after each trial to determine the erythrocyte iron incorporation, which was used to calculate iron absorption. Linear mixed-modeling was used to analyze the data.

Results

Overall, exercise significantly increased the concentrations of IL-6 (4.938 pg·mL−1; P = 0.006), and hepcidin-25 concentrations significantly increased 3 h after exercise by 0.380 nM (P < 0.001). During the pm trial, hepcidin concentrations exhibited diurnal tendency, increasing 0.55 nM at rest (P = 0.007), before further increasing 0.68 nM (P < 0.001) from prerun to 3 h postrun. Fractional iron absorption was significantly greater at breakfast after the am run, compared with both the rested condition (0.778%; P = 0.020) and dinner in the am run trial (0.672%; P = 0.011).

Conclusions

Although exercise resulted in increased concentrations of IL-6 and hepcidin, iron was best absorbed in the morning after exercise, indicating there may be a transient mechanism during the acute postexercise window to promote iron absorption opposing the homeostatic regulation by serum hepcidin elevations.
Change in Physical Activity and Cardiac Structure over 10 Years: The Multi-Ethnic Study of Atherosclerosis
Authors: FLORIDO ROBERTA , ZHAO DI , NDUMELE CHIADI E. , BLUEMKE DAVID A. , HECKBERT SUSAN R. , ALLISON MATTHEW A. , AMBALE-VENKATESH BHARATH , LIU CHIA-YING , LIMA JOAO , MICHOS ERIN D.
Published: May 2019

Introduction

Physical activity (PA) is inversely associated with risk of heart failure and cardiovascular disease (CVD), whereas increased left ventricular (LV) mass and mass to volume (m:v) ratio are unfavorable CVD risk factors. We assessed whether changes in leisure time PA were associated with longitudinal changes in cardiac structure in a community-based population.

Methods

We included 2779 Multi-Ethnic Study of Atherosclerosis participants, free of baseline CVD, who had available data on PA and cardiac magnetic resonance imaging at examinations 1 (2000–2002) and 5 (2010–2012). Physical activity was measured by a Typical Week PA Survey and converted to MET-minutes per week of moderate+vigorous activity. We used linear mixed effect models to estimate the associations of baseline and change in PA with baseline and change in cardiac structure, adjusting for CVD risk factors and body size.

Results

At baseline, the mean age was 59 yr, 53% were women, and 58% of nonwhite race/ethnicity. During average 10-yr follow-up, and after accounting for baseline PA levels, the highest quintiles of PA increase were significantly associated with increases in LV mass (2.3 g; 95% confidence interval [CI], 0.4–4.2), LV end-diastolic volume (4.7 mL; 95% CI, 2.4–7.0), and stroke volume (3.3 mL; 95% CI, 1.6–5.1), but lower M:V ratio (−2.9; 95% CI, −5.0 to −0.8) compared with the lowest quintiles. Increasing exercise PA was associated with increases in LV diameter and reductions in M:V ratio, whereas occupational PA was associated with increases in m:v ratio. Increasing PA over 10 yr was also associated with greater risk of eccentric dilated LV hypertrophy at examination 5.

Conclusions

After accounting for baseline PA, greater positive changes in leisure-time PA levels were associated with a more eccentric-type of LV remodeling pattern over 10 yr. The clinical implications of such findings remain to be determined.
One-Year Lifestyle Intervention, Muscle Lipids, and Cardiometabolic Risk
Authors: MALTAIS ALEXANDRE , LEMIEUX ISABELLE , ALMÉRAS NATALIE , TREMBLAY ANGELO , BERGERON JEAN , POIRIER PAUL , DESPRÉS JEAN-PIERRE
Published: May 2019

Purpose

Low-attenuation muscle (LAM) area at mid-thigh, a computed tomography (CT)–derived index of intramuscular lipids, is associated with insulin resistance, obesity, and type 2 diabetes. The present study aimed at testing the hypothesis that changes in LAM area in trunk muscles from a single abdominal scan could provide relevant information to evaluate the effects of a lifestyle intervention without the use of a mid-thigh CT scan.

Methods

Cardiometabolic risk variables, including waist circumference, lipoprotein–lipid profile, glucose tolerance, and cardiorespiratory fitness, were assessed in a sample of 102 dyslipidemic viscerally obese men at baseline and after a 1-yr lifestyle intervention. Abdominal (L4–L5) and mid-thigh CT scans were performed and abdominal muscles classified as psoas and core muscles. Scans were segmented to calculate muscle areas, LAM areas, and mean attenuation values.

Results

All muscle groups showed a decrease in LAM areas (P < 0.0001) in response to the lifestyle intervention. Changes in LAM areas were significantly associated with changes in triglycerides, high-density lipoprotein (HDL) cholesterol, cholesterol/HDL cholesterol ratio and log triglycerides/HDL cholesterol ratio (mid-thigh, 0.20 ≤ |r| ≤ 0.29; psoas, 0.28 ≤ |r| ≤ 0.38; core, 0.29 ≤ |r| ≤ 0.34, P < 0.05). Changes in core LAM area were significantly associated with changes in 2-h glucose levels, glucose area measured during the oral glucose tolerance test and homeostasis model assessment of insulin resistance (0.21 ≤ r ≤ 0.34, P < 0.05). Stepwise regression analyses showed that changes in LAM psoas area were associated with changes in HDL cholesterol and the cholesterol/HDL cholesterol ratio independently from changes in visceral adiposity.

Conclusions

Changes in trunk LAM areas are useful indices of changes in mid-thigh LAM area observed with a 1-yr lifestyle intervention. Thus, an additional mid-thigh scan is not necessary to evaluate muscle lipid content by CT when an abdominal CT scan is available.
Bernard Soulier Syndrome: 10 years’ experience at a tertiary care hospital
Authors: Farhan Saima , Iqbal Irem , Ahmed Nisar
Published: May 2019

Objective: To determine clinical manifestations and laboratory findings in patients with BSS diagnosed through platelet aggregometry followed in a tertiary care hospital in Lahore, Pakistan.

Methods: The retrospective study comprised patients who presented in Hematology and Transfusion Medicine Department of The Children Hospital & Institute of Child Health, Lahore with the relevant diagnosis from 2006 to 2013. The result of all the patients were collected on a predesigned proforma. Medical data was scrutinized to collect age, gender, clinical findings along with results of complete blood count, bleeding time and platelet aggregation studies for the diagnosis of Bernard Soulier Syndrome.

Results: Among 49 patients, 26 patients were females and 23 males. The mean age of the patients was 5±2.5 years. 81% had a family history of consanguinity. The most common presenting symptom included epistaxis seen in 73.4% patients. Complete blood count demonstrated decreased platelets in 85.7% of patients ranging from 20 X 109/L to 130 X 109/L. Anemia was seen in 67.3% and 93.8% had prolonged bleeding time. Peripheral blood smears demonstrated giant platelets in all patients. The majority of patients 65.3% had mild bleeding episodes. Platelet aggregation studies showed normal aggregation with ADP, Collagen and Epinephrine in 100% of our patients whereas all showed no response of aggregation with Ristocetin.

Conclusion: Our data is consistent with other reports regarding clinical presentation of BSS, but we report large number of BSS patients from our area, emphasizing significance to provide diagnostic services in Pakistan to find out exact magnitude of disease.

doi: https://doi.org/10.12669/pjms.35.3.980

How to cite this:Farhan S, Iqbal I, Ahmed N. Bernard Soulier Syndrome: 10 years’ experience at a tertiary care hospital. Pak J Med Sci. 2019;35(3):705-708. doi: https://doi.org/10.12669/pjms.35.3.980

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