bluuebunny/crossref_metadata_2025 huggingface dataset:
Cryptogenic Organizing Pneumonia with Sarcoidosis Overlap: An Atypical Case Study
Authors: Neelambra Ajmal Nazir , Acharya Vishak , Sundararajan Sowmya
Published: June 2018

Case Summary. We present a case of a young female with subacute symptoms of cough and progressive dyspnoea. On evaluation, the patient was diagnosed as cryptogenic organizing pneumonia based on her histopathological reports. However, her significant elevation of serum angiotensin-converting enzyme (SACE) levels which drop after treatment with oral steroids, relapse, and clinical presentation pointed towards sarcoidosis as clinical diagnosis. Discussion. Here, in this patient, transbronchial biopsy was suggestive of cryptogenic organizing pneumonia along with chest X-ray, and the HRCT finding was also favouring the same. But in this case, we have also seen elevated levels of serum ACE which dropped significantly to the normal level along with a complete clearance of lesions with systemic steroids, and this favours sarcoidosis. Also, the recurrence was in different areas of the lung, and lesions once again responded both clinically and radiologically to steroids with a consistent drop in serum angiotensin-converting enzyme (SACE) levels, which again is a feature common in sarcoidosis. In COP, often complete clearance of the lesions is seldom seen, even though they do respond to steroids but not as dramatically as in our case. Also, recurrence of the lesion with BOOP at different sites is uncommon as it generally progresses in the same site. Conclusion. This case report suggests that sarcoidosis as a possible cause of cryptogenic organizing pneumonia is worth considering with the mixed spectrum of presentation as in our case. And to our knowledge, this type of presentation of cryptogenic organizing pneumonia with sarcoidosis as an overlap disease is very rare, and this possibility needs to be explored by more series of such cases.
A Method for Tooth Model Reconstruction Based on Integration of Multimodal Images
Authors: Zhou Xinwen , Gan Yangzhou , Xiong Jing , Zhang Dongxia , Zhao Qunfei , Xia Zeyang
Published: June 2018

A complete digital tooth model is needed for computer-aided orthodontic treatment. However, current methods mainly use computed tomography (CT) images to reconstruct the tooth model which may require multiple CT scans during orthodontic progress, and the reconstructed model is also inaccurate in crown area. This study developed a tooth model reconstruction method based on integration of CT images and laser scan images to overcome these disadvantages. In the method, crown models and complete tooth models are first reconstructed, respectively, from laser scan images and CT images. Then, crown models from laser scan images and tooth models from CT images are registered. Finally, the crown from laser scan images and root from CT images were fused to obtain a new tooth model. Experimental results verified that the developed method is effective to generate the complete tooth model by integrating CT images and laser scan images. Using the proposed method, the reconstructed models provide more accurate crown than CT images, and it is feasible to obtain complete tooth models at any stage of orthodontic treatment by using one CT scan at the pretreatment stage and one laser scan at that stage to avoid multiple CT scans.
A Rare Case of Chronic Appendicitis Superimposed on an Incarcerated de Garengeot Hernia Prospectively Identified on Computed Tomography
Authors: Goldbach Alyssa , Hota Partha , Czulewicz Andrew , Burgert-Lon Christine , Agosto Omar
Published: June 2018

The de Garengeot hernia is an uncommon and potentially confounding pathologic process in which the appendix is contained within a femoral hernia. While typically a benign incidental finding, superimposed acute appendicitis is a rare but serious complication. Identification of this entity is crucial to patient management and ultimately outcome with imaging playing a critical role. Cross-sectional imaging, with either CT or MRI, should be performed in all cases of suspected incarcerated de Garengeot hernia to facilitate the appropriate diagnosis and surgical intervention. Herein, we present the fifth case of a prospective CT diagnosis of the de Garengeot hernia in a 61-year-old female who presented with an irreducible right femoral hernia. The patient underwent CT examination which demonstrated the appendix within the femoral hernia sac with an associated periappendiceal fluid collection. The patient was taken for emergent surgical intervention at which time the appendix was found within the hernia sac. The appendix was removed, the defect repaired, and ultimately the patient recovered well.
A Panel of MicroRNA Signature as a Tool for Predicting Survival of Patients with Urothelial Carcinoma of the Bladder
Authors: Inamoto Teruo , Uehara Hirofumi , Akao Yukihiro , Ibuki Naokazu , Komura Kazumasa , Takahara Kiyoshi , Takai Tomoaki , Uchimoto Taizo , Saito Kenkichi , Tanda Naoki , Yoshikawa Yuki , Minami Koichiro , Hirano Hajime , Nomi Hayahito , Kato Ryuji , Hayashi Tetsuya , Azuma Haruhito
Published: June 2018

Introduction and Objectives. MicroRNA (miRNA) expression is altered in urologic malignancies, including urothelial carcinoma of the bladder (UCB). Individual miRNAs have been shown to modulate multiple signaling pathways that contribute to BC. To identify a panel of miRNA signature that can predict aggressive phenotype from normal nonaggressive counterpart using miRNA expression levels and to assess the prognostic value of this specific miRNA markers in patients with UCB. Methods. To determine candidate miRNAs as prognostic biomarkers for dividing aggressive type of UCB, miRNA expression was profiled in patients’ samples with an aggressive phenotype or nonaggressive phenotype using 3D-Gene miRNA labeling kit (Toray, Japan). To create a prognostic index model, we used the panel of 9-miRNA signature based on Cancer Genome Atlas (TCGA) data portal (TCGA Data Portal (https://tcgadata.nci.nih.gov/tcga/tcgaHome2.jsp)). miRNA expression data and corresponding clinical data, including outcome and staging information of 84 UCB patients, were obtained. The Kaplan-Meier and log-rank test were performed to quantify the survival functions in two groups. Results. Deregulation of nine miRNAs (hsa-miR-99a-5p, hsa-miR-100-5p, hsa-miR-125b-5p, hsa-miR-145-5p, hsa-miR-4324, hsa-miR-34b-5p, hsa-miR-29c-3p, hsa-miR-135a-3p, and hsa-miR-33b-3p) was determined in UCB patients with aggressive phenotype compared with nonaggressive subject. To validate the prognostic power of the nine-signature miRNAs using the TCGA dataset of bladder cancer, the survival status and tumor miRNA expression of all 84 TCGA UCB patients were ranked according to the prognostic score values. Of nine miRNAs, six were associated with high risk (hsa-miR-99a-5p, hsa-miR-100-5p, hsa-miR-125b-5p, hsa-miR-4324, hsa-miR-34b-5p, and hsa-miR-135a-3p) and three were shown to be protective (hsa-miR-145-5p, hsa-miR-29c-3p, and hsa-miR-33b-3p). Patients with the high-risk miRNA signature exhibited poorer OS than patients expressing the low-risk miRNA profile (HR = 7.05, p<0.001). Conclusions. The miRNA array identified nine dysregulated miRNAs from clinical samples. This panel of nine-miRNA signature provides predictive and prognostic value of patients with UCB.
Development of Novel Single-Chain Antibodies against the Hydrophobic HPV-16 E5 Protein
Authors: Monjarás-Ávila César , Bernal-Silva Sofía , Bach Horacio
Published: June 2018

The human papilloma virus type 16 infects genital mucosa with high prevalence in the oncogenesis of cervical and oropharyngeal cancers. The E5 protein of this virus is a small hydrophobic protein, whose expression generally decreases as the infection progresses to malignancy. These characteristics point to a role of E5 in the establishment of HPV infection and the initiation into cell transformation. The study of the HPV-16 E5 functions has been hindered because of the lack of antibodies. Detection is very difficult because of its hydrophobic nature, membrane location, and very low levels of expression. Thus, the objective of this study was to select single-chain antibodies against the full size E5 protein, which was coexpressed with maltose-binding protein. We report that the E5 protein was recognized by the antibody and was validated in W12 cells by fluorescent microscopy, including a colocalization with one of its host substrates. The use of this antibody could increase our knowledge about the functions of the oncogenic HPV-16 E5 protein during the earliest stages of keratinocyte infection in human.
A Case of Atorvastatin-Associated Necrotizing Autoimmune Myopathy, Mimicking Idiopathic Polymyositis
Authors: Dixit Ayushi , Abrudescu Adriana
Published: June 2018

Statin-induced necrotizing autoimmune myopathy (SINAM) is a rare side effect of statin use which manifests as progressive muscle weakness. Because statins are a widely prescribed medication for coronary artery disease, hyperlipidemia, and many other diseases, many patients are at risk of developing SINAM or one of the many other statin-induced myopathies. Due to identification of an antibody specific to this disease, we were able to diagnose SINAM in a patient whose symptoms had progressed to the extent that they were debilitating. Our case describes SINAM in a patient undergoing treatment with a statin for an extended period of time, diagnosis of the disease process, treatment, and resolution of symptoms.
An Interesting Case of a 57-Year-Old Male with an Upper Gastrointestinal Bleeding and Obstructive Uropathy with Bilateral Hydronephrosis Diagnosed with Systemic Mucormycosis
Authors: Izaguirre-Anariba Dora E. , Chee Felicia , Thet Zeyar , Lanza Jesus
Published: June 2018

Mucormycosis is a rare and invasive fungal disease with high mortality rate caused by members of the order Mucorales. Mucorales species are vasotrophic organisms that may cause angioinvasive disease in immunosuppressed hosts. Risk factors include diabetic ketoacidosis, chronic kidney disease, organ or bone marrow transplantation, neutropenia, burns, malignancies, and steroid therapy. There are six different clinical presentations of mucormycosis, which includes rhino-orbital cerebral, pulmonary, gastrointestinal, cutaneous, disseminated, and miscellaneous infection. Here, we report a case of a 57-year-old male with stage-IV sarcoidosis on long-term steroids presenting with upper gastrointestinal bleeding and obstructive uropathy who was diagnosed with systemic mucormycosis. Biopsy obtained by endoscopy revealed necrotic debris with acute leukocytic exudate and numerous variably sized, 90-degree angulated fungal hyphae favoring mucormycosis-causing species. Imaging studies showed hydronephrosis, and cystoscopy findings were consistent with fungal infection of the bladder. Isavuconazonium sulfate was used as systemic salvage therapy along with continuous bladder irrigation with amphotericin-B for localized bladder infection after a trial with first-line systemic treatment with intravenous liposomal amphotericin-B failed. A repeat endoscopy showed inflammatory changes with a pathology report in which mucormycosis was no longer appreciated. The patient was discharged home to complete 6 months of antifungal therapy with monthly follow-ups. The patient has been asymptomatic after 12-month completion of therapy.
Actinomyces europaeusIsolated from a Breast Abscess in a Penicillin-Allergic Patient
Authors: White Sarah E. , Woolley Stephen D.
Published: June 2018

This is a case ofActinomyces europaeusin the breast abscess of a penicillin-allergic woman. The mainstay of treatment for actinomycosis is penicillin, and there is a lack of literature describing nonpenicillin treatment options. A 69-year-old woman presented acutely with a breast abscess which was managed with incision and drainage and antibiotic therapy to good response. 21 days after presentation,Actinomyceswere grown from the culture of pus, so the patient was recalled and more rigorous treatment and follow-up were initiated. The penicillin allergy led to difficulty in the identification of an appropriate antimicrobial agent that was also logistically feasible to be given on an outpatient IV basis. IV tigecycline followed by oral clarithromycin was found to be effective treatment.
Delayed Presentation of Tetralogy of Fallot with Isolated Cyanosis
Authors: Zemore Zachary , Sharma Avni , Carter Kerri , Baghdassarian Aline
Published: June 2018

A pediatric patient with hypoxia or cyanosis can frighten even the most seasoned emergency providers. Patients with these symptoms require immediate evaluation and intervention to stabilize their condition. While the differential can be broad, specific attention must be paid to cardiopulmonary etiologies. Tetralogy of Fallot is the most common cyanotic congenital heart abnormality, and routine screening surprisingly misses a significant amount of these cases. This case serves as an example of a missed diagnosis by screening efforts and reaffirms the resuscitation algorithm of a hypoxic pediatric patient that all emergency providers should be familiar with.
The Relationship between Multiple Myeloma with Renal Failure and Metastatic Calcification
Authors: Fukuta Takanori , Tanaka Takayuki , Hashimoto Yoshinori , Omura Hiromi
Published: June 2018

While cases of multiple myeloma (MM) with metastatic calcification have been reported, the mechanisms for this calcification have yet to be explained. We observed a case of MM in a patient with end-stage renal failure who developed vascular and pulmonary calcification. A 51-year-old male was diagnosed with Bence-Jones type MM and required maintenance hemodialysis. He was treated with bortezomib-dexamethasone, vincristine-doxorubicin-dexamethasone, the M2 protocol, and lenalidomide-dexamethasone (Rd) therapy. During the sixth cycle of Rd therapy, he complained of pain in both lower legs. Well-demarcated ulcers with severe pain had developed on the right lower leg, both exterior thighs, and penis. We found that the patient’s serum intact parathyroid hormone level was elevated, while it had previously been permissively controlled. Computed tomography scan showed widespread centrilobular opacities of the bilateral lungs and high-density lesions along small blood vessels in the trunk and all four extremities. Histological calcifications were identified in small blood vessels and the alveolar walls. The risk of metastatic calcification in MM appears to be associated with renal failure, but not with MM itself.
A Novel UDP-Glycosyltransferase of Rhodiola crenulata Converts Tyrosol to Specifically Produce Icariside D2
Authors: Liao Zhihua , Qiu Fei , Zeng Junlan , Gu Li , Wang Bangjun , Lan Xiaozhong , Chen Min
Published: June 2018

Rhodiola crenulata is a Tibetan native herbal plant belonging to the family of Crassulaceae, which produces the pharmaceutical icariside D2 with the activities of inhibiting angiotensin-converting enzyme and killing leukemia cancer cells. In this study, we functionally characterized a novel UDP-glycosyltransferase (RcUGT1) that converted tyrosol to specifically produce icariside D2 from R. crenulata at molecular and biochemical levels. RcUGT1 was highly expressed in flowers and roots, while the icariside D2 content was much higher in stems than that in other organs, suggesting the potential translocation of icariside D2 from flowers and roots to stems. The high production of icariside D2 in stems provided a reasonable suggestion to farmers to harvest stems instead of roots for icariside D2 production. Enzymatic assays of recombinant RcUGT1 indicated that it converted tyrosol to specifically form icariside D2, with the values of Km 0.97±0.10 mM, Vmax 286±8.26 pKat/mg, Kcat 0.01552 s−1, and Kcat/Km 159.55 s−1 M−1. Functional identification of RcUGT1 facilitated the icariside D2 production through metabolic engineering in plants or synthetic biology in microbes.
Maternal Overnutrition Programs Central Inflammation and Addiction-Like Behavior in Offspring
Authors: Montalvo-Martínez Larisa , Maldonado-Ruiz Roger , Cárdenas-Tueme Marcela , Reséndez-Pérez Diana , Camacho Alberto
Published: June 2018

Obesity or maternal overnutrition during pregnancy and lactation might have long-term consequences in offspring health. Fetal programming is characterized by adaptive responses to specific environmental conditions during early life stages. Programming alters gene expression through epigenetic modifications leading to a transgenerational effect of behavioral phenotypes in the offspring. Maternal intake of hypercaloric diets during fetal development programs aberrant behaviors resembling addiction in offspring. Programming by hypercaloric surplus sets a gene expression pattern modulating axonal pruning, synaptic signaling, and synaptic plasticity in selective regions of the reward system. Likewise, fetal programming can promote an inflammatory phenotype in peripheral and central sites through different cell types such as microglia and T and B cells, which contribute to disrupted energy sensing and behavioral pathways. The molecular mechanism that regulates the central and peripheral immune cross-talk during fetal programming and its relevance on offspring’s addictive behavior susceptibility is still unclear. Here, we review the most relevant scientific reports about the impact of hypercaloric nutritional fetal programming on central and peripheral inflammation and its effects on addictive behavior of the offspring.
Expression Analysis of Nitrogen Metabolism-Related Genes Reveals Differences in Adaptation to Low-Nitrogen Stress between Two Different Barley Cultivars at Seedling Stage
Authors: Chen Zhiwei , Liu Chenghong , Wang Yifei , He Ting , Gao Runhong , Xu Hongwei , Guo Guimei , Li Yingbo , Zhou Longhua , Lu Ruiju , Huang Jianhua
Published: June 2018

The excess use of nitrogen fertilizers causes many problems, including higher costs of crop production, lower nitrogen use efficiency, and environmental damage. Crop breeding for low-nitrogen tolerance, especially molecular breeding, has become the major route to solving these issues. Therefore, in crops such as barley (Hordeum vulgare L.), it is crucial to understand the mechanisms of low-nitrogen tolerance at the molecule level. In the present study, two barley cultivars, BI-04 (tolerant to low nitrogen) and BI-45 (sensitive to low nitrogen), were used for gene expression analysis under low-nitrogen stress, including 10 genes related to primary nitrogen metabolism. The results showed that the expressions of HvNIA2 (nitrite reductase), HvGS2 (chloroplastic glutamine synthetase), and HvGLU2 (ferredoxin-dependent glutamate synthase) were only induced in shoots of BI-04 under low-nitrogen stress, HvGLU2 was also only induced in roots of BI-04, and HvGS2 showed a rapid response to low-nitrogen stress in the roots of BI-04. The expression of HvASN1 (asparagine synthetase) was reduced in both cultivars, but it showed a lower reduction in the shoots of BI-04. In addition, gene expression and regulation differences in the shoots and roots were also compared between the barley cultivars. Taken together, the results indicated that the four above-mentioned genes might play important roles in low-nitrogen tolerance in barley.
A Sparse Temporal Synchronization Algorithm of Laser Communications for Feeder Links in 5G Nonterrestrial Networks
Authors: Zhu Lichen , Han Hangcheng , Bu Xiangyuan , Wang Jichao
Published: June 2018

To foster the rollout of 5G in unserved areas, 3GPP has kicked off a study item on new radio to support nonterrestrial networks (NTNs). Due to ultra‐wideband of laser, laser communication is very promising for the feeder links of NTNs; however, imprecise temporal synchronization hinders its deployment, which results from a combination of propagation delay, velocity, acceleration, and jerk of NTN platform. The prior synchronization algorithms are inapplicable to the temporal synchronization in laser communications due to the extremely high data rate and Doppler shift. This paper is devoted to addressing the temporal synchronization problem in laser communications. In particular, we first observe the sparsity of laser signal in time‐frequency domain. On top of this observation, we propose a new sparsity‐aware algorithm for temporal synchronization without carrier aid through sparse discrete polynomial‐phase transform and sparse discrete fractional Fourier transform. Subsequently, we implement the proposed algorithm via designing a hardware prototype. To further evaluate its performance, we conduct extensive simulations, and the results demonstrate the effectiveness of the proposed algorithm in terms of good accuracy, low power consumption, and low computational complexity, suggesting its attractiveness for the feeder links of 5G NTNs.
Rhinogenic Optic Neuritis Caused by Sphenoid Mucocele with Sinusitis
Authors: Siritho Sasitorn , Tantinikorn Weerachai , Wichiwaniwate Paithoon , Pongpirul Krit
Published: June 2018

A 59-year-old male who presented with a nonspecific headache at the vertex, resembling retrobulbar optic neuritis, was treated as such but did not show any improvement. Although optic nerve compression from sphenoid mucocele was finally discovered, the delayed diagnosis and improper treatment led to a permanent visual loss. Optic neuritis could be caused by a common problem, “mucocele/sinusitis,” but might be easily overlooked in general practice. Rhinogenic optic neuropathy should, therefore, be considered in every case of optic neuritis whenever atypical presentation occurs or is unresponsive to high-dose steroid treatment.
Polymerization Efficiency of a Dual-Cured Resin Cement through Zirconia with Three Different Cusp Inclinations
Authors: Zhang Chang-Yuan , Yu Hao , Cheng Yi-Ling , Wu Wen-Zhou , Xu Liang-Jun , Cheng Hui
Published: June 2018

Assessing the polymerization efficiency of a dual-cured resin cement through zirconia with three different cusp inclinations is the aim of this study. Seventy-two resin cement (Multilink Speed) specimens were light-cured through the zirconia with three different cusp inclinations (30°, 20°, and 0°) for 20 s or 40 s (n=12). For each group, the Vickers hardness (VH) measurement was performed on half of the specimens, whereas the degree of conversion (DC) was tested for the other half with a Fourier transform infrared spectrometer. The recorded data were analyzed with a two-way ANOVA. Varied VH (32.3 ± 3.2–40.3 ± 4.8) and DC (50.5% ± 3.0%–59.6% ± 2.4%) values were obtained from different groups. The cusp inclinations significantly affect the VH (p=0.001) and DC (p<0.001) of the resin cement, and the curing time exhibited a significant effect on the DC (p=0.014) of resin cement but not on the VH (p=0.167). In conclusion, the cusp inclination of zirconia significantly affects the polymerization efficiency of dual-cured resin cement.
Analysis of Acoustic Wave Frequency Spectrum Characters of Rock Mass under Blasting Damage Based on the HHT Method
Authors: Yuan Haiping , Liu Xiaole , Liu Yan , Bian Hanbing , Chen Wen , Wang Yixian
Published: June 2018

The limitation associated with Fourier transform and wavelet analysis that they often fail to produce satisfactory resolution simultaneously in time and frequency when dealing with nonlinear and nonstationary signals is frequently encountered. Therefore, this paper aims at using the HHT (Hilbert–Huang transform) method, which is built on the basis of the EMD‐ (empirical mode decomposition‐) based wavelet threshold denoising technique and the Hilbert transform, to analyze the blasting vibration signals in a south China lead‐zinc mine. The analysis is conducted in terms of three‐dimensional Hilbert spectrum, marginal spectrum, and instantaneous energy spectrum. The results indicate that the frequencies of the blasting vibration signals lie mainly within 0∼200 Hz, which consists of more than 90% of the total signal energy. At the onset of the blasting, the vibration frequency tends to be low, with the frequency that is less than 50 Hz being dominant. By using instantaneous energy spectrum, which can reveal the condition of energy release for detonator explosion, the initiation moments of detonators with 7 time‐lag levels are accurately identified. This accurate identification demonstrates the superiority of the HHT method in coping with nonlinear and nonstationary signals. Additionally, the HHT method that is characterized by adaptivity, completeness, strong reconfigurability, and high accuracy provides an opportunity for reflecting signals’ change features with regard to time domain, frequency domain, and energy irrespective of the limitation of the Heisenberg uncertainty principle.
Fibrous Pseudotumor of Tunica Albuginea Testis Mimicking Testicular Neoplasm in a Young Man
Authors: Nazim Syed Muhammad , Nusrat Ayesha , Kazmi Zehra
Published: June 2018

Intrascrotal lesions are common findings with a majority occurring in paratesticular tissue. Fibrous pseudotumors are rare, benign lesions of the testicular tunics and present with mass lesion(s) in the scrotum. Preoperative clinical and radiological diagnosis is challenging. We report a case of a 34-year-old man who presented with a 3-year history of left testicular swelling and was advised left radical orchidectomy by another surgeon. Physical examination revealed a firm, nontender mass attached to the lower pole of the testis. Testicular tumor markers were all negative, and ultrasound scan showed a relatively hypoechoic lesion closely associated with the left testis and suspicious for neoplastic process. The patient underwent a testicular sparing surgery. An intraoperative frozen section biopsy confirmed the lesion to be benign and this was reported on permanent section to be fibrous pseudotumor of the tunica albuginea. We also present the clinical, sonographic, and histopathological findings of this condition along with the literature review.
Organ-Specific Phytochemical Profiling and Antioxidant Analysis of Parthenium hysterophorus L.
Authors: Ahmad Javed , Bagheri Rita , Bashir Humayra , Baig M. Affan , Al-Huqail Asma , Ibrahim Mohamed M. , Qureshi M. Irfan
Published: June 2018

Parthenium hysterophorus is a weed of global concern with high threshold of tolerance against most of biotic and abiotic stresses. Phytochemical profile and in vitro antioxidant analysis may help in understanding its tolerance to stresses. Root, stem, leaf, phyllary, and receptacle (including disc and ray florets) were chemotyped employing GC tof-MS and assessed for antioxidant activity by DPPH, FRAP, HRSA, and TAC assays. Phytochemicals identified were terpenes, fatty acids, hydrocarbons, phytosterols, and compounds of miscellaneous chemical nature. Organ-specific maximum concentration of metabolite was β-vatirenene (root), hexadecanoic acid methylester (stem), aristolene epoxide (leaf), hexadecanoic acid methylester (phyllary), and hexadecanoic acid methylester (receptacle). Identified metabolites could be associated with stress tolerance mechanisms, basic metabolism, and allelopathy, etc. Root extracts showed highest antioxidant potential followed by receptacle. It can be concluded that diverse and unique phytochemical profile and great antioxidant potential make P. hysterophorus stress-tolerant, hence a weed of global habitat.
Nonlinear Random Response Analyses of Panels Considering Transverse Shear Deformations under Combined Thermal and Acoustic Loads
Authors: Kim Yeong-Nam , Park Jae-Sang , Go Eun-Soo , Jeon Min-Hyuk , Kim In-Gul
Published: June 2018

The panel structures of flight vehicles at supersonic or hypersonic speeds are subjected to combined thermal, acoustic, and aerodynamic loads. Because of the combined thermal and acoustic loads, the panel structure may exhibit nonlinear random vibration responses, such as the snap‐through phenomenon and random vibrations. These unique dynamic behaviors of the panel structure under combined thermal and acoustic loads can result in serious damage or fatigue failure of the panel structures of high‐speed flight vehicles. This study investigates the nonlinear random responses of thin and thick panels under combined thermal and acoustic loads. The panels are modeled based on the first‐order shear deformation theory (FSDT) to account for transverse shear deformations. The von‐Karman nonlinear strain–displacement relationship is used for geometric nonlinearity in the out‐of‐plane direction of the panel. The thermal load distribution is assumed to be constant in the thickness direction of the panel. The random acoustic load is represented as stationary White–Gaussian random pressure with zero mean and uniform magnitude over the panels. Static and dynamic equations are derived using the principle of virtual work and the nonlinear finite element method. A thermal postbuckling analysis is conducted using the Newton–Raphson method, and the dynamic nonlinear equations are solved using the Newmark‐β time integration method. In the present numerical analyses, the snap‐through responses for both the thin and thick panels are investigated, and the results indicate that the loading conditions that cause snap‐through are different for thin and thick panels.
LDHA in Neuroblastoma Is Associated with Poor Outcome and Its Depletion Decreases Neuroblastoma Growth Independent of Aerobic Glycolysis
Authors: Dorneburg Carmen , Fischer Matthias , Barth Thomas F.E. , Mueller-Klieser Wolfgang , Hero Barbara , Gecht Judith , Carter Daniel R. , de Preter Katleen , Mayer Benjamin , Christner Lisa , Speleman Frank , Marshall Glenn M. , Debatin Klaus-Michael , Beltinger Christian
Published: June 2018

Purpose: To investigate whether lactate dehydrogenase A (LDHA), an important component of the LDH tetramer crucial for aerobic glycolysis, is associated with patient outcome and constitutes a therapeutic target in neuroblastoma (NB).

Experimental Design: Expression of LDHA mRNA and protein was determined in 709 and 110 NB patient samples, respectively, and correlated with survival and risk factors. LDHA and LDHB were depleted in human NB cell lines by CRISPR/Cas9 and shRNA, respectively, and aerobic glycolysis, clonogenicity, and tumorigenicity were determined. Expression of LDHA in relation to MYCN was measured in NB cell lines and in the TH-MYCN NB mouse model.

Results: Expression of LDHA, both on the mRNA and the protein level, was significantly and independently associated with decreased patient survival. Predominant cytoplasmic localization of LDHA protein was associated with poor outcome. Amplification and expression of MYCN did not correlate with expression of LDHA in NB cell lines or TH-MYCN mice, respectively. Knockout of LDHA inhibited clonogenicity, tumorigenicity, and tumor growth without abolishing LDH activity or significantly decreasing aerobic glycolysis. Concomitant depletion of LDHA and the isoform LDHB ablated clonogenicity while not abrogating LDH activity or decreasing aerobic glycolysis. The isoform LDHC was not expressed.

Conclusions: High expression of LDHA is independently associated with outcome of NB, and NB cells can be inhibited by depletion of LDHA or LDHB. This inhibition appears to be unrelated to LDH activity and aerobic glycolysis. Thus, investigations of inhibitory mechanisms beyond attenuation of aerobic glycolysis are warranted, both in NB and normal cells. Clin Cancer Res; 24(22); 5772–83. ©2018 AACR.
Improving Global Kidney Health: International Society of Nephrology Initiatives and the Global Kidney Health Atlas
Authors: Levin Adeera
Published: June 2018

Background: Chronic Kidney Disease (CKD) is a major public health problem and is increasingly being recognized as an important driver of costs in all health care systems. The diversity of outcomes for people living with CKD is in part due to variability in biology, access to care, environmental factors, and health care system differences. The International Society of Nephrology (ISN), working in collaboration with its partners, has evolved into a philanthropic organization, from a traditional medical society, committed to a vision that sees “a future where all people have access to sustainable kidney health”. A set of activities, including a Global Kidney Health Summit, the Global Kidney Health Atlas, and a Global Kidney Health Policy Forum, which has formed the basis of a multi-stakeholder engagement process, building on a solid base of ISN programs and educational activities, is described. Through building awareness and increasing capacity to conduct research, the international community will build a more solid foundation on which to advocate for sustainable, ethical solutions to the problem of kidney disease throughout the world. Summary: The ISN aims to improve kidney health worldwide through a variety of diverse activities addressing education, advocacy, and research. Collaboration with partners within and outside the medical community is key in achieving this goal. Key Messages: Kidney disease is an important public health problem and is driven by genetic, environmental, and socioeconomic factors. Through active collaboration with diverse partners, the international community is striving for sustainable kidney health and aims to achieve this through coordinated work in a variety of spheres.
Vasopressin and Diabetic Kidney Disease
Authors: El Boustany Ray
Published: June 2018

Background: Diabetic nephropathy has become the most common cause of chronic kidney disease (CKD). Despite the progress accomplished in therapy, the prevalence of renal disorders remains high. Some modifiable factors driving the increase in incidence of CKD, in diabetes and other settings, might have been overlooked. Consistent evidence supports a role for vasopressin, hydration state, and urine concentration in kidney health. Summary: Plasma vasopressin is elevated in diabetes, even if metabolic control is good. Several epidemiological studies have pointed to a positive association between markers of vasopressin secretion (24-h fluid intake, urine volume, plasma copeptin concentration) and renal function decline in both the community and populations at high risk of CKD, namely, diabetic patients. Research involving animal models also supports a critical causal role of the V2 receptor antidiuretic effects of vasopressin in the early signs of kidney disease associated with type 1 or type 2 diabetes. Key Messages: Data supporting the detrimental effects of chronic vasopressin action on the kidney is consistent in animal models and human observational studies. Since vasopressin secretion can be modulated by water intake, and its actions by selective receptor antagonists, the vasopressin-hydration system could be a potential therapeutic target for the prevention and treatment of diabetic nephropathy. Intervention studies are needed to examine the relevance of lifestyle or pharmacological interventions.
Osmoregulation in Polycystic Kidney Disease: Relationship with Cystogenesis and Hypertension
Authors: Underwood Conor F. , Phillips Jacqueline K. , Hildreth Cara M.
Published: June 2018

Polycystic kidney disease (PKD) is a group of monogenetic conditions characterised by the progressive accumulation of multiple renal cysts and hypertension. One of the earliest features of PKD is a reduction in urinary concentrating capacity that impairs extracellular fluid conservation. Urinary concentrating impairment predisposes PKD patients to periods of hypohydration when fluid loss is not adequately compensated by fluid intake. The hypohydrated state provides a blood hyperosmotic stimulus for vasopressin release to minimise further water loss. However, over-activation of renal V2 receptors contributes to cyst expansion. Although suppressing vasopressin release with high water intake has been shown to impair disease progression in rodent models, whether this approach is efficacious in patients remains uncertain. The neural osmoregulatory pathway that controls vasopressin secretion also exerts a stimulatory action on vasomotor sympathetic activity and blood pressure during dehydration. Recurrent dehydration leads to a worsening of hypertension in rodents and cross-sectional data suggests that reduced urinary concentrating ability may contribute to hypertension development in the clinical PKD population. Experimental studies are required to evaluate this hypothesis and to determine the underlying mechanism.
Vasopressin and the Regulation of Thirst
Authors: Bichet Daniel G.
Published: June 2018

Recent experiments using optogenetic tools allow the identification and functional analysis of thirst neurons and vasopressin producing neurons. Two major advances provide a detailed anatomy of taste for water and arginine-vasopressin (AVP) release: (1) thirst and AVP release are regulated not only by the classical homeostatic, intero-sensory plasma osmolality negative feedback, but also by novel, extero-sensory, anticipatory signals. These anticipatory signals for thirst and vasopressin release converge on the same homeostatic neurons of circumventricular organs that monitor the composition of the blood; (2) acid-sensing taste receptor cells (which express polycystic kidney disease 2-like 1 protein) on the tongue that were previously suggested as the sour taste sensors also mediate taste responses to water. The tongue has a taste for water. The median preoptic nucleus (MnPO) of the hypothalamus could integrate multiple thirst-generating stimuli including cardiopulmonary signals, osmolality, angiotensin II, oropharyngeal and gastric signals, the latter possibly representing anticipatory signals. Dehydration is aversive and MnPO neuron activity is proportional to the intensity of this aversive state.
Robotic Head and Neck Surgery: History, Technical Evolution and the Future
Authors: Garas George , Arora  Asit
Published: June 2018

The first application of robotic technology in surgery was described in 1985 when a robot was used to define the trajectory for a stereotactic brain biopsy. Following its successful application in a variety of surgical operations, the da Vinci® robot, the most widely used surgical robot at present, made its clinical debut in otorhinolaryngology and head and neck surgery in 2005 when the first transoral robotic surgery (TORS) resections of base of tongue neoplasms were reported. Subsequently, the indications for TORS rapidly expanded, and they now include tumours of the oropharynx, hypopharynx, parapharyngeal space, and supraglottic larynx, as well as obstructive sleep apnoea (OSA). The da Vinci® robot has also been successfully used for scarless-in-the-neck thyroidectomy and parathyroidectomy. At present, the main barrier to the wider uptake of robotic surgery is the prohibitive cost of the da Vinci® robotic system. Several novel, flexible surgical robots are currently being developed that are likely to not only enhance patient safety and expand current indications but also drive down costs, thus making this innovation more widely available. Future directions relate to overlay technology through augmented reality/AR that allows real-time image-guidance, miniaturisation (nanorobots), and the development of autonomous robots.
Targeting SHP-1, 2 and SHIP Pathways: A Novel Strategy for Cancer Treatment?
Authors: Dempke Wolfram C.M. , Uciechowski Peter , Fenchel Klaus , Chevassut Timothy
Published: June 2018

Well-balanced levels of tyrosine phosphorylation, maintained by the reversible and coordinated actions of protein tyrosine kinases (PTKs) and protein tyrosine phosphatases (PTPs), are critical for a wide range of cellular processes including growth, diﬀerentiation, metabolism, migration, and survival. Aberrant tyrosine phosphorylation, as a result of a perturbed balance between the activities of PTKs and PTPs, is linked to the pathogenesis of numerous human diseases, including cancer, suggesting that PTPs may be innovative molecular targets for cancer treatment. Two PTPs that have an important inhibitory role in haematopoietic cells are SHP-1 and SHP-2. SHP-1, 2 promote cell growth and act by both upregulating positive signaling pathways and by downregulating negative signaling pathways. SHIP is another inhibitory phosphatase that is specific for the inositol phospholipid phosphatidylinositol-3,4,5-trisphosphate (PIP3). SHIP acts as a negative regulator of immune response by hydrolysing PIP3, and SHIP deficiency results in myeloproliferation and B-cell lymphoma in mice. The validation of SHP-1, 2 and SHIP as oncology targets has generated interest in the development of inhibitors as potential therapeutic agents for cancers; however, SHP-1, 2 and SHIP have proven to be an extremely diﬃcult target for drug discovery, primarily due to the highly conserved and positively charged nature of their PTP active site, and many PTP inhibitors lack either appro­priate selectivity or membrane permeability. To overcome these caveats, novel techniques have been employed to synthesise new inhibitors that specifically attenuate the PTP-dependent signaling inside the cell and amongst them; some are already in clinical development which are discussed in this review.
Impact of Laparoscopic Repair of Large Hiatus Hernia on Quality of Life: Observational Cohort Study
Authors: Siboni Stefano , Asti Emanuele , Milito Pamela , Bonitta Gianluca , Sironi Andrea , Aiolfi Alberto , Bonavina Luigi
Published: June 2018

Background: Laparoscopic surgery has proven safe and effective in the treatment of large hiatus hernia. Differences may exist between objectively assessed surgical outcomes, symptomatic scores, and patient-reported outcomes. Methods: An observational, single-arm cohort study was conducted in patients undergoing primary laparoscopic repair with crura mesh augmentation and Toupet fundoplication for large (> 50% of intrathoracic stomach) type III–IV hiatus hernia. Data were extracted from hospital charts and a prospectively updated research database. The main study outcome was quality of life assessed by the Gastroesophageal reflux disease Health-Related Quality of Life (GERD-HRQL) score and the Short-form 36 (SF-36). Results: Between 2013 and 2016, 37 out of 49 operated patients completed the comprehensive quality-of-life evaluation at the 2-year follow-up. The GERD-HRQL score significantly decreased compared to baseline (p < 0.001). All items of the SF-36 significantly improved compared to baseline (p < 0.05). Both Physical and Mental Component Summary scores were significantly higher than preoperative scores, with a medium Cohen’s effect size (–0.77 and 0.56, respectively). At the 2-year follow-up, symptoms had disappeared in the majority of patients. The use of proton-pump inhibitors significantly decreased compared to baseline (13.5 vs. 86.4%, p < 0.001). Also, the use of antidepressants and benzodiazepines significantly decreased after surgery (8.1 vs. 32.4%, p < 0.001). The overall alimentary satisfaction score was > 8 in 92% of patients. There were no safety issues related to the use of the absorbable synthetic mesh. The incidence of anatomical hernia recurrence was 5.4%, but no patient with recurrent hernia required surgical revision. Conclusions: Laparoscopic repair of large hiatus hernia with mesh and partial fundoplication is associated with symptomatic relief, no side-effects, and a significant improvement in disease-specific and generic quality of life at 2-year follow-up.
ОСОБЛИВОСТІ ЕМОЦІЙНОЇ СФЕРИ МЕДИЧНИХ ПРАЦІВНИКІВ
Authors: Pavlyuk T.` V. , Tolokiva T. I.
Published: June 2018

Стаття присвячена вивченню особливостей емоційної сфери медичних працівників. Зміни в емоційній сфері медиків пов’язані з емоційними та етичними перевантаженнями в професійній діяльності. Розглянуто основні характеристики і встановлено чинники, які зумовлюють порушення емоційної сфери у медичних працівників.
КОМОРБІДНІСТЬ ПРИ ХРОНІЧНОМУ ОБСТРУКТИВНОМУ ЗАХВОРЮВАННІ ЛЕГЕНЬ – ГЕНДЕРНИЙ АСПЕКТ
Authors: Miroshnik G. O. , Shumeliak A. M. , Lublinska M. S. , Mialiuk O. P. , Marushchak M. I.
Published: June 2018

У статті наведено дані про коморбідні стани при хронічному обструктивному захворюванні легень у пацієнтів віком до 60 років у гендерному аспекті. Встановлено, що хронічне обструктивне захворювання легень однаковою мірою спостерігають як у чоловіків, так і в жінок віком до 60 років із переважанням II стадії, за GOLD. Найпоширенішими коморбідними станами у пацієнтів із хронічним обструктивним захворюванням легень в дорослих осіб обох статей є серцево-судинні захворювання. Хронічне обструктивне захворювання легень має несприятливий вплив на якість життя, включно емоційний та фізичний стан пацієнта, що є передумовою для активної просвітньої роботи медичного персоналу.
ЗВ’ЯЗОК РОЗВ’ЯЗАННЯ ПРОБЛЕМИ ВАЖКОВИХОВУВАНОСТІ ПІДЛІТКІВ ІЗ РОБОТОЮ МЕДИЧНОЇ СЕСТРИ
Authors: Morvaniuk V. Yu.
Published: June 2018

У статті висвітлено результати аналізу наукових поглядів видатних педагогів із проблеми важковиховуваних підлітків. Відображено зв’язок розв’язання проблеми важковиховуваності підлітків із роботою медичної сестри.
КОМПЕТЕНТНІСТЬ МЕДИЧНИХ СЕСТЕР У ПИТАННІ ЗНЕБОЛЮВАННЯ ПАЛІАТИВНИХ ХВОРИХ
Authors: Lуtvуnovа A. E.
Published: June 2018

Адекватне знеболювання паліативних пацієнтів на сьогодні є надзвичайно актуальною темою. У зв’язку зі змінами у системі використання наркотичних анальгетиків для допомоги паліативним хворим медичні сестри потребують підвищення компетентності у цьому питанні.
СУЧАСНІ МЕТОДИ РЕАБІЛІТАЦІЇ ХВОРИХ іЗ ЗАКРИТОЮ ТРАВМОЮ КОЛІННОГО СУГЛОБА
Authors: Novikova P. P.
Published: June 2018

У статті висвітлено основні принципи застосування методів реабілітаційного лікування хворих з ушкодженнями колінного суглоба. Значну увагу приділено методології проведення медичної реабілітації у лікарняний та післялікарняний періоди.
ДОСЛІДЖEННЯ ПСИХОПРОФІЛAКТИЧНОЇ РОЛІ ПAРТНEРСЬКОЇ ПІДТРИМКИ ПІД ЧAС ПОЛОГІВ
Authors: Stebelska I. Ya.
Published: June 2018

Рeзультaти нaукового досліджeння поглиблюють знaння про особливості психічного тa eмоційного стaтусу жінок під чaс вaгітності тa пологів. Провeдeно порівняльну оцінку рівнів рeaктивної тa особистісної тривожності роділь, які нaроджувaли у звичaйних пологaх, тa роділь, які нaроджувaли у пaртнeрських пологaх. Встaновлeно вищі рівні рeaктивної тривожності роділь, які нaроджувaли у звичaйних пологaх. Цe підтвeрджує психопрофілaктичну роль пaртнeрської підтримки під чaс пологів як прогрeсивної aкушeрської тeхнології.
СТРУКТУРНА МОДЕЛЬ КОНСУЛЬТУВАННЯ СІМ’Ї В РОБОТІ МЕДИЧНОЇ СЕСТРИ
Authors: Bryk O. I.
Published: June 2018

Розглянуто сутність структурної моделі сімейного консультування. Визначено особливості реалізації цієї моделі з метою визначення можливостей її використання у професійній діяльності медичної сестри.
ВИВЧЕННЯ СИНДРОМУ ПСИХОЕМОЦІЙНОГО ВИГОРАННЯ У ПРЕДСТАВНИКІВ РІЗНИХ ПРОФЕСІЙНИХ ГРУП
Authors: Klymenko S. M. , Iavorska I. V.
Published: June 2018

У статті проведено порівняльний аналіз результатів дослідно-експериментальної роботи та доведено гіпотезу дослідження: виникнення синдрому професійного вигорання частіше виникає у спеціалістів, які належать до професійної групи медичних працівників. Результати показали, що ступінь сформованості синдрому психоемоційного вигорання в професійній групі медичних працівників вищий, ніж серед педагогів: педагоги – 415 балів, медичні працівники – 490 балів.
ОСОБЛИВОСТІ НАДАННЯ ЕКСТРЕНОЇ ДОГОСПІТАЛЬНОЇ МЕДИЧНОЇ ДОПОМОГИ ПОСТРАЖДАЛИМ З ТОРАКАЛЬНОЮ ТРАВМОЮ
Authors: Liakhovych R. M. , Savchuk V. M. , Doroshenko B. V. , Doroshenko B. V. , Kitsak Y. M.
Published: June 2018

Статтю присвячено оцінці діяльності бригад екстреної (швидкої) медичної допомоги при діагностиці та виявленні  торакальної травми. Висвітлено базові сучасні методики виконання первинного та вторинного обстеження постраждалих із такими ушкодженнями. Розглянуто найбільш типові варіанти цієї патології та особливості надання екстреної медичної допомоги відповідно до сучасних клінічних протоколів із медицини невідкладних станів.
Socrates’ opinion on the art of Evenus from an oblique optative in Plato’s Apology 20b8-c1
Authors: Bieda Esteban Enrique
Published: June 2018

At the beginning of Plato’s Apology Socrates says: καὶ ἐγὼ τὸν Εὔηνον ἐμακάρισα εἰ ὡς ἀληθῶς ἔχοι ταύτην τὴν τέχνην καὶ οὕτως ἐμμελῶς διδάσκει (20b8-c1). In this text we find the syntactic phenomenon known as “oblique optative”, but coordinated with another verb in indicative mood. The only coincidence regarding this use of the optative is that the main verb has to be a past tense. But there is little coincidence around the semantic reasons for this use of the optative. In the present paper we will try to show the specific semantics of the oblique optative and its importance for the interpretation of the text.