bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimization of Xylanase Production from Aspergillus foetidus in Soybean Residue
Authors: Cunha Luana , Martarello Raquel , Souza Paula Monteiro de , Freitas Marcela Medeiros de , Barros Kleber Vanio Gomes , Ferreira Filho Edivaldo Ximenes , Homem-de-Mello Mauricio , Magalhães Pérola Oliveira
Published: April 2018

Enzymatic hydrolysis is an important but expensive step in the process to obtain enzyme derived products. Thus, the production of efficient enzymes is of great interest for this biotechnological application. The production of xylanase by Aspergillus foetidus in soybean residues was optimized using 2×23 factorial designs. The experimental data was fitted into a polynomial model for xylanase activity. Statistical analyses of the results showed that variables pH and the interaction of pH and temperature had influenced the production of xylanase, with the best xylanase production level (13.98 U/mL) occurring at fermentation for 168 hours, pH 7.0, 28°C, and 120 rpm.
Asymptotic Approximation of the Nonsteady Micropolar Fluid Flow through a Circular Pipe
Authors: Pažanin Igor , Radulović Marko
Published: April 2018

We study the nonsteady flow of a micropolar fluid through a thin cylindrical pipe. The asymptotic behaviour of the flow is found via asymptotic analysis with respect to the small parameter ϵ, representing the pipe’s thickness. The asymptotic approximation is derived in the form of the explicit formulae for the fluid velocity and microrotation. We also provide the numerical examples in order to visualize the effects of the micropolar nature of the fluid. The illustrations indicate the influence of the micropolarity on the effective flow of the fluid in the whole domain. In particular, those effects are most clearly observed for the velocity approximation near the boundary of the domain.
Brugada Phenocopy Induced by Recreational Drug Use
Authors: Akinlonu Adedoyin , Suri Ranjit , Yerragorla Priyanka , López Persio D. , Mene-Afejuku Tuoyo O. , Ola Olatunde , Dumancas Carissa , Chalabi Jumana , Pekler Gerald , Visco Ferdinand , Mushiyev Savi
Published: April 2018

Recreational drugs are commonly abused in all age groups. Intoxication with these substances can induce silent but significant electrocardiographic signs which may lead to sudden death. In this case study, we present a 49-year-old male with no medical comorbidities who came to the emergency department requesting opioid detoxification. Toxicology screen was positive for cocaine, heroin, and cannabis. Initial electrocardiogram (EKG) showed features of a Brugada pattern in the right precordial leads, which resolved within one day into admission. This presentation is consistent with the recently recognized clinical entity known as Brugada phenocopy.
An Exact Solution of the Second-Order Differential Equation with the Fractional/Generalised Boundary Conditions
Authors: Ciesielski Mariusz , Blaszczyk Tomasz
Published: April 2018

We analysed the initial/boundary value problem for the second-order homogeneous differential equation with constant coefficients in this paper. The second-order differential equation with respect to the fractional/generalised boundary conditions is studied. We presented particular solutions to the considered problem. Finally, a few illustrative examples are shown.
Synaptic Paths to Neurodegeneration: The Emerging Role of TDP-43 and FUS in Synaptic Functions
Authors: Ling Shuo-Chien
Published: April 2018

TAR DNA-binding protein-43 KDa (TDP-43) and fused in sarcoma (FUS) as the defining pathological hallmarks for amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD), coupled with ALS-FTD-causing mutations in both genes, indicate that their dysfunctions damage the motor system and cognition. On the molecular level, TDP-43 and FUS participate in the biogenesis and metabolism of coding and noncoding RNAs as well as in the transport and translation of mRNAs as part of cytoplasmic mRNA-ribonucleoprotein (mRNP) granules. Intriguingly, many of the RNA targets of TDP-43 and FUS are involved in synaptic transmission and plasticity, indicating that synaptic dysfunction could be an early event contributing to motor and cognitive deficits in ALS and FTD. Furthermore, the ability of the low-complexity prion-like domains of TDP-43 and FUS to form liquid droplets suggests a potential mechanism for mRNP assembly and conversion. This review will discuss the role of TDP-43 and FUS in RNA metabolism, with an emphasis on the involvement of this process in synaptic function and neuroprotection. This will be followed by a discussion of the potential phase separation mechanism for forming RNP granules and pathological inclusions.
The Highest Cited Papers in Brucellosis: Identification Using Two Databases and Review of the Papers’ Major Findings
Authors: Bakri Faris Ghalib , AlQadiri Hamzah M. , Adwan Marwan Hmoud
Published: April 2018

Citation classics represent the highest impact work in a given field. We aim to identify and analyze the most frequently cited papers on brucellosis. We used the databases Scopus and Web of Science to determine the most frequently cited papers. The most cited fifty papers in each database were identified. We then ranked the papers according to the highest citation count recorded from any of the two databases. The most frequently cited paper received 964 citations and was by DelVecchio VG et al. reporting the complete genomic sequencing ofBrucella melitensis. The papers were published in 30 journals led by the “Infection and Immunity” journal and the “Veterinary Microbiology” journal (each had 7 papers). Citation classics in brucellosis were all in English except one in French and were mostly of basic science type. In addition, we noticed that 12 articles that were identified among the highest fifty articles in one database were missed by the other database and vice versa. Therefore, we suggest that searching in more than one database would detect additional citation classics.
Hepatoprotective Activity of Vitamin E and Metallothionein in Cadmium‐Induced Liver Injury in Ctenopharyngodon idellus
Authors: Duan Yajiao , Duan Jing , Feng Yang , Huang Xiaoli , Fan Wei , Wang Kaiyu , Ouyang Ping , Deng Yongqiang , Du Zongjun , Chen Defang , Geng Yi , Yang Shiyong
Published: April 2018

As an environmental and industrial pollutant, cadmium (Cd) can cause a broad spectrum of toxicological effects. Multiple organs, especially the liver, are considerably affected by Cd in both humans and animals. We investigated the protective effects of metallothionein (MT) and vitamin E (VE) supplementation on Cd‐induced apoptosis in the grass carp (Ctenopharyngodon idellus) liver. Grass carp were divided into four groups: the control group, Cd + phosphate‐buffered saline (PBS) group, Cd + VE group, and Cd + MT group. All fish were injected with CdCl2 on the first day and then VE, MT, and PBS were given 4 days postinjection, respectively. The results showed that Cd administration resulted in liver poisoning in grass carp, which was expressed as an increase in Cd contents, malondialdehyde (MDA) concentration, percentage of hepatocyte apoptosis, and apoptosis‐related gene mRNA transcript expression. However, VE and MT treatments protected against Cd‐induced hepatotoxicity in grass carp by decreasing Cd contents, lipid peroxidation, and histological damage and reducing the percentage of hepatocyte apoptosis by regulating related mRNA transcript expression. These data demonstrate that oxidative stress and activation of the caspase signaling cascade play a critical role in Cd‐induced hepatotoxicity. However, VE and MT alleviate Cd‐induced hepatotoxicity through their antioxidative and antiapoptotic effects, and MT has a more powerful effect than VE.
Pruritus: Progress toward Pathogenesis and Treatment
Authors: Song Jing , Xian Dehai , Yang Lingyu , Xiong Xia , Lai Rui , Zhong Jianqiao
Published: April 2018

Pruritus, the most common cutaneous symptom, is widely seen in many skin complaints. It is an uncomfortable feeling on the skin and sometimes impairs patients’ quality of life. At present, the specific mechanism of pruritus still remains unclear. Antihistamines, which are usually used to relieve pruritus, ineffectively work in some patients with itching. Recent evidence has suggested that, apart from histamine, many mediators and signaling pathways are involved in the pathogenesis of pruritus. Various therapeutic options for itching correspondingly have been developed. In this review, we summarize the updated pathogenesis and therapeutic strategies for pruritus.
Peri-Implant Bone Behavior after Single Drill versus Multiple Sequence for Osteotomy Drill
Authors: Gehrke Sergio Alexandre , Bettach Raphaél , Aramburú Júnior Jaime Sardá , Prados-Frutos Juan Carlos , Del Fabbro Massimo , Shibli Jamil Awad
Published: April 2018

Objectives. The present study aims to compare the drilling protocol effect on osseointegration event in three commercially available titanium dental implants with different drill protocol using a rabbit tibia model. Materials and Methods. Three different drilling sequences were compared as follows: drilling sequence using a single unique drill of 4.2 mm conical implant (Group 1), drilling sequence using 3 consecutive cylindrical drills for a 4.1 mm cylindrical implant (Group 2), and drilling sequence using 3 consecutive conical drills for a 4.3 mm conical implant (Group 3). For each group, 18 drilling procedures and implant placements were performed, totalizing 54 commercially available titanium dental implants. The samples were removed 6 weeks after implantation. Resonance frequency analyses (RFA) were performed immediately after the implantation, and at 6 weeks removal torque test (RTt) and histological analysis were performed. Results. The RFA measured showed statistical difference between the groups in time 1 and no significant statistical differences in time 2 (p>0.05). In the RTt no significant difference was found between the 3 groups tested. Histomorphometric analysis showed no significant difference between groups in the bone-to-implant contact% (p>0.05). Conclusion. In the present preclinical study, osteotomy using a single bur did not show differences regarding the proposed and evaluated tests parameters for assessing the peri-implant behavior.
Early Ambulation Among Hospitalized Heart Failure Patients Is Associated With Reduced Length of Stay and 30-Day Readmissions
Authors: Fleming Lisa M. , Zhao Xin , DeVore Adam D. , Heidenreich Paul A. , Yancy Clyde W. , Fonarow Gregg C. , Hernandez Adrian F. , Kociol Robb D.
Published: April 2018

Background:

Early ambulation (EA) is associated with improved outcomes for mechanically ventilated and stroke patients. Whether the same association exists for patients hospitalized with acute heart failure is unknown. We sought to determine whether EA among patients hospitalized with heart failure is associated with length of stay, discharge disposition, 30-day post discharge readmissions, and mortality.

Methods and Results:

The study population included 369 hospitals and 285 653 patients with heart failure enrolled in the Get With The Guidelines-Heart Failure registry. We used multivariate logistic regression with generalized estimating equations at the hospital level to identify predictors of EA and determine the association between EA and outcomes. Sixty-five percent of patients ambulated by day 2 of the hospital admission. Patient-level predictors of EA included younger age, male sex, and hospitalization outside of the Northeast (
P
<0.01 for all). Hospital size and academic status were not predictive. Hospital-level analysis revealed that those hospitals with EA rates in the top 25% were less likely to have a long length of stay (defined as >4 days) compared with those in the bottom 25% (odds ratio, 0.83; confidence interval, 0.73–0.94;
P
=0.004). Among a subgroup of fee-for-service Medicare beneficiaries, we found that hospitals in the highest quartile of rates of EA demonstrated a statistically significant 24% lower 30-day readmission rates (
P
<0.0001). Both end points demonstrated a dose–response association and statistically significant
P
for trend test.

Conclusions:

Multivariable-adjusted hospital-level analysis suggests an association between EA and both shorter length of stay and lower 30-day readmissions. Further prospective studies are needed to validate these findings.
Longitudinal Association Between Orthostatic Hypotension at 30 Seconds Post-Standing and Late-Life Depression
Authors: Briggs Robert , Carey Daniel , Kennelly Sean P. , Kenny Rose Anne
Published: April 2018

There is an established cross-sectional association between orthostatic hypotension (OH) and late-life depression. The aim of this observational study was to clarify the longitudinal association between baseline symptomatic OH (sOH-30) and incident depression in a sample of >3000 older people without baseline depression (mean age: 62 years at baseline). This study was embedded within the Irish Longitudinal Study on Ageing using data from waves 1 to 3, collected between 2009 and 2014. At 2- and 4-year follow-up, a score ≥9 on the 8-item Center for Epidemiological Studies Depression Scale was used to define incident depression. sOH-30 was defined as a drop in systolic blood pressure ≥20 mm Hg or diastolic blood pressure ≥10 mm Hg at 30 seconds post-standing in conjunction with orthostatic symptoms, such as dizziness, using beat-to-beat measurements. Almost one fifth (proportion, 18%; 95% confidence interval [CI], 16–20) of the study sample had sOH-30. One tenth (proportion, 10%; 95% CI, 9–12) had incident depression. Participants with incident depression were twice as likely to have sOH-30 at baseline compared with those without incident depression (linear regression, 13% [95% CI, 8–19] versus 7% [95% CI, 6–8]). Weighted logistic regression models demonstrated that sOH-30 predicted incident depression with an odds ratio of 1.90 (95% CI, 1.15–3.15) after controlling for covariates, including subthreshold depression, hypotension, cognitive impairment, and antidepressant use. Asymptomatic OH at 30 seconds and initial OH did not predict depression. This study demonstrates that sOH-30 predicts incident depression in a population-representative sample of older people and may, therefore, represent a potentially modifiable risk factor for late-life depression.
Necessity and Future-Dependence: ‘Ockhamist’ Accounts of Abraham’s Faith at Paris around 1200
Authors: Wciórka Wojciech
Published: April 2018

This article aims to show that the so-called ‘Ockhamist’ solution to the determinist challenge was a commonplace among Parisian scholastics around 1200. On the ‘Ockhamist’ view, some propositions about the past do not fall under the necessity of the past, since their truth-value depends on the future. The paper focuses on two puzzles involving Abraham’s belief in the future Incarnation. The author discusses the ‘Ockhamist’ strategies adopted by theologians of the period, including Simon of Tournai, Peter of Poitiers, Praepositinus of Cremona, Stephen Langton, Geoffrey of Poitiers, and William of Auxerre. Langton draws an analogy between Abraham’s faith and Christ’s statement “Thou shalt deny me thrice” and suggests (while weighing alternatives) that past movements of faith are counterfactually flexible with regard to content. In order to interpret Langton’s statements, the author sketches a model of empty slots in the supernatural layer of the past, retrospectively infused with grace.
Looking at the “Qu qie” Chapter of the Zhuangzi from the Guodian *Yucong iv Bamboo Slip Manuscript (從郭店簡《語叢四》看《莊子·胠篋》)
Authors: Xueqin (李學勤) Li
Published: April 2018

The *Yucong
iv manuscript, part of the Guodian bamboo manuscript corpus, has an excerpt from the “Qu qie” chapter of the Zhuangzi. Since the date of the Guodian materials is no later than 300 b.c.e., the date of the composition of the “Qu qie” chapter must have been earlier than this. Since “Qu qie” is assigned to the Outer Chapters in the Zhuangzi, modern scholars have often regarded it as a later product. Now that *Yucong
iv has an excerpt from this chapter, we know that this traditional interpretation is by no means accurate. Information in “Qu qie” provides additional clues to further determine that the date of this chapter is earlier than 300 b.c.e. Because of this, “Qu qie” must have been from the hand of Zhuangzi himself or from one of his immediate pupils. However, since the philosophical perspective and many terms and language of “Qu qie” are drawn from the Laozi, we can also learn more about the issue of whether or not the Laozi and early Daoism and Confucianism were philosophically differentiated.

郭店簡《語叢四》摘錄了《莊子 · 胠篋》篇的文句，而這批楚簡的時代不晚於公元前300年，故《胠篋》篇的時代要早於這一時間。由於《胠篋》列於《莊子》外篇，近代學者多以爲晚出，現在知道《語叢四》已經引用該篇，可知以往的這一認識幷不正確。根據《胠篋》篇中一些可供判斷年代的地方，也能看出該篇的時代在公元前300年以前，因此《胠篋》篇應當是出自莊子或其及門弟子之手。而《胠篋》的思想觀點和許多詞語是由《老子》引申而來，對於瞭解《老子》及早期道家與儒家是否有思想分歧的問題也有重要的幫助。
Non-Chu Characteristics in the Guodian *Wu xing 五行 Manuscript (談談郭店簡《五行》篇中的非楚文字因素)
Authors: Shengjun (馮勝君) Feng
Published: April 2018

The Guodian *Wu xing 五行 is a Chu 楚 manuscript that contains a number of non-Chu scribal characteristics. In some cases we can identify which regional script the characteristics were inherited from. The *Wu xing manuscript provides a unique opportunity to help us better understand the process of how ancient Chinese texts were copied.

郭店簡《五行》篇，總體來説是一篇楚文字抄本，但其中夾雜了一些非楚文字因素。這些因素有的能夠斷定其地域特征，有的則不能。這篇簡文爲我們認識古書傳抄過程中的一些現象，提供了難得的樣本。
Description of a new Katha species from India, with a key to the Oriental species (Lepidoptera, Erebidae, Arctiinae)
Authors: JOSHI RAHUL , SINGH NAVNEET , SINGH JAGBIR
Published: April 2018

A new species: Katha volynkini Joshi & Singh, sp. nov. is described from Mizoram & Meghalaya (North East India). A checklist of Katha species from the World with a taxonomic key to the Oriental species is provided. A new combination, Katha suffusa (Leech), comb. nov. is established, and L. chekiangica Daniel, is synonymized under K. suffusa.
Notes on the orb-weaving spider genus Alpaida (Araneae, Araneidae) with description of four new species from Rio de Janeiro, Brazil
Authors: BAPTISTA RENNER LUIZ CERQUEIRA , DE SOUZA CASTANHEIRA PEDRO , PRADO ANDRÉ WANDERLEY DO
Published: April 2018

Four new species of the orb-weaving spider genus Alpaida O. P.-Cambridge, 1889 from Rio de Janeiro state, Brazil are illustrated and described based on males and females from the following municipalities: Alpaida imperatrix new species (Macaé and Rio de Janeiro); Alpaida imperialis new species (Mendes and Rio de Janeiro); Alpaida marista new species (Mendes and Pinheiral); and Alpaida mendensis new species (Mendes). Furthermore, two new synonymies are herein proposed: Alpaida lanei Levi, 1988 = Alpaida atomaria (Simon, 1895) and Alpaida caxias Levi, 1988 = Alpaida tijuca Levi, 1988, alongside new records for both species and also Alpaida venger Castanheira & Baptista, 2015.
A new species of Polietina (Diptera: Muscidae) from South America, with an updated phylogeny of the genus and a review of species’ identity in GenBank
Authors: DE CARVALHO CLAUDIO J. B. , HASEYAMA KIRSTERN LICA F.
Published: April 2018

After a 20 years hiatus, we describe a new species, Polietina ponti sp. nov., from Madre de Dios, Tambopata River, Peru. Additionally, we propose Polietina nigra Couri & Carvalho, 1996 as a junior synonym of Polietina prima (Couri & Medeiros, 1990). A previous phylogenetic hypothesis was updated with the inclusion of the new taxon described here, which yielded a single most parsimonious tree that is similar to a previously published hypothesis (Pyrellina marsya (Pyrellina distincta (Deltotus facetus ((Polietina steini (Polietina ponti sp. nov., P. prima (P. bicolor, P. minor, P. univittata)(P. flavithorax, P. major)))(P. flavidicincta (P. rubella (P. concinna (P. orbitalis, P. wulpi)))))))). The identity of Polietina vouchers with nucleotide sequences registered in the GenBank were also verified and corrected.
Educational approach to the wye–delta transformations using simple circuit analysis techniques
Authors: Arabasi Sameer
Published: April 2018

The wye-to-delta (Y–Δ) transformation is part of every circuit analysis course. In electric circuits textbooks, the transformation is found by comparing the two networks and making sure that the resistance between each pair of nodes in one network is the same as the resistance between the same pair of nodes in the other network. The two networks are compared as open-circuit networks. This creates confusion among students because usually the network is part of a larger closed-circuit network. In this paper, an alternative method is proposed. The new method starts from one configuration and finds the corresponding equivalent configuration by deriving currents and voltages, as part of a closed circuit. This method can be adopted in circuit analysis courses to help students develop a deeper understanding of this topic.
Depletion of Bile Acids and Bilirubin in Dogs with Biliary Obstruction by Plasmaperfusion of Usp-Charcoal-Coated Glass Beads
Authors: Lauterburg B.H. , Dickson E.R. , Pineda A.A. , Taswell H.F.
Published: April 2018

Patients with severe, inoperable cholestasis and intractable pruritus not responding to conventional medical therapy might benefit from a depletion of their bile acid pool by sorbent perfusion since accumulated bile acids are possibly responsible for their itching. In vitro, USP-charcoal-coated glass beads removed bile acids from human plasma far better than any other sorbent tested. In order to demonstrate the safety and efficacy of charcoal plasmaperfusion in vivo, five dogs underwent plasmapheresis one week following cholecystectomy and bile duct ligation, and 2.2 ± 0.2 (x̄ ± SD) times their plasma volume was passed over a column containing 400 ml of charcoal-coated glass beads prior to reinfusion. During the procedure the plasma bile acid concentration was reduced by 40.2 ± 4.0% and the bilirubin level by 48.2 ± 3.3%. The columns, whose capacity was far from being saturated, retained 1.3 ± 0.4 times the pre-perfusion plasma pool of bile acids (1.1 ± 0.2 for bilirubin) suggesting that substantial amounts of bile acids and bilirubin were mobilized from tissue stores. The procedure was well tolerated by the animals and might have promising clinical applications.
Immobilization of Arginase on Hollow Fiber Hemodialyzer
Authors: Rossi V. , Malinverni A. , Callegaro L.
Published: April 2018

The enzyme arginase, purified from bovine liver, was covalently immobilized by the glutaraldehyde method to the inner surface of Cuprophan hollow fibers of a conventional hemodialyzer with a surface 1.3 m3. The yield of the process was 0.3 μg/cm2 of active enzyme at physiological pH. The immobilization method did not adversely affect the physical and mechanical properties of hollow fibers neither their hemocompatibility. After sterilization with ethylene oxide, the bioreactor was able to metabolize five liters of 50 μM arginine solution at pH 7.4, in six hours.
Bilirubin Removal from an Hepatic Failure Patient by Resin Hemoperfusion
Authors: Mor L. , Sideman S. , Mihich M. , Taitelman U.
Published: April 2018

An hemoperfusion (HP) column, packed with beads of a macroreticular MR ion exchange resin which were made biocompatible by coating with a fine layer of cross-linked human albumin, was applied to the removal of bilirubin (BIL) from a jaundiced 69-year old man with hepatic failure.

The column was found most suitable for BIL removal. However, the high volumetric mass transfer coefficient of the unconjugated (UC) BIL indicates that this column could best be used for BIL removal from babies suffering from unconjugated hyperbilirubinemia.
Sintered Platinum for Cardiac Pacing
Authors: Freud G.E. , Chinaglia B.
Published: April 2018

Platinum electrodes for cardiac stimulation having a surface porosity in the range of 40 μm have been prepared with a sintering process.

These electrodes showed excellent in vitro characteristics (low polarization and sensing impedance). Animal testing proved good tissue acceptance and clinical trials in 31 patients gave the following results: threshold at implant 0,375 μJ (SD: 0.174 μJ), chronic threshold 1.15 μJ (SD: 1.05 μJ). The longest observation period was 7 months and the mean observation period was 17.1 weeks.

These results indicate that this type of electrode allows safe stimulation of the heart with low energy pulses; in particular a reliable safety margin could be obtained with pulses having the amplitude of the existing lithium batteries, avoiding the need for a voltage doubler. This would improve the battery utilization and the pulse generator longevity.
Cardiopulmonary Bypass-induced Complement Activation. Evidence for C5a Participation
Authors: Wysocki H. , Ponizyński A. , Wierusz-Wysocka B. , Brocki Z. , Czarnecki R.
Published: April 2018

Plasma activity inducing polymorphonuclear neutrophils (PMN) aggregation, augmenting PMN adherence, plasma chemotatic activity as well as peripheral PMN count were estimated in patients during cardiopulmonary bypass. In the course of the surgical procedure the chemotactic activity and the activity inducing PMN aggregation were detected in plasma. The top of these two activities was always followed by the significant fall of the peripheral PMN count. The increase of the activity augmenting PMN adherence was observed in a part of cases, but when noticed, always preceded the maximum of the remaining evaluated activities.
Neutrophil Adherence during Hemoperfusion in Fulminant Hepatic Failure
Authors: Altin M. , Hughes R.D. , Williams R.
Published: April 2018

Neutrophil adherence to nylon fibre packed in plastic syringes was determined in blood from patients with fulminant hepatic failure, both before and during charcoal hemoperfusion carried out with prostacyclin infusion and resin hemoperfusion without prostacyclin.

During charcoal hemoperfusion there was a progressive decrease in neutrophil adherence, reaching the lowest value at 4 h (30.4 ± SE 4.8%). After completion of hemoperfusion the adherence value returned to the preperfusion level (53.0 ± 8.4%). These effects are probably attributable to the PGI2 infusion.

No marked changes in neutrophil adherence were observed during resin hemoperfusion.
Origin of Glycosylated Hemoglobin Al in Chronic Renal Failure
Authors: De Marchi S. , Cecchin E. , Camurri C. , Quaia P. , Raimondi A. , Donadon W. , Lippi U. , Tesio F.
Published: April 2018

In chronic renal failure both HbAI and HbAlc levels have been reported to be elevated. In order to investigate the causes of such increase we measured HbAI (cation-exchange chromatography), blood urea nitrogen, arterial blood pH, plasma bicarbonate, phosphatemia, serum iron and serum ferritin before dialysis in 60 uremic patients receiving long term hemodialysis. The increased levels of HbAI do not correlate with glucose intolerance, phosphatemia, blood urea nitrogen, time averaged concentration of urea, serum iron and serum ferritin. On the contrary the presence of a highly significant correlation between HbAI and arterial blood pH (p < 0.001) and between HbAI and plasma bicarbonate (p < 0.001) seems to emphasize a major role for acidosis in increasing the HbAI levels in uremic patients on long term hemodialysis.
Right Atrial Ball Thrombus as a Complication of Subclavian Catheter Insertion for Hemodialysis Access
Authors: Wijeyesinghe E.C.R. , Pei Y. , Feritori S.S.A. , Uldall P.R.
Published: April 2018

In two patients right atrial ball thrombi developed following prolonged subclavian cannulation for hemodialysis. One patient died, the other had the ball thrombus removed by open heart surgery. It appears that repeated friction of the catheter tip may have damaged the endothelium of the right atrial wall.

This hitherto unrecognised complication might be prevented by ensuring that subclavian hemodialysis catheters are never allowed to reach as far as the right atrium.
Progression to end Stage Renal Disease in Poststreptococcal Glomerulonephritis (PSGN) - Chandigarh Study
Authors: Chugh K.S. , Malhotra H.S. , Sakhuja V. , Bhusnurmath S. , Singhal P.C. , Unni V.N. , Singh N. , Pirzada R. , Kapoor M.M.
Published: April 2018

193 patients (142 adults and 51 children) with acute PSGN were followed long term. Sixty percent had elevated serum creatinine and 14% had nephrotic range proteinuria at the onset. By two years 28 patients (14%) had died from uremia, and 19 were lost to follow up. Amongst the remainder, 8 patients (4%) had developed mild to moderate renal insufficiency, 12% were hypertensive, and 22% had urinary abnormalities. Of the 146 patients alive at 2 years, 107 were followed up to 10 years (mean 4.8 years). In addition to the 8 patients with renal insufficiency at 2 years, another 7 developed renal failure subsequently. Four out of these 15 patients progressed to uremia within 4 to 10 years after the onset of disease. Hypertension and persistent urinary abnormalities were present in 15% and 24% respectively. Progression to uremia occurred in 6% of children and 20% of adults. Nephrotic range proteinuria, renal insufficiency at the onset, and crescents in more than one third of glomeruli indicated a poor prognosis.
Continuous Arteriovenous Renal Replacement Therapy
Authors: Zobel G. , Ring E. , Trop M.
Published: April 2018

As urea and creatinine clearances achieved by continuous arteriovenous hemofiltration tend to be low, efforts were made to increase urea and creatinine elimination by modifying the original continuous arteriovenous hemofiltration system. We investigated the urea and creatinine clearances of different continuous renal replacement therapy systems. Urea clearance achieved by spontaneous arteriovenous hemofiltration was 9.1 ml/min, suction-supported arteriovenous hemofiltration 15.3 ml/min, arteriovenous hemodiafiltration 15.4 to 19.3 ml/min, arteriovenous hemodialysis 18.9 to 22.1 ml/min. Creatinine clearances ranged between 11.1 (spontaneous arteriovenous hemofiltration) and 25.1 ml/min (arteriovenous hemodialysis). Continuous arteriovenous hemodialysis seems at present to be the ideal renal replacement therapy system to compensate azotemia in hypercatabolic patients. Its urea and creatinine clearances are high, its clinical tolerance good and it is simple and safe.
Technical and clinical evaluation of a new polyamide hollow fiber hemofilter for CAVH
Authors: Ronco C. , Brendolan A. , Bragantini L. , Fabris A. , Feriani M. , Chiaramonte S. , Milan M. , Dell'Aquila R. , La Greca G.
Published: April 2018

We carried out an in-vivo and in-vitro evaluation of a new polyamide hollow fiber hemofilter especially designed to operate under conditions of low pressure and low blood flow, such as in continuous arteriovenous hemofiltration (CAVH).

The results obtained suggest that this filter is a prototype of a new generation of hemofilters especially designed for CAVH. Its low resistance permits its use even in patients with severe hypotension. The high blood flows achieved at a given pressure reduce the risk of clotting and increase the ultrafiltration rate. When an average ultrafiltration of 20-25 ml/min is achieved in 24 hours CAVH becomes very efficient, and alternative techniques to increase its efficiency are no longer required.
Thrombotic Microangiopathy of the Miscellaneous Secondary Type Responding to Plasma Exchange in a Liver Transplant Recipient
Authors: Valbonesi M. , Valente U. , Pellicci R. , Piri C. , Ferrari M. , Frisoni R. , Zia S. , Quaratino S. , Fella M.
Published: April 2018

A thrombotic microangiopathy syndrome, clinically and pathologically similar to thrombotic thrombocytopenic purpura (TTP) has been reported in recipients of tissue transplants, including renal and bone marrow allografts. The diagnosis is made only after other causes of microangiopathic hemolytic anemia have been excluded. In this case report we present the outcome of the combination of plasma exchange, dipyridamole and aspirin in the management of a TTP-like syndrome that complicated the post-operative course of liver transplantation.
The in vitro Bleeding Time While Using a Stable Prostacyclin Analogue during Hemodialysis
Authors: Maurin N.
Published: April 2018

A serious disadvantage of preventing clot formation by using prostacyclin (PGI2) to inhibit thrombocyte function during dialysis is that there exists no rapidly measurable monitoring parameter. The “in vitro bleeding time” fin vitro BT) is a new method for measuring primary hemostasis in vitro. Five chronic dialysis patients each underwent two dialyses: 1) with conventional full heparinization, and 2) with the stable PGI2 analogue CG 4203 and additional “low-dose” heparin. The predialytic in vitro BT is longer than normal values and values 1 h after the end of dialysis. While heparin has no significant effect on the in vitro BT, CG 4203 prolongs it concentration-dependently. Infusing CG 4203 at a rate of 25 ng/kg/min, the in vitro BT is extended beyond the measurable range of 800 μl during the first approx. 150 min of dialysis. During the next approx. 90 min it steadily decreases.
Effect of Oral Adsorbent on Blood Metabolites in Hepatic Failure Dogs
Authors: Hiraishi M. , Takahama T. , Yamazaki Z. , Kanai F. , Ohnishi K. , Idezuki Y. , Inoue N.
Published: April 2018

AST-120 is a specially synthesized carbonaceous adsorbent for oral use. It mainly adsorbs low to middle molecules in the alimentary tract. In the present study, AST-120 was administered to hepatic failure dogs, and blood metabolites were analyzed by high performance liquid chromatography (HPLC).

Thirty adult mongrel dogs underwent posta-cavae (P-C) shunts with 40% and 70% hepatectomies. They were divided into two groups, the AST group (n= 19) and control group (n=11). The AST group received about 0.5 g/kg of the adsorbent intermittently with diet after the operation. The control group was fed the ordinary diet. Body weight, blood ammonia, plasma bile acids were measured, and blood metabolites were analyzed by the multi-column HPLC system.

P-C shunt dogs with 70% hepatotectomies died within three months showing about 40–50% body weight loss. HPLC analysis of their plasma showed some specific peaks for middle molecules, about 3000–5000 daltons. After administration of the adsorbent, these peaks were not detected, so it was considered that these substances had been adsorbed.
Enzymatic Detoxification using Lipophilic Hollow-Fiber Membranes: IV. Glutathione Conjugation Reactions
Authors: Tsikas D. , Brunner G.
Published: April 2018

A hollow-fiber technique was used in the enzymatic glutathione conjugation of lipophilic toxins. Native enzyme was circulated on the external side of a lipophilic hollow-fiber membrane while the toxin-containing media (blood, plasma or aqueous solution) were circulated inside the fiber. Glutathione conjugation reactions were catalyzed by rat liver cytosol, with a specific glutathione transferase activity of 40 nmol/min/mg protein (acceptor: 1,2-epoxy-3-(p-nitrophenoxy)propane). Clearance rates of 1,2-epoxy-3-(p-nitrophenoxy)propane, phenylglycidether, styrene oxide, cis-9, 10-epoxystearic acid, cis-9, 10-epoxystearic acid methyl ester, 5a, 6a-cholesterol oxide, 16-, 17a-pregnenolone oxide, and p-nitrobenzylchloride were 10.44, 13.37, 32.25, 7.60, 7.31, 3.92, 4.20 and 29.24 nmol/mg protein/h/cm2 hollow-fiber surface respectively. This technique makes possible glutathione conjugation reactions with crude enzyme preparations over long periods without loss of activity from covalent immobilization and without loss of cofactor from (auto)oxidation. The lipophilic membrane ensures the absence of hemolysis, immunological hazards and hormone loss, while elimination of the toxin is not impaired.
Hemoglobin Solutions in Experimental Cardioplegia
Authors: Přistoupil T.I. , Vrána M. , Havlíčková J. , Kramlová M.
Published: April 2018

The addition of stroma-free hemoglobin solution to a standard St. Thomas Hospital cardioplegic solution significantly protected the heart from ischemic damage compared to the effect of the same solution without added hemoglobin. An experimental model of rat heart cardioplegia and transplantation comprising heart arrest for three hours at 20°C was used. The number of hearts performing strong contractions after cardioplegia with iso-oncotic oxyhemoglobin prior to transplantation was close to the results with histidine-buffered cardioplegic solution according to Bretschneider. Comparative biochemical model experiments in vitro confirmed that the positive effect of oxyhemoglobin was due predominantly to its buffering capacity. The role of oxygen transport to tissues by hemoglobin was limited only to the first minutes of cardioplegia since neither recirculation nor reoxygenation took place in the present experimental setting.
Relationship between Design and Control of Artificial Heart for Protection of the Right/Left Balance
Authors: Nabel H.-J. , Schmitz K.-P. , Urbaszek W. , Scharf W. , Emmrich K. , Klinkmann H.
Published: April 2018

Right/left matching in the total artificial heart (TAH) is essential to prevent fatal volume displacement into the pulmonary circuit. Measurements were made with three different sized Rostock pneumatic artificial ventricles incorporated in the Donovan mock circulatory system together with the heart driver AKT 86. First for each ventricle we determined the dependence of the maximum effective stroke volume on the systolic driving pressure and the afterload. The right ventricle (RV) is about 10% more effective than the left ventricle (LV). Control of the TAH permits different or equal frequencies for the RV and LV. For control with equal frequencies and full-to-empty regimen of one ventricle (RV-Master or LV-Master) the ratio of designed stroke volumes between RV and LV is important. This follows from the smaller efficiency of the LV and the left-to-left shunt. Otherwise a control mode with different heart rates must be used.
Conjugated Human Hemoglobin as a Physiological Oxygen Carrier - Pyridoxalated Hemoglobin Polyoxyethylene Conjugate (PHP)
Authors: Malchesky P.S. , Takahashi T. , Iwasaki K. , Harasaki H. , Nosé Y.
Published: April 2018

Problems associated with specific physiological properties of Hb-based blood substitutes, such as a low P50, short plasma half-life and nephrotoxicity are still major issues to be addressed. Extensive investigations aimed at overcoming these problems have resulted in the preparation of pyridoxalated-hemoglobin-polyoxyethylene conjugate (PHP). PHP was developed from human hemoglobin by two major chemical modifications; pyridoxylation for the purpose of lowering the oxygen affinity (P50 of 19.5 ± 1.2 mmHg), and coupling with polyoxyethylene (POE) to increase its molecular weight (to approximately 90 kdaltons). The circulating half-life of PHP is about 40 hours in dogs. Toxicologicai and physiological studies including renal function assessments have demonstrated that PHP does not have untoward effects on major organ functions. Its efficacy in transporting oxygen has been shown in ET and intracoronary perfusion, and in in vitro studies with sickle cells. Studies to date suggest that PHP is a promising candidate as a physiological oxygen carrier. In this paper the properties of PHP, its safety and efficacy aspects, and its potential as a clinical oxygen carrier are reviewed based on studies conducted in the Author's laboratory.
Effect of Anticoagulant on Biocompatibility in Membrane Plasmapheresis
Authors: Omokawa S. , Malchesky P.S. , Yamashita M. , Suzuki T. , Goldcamp J.G. , Murabayashi S. , Nosè Y.
Published: April 2018

The effect of heparin or citrate anticoagulation on blood cellular, complement pathway and coagulation pathway was investigated in a membrane plasma exchange procedure. Two membrane plasma separators constructed of cellulose di-acetate (CA) and polyvinyl chloride (PVC) were evaluated with heparin or citrate alone for anticoagulation in a 26 year old male with myasthenia gravis. Maximum white blood cell counts decrease was 21% at 30 min for the CA with heparin while no decrease was observed for the other schemes. Platelet counts changes were comparable between heparin and citrate, while the PVC groups showed less changes than the CA groups. The CA groups, regardless of the type of anticoagulant used, indicated that complement activation occurred via the classical pathway within the module in addition to the activation via alternative pathway for the CA with heparin. In the PVC groups, complement activation was noted to occur only when heparin was used for anticoagulation. PT and PTT showed slight increases with citrate, while they were remarkably prolonged with heparin. Citrate showed less changes in cellular and humoral factors compared to heparin. CA with heparin was the most activating combination of membrane material and anticoagulant, while the PVC with citrate was the least activating combination.
“For Their Own Good”: A Response to Popular Arguments Against Permitting Medical Assistance in Dying (MAID) where Mental Illness Is the Sole Underlying Condition
Authors: Dembo Justine , Schuklenk Udo , Reggler Jonathan
Published: April 2018

Canada is approaching its federal government’s review of whether patients should be eligible for medical assistance in dying (MAID) where mental illness is the sole underlying medical condition, and when “natural death” is not “reasonably foreseeable”. For those opposed, arguments involve the following themes: capacity, value of life, vulnerability, stigma, irremediability, and the role of physicians. It has also been suggested that those who are able-bodied should have to kill themselves, even though suicide may be painful, lonely, and violent. Opponents of MAID for severe, refractory suffering due to mental illness imply that it is acceptable to remove agency from such patients on paternalistic grounds. After years of efforts to destigmatise mental illness, these kinds of arguments effectively declare all patients with mental illness, regardless of capacity, unable to make considered choices for themselves. The current paper argues that decisions about capacity must be made on an individual-patient basis. Given the rightful importance granted to respect for patient autonomy in liberal democracies, the wholesale removal of agency advocated by opponents of a permissive MAID regime is difficult to reconcile with Canadian constitutional values.
A framework of product design by metaphor
Authors: Wang HH
Published: April 2018

Design by metaphor is one of the primary activities of designers’ conceptualization of new products. Literature suggests metaphor plays an important role in problem solving while theorizing on good metaphors in design is still in its early stages. Focusing on the notions of category dissimilarity, object similarity, and salience imbalance, this paper proposes a framework of metaphorical design based on three hypotheses on good metaphorical designs. The hypotheses are tested by an experiment in which 62 undergraduates of a university rate three groups of stimuli. Results show all the hypotheses are strongly supported. The target and source of good metaphorical designs have the significant category dissimilarity, object similarity, and the salience imbalance of object similarity. Therefore, the framework has potentials to describe and explain the goodness for understanding the metaphorical meaning of products, as well as to develop guidelines for design by metaphor.
The effects of the lower outlet on the flow field of small gas–liquid cylindrical cyclone
Authors: Zhu Weibing , Hu Liang , Zhang Xiaobin
Published: April 2018

In this study, the effects of the lower outlet on the flow field of small gas–liquid cylindrical cyclones are investigated using Reynold stress turbulence model. Under the same operating conditions, four configurations with different outlet styles and angles are established. The time-averaged tangential velocity, axial velocity, and root mean square velocity are compared, respectively. It is shown that many local secondary flow patterns are present in small gas–liquid cylindrical cyclones, and those flow patterns may cause serious energy losses. The lower outlet mainly influences the gas–liquid cylindrical cyclones flow field in the central region. The small gas–liquid cylindrical cyclones with single rectangular outlet provides a steady flow field and a large backflow zone, which are helpful in improving the separation efficiency. According to the simulations, a single rectangular lower outlet is the optimal one for small gas–liquid cylindrical cyclones.
Increased flexibility, pain reduction and unaltered levels of IL-10 and CD11b + lymphocytes in patients with systemic lupus erythematosus were associated with kinesiotherapy
Authors: Timóteo R Pessato , Silva A Ferreira , Micheli D Côbo , Candido Murta E F , Freire M , Teodoro R Botelho , Lima F M , Martins Tavares Murta B , Bertoncello D
Published: April 2018

The effect of physical activity on the immune system is still poorly understood in cases of systemic lupus erythematosus (SLE). Therefore, our aim was to investigate differences in the serum levels of cytokines (IL-2, IL-5, IL-6, IL-8, IL-10 and TNF-α) and the numbers of CD11b + and CXCR2 + neutrophils and lymphocytes in women with SLE undergoing drug treatment, without ( n = 9) or with ( n = 5) 4 months of kinesiotherapy. Parameters related to functional capacity were also analyzed. In the case of the patients who were not submitted to kinesiotherapy, there were reductions in the levels of IL-5, IL-6 and IL-10, and an increase in the number of CD11b + leukocytes, in addition to an increase in abdominal circumference after the monitoring time. Patients submitted to kinesiotherapy did not present changes in serum cytokines or in the numbers of CD11b + and CXCR2 + neutrophils and lymphocytes, but there were increases of flexibility and strength, as well as a reduction in pain sensation after the monitoring time. In conclusion, kinesiotherapy was able to increase flexibility and reduce pain in SLE patients without influencing immune parameters.
Microthrombotic renal involvement in an SLE patient with concomitant catastrophic antiphospholipid syndrome: the beneficial effect of rituximab treatment
Authors: Diószegi Á , Tarr T , Nagy-Vincze M , Nánásy-Vass M , Veisz R , Bidiga L , Dezső B , Balla J , Szodoray P , Szekanecz Z , Soltész P
Published: April 2018

Antiphospholipid syndrome is characterized by multiple arterial and/or venous thrombotic events, recurrent fetal losses in the presence of antiphospholipid antibodies (aPL). Catastrophic antiphospholipid syndrome is a life-threatening, rare subset of antiphospholipid syndrome when the thrombotic events affect at least three organs, and clinical manifestations develop simultaneously or within a week. Diagnostically, small vessel occlusions can be detected by histopathology in the presence of aPL. Our case report describes an 18-year-old man who has been treated for antiphospholipid syndrome associated with systemic lupus erythematosus (SLE) since 2011. The clinical findings were dominated by recurrent deep vein thrombosis, and severe proteinuria caused by lupus nephritis, accompanied by mild serological and laboratory findings. The patient was hospitalized in March 2014 because of severe thrombocytopenia and infective diarrhoea. At this time the renal functions deteriorated rapidly. Simultaneously, left upper extremity paresis was observed; computed tomography showed ischaemic lesions in the territory of the middle cerebral artery. Abdominal discomfort and pain occurred. On computed tomography scan ischaemic lesions were seen in the spleen, the right kidney and the coeliac trunk. Laboratory and serological findings verified the presence of aPL and anti-DNA antibodies, anaemia and thrombocytopenia. Based on the above-mentioned clinical and laboratory findings, the diagnosis of catastrophic antiphospholipid syndrome was established. Anticoagulation, corticosteroids and plasma exchange treatment, as well as haemodiafiltration were initiated. Although the thrombotic cascade decelerated following these interventions, we could not see an improvement in the renal function. Rituximab treatment was started, leading to a significant improvement in renal function. After 5 weeks of treatment the patient was discharged from hospital.