bluuebunny/crossref_metadata_2025 huggingface dataset:
Longitudinal Screening Detects Cognitive Stability and Behavioral Deterioration in ALS Patients
Authors: Woolley Susan , Goetz Ray , Factor-Litvak Pam , Murphy Jennifer , Hupf Jonathan , Lomen-Hoerth Catherine , Andrews Howard , Heitzman Daragh , Bedlack Richard , Katz Jonathan , Barohn Richard , Sorenson Eric , Oskarsson Bjorn , Filho Americo Fernandes , Kasarskis Edward , Mozaffar Tahseen , Nations Sharon , Swenson Andrea , Koczon-Jaremko Agnes , Christodoulou Georgia , Mitsumoto Hiroshi
Published: October 2018

Objective. To evaluate longitudinal cognitive/behavioral change over 12 months in participants enrolled in the ALS Multicenter Cohort Study of Oxidative Stress (ALS COSMOS). Methods. We analyzed data from 294 ALS participants, 134 of whom were studied serially. Change over time was evaluated controlling for age, sex, symptom duration, education, race, and ethnicity. Using multiple regression, we evaluated associations among decline in ALS Functional Rating Scale-Revised (ALSFRS-R) scores, forced vital capacity (FVC), and cognitive/behavioral changes. Change in cognitive/behavioral subgroups was assessed using one-way analyses of covariance. Results. Participants with follow-up data had fewer baseline behavior problems compared to patients without follow-up data. We found significant worsening of behavior (ALS Cognitive Behavioral Screen (ALS CBS) behavioral scale, p<0.001; Frontal Behavioral Inventory-ALS (FBI-ALS) disinhibition subscale, p=0.044). Item analysis suggested change in frustration tolerance, insight, mental rigidity, and interests (p<0.05). Changes in ALSFRS-R correlated with the ALS CBS. Worsening disinhibition (FBI-ALS) did not correlate with ALSFRS-R, FVC, or disease duration. Conclusion. We did not detect cognitive change. Behavioral change was detected, and increased disinhibition was found among patients with abnormal baseline behavioral scores. Disinhibition changes did not correlate with disease duration or progression. Baseline behavioral problems were associated with advanced, rapidly progressive disease and study attrition.
Traumatic Lumbosacral Dislocation: Current Concepts in Diagnosis and Management
Authors: Moon Andrew S. , Atesok Kivanc , Niemeier Thomas E. , Manoharan Sakthivel R. , Pittman Jason L. , Theiss Steven M.
Published: October 2018

Traumatic lumbosacral dislocation is a rare, high-energy mechanism injury characterized by displacement of the fifth lumbar vertebra in relation to the sacrum. Due to the violent trauma typically associated with this lesion, there are often severe, coexisting injuries. High-quality radiographic studies, in addition to appropriate utilization of CT scan and MRI, are essential for proper evaluation and diagnosis. Although reports in the literature include nonoperative and operative management, most authors advocate for surgical treatment with open reduction and decompression with instrumentation and fusion. Despite advances in early diagnosis and management, this injury type is associated with significant morbidity and mortality, and long-term patient outcomes remain unclear.
Active Case Finding for Improved Ebola Virus Disease Case Detection in Nimba County, Liberia, 2014/2015: Lessons Learned
Authors: Namukose E. , Bowah C. , Cole I. , Dahn G. , Nyanzee P. , Saye R. , Duworko M. , Nsubuga P. , Mawanda M. , Mahmoud N. , Clement P. , Ngabirano T. D. , Nyenswah T. , Gasasira A.
Published: October 2018

Objectives. Early case detection and isolation of patients infected with highly infectious diseases are crucial in the management and control of epidemics such as Ebola Virus Disease (EVD). In this paper, we share the lessons learned from implementation of active case finding as a strategy for improved EVD case detection in Nimba County, Liberia. Methods. We adopted the World Health Organization (WHO) active surveillance strategy to identify and report suspected EVD cases, follow up contacts of confirmed cases, and report community deaths. We identified, trained, and deployed 1060 Community Health Volunteers (CHVs) in 718 communities in Nimba County. The CHVs were supervised by 142 health workers within their catchment area. The health workers were supervised by the District Health Officers (DHOs). The DHOs reported to the County Health Team (CHT) who provided supportive supervision. Data collection was based on the EVD contact tracing and active case finding forms adopted from WHO. Data analysis was based on epi-weeks. Results. The number of EVD suspected cases increased by more than 75% following the initiation of active case finding. Average duration between symptom onset and case detection reduced from between three and five days to within 24 hours. Collection of oral swabs from dead bodies increased from two to 15 within the first week of active case finding strategy implementation. Reporting of other IDSR priority diseases and conditions also improved. Conclusion. Active case finding strategy in Nimba increased suspected EVD case detection and reduced the duration between onset of symptoms and detection of cases.
An Efficient Hybrid Approach of Finite Element Method, Artificial Neural Network-Based Multiobjective Genetic Algorithm for Computational Optimization of a Linear Compliant Mechanism of Nanoindentation Tester
Authors: Chau Ngoc Le , Dao Thanh-Phong , Nguyen Van Thanh Tien
Published: October 2018

This paper proposes a new evolutionary multiobjective optimization technique for a linear compliant mechanism of nanoindentation tester. The mechanism design is inspired by the elastic deformation of flexure hinge. To improve overall static performances, a multiobjective optimization design was carried out. An efficient hybrid optimization approach of central composite design (CDD), finite element method (FEM), artificial neural network (ANN), and multiobjective genetic algorithm (MOGA) is developed to solve the optimization problem. In this procedure, the CDD is used to lay out the experimental data. The FEM is developed to retrieve the quality performances. And then, the ANN is developed as black box to call the pseudo-objective functions. Unlike previous studies on multiobjective evolutionary algorithms, most of which generating only one Pareto-optimal solution, this proposed approach can generate more than three Pareto-optimal solutions. Based on the user’s real-work problem, one of the best optimal solutions is chosen. The results showed that the optimal results were found at the displacement of 330.68 μm, stress of 140.65 MPa, and safety factor of 3.6. The statistical analysis is conducted to investigate the behavior of the MOGA. The sensitivity analysis was carried out to determine the significant contribution of each factor. The results revealed that the lengths and thickness almost significantly affect both responses. It confirms that the proposed hybrid optimization approach gains high robustness and effectiveness with flexible decision maker rules to solve complex optimization engineering problems.
Role of Exercise in Vascular Function and Inflammatory Profile in Age-Related Obesity
Authors: Pedrinolla Anna , Venturelli Massimo , Kirmizi Emine , Moschetta Federica , Zardini Monica , Rudi Doriana , Bacchi Elisabetta , Schena Federico , Moghetti Paolo , Lanza Massimo
Published: October 2018

In western countries, aging is often accompanied by obesity and age-related obesity is characterized by vascular dysfunction and a low-grade inflammatory profile. Exercise is a nonpharmacological strategy able to decrease the development and incidence of risk factors for several health-threatening diseases. Nonetheless, its long-term effect on vascular function and inflammation in age-related obesity is still unclear. The aim of this study was to investigate the effect of regular, supervised exercise on inflammatory profile and vascular function in age-related obesity. We also hypothesized that vascular function and inflammatory profile would have been correlated in overweight and obese individuals. Thirty normal weight (NW; 70 ± 5 years, 23.9 ± 2.6 BMI) and forty overweight and obese elderly (OW&OB; 69 ± 5 years, 30.1 ± 2.3 BMI) regularly taking part in a structured, supervised exercise program were enrolled in the study and evaluated for vascular function (flow-mediated dilation; FMD) and inflammatory profile (plasma CRP, IL-1β, IL-1ra, IL-6, IL-8, IL-10, TNF-α, and MCP-1). Although no differences between groups were found concerning performance and the weekly amount of physical activity, the OW&OB group compared with the NW group demonstrated higher systolic and diastolic blood pressure (+10%, p=0.001; +9%, p=0.005, respectively); lower FMD% (−36%, p<0.001) and FMD/shear rate (−40%, p=0.001); and higher levels of CRP (+33%, p=0.005), IL-6 (+36%, p=0.048), MCP-1 (+17%, p=0.004), and TNF-α (+16%, p=0.031). No correlations between vascular function and inflammation were found in OW&OB or NW. Although exercising regularly, overweight and obese elderly exhibited poorer vascular function and higher proinflammatory markers compared with the leaner group. These results support the idea that exercise alone cannot counteract the negative effect of adiposity on vascular function and inflammatory profile in elderly individuals and these two processes are not necessarily related.
Isolation of Helicobacter pylori from Gastric Biopsy of Dyspeptic Patients in Ghana and In Vitro Preliminary Assessment of the Effect of Dissotis rotundifolia Extract on Its Growth
Authors: Adinortey Michael Buenor , Ansah Charles , Adinortey Cynthia Ayefoumi , Bockarie Ansumana Sandy , Morna Martin Tangnaa , Amewowor Damian H.
Published: October 2018

Helicobacter pylori (H. pylori) is a gram-negative bacterium that colonizes the human stomach. Infection with this microaerophilic bacterium causes gastric and duodenal ulcer. This study sought to isolate H. pylori, from gastric biopsy samples of dyspeptic patients in Ghana using a 2,3,5-triphenyltetrazolium chloride (TTC) dye incorporated medium method. This TTC dye method was further used in an antimicrobial susceptibility assay involving Dissotis rotundifolia extract (DRE). H. pylori were successfully isolated from gastric biopsy of dyspeptic patients. Pure cultures of H. pylori in 2,3,5-triphenyltetrazolium chloride (TTC) dye incorporated medium were seen as sparkling colonies. Isolates, identified as H. pylori, were gram-negative and urease, catalase, and oxidase positive and showed characteristic morphology as spiral-shaped bacteria under the microscope. The organisms were found to be susceptible to cephalothin and resistant to nalidixic acid. Above all, the observation that H. pylori grew only at 37°C and not 25°C or 42°C affirms that the bacterium is neither Helicobacter cinaedi nor Helicobacter fenneliae. The anti-H. pylori study depicts a statistically lower zone of inhibition for DRE compared to standard drugs [amoxicillin and clarithromycin] (p<0.05), whereas metronidazole showed no zone of inhibition. This study reports the first successful isolation and culturing of H. pylori in Ghana using TTC dye. It also shows that DRE possess an in vitro anti-H. pylori activity and that DRE has some therapeutic potential against H. pylori infection.
Protective Effect of JXT Ethanol Extract on Radiation‐Induced Hematopoietic Alteration and Oxidative Stress in the Liver
Authors: Dong Xian-Zhe , Wang Yu-Ning , Tan Xiao , Liu Ping , Guo Dai-Hong , Yan Can
Published: October 2018

This study aims at investigating the radioprotective effect of ethanol extract from Ji‐Xue‐Teng (JXT, Spatholobus suberectus) on radiation‐induced hematopoietic alteration and oxidative stress in the liver. Mice were exposed to a single acute γ‐radiation for the whole body at the dose of 6.0 Gy, then subjected to administration of amifostine (45 mg/kg) or JXT (40 g crude drug/kg) once a day for 28 consecutive days, respectively. Bone marrow cells and hemogram including white cells, red cells, platelet counts, and hemoglobin level were examined. The protein expression levels of pJAK2/JAK2, pSTAT5a/STAT5a, pSTAT5b/STAT5b, and Bcl‐2 in bone marrow tissue; levels of reactive oxygen species (ROS); and the activity of superoxide dismutase (SOD), malondialdehyde (MDA), and glutathione peroxidase (GSH‐Px) in serum and liver tissue were determined. At the end of the experiment, the effect of JXT on cell viability and G‐CSF and G‐CSFR levels in NFS‐60 cells were tested by CCK‐8 assay, ELISA, and flow cytometry. The results showed that the mice exposed to γ‐radiation alone exhibited a typical hematopoietic syndrome. In contrast, at the end of the 28‐day experiment, irradiated mice subjected to oral administration of JXT showed an obvious improvement on blood profile with reduced leucopenia, thrombocytopenia (platelet counts), RBC, and hemoglobin levels, as well as bone marrow cells. The expression of pJAK2/JAK2, pSTAT5a/STAT5a, and Bcl‐2 in bone marrow tissue was increased after JXT treatment. The elevation of ROS was due to radiation‐induced toxicity, but JXT significantly reduced the ROS level in serum and liver tissue, elevated endogenous SOD and GSH‐PX levels, and reduced the MDA level in the liver. JXT could also increase cell viability and G‐CSFR level in NFS‐60 cells, which was similar to exogenous G‐CSF. Our findings suggested that oral administration of JXT effectively facilitated the recovery of hematopoietic bone marrow damage and oxidative stress of the mice induced by γ‐radiation.
Relationship between Experimental Diet in Rats and Nonalcoholic Hepatic Disease: Review of Literature
Authors: Rodrigues Ayane A. , Andrade Raíssa S. B. , Vasconcelos Daniel F. P.
Published: October 2018

Background.The pathophysiology of nonalcoholic fatty liver disease (NAFLD) is related to unhealthy lifestyles that combine sedentary lifestyle, hypercaloric diets, excessive saturated fats, refined carbohydrates, and high intake of fructose as a food additive to various processed products. Both the broader recognition of the disease and the additional efforts to elucidate the NAFLD pathogenesis have led to an increase in animal models in recent years. Objective.This review was performed to provide better understanding of the association between the NAFLD and animal models.Methods.The search in the literature occurred before May of 2018 in the PUBMED database.Results.Most studies investigating the influence of diet on liver fat content have been performed using a high-calorie diet that leads to a significant increase in fat content in the liver.Conclusion.The findings of this review show that diet is one of the factors that predisposes to the appearance of NAFLD and that the studies presented a wide variety of designs.
Oxygen Tension Strongly Influences Metabolic Parameters and the Release of Interleukin-6 of Human Amniotic Mesenchymal Stromal CellsIn Vitro
Authors: Banerjee Asmita , Lindenmair Andrea , Steinborn Ralf , Dumitrescu Sergiu Dan , Hennerbichler Simone , Kozlov Andrey V. , Redl Heinz , Wolbank Susanne , Weidinger Adelheid
Published: October 2018

The human amniotic membrane (hAM) has been used for tissue regeneration for over a century.In vivo(in utero), cells of the hAM are exposed to low oxygen tension (1–4% oxygen), while the hAM is usually cultured in atmospheric, meaning high, oxygen tension (20% oxygen). We tested the influence of oxygen tensions on mitochondrial and inflammatory parameters of human amniotic mesenchymal stromal cells (hAMSCs). Freshly isolated hAMSCs were incubated for 4 days at 5% and 20% oxygen. We found 20% oxygen to strongly increase mitochondrial oxidative phosphorylation, especially in placental amniotic cells. Oxygen tension did not impact levels of reactive oxygen species (ROS); however, placental amniotic cells showed lower levels of ROS, independent of oxygen tension. In contrast, the release of nitric oxide was independent of the amniotic region but dependent on oxygen tension. Furthermore, IL-6 was significantly increased at 20% oxygen. To conclude, short-time cultivation at 20% oxygen of freshly isolated hAMSCs induced significant changes in mitochondrial function and release of IL-6. Depending on the therapeutic purpose, cultivation conditions of the cells should be chosen carefully for providing the best possible quality of cell therapy.
Endovascular Management of Middle Aortic Syndrome Presenting with Uncontrolled Hypertension
Authors: Glotzer Owen S. , Bowser Kathryn , Harad F. Todd , Weiss Sandra
Published: October 2018

Middle Aortic Syndrome is a rare vascular disorder consisting of narrowing or stenosis of the distal thoracic or abdominal aorta. It is described in the literature in the form of case studies and case series. The authors present an unusual case of Middle Aortic Syndrome attributed to Takayasu’s arteritis in a 60-year-old female who presented to the emergency department with uncontrolled hypertension. Traditional intervention involves open surgical bypass. This case study reviews the published literature on this rare syndrome and illustrates a successful alternative to open surgery through an endovascular approach.
Sparse Representation-Based Extreme Learning Machine for Motor Imagery EEG Classification
Authors: She Qingshan , Chen Kang , Ma Yuliang , Nguyen Thinh , Zhang Yingchun
Published: October 2018

Classification of motor imagery (MI) electroencephalogram (EEG) plays a vital role in brain-computer interface (BCI) systems. Recent research has shown that nonlinear classification algorithms perform better than their linear counterparts, but most of them cannot extract sufficient significant information which leads to a less efficient classification. In this paper, we propose a novel approach called FDDL-ELM, which combines the discriminative power of extreme learning machine (ELM) with the reconstruction capability of sparse representation. Firstly, the common spatial pattern (CSP) algorithm is adopted to perform spatial filtering on raw EEG data to enhance the task-related neural activity. Secondly, the Fisher discrimination criterion is employed to learn a structured dictionary and obtain sparse coding coefficients from the filtered data, and these discriminative coefficients are then used to acquire the reconstructed feature representations. Finally, a nonlinear classifier ELM is used to identify these features in different MI tasks. The proposed method is evaluated on 2-class Datasets IVa and IIIa of BCI Competition III and 4-class Dataset IIa of BCI Competition IV. Experimental results show that our method achieved superior performance than the other existing algorithms and yielded the accuracies of 80.68%, 87.54%, and 63.76% across all subjects in the above-mentioned three datasets, respectively.
Formulated Chinese Medicine Shaoyao Gancao Tang Reduces Tau Aggregation and Exerts Neuroprotection through Anti‐Oxidation and Anti‐Inflammation
Authors: Chen I-Cheng , Lin Te-Hsien , Hsieh Yu-Hsuan , Chao Chih-Ying , Wu Yih-Ru , Chang Kuo-Hsuan , Lee Ming-Chung , Lee-Chen Guey-Jen , Chen Chiung-Mei
Published: October 2018

Misfolded tau proteins induce accumulation of free radicals and promote neuroinflammation by activating microglia‐releasing proinflammatory cytokines, leading to neuronal cell death. Traditional Chinese herbal medicines (CHMs) have been widely used in clinical practice to treat neurodegenerative diseases associated with oxidative stress and neuroinflammation. This study examined the neuroprotection effects of formulated CHMs Bai‐Shao (made of Paeonia lactiflora), Gan‐Cao (made of Glycyrrhiza uralensis), and Shaoyao Gancao Tang (SG‐Tang, made of P. lactiflora and G. uralensis at 1 : 1 ratio) in cell model of tauopathy. Our results showed that SG‐Tang displayed a greater antioxidative and antiaggregation effect than Bai‐Shao and Gan‐Cao and a stronger anti‐inflammatory activity than Bai‐Shao but similar to Gan‐Cao. In inducible 293/SH‐SY5Y cells expressing proaggregant human tau repeat domain (ΔK280 tauRD), SG‐Tang reduced tau misfolding and reactive oxygen species (ROS) level in ΔK280 tauRD 293 cells and promoted neurite outgrowth in ΔK280 tauRD SH‐SY5Y cells. Furthermore, SG‐Tang displayed anti‐inflammatory effects by reducing nitric oxide (NO) production in mouse BV‐2 microglia and increased cell viability of ΔK280 tauRD‐expressing SH‐SY5Y cells inflamed by BV‐2 conditioned medium. To uncover the neuroprotective mechanisms of SG‐Tang, apoptosis protein array analysis of inflamed tau expressing SH‐SY5Y cells was conducted and the suppression of proapoptotic proteins was confirmed. In conclusion, SG‐Tang displays neuroprotection by exerting antioxidative and anti‐inflammatory activities to suppress neuronal apoptosis in human tau cell models. The study results lay the base for future applications of SG‐Tang on tau animal models to validate its effect of reducing tau misfolding and potential disease modification.
Strapdown Sculling Velocity Algorithms Using Novel Input Combinations
Authors: Huang Lei , Li Zhaochun , Xie Fei , Feng Kai
Published: October 2018

Sculling motion is a standard input to evaluate the performance of the velocity algorithm in a highly dynamic environment. Conventional sculling algorithms usually adopt incremental angle/specific force increments or angular rate/specific force as algorithm inputs. However modern inertial sensors have different output types now, which do not correspond to the inputs of those traditional algorithms. For example, some inertial sensors have the integrated angular rate (incremental angle)/specific force outputs or angular rate/specific force increments outputs. Hence the conventional sculling algorithms cannot be easily applied to these situations. A novel sculling algorithm using incremental angle/specific force inputs or angular rate/specific force increments inputs is developed in this paper. The advantage of the novel algorithm is that it can calculate the carrier velocity directly without converting the dimension of inertial sensor outputs values. Theoretical analysis, digital simulations, and a trial study are carried out to verify our algorithm. The results demonstrate that for corresponding types of strapdown inertial navigation systems (SINS) the novel sculling algorithm exhibits better performance than the conventional sculling velocity algorithms.
Reliability of Estrogen Receptor and Human Epidermal Growth Factor Receptor 2 Expression on Breast Cancer Cells Stored in Cellprep® Vials
Authors: Ryu Ayumi , Ashimura Jyun-ichi , Nakayama Takahiro , Tamaki Yasuhiro , Nakatsuka Shin-ichi , Tomita Yasuhiko
Published: October 2018

Objective: The aim of this study was to evaluate the reliability of estrogen receptor (ER) and human epidermal growth factor receptor 2 (HER2) expression levels in Cellprep® (CP). Study Design: We evaluated the stability of immunocytochemistry (ICC) of ER and HER2 for primary or recurrent breast cancer samples rinsed in CP vials. Samples were prepared from CP vials stored for 1–30 or 160–240 days. ER and HER2 statuses were determined after 1–30 days (26 and 25 tests, respectively) or 160–240 days (15 and 18 tests, respectively) with the same protocols as immunohistochemistry (IHC), and were compared with the corresponding surgically resected specimens. Results: ER statuses according to CP samples showed perfect agreement (1–30 days: kappa, κ = 1; 160–240 days: κ = 1). HER2 statuses also showed good agreement (1–30 days: κ = 0.79; 160–240 days: κ = 0.64), although there were more equivocal HER2 cases in CP than in the surgically resected specimens. Conclusion: ER ICC in CP vials is reliable regardless of the preservation period. HER2 ICC in CP has more equivocal cases than HER2 IHC in surgically resected specimens. Both improvement of the immunostaining protocol and further validation study of in situ hybridization are indispensable for the practical application of ICC in CP.
Poorly Differentiated Small-Cell-Type Neuroendocrine Carcinoma of the Prostate: A Case Report and Literature Review
Authors: Kumar Kishore , Ahmed Rafeeq , Chukwunonso Chime , Tariq Hassan , Niazi Masooma , Makker Jasbir , Ihimoyan Ariyo
Published: October 2018

Neuroendocrine cells are widespread throughout the body and can give rise of neuroendocrine tumors due to abnormal growth of the chromaffin cells. Neuroendocrine tumors divide into many subtypes based on tumor grade (Ki-67 index and mitotic count) and differentiation. These tumors can be further divided into secretory and nonsecretory types based on the production of peptide hormone by tumor cells. Poorly differentiated small-cell-type neuroendocrine tumors are one of the subtypes of neuroendocrine tumors. These tumors are less common; however, they tend to be locally invasive and aggressive in behavior with poor overall median survival. Treatment of the nonsecretory small-cell type is modeled to small-cell lung cancer with a regimen consisting of platinum-based chemotherapy and etoposide with variable response. Here, we present a case of poorly differentiated small-cell neuroendocrine tumor originating from the prostate.
Non-Invasive Ventilation as an Adjunct to Exercise Training in Chronic Ventilatory Failure: A Narrative Review
Authors: Vitacca Michele , Ambrosino Nicolino
Published: October 2018

Background: Chronic ventilatory failure (CVF) may be associated with reduced exercise capacity. Long-term non-invasive ventilation (NIV) may reduce patients’ symptoms, improve health-related quality of life and reduce mortality and hospitalisations. There is an increasing use of NIV during exercise training with the purpose to train patients at intensity levels higher than allowed by their pathophysiological conditions. Objective: This narrative review describes the possibility to train patients with CVF and NIV use as a tool to increase the benefits of exercise training. Methods: We searched papers published between 1985 and 2018 in (or with the summary in) English language in PubMed and Scopus databases using the keywords “chronic respiratory failure AND exercise,” “non invasive ventilation AND exercise,” “pulmonary rehabilitation” and “exercise training.” Results: Exercise training is feasible and effective also in patients with CVF. Assisted ventilation can improve exercise tolerance in different clinical conditions. In patients under long-term home ventilatory support, NIV administered also during walking results in improved oxygenation, decreased dyspnoea and increased walking distance. Continuous positive airway pressure and different modalities of assisted ventilation have been delivered through different interfaces during exercise training programmes. Patients with CVF on long-term NIV may benefit from exercising with the same ventilators, interfaces and settings as used at home. Conclusion: We need more randomised clinical trials to investigate the effects of NIV on exercise training in patients with CVF and define organisation and setting.
The Influence of Breast Cancer on the Distribution of Cherry Angiomas on the Anterior Thoracic Wall: A Case Series Study
Authors: Guastafierro Antonio , Verdura Vincenzo , Di Pace Bruno , Faenza Mario , Rubino Corrado
Published: October 2018

Background/Aims: Cherry angiomas (CAs) are one of the most common vascular manifestations of the skin. By and large, these benign lesions often only represent an aesthetic problem. In the literature, few authors have focused on the pathogenesis of these lesions, and some risk factors have been identified, such as the presence of cutaneous and non-skin neoplasias. In this study, the correlation between the distribution of CAs and breast cancer was investigated. Methods: We carried out a study whereby 50 women with unilateral breast cancer and the presence of CAs on the anterior thoracic wall were evaluated, with a particular focus on the difference in the number of CAs between the two haemithoraces. The data was elaborated using the Wilcoxon signed-rank test in order to evaluate whether there was a statistical significance in the distribution of CAs. Results: In 31 patients we found that the number of CAs was greater on the cancerous breast than on the contralateral one (p value <0.0001). This was confirmed both in the group of patients suffering from ductal breast cancer and in the group with early invasive breast tumours. Conclusion: It is not clear whether CAs develop prior to or following breast cancer, indicating the possibility that this cutaneous manifestation could take on a predictive, prognostic development or represent only an epiphenomenon. Further in-depth studies into the pathogenesis of CAs and the relationship with breast cancer could lead to noteworthy diagnostic-therapeutic advances.
Short-Term Intensified Dosage Regimen of Mycophenolic Acid is Associated with Less Acute Rejection in Kidney Transplantation from Donation after Circulatory Death
Authors: Peng Wenhan , Liu Guangjun , Huang Hongfeng , Wu Jianyong , Chen Jianghua
Published: October 2018

Introduction: Whether an early, short-term, adequate exposure to mycophenolic acid (MPA) under tacrolimus-based immunosuppression regimen in kidney transplantation from donation after circulatory death (DCD) was effective and safe is yet unknown. Material and Methods: The study was a single-center, retrospective, cohort study of DCD transplantation in China. Intensified and standard dosage regimens of enteric-coated mycophenolate sodium (EC-MPS) were week 1, 2,160 vs. 1,440 mg/day. The incidences of biopsy-proven acute rejection (BPAR), delayed graft function, infection, and patient and graft survival were compared between the 2 groups. Results: A total of 209 patients (n = 82 in intensified group and n = 127 in standard group) were enrolled from August 2013 to December 2014. The incidence of BPAR at 12 months was significantly lower in the intensified group as compared to that of the standard group. (2.4 vs. 10.2%, p = 0.035). The mean MPA area under curve (AUC) levels at day 7 was significantly higher in the intensified group than that in the standard group (66.18 ± 35.48 vs. 45.30 ± 23.5 mg·h/L, p < 0.001). MPA AUC levels were significantly decreased in patients with BPAR as compared to those with NO-BPAR. Conclusion: An early, short-term regimen of intensified EC-MPS with tacrolimus increased early MPA exposure and achieved a low rate of BPAR in kidney transplantation from DCD.
Complications and Anticoagulation Strategies for Percutaneous Epicardial Ablation Procedures
Authors: Nakamura Tomofumi , Davogustto Giovanni E. , Schaeffer Benjamin , Tanigawa Shinichi , Muthalaly Rahul G. , Kanagasundram Arvindh , John Roy M. , Michaud Gregory F. , Tedrow Usha B. , Stevenson William G.
Published: October 2018

Background:

Percutaneous pericardial access for catheter ablation is associated with a bleeding risk. We sought to elucidate the relation of hemorrhagic and thromboembolic events associated with epicardial procedures to anticoagulation strategy.

Methods:

Anticoagulation strategy before and during pericardial access for 355 patients (57±14 years old) who had ventricular arrhythmia mapping and ablation were reviewed. Oral anticoagulants were stopped perioperatively and heparin administered before the procedure. Pericardial bleeding >80 mL was considered significant. The patients were divided into 3 groups per the anticoagulation strategy. Group 1: no heparin was administered before pericardial access, group 2: heparin was administered and reversed before pericardial access, and group 3: heparin was administered and not reversed.

Results:

Significant pericardial bleeding occurred in 46 cases (13%) and did not differ among the groups (
P
=0.720). Unintentional cardiac puncture and left ventricular ejection fraction ≤35% were independently associated with pericardial bleeding (odds ratio, 16.4; 95% CI, 7.35–36.40;
P
<0.001 and odds ratio, 2.28; 95% CI, 1.02–5.10;
P
=0.044). Of 38 procedures with unintentional cardiac puncture, there was no difference in pericardial bleeding for different anticoagulation strategies. Thromboembolic events occurred in 5 patients; 1 coronary embolism, 1 stroke, 2 deep vein thrombosis with 1 fatal pulmonary embolism, and 1 thrombus on a temporary ventricular assist device.

Conclusions:

Bleeding is the major risk related to pericardial access and seems to be more related to unintentional cardiac puncture than to the anticoagulation strategy. Thrombotic complications are infrequent but potentially severe. The major focus for improving safety should be on the prevention of unintentional cardiac puncture.
Body Mass Index, Natriuretic Peptides, and Risk of Adverse Outcomes in Patients With Heart Failure and Preserved Ejection Fraction: Analysis From the TOPCAT Trial
Authors: Pandey Ambarish , Berry Jarett D. , Drazner Mark H. , Fang James C , Tang W. H. Wilson , Grodin Justin L.
Published: October 2018

Background

The prognostic interrelationship between natriuretic peptide (
NP
) levels and body mass index (
BMI
) among patients with chronic stable heart failure with preserved ejection fraction is not well characterized.

Methods and Results

Participants from the
TOPCAT
(Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist) trial enrolled in the Americas meeting inclusion by the
NP
stratum were stratified into 4 data‐derived categories by
BMI
and standardized
NP
‐z score. Adjusted Cox‐proportional models determined the independent association of
BMI
,
NP
‐z score, and
BMI
/
NP
categories with composite primary end point, heart failure hospitalization, and all‐cause mortality. The study population included 997 participants. There was a U‐shaped relationship between
BMI
and
NP
with elevated
NP
levels noted at extremes of
BMI
distribution. There was also a U‐shaped relationship between
BMI
and risk of adverse clinical outcomes with the lowest risk among patients approximating a
BMI
of 25 kg/m
2
. In contrast, higher
NP
levels were linearly associated with higher risk of adverse clinical outcomes. For
BMI
/
NP
‐based categories, participants in the high
BMI
/high
NP
group had greater prevalence of cardiac structural and functional abnormalities and the highest risk of adverse clinical outcomes (hazard ratio for primary end point; 95% confidence interval: 2.29 [1.36–3.84] Reference: low
BMI
/low
NP
).

Conclusions

There is a U‐shaped association between
BMI
and
NP
levels among patients with chronic heart failure with preserved ejection fraction. Higher
NP
levels are independently associated with a higher risk of mortality across both high and low
BMI
strata. Among obese patients with heart failure with preserved ejection fraction, elevated
NP
levels identify a higher risk phenotype with a significantly increased incidence of both mortality and heart failure hospitalization.
Cardiovascular Risk Factors and White Matter Hyperintensities: Difference in Susceptibility in South Asians Compared With Europeans
Authors: Sudre Carole H. , Smith Lorna , Atkinson David , Chaturvedi Nish , Ourselin Sébastien , Barkhof Frederik , Hughes Alun D. , Jäger H. Rolf , Cardoso M. Jorge
Published: October 2018

Background

Cardiovascular risk factors vary between ethnicities but little is known about their differential effects on white matter hyperintensities (
WMH
), an indicator of brain aging and burden of cerebrovascular disease.

Methods and Results

Brain magnetic resonance imaging scans from 213 people of South Asian and 256 of European ethnicity (total=469) were analyzed for global and regional
WMH
load. Associations with cardiovascular risk factors and a composite cardiovascular risk score (National Cholesterol Education Programme Adult Treatment Panel III) were compared by ethnicity, diabetes mellitus, smoking, and hypertension status. Distributional patterns of
WMH
were similar by ethnicity but the vulnerability to specific risk factors differed. Associations between
WMH
and age or National Cholesterol Education Programme Adult Treatment Panel III scores were stronger in South Asians compared with Europeans. For instance, a year of age led to an excess of 3.8% (confidence interval=[0.2, 7.6];
P
=0.04) of
WMH
load in frontal regions in South Asians compared with Europeans. In the diabetic subgroup, South Asians had more
WMH
than Europeans (+63.3%, confidence interval=[14.1, 133.9];
P
=0.007), particularly in the deeper regions (+102% confidence interval=[24, 329];
P
=0.004). In the population as a whole, diabetes mellitus was not, or only weakly, related to an increase in
WMH
volume (12.4%, confidence interval=[−10.7, 41.3];
P
=0.32), and diabetes mellitus duration was a positive predictor of frontal periventricular
WMH
load in Europeans but not in South Asians. In turn, diastolic blood pressure was positively associated with
WMH
volumes in South Asians but not in Europeans. Hypertension was not associated with
WMH
load (
P
=0.9).

Conclusions

Distribution patterns of
WMH
are similar in South Asians and Europeans but older age and higher cardiovascular risk are associated with more
WMH
in South Asians.
Intellectual Property Rights for Innovations on the Internet: The Islamic Law Requisites
Authors: Ishola Abdullahi Saliu , Solahudeen Isa Olawale , Akangbe Ibrahim
Published: October 2018

Intellectual property (IP) protection has attracted diverse views among Islamic law researchers, leading to its eventual acceptance on the premise of indirect legal authority by most Muslim scholars. This paper explores the preconditions that any innovation on the internet must meet to enjoy IP protection under Islamic law. It provides working tools for Muslims on the principles to be observed in seeking IP protection for any of their innovations. It also urges governments of Muslim countries which have hitherto refused to accord legal protection to IP on religious grounds to change their position.
Punishing Polluters: Trends, Local Practice, and Influences, and Their Implications for Administrative Law Enforcement in China
Authors: van Rooij Benjamin , Na Li , Qiliang Wang
Published: October 2018

Scholars and politicians often complain about how weak administrative law enforcement is in China. To better understand the challenges in law enforcement, as well as variation in actual practices and influences on such practices, the current paper analyzes Chinese pollution law enforcement data from the last two decades as well as in depth qualitative case studies of everyday enforcement practices. It finds that recently enforcement has become much more frequent and stricter. It finds that recent changes in national legislation, centralization reforms, increased citizen complaints, as well as enforcement campaigns all played a role in this. While this has helped strengthen enforcement, and maybe has played a part in recent pollution reductions, it has not fundamentally overcome structural enforcement impediments. The increased authority, independence, and pressure on environmental authorities for stricter enforcement, does not seem to be matched with sufficient investment in resource capacity and support for regular procedural enforcement practices. In addition, the ad-hoc pressure on enforcement has undermined regular legal procedure and stimulated greater socio-economic inequality. These findings about pollution enforcement force us to question simplistic static generalizations of administrative law enforcement and instead develop both large-scale studies that map change over time as well as in-depth case studies that provide a thorough picture of actual practices on the ground. Moreover, the paper concludes that a true picture of administrative enforcement must move beyond looking at the enforcement itself, to looking at how it arrives at the regulated companies and shapes their compliance.
Phlebia ailaoshanensis sp. nov. (Polyporales, Basidiomycota) evidenced by morphological characters and phylogenetic analyses
Authors: SHEN SHAN , MA XIANG , XU TAI-MIN , ZHAO CHANG-LIN
Published: October 2018

A new wood-inhabiting fungus, Phlebia ailaoshanensis, is proposed based on a combination of morphological features and molecular evidence. The species is characterized by an annual growth habit, resupinate basidiocarps with tuberculate to phlebioid hymenial surface, a monomitic hyphal system with slightly thick-walled generative hyphae bearing simple septa, IKI–, CB– and ellipsoid, hyaline, thin-walled, smooth, IKI–, CB– basidiospores measuring as 5.7–8.5 × 3–4.3 µm. Sequences of ITS and LSU nrRNA gene regions of the studied samples were generated, and phylogenetic analyses were performed with maximum likelihood, maximum parsimony and bayesian inference methods. The phylogenetic analyses based on molecular data of ITS+nLSU sequences showed that P. ailaoshanensis belonged to the Meruliaceae and nested into the phlebioid clade. Further investigation was obtained for more representative taxa in the Phlebia based on ITS+nLSU sequences, in which the result demonstrated that the species P. ailaoshanensis formed a monophyletic lineage with a strong support (100% BS, 100% BP, 1.00 BPP) and then grouped with P. acanthocystis, P. chrysocreas, P. ludoviciana, P. subcretacea and P. uda.
Tolmerus calceatus (Meigen) confirmed as a valid species separate from Tolmerus atricapillus (Fallén) (Diptera: Asilidae)
Authors: VAN DEN BROEK REINOUD , SMIT JOHN T. , BREE ELIAS DE , BEENTJES KEVIN
Published: October 2018

The status of Tolmerus atricapillus calceatus (Meigen) is discussed. Based on morphological, ecological as well as genetic information it is concluded that Tolmerus calceatus stat. rev. should be treated as a valid species separate from T. atricapillus (Fallén). Characters to separate both are provided as well as a key to all Tolmerus species of northwestern Europe.
Storm Track Response to Oceanic Eddies in Idealized Atmospheric Simulations
Authors: Foussard A. , Lapeyre G. , Plougonven R.
Published: October 2018

Large-scale oceanic fronts, such as in western boundary currents, have been shown to play an important role in the dynamics of atmospheric storm tracks. Little is known about the influence of mesoscale oceanic eddies on the free troposphere, although their imprint on the atmospheric boundary layer is well documented. The present study investigates the response of the tropospheric storm track to the presence of sea surface temperature (SST) anomalies associated with an eddying ocean. Idealized experiments are carried out in a configuration of a zonally reentrant channel representing the midlatitudes. The SST field is composed of a large-scale zonally symmetric front to which are added mesoscale eddies localized close to the front. Numerical simulations show a robust signal of a poleward shift of the storm track and of the tropospheric eddy-driven jet when oceanic eddies are taken into account. This is accompanied by more intense air–sea fluxes and convective heating above oceanic eddies. Also, a mean heating of the troposphere occurs poleward of the oceanic eddying region, within the storm track. A heat budget analysis shows that it is caused by a stronger diabatic heating within storms associated with more water advected poleward. This additional heating affects the baroclinicity of the flow, which pushes the jet and the storm track poleward.
Revising Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria for the bipolar disorders: Phase I of the AREDOC project
Authors: Parker Gordon , Tavella Gabriela , Macqueen Glenda , Berk Michael , Grunze Heinz , Deckersbach Thilo , Dunner David L , Sajatovic Martha , Amsterdam Jay D , Ketter Terence A , Yatham Lakshmi N , Kessing Lars Vedel , Bassett Darryl , Zimmerman Mark , Fountoulakis Kostas N , Duffy Anne , Alda Martin , Calkin Cynthia , Sharma Verinder , Anand Amit , Singh Manpreet K , Hajek Tomas , Boyce Philip , Frey Benicio N , Castle David J , Young Allan H , Vieta Eduard , Rybakowski Janusz K , Swartz Holly A , Schaffer Ayal , Murray Greg , Bayes Adam , Lam Raymond W , Bora Emre , Post Robert M , Ostacher Michael J , Lafer Beny , Cleare Anthony J , Burdick Katherine E , O’Donovan Claire , Ortiz Abigail , Henry Chantal , Kanba Shigenobu , Rosenblat Joshua D , Parikh Sagar V , Bond David J , Grunebaum Michael F , Frangou Sophia , Goldberg Joseph F , Orum Margo , Osser David N , Frye Mark A , McIntyre Roger S , Fagiolini Andrea , Manicavasagar Vijaya , Carlson Gabrielle A , Malhi Gin S
Published: October 2018

Objective:

To derive new criteria sets for defining manic and hypomanic episodes (and thus for defining the bipolar I and II disorders), an international Task Force was assembled and termed AREDOC reflecting its role of Assessment, Revision and Evaluation of DSM and other Operational Criteria. This paper reports on the first phase of its deliberations and interim criteria recommendations.

Method:

The first stage of the process consisted of reviewing Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and recent International Classification of Diseases criteria, identifying their limitations and generating modified criteria sets for further in-depth consideration. Task Force members responded to recommendations for modifying criteria and from these the most problematic issues were identified.

Results:

Principal issues focussed on by Task Force members were how best to differentiate mania and hypomania, how to judge ‘impairment’ (both in and of itself and allowing that functioning may sometimes improve during hypomanic episodes) and concern that rejecting some criteria (e.g. an imposed duration period) might risk false-positive diagnoses of the bipolar disorders.

Conclusion:

This first-stage report summarises the clinical opinions of international experts in the diagnosis and management of the bipolar disorders, allowing readers to contemplate diagnostic parameters that may influence their clinical decisions. The findings meaningfully inform subsequent Task Force stages (involving a further commentary stage followed by an empirical study) that are expected to generate improved symptom criteria for diagnosing the bipolar I and II disorders with greater precision and to clarify whether they differ dimensionally or categorically.
‘I’m a genuine Italian, but not a genuine Italian’: Complex and shifting strategies of ethnic and moral boundary making in the narratives of Italian minority parents in Flanders
Authors: Clycq Noel
Published: October 2018

It is well-documented in (ethnic) identity research that individuals to a large extent construct an identity they feel comfortable with. However, this is not an easy task and one’s identity is, for some more than for others, under constant pressure to be reflected upon and reconstructed. At the same time many individuals often feel that there is a core element in their (ethnic) identity that does not change and remains stable. Based upon 13 in-depth interviews with Italian origin parents in Flanders, this article discusses what might be a constant mechanism underlying identification processes for this group of individuals: the presentation of the self as morally good and valuable. However, to be able to do this, the Italian origin participants in this study have to develop a variety of sometimes contradictory strategies. In a Flemish society where their Italian ethnicity is not questioned or problematized, the participants seem very keen to underline how ethnically different from the Flemish-Belgian majority they are. Yet, at other times they present themselves as much more similar to this majority group when discussing other minority groups, in particular Muslims. However, the most striking group reconstruction occurs when participants use the example of ‘genuine Italians’ to differentiate themselves from a specific group of Italians, while at the same time stressing they are genuine Italians themselves. When studying these various strategies from the perspective of presentation of the self as morally good and valuable, it becomes clear why these seemingly contradictory strategies do not at all feel contradictory to the participants. The findings show how strong the need for such a recognition of the self is.